Wireless Healthcare World

Marc Bage, Ph.D., ing.

International Institute of Telecommunications - Research

INET 2007Toronto, ON

20 June 2007

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AgendaAgenda Technologies

Taxonomy Applications

Wireless Devices Consulting Diagnosis Monitoring

Systems Projects

Care Process Benefits

3 Points of View Challenges Conclusions

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Range

Taxonom

y of Wireless T

echnologiesT

axonomy of W

ireless Technologies

1cm

10cm

1m

10m

100m

1km

10km

100km

10kb/s

100kb/s

1Mb/s

10Mb/s

100Mb/s

1Gb/s

WANAccessLANBAN

Microwave& Satellite

ZigBee

ZigBee

Bluetooth

UWB

Mesh

WiFi

2.5G

3G

Rev.A/HSDPA

1xEV-DO

Rev. B WiMaxPassive

RFIDActive

RFIDIrDA

Capacity

Continuous Monitoring

IntensiveMonitoring,

EPR, Comm.

Process

Consultation, Diagnosis,Monitor in Remote AreasDiagnosis

EPR, Comm.Process,

WirelessDevices,Diagnosis, Process

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Wireless Monitoring DevicesWireless Monitoring Devices

Location

Stethoscope

Glucometer

ECG

Temperature

HeartRate

BloodPressure

Oxygen

Weight

Expect Increasing Integration

with Cell PhoneUsing Bluetooth and

RFID !!

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ConsultingConsulting

REACH (ON) Assertive Community Treatment (ACT) Medical Home Care Solution (Teleconference, Remote Vital

Sign Monitoring) Telesat, London Health Sciences Center Research + others

3GDoctor (UK) Cellular Form Filling Screening of Patient Based on Health-Related Questions

MyFoodPhone (Qc) 3G Imaging of Meal Dietician Feedback + …

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Telerobotic Devine-Tidewater Urology (Virginia) St-Joseph Mercy Oakland Hospital (Pontiac, Michigan) Physian Rounds Patient Length of Stay

Alzheimer's Disease Silverado Senior Living (Los Angeles)

InTouch Health Inc. (California) Qualcomm (San Diego)

Rev.A

ConsultingConsulting

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DiagnosisDiagnosis

Bravo Capsule Wireless pH-metry Medtronic (Minneapolis)

Gastroenterology Gastric Acid Reflux Detection

RFID impedance monitoring system that uses electrical impulses to detect oesophageal reflux

U of Texas Southwestern Medical Center doctors and UT Arlington engineers

Capsule Endoscopy PillCam = Two-Sided Camera + Light 2600 Color Pictures; 14 Frames per Second Given Imaging (Israel)

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Watch

-Like

Wire

less

Reader

Wireless Monitoring SystemsWireless Monitoring Systems Télémédic (Qc)

SpO2, Temperature, Heart Rate

AMON: Advanced care and alert portable telemedical MONitor (Israel)

Alive Technologies (Australia) SpO2 , ECG, GPS, accelerometer Sleep Apnea, Atrial Fibrillation

Medtronic (Minneapolis) Implantable Defibrillator Measures Pressure and Fluid inside a Patient's Heart

Sensor for Medicine and Science (Maryland) Glucose Sensor to be Implanted Under Skin of Forearm (in Development) Fluorescence-Based Oxygen Sensor

Medical Intelligence (Qc, Fr) Alzheimer Disease: Alarm when Crossing a Programmable Virtual Fence Urgentys: GPS- and WiFi-Based Location + Voice and Alerts

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Monitoring ProjectsMonitoring Projects MobiHelath

7 Sub-Pprojects : Home Monitoring, Trauma, Nurse Visits Risky pregnancies, Chronic Obstrusive Pulmonary Disease, Ventricular

Arrythmias U of Twente (NL), Germany, Spain, Sweden, Ericsson (Ge), Philips (NL)

IIT-R 3G-Based Proofs of Concept Biomonitoring (Contextual Analysis and Actions) Teletrauma (Ambulance to Hospital: Voice, EPR, ECG, Other Signs, Video,

Camera Remote Control, Image, Annotation)

WIISARD Monitoring in Disasters and Mass Casualties Communications Between First Responders Fault Tolerant Wireless Biomonitors in Mesh Ad-Hoc Networks UCSD

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Care ProcessCare Process

Communications Voice + Text Messaging

2-way handsfree voice-controlled wearable badge Kingston General Hospital and St-Thomas Elgin General Hospital Vocera Communications

Medication On Demand RFID Access to Drug Dispensing Box Avancen (Florida)

Logistics Outpatient Registration

Shorter and Fair Queuing Tongren Hospital, China

SMS Patient Reminder (UK) At some outpatient clinics, reduced’ DNA rate by 30% (with only 20%

uptake by patients)

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RFID in Care ProcessRFID in Care Process

Asset Management Up-to-Date-Inventory and Optimized Restocking Gurneys, Wheelchairs, Pacemakers, Stents, Mobile Lab Equipment Supply Chain Systems and Smart Shelving

People Management (Doctors, Nurses, Patients) Access Control and Security Patient Flow Management Outpatient Tracking

waiting time, EPR, billing RFID in Patient ID Wrist Bracelet

saved lives, improved workflow efficiency, reduced cost of care correct medication and surgical procedures Siemens (Germany)

Bhagwan Mahaveer Jain Heart Center in Bangalore, India

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RFID ImplantsRFID Implants Size of Rice Grain Implanted Under Skin of Upper Arm

Surgical or Syringe

Secure Access Amal Graafstra, Washington, DC

Electronic Patient Record

Medical Implants Alzheimer, diabetes, chronic diseases Mexico City

Animal Control Government initiative to control rabies all Portuguese dogs must be RFID tagged by 2007. Similarly in Serbia

dog's history owner's information

Verichip by Applied Digital Solutions + Digital Angel (Glucose monitor) Patient Identification FDA 2004

PHOTO: Amal Graafstra

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Care Process (more)Care Process (more)

Closing the Gap Healthcare Group Telus + HealthPhone (NZ) + Microsoft Community Care Management Solution

Optimize direct patient care time Increase patient safety through one-time recording of clinical notes at the Point of

Care Improve patient outcomes by facilitating sharing of healthcare information across

the continuum of care

Taiwan Mobile Healthcare Services M-Taiwan Initiative Chunghwa Telecom + Nortel (WiMax)

Mobile Nurse Outpatient Registration

Treatment Assistant Access to EPR

Wireless Care Genie Bluetooth monitoring of patients

Health Care Guru Virtual Information center

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Benefits of Wireless HealthcareBenefits of Wireless Healthcare Patient’s Quality of Life

Mobility (Tetherless / Cordless, Ambulatory, Vehicular) Home Treatment vs Hospital Treatment Reduced Waiting Time, Travel Time and Travel Costs

Medical and Professional Point of View Early Detection of Upcoming Health Problem More Sophisticated Healthcare

Increasing Bandwidth Imaging, X-Ray ECG

Better Prognosis ECG Door to Needle/Balloon :

1 min saved = +11 days for patient Saving of 20 to 55 min = + ?? days for patient

Home Monitoring Increases Survival Rate by 15% in Post-Hospitalization Care + 26% Reduction in Hospital Days per Patient Compared to Nurse Telephone Support.

Access to the Most Up-to-Date and Complete EPR

System Improvements Reduced Bed Blocking Reduced Nosocomial Infections Single Data Entry (Resulting in Reduced Errors) Reduction in Duplication of Tests and Analysis ($$$) Inventory Control

TEN-HMS

Philips Medical SystemUniversity of Hull (UK)

Swiss Institute of Medical

Informatics

TEN-HMS

Philips Medical SystemUniversity of Hull (UK)

Swiss Institute of Medical

Informatics

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Challenges of Wireless Healthcare (1) Challenges of Wireless Healthcare (1) Technical Issues

Radiation Level Fœtal FDA Testing of RFID Effects on Drugs

Power Supply Battery Life Range Bandwidth Environmentally-Save

Financial Model Role of Cellular Operators Payer: Patient, Government, Insurance

Logistics Issues How to Work Differently

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Challenges (2): Patient ConcernsChallenges (2): Patient Concerns Product and Service Features

Accuracy and Radiation BUPT (Beijing University of

Post and Telecom)

Ethical Acceptability Human-Chipping Presentation, March, Prayer Vigil,

West Palm Beach, Florida, May 12, 2007

CASPIAN: Customers Against Supermarket Privacy Invasion And Numbering

Acceptability of Wireless Healthcare

0% 10% 20% 30% 40% 50% 60% 70%

Accuracy

Radiation

Timeliness

Price

Confidentiality

Ergonomy

Willingness

Co

nc

ern

adapted from G.Kang, BUPT, "Attitude tow ards Wireless Applications in Healthcare Industry in China"

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ConclusionsConclusions

Healthcare Providers Are Pushing Care Elements at the Edge of the Healthcare Network. This is Where Wireless Access Networking Can Help.

Remote Care Also Needs Remote DiagnosTICs Demonstrated Technical Feasibility Economic Viability Yet To Be Proven

Look at the Big Picture

Challenge: How to Work Differently … World Wide Wireless Health is Progressing Fast.

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Thank You for your attention!

Vendors, products and services named in this presentation are for illustration purposes only without any implied endorsement by IIT. Trademarks belong to their respective owners.

Dr Marc Bage, Researcher, 1.514.395.8018 / marc.bage@iitelecom.com