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Interoperability to boost medical devices take-up

Posted: 23 Feb 2007     Print Version  Bookmark and Share

Keywords:personal medical  telemedicine  telehealth  blood glucose meter  digital blood pressure meter 

Personal medical devices are portable electronic instruments that individuals can use at home for health and fitness, disease management and elderly patient monitoring.

With an increase in obesity, heart disease, diabetes and other chronic conditions, there has been an increase in the availability of affordable personal medical devices for home use for monitoring blood pressure, heart rate, glucose levels, temperature, weight, respiration etc. The demand for these devices is on the rise as the population is ageing and a number of elderly people are living with chronic diseases. Add to this the increasing use of health monitoring electronic devices in the growing fitness market.

These trends are not limited to the United States or Europe. The number of overweight people worldwide exceed 100 crore of which nearly 30 crore are clinically obese. With wireless connectivity some of the personal medical devices can also play an important role in telemedicine for remote rural populations in countries like India. So, the market need for low-cost personal medical devices is expected to exhibit tremendous growth.

The personal medical devices are as diverse as pedometers, weighing scales and blood pressure and blood glucose monitors. Some are stand-alone and others wearable.

Wearable activity sensors establish human motion models in order to determine when there is an unanticipated change in a model in order to notify a remote person of this change. Home activity monitoring sensors establish activity models in order to determine when there is an unanticipated change in a model in order to notify a remote person of this change and may automate things like turning on lights in order to prevent falls. Wireless scales and thermometers may be used to transparently monitor and remotely log the weight of elderly people. Elderly monitoring systems wirelessly collect a variety of home-based and personal information to provide a safer environment, ensure needed medications are taken, monitor weight and temperature, and detect falls and call a caregiver when an abnormal event or condition occurs.

Many of these devices come with software that runs on a PC, PDA or even a mobile phone. This will enable personal health recordkeeping. These records can be shared with a personal trainer, a dietician or a physician during a visit or remotely via a PC or a mobile phone.

Highly integrated and high-performance semiconductor chips are enabling this growth in personal medical devices. Whether developing a blood glucose meter, digital blood pressure meter, blood gas meter, digital pulse/heart rate monitor or even a digital thermometer there are five system level blocks that are common to each one: power/battery management, control and data processing, amplification and A/D conversion of the sensor input, some type of display and the sensor element(s) itself. In general, these are controlled by a microcontroller controlled handheld devices that operate on battery and take measurements using various bio-sensors. Obviously, the actual implementation topology of these blocks will differ greatly with the sensing, processing and information display demands of the meter type and feature set.

Design challenges
Key design considerations are ultra-low power consumption and high efficiency driven by the need for extended battery life, and high precision with a fast response time driven by the users' need to quickly know the status of their health. Additional requirements may drive needs for additional memory to allow for historical profiling, cabled or wireless interfaces for data upload to a computer at home of in the doctors office or even for access to the sensor, and possibly audio feedback for simple good/not good indication or more complex step by step utilisation instructions. Adding these features without increasing power consumption is a significant challenge.

With the wide variety of devices being introduced, interoperability and seamless connectivity become issues. Standardisation is the key and there are a number of initiatives towards that end, including work done by the IEEE and the Continua Health Alliance formed last year. Broad interoperability has yet to be achieved, and is an emerging priority for health systems and for the medical and information technology industries.

Defining personal telehealth talk
The IEEE has begun work on 10 telehealth device standards for controlling information exchange among the devices and cell phones, personal computers, personal health appliances and other compute engines. These standards, a part of the ISO/IEEE 11073 family of health informatic standards, will provide clear definitions of what is needed to implement common communication features for personal telehealth devices.

The new standards will define a common core of communication functionality for these devices and specify the use of term codes, formats and behaviours in a telehealth environment to favour plug-and-play interoperability.

The new telehealth standards projects are:

  • IEEE P11073-00103, "Health informatics—Personal Health Device Communication—Technical report – Overview", will describe transport-independent applications and information profiles for personal telehealth devices. These profiles will define data exchange, data representation and terminology for communication between personal telehealth devices and compute engines.
  • IEEE P11073-10400, "Health informatics—Personal Health Device Communication—Device Specialisation—Common Framework", will establish a framework of communication between personal telehealth devices and compute engines. It will include common ways of receiving information and managing devices and allow vendors to access non-standard features.
  • IEEE P11073-10404, "Health informatics—Personal Health Device Communication—Device Specialisation—Pulse Oximeter", will define communications between personal telehealth pulse oximeters and compute engines.
  • IEEE P11073-10406, "Health informatics—Personal Health Device Communication—Device Specialisation—Heart Rate Monitor", will define communications between personal telehealth heart rate monitor devices and compute engines.
  • IEEE P11073-10407, "Health Informatics—Personal Health Device Communication—Device Specialisation—Blood Pressure Monitor", will define communication between personal telehealth blood pressure monitors and compute engines.
  • IEEE P11073-10408, "Health Informatics—Personal Health Device Communication—Device Specialisation – Thermometer", will define communications between personal telehealth thermometers and compute engines.
  • IEEE P11073-10415, "Health Informatics—Personal Health Device Communication—Device Specialisation—Weighing Scale", will define communications between personal telehealth weighing scales and compute engines.
  • IEEE P11073-10417, "Health Informatics—Personal Health Device Communication—Device Specialisation—Glucose Meter", will establish a definition of communication between personal telehealth glucose meters and compute engines.
  • IEEE P11073-20401, "Health informatics—Point-of-Care Medical Device Communication—Application Profile—Common Networking Infrastructure", will focus on the use of the Internet protocols and encompass various networking technologies for medical device communication. It will enumerate the mechanisms needed for real-time, plug-and-play interoperability and define protocols and services for medical devices in networked operating contexts.
  • IEEE P11073-20601, "Health Informatics—Personal Health Device Communication—Application Profile—Optimised Exchange Protocol ", which will define a common framework for creating an abstract model of personal health data available in transport-independent transfer syntax. Such syntax will provide logical connections between systems and presentation capabilities in communication tasks.

This body of standards will serve a wide range of audiences, including medical device and system developers; those who deploy and manage healthcare systems and who regulate their use; personal telehealth device and compute engine vendors and users; and institutions that use data from these devices.

The standards are sponsored by the IEEE Engineering in Medicine and Biology Society. See http://standards.ieee.org/.

- By Shekar Rao
  Worldwide Manager, Medical Electronics Solutions
  Texas Instruments

  Chair of the IEEE
  Engineering in Medicine and Biology Society
  Dallas Chapter




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