Post on 15-Jan-2017
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TeleMedIS™TeleMedIS™A Novel Mobile-Health A Novel Mobile-Health
System in SwedenSystem in Sweden Presentation by: R&D Engineer, Sven Jonsson
Biomedical Engineering Department, Karolinska University Hospital
Project co-financed by:
TTeC 2006, Tromsö, Sven Jonsson, Karolinska
AgendaAgenda
TeleMedISTM Project
TeleMedISTM Main Sub-systems
The Users
Trials Program
Potential Benefits
Conclusion
Reflection from the past
TTeC 2006, Tromsö, Sven Jonsson, Karolinska
TeleMedISTeleMedISTMTM Project Project
Telehealth Telehealth Monitoring Monitoring
Wristwatch (TMW) Wristwatch (TMW) TeleMed HC TeleMed HC
Platform (TP) Platform (TP) Wireless Network Wireless Network
(WN) (WN)
Telehealth Telehealth Monitoring Monitoring
Wristwatch (TMW) Wristwatch (TMW) TeleMed HC TeleMed HC
Platform (TP) Platform (TP) Wireless Network Wireless Network
(WN) (WN)
Tadiran LifeCare(Israel) TeliaSonera
(Sweden) Karolinska(Sweden)
“Wireless, anytime, anywhere, real-time monitoring of patient’s vital signs”
TTeC 2006, Tromsö, Sven Jonsson, Karolinska
Telehealth Monitoring WristwatchTelehealth Monitoring WristwatchThe Device:
• Wrist-wearable, mobile and personal • Single unit• Very easy to carry and simple to use
Vital Signs:
• Multi-parameter monitoring: pulse rate, blood oxygen saturation level (SpO2), and 1-lead ECG
• Automatic measurements• On demand measurements (local and remotely)• Personalized for each user
Communications:• Cellular communication• Two-way voice & data communications• Real time messaging• Emergency alarm pushbutton
TTeC 2006, Tromsö, Sven Jonsson, Karolinska
TeleMed Home-Care PlatformTeleMed Home-Care PlatformSeamless connection of the hospital to patients
(in and out of the hospital)
Integrate and coordinate patient’s medical data from various resources
Enhanced level of information in real-time for patients & caregivers
Common infrastructure for telemedicine applications
Rapid Development of future applications
Easier management, and greater extensibility
TTeC 2006, Tromsö, Sven Jonsson, Karolinska
TeleMedISTeleMedISTMTM – System Layout – System LayoutRemote Center
GPRS
Internet
SMS
InternetZone
ExtranetZone
Firewall Firewall
IntranetZone
Gateway
FTPServer
SMSTransmitter
FilesOrganizer
FirewallLAN
CellularTerminal
LAN
TP
TPApplication
LAN
TMW
TTeC 2006, Tromsö, Sven Jonsson, Karolinska
TeleMedISTeleMedISTMTM Users UsersPopulations:
• In-hospital patients • Post-hospital patients (at home) • People at risk groups (living in the community) • Elderly people
Diseases:
• Congestive Heart Failure (CHF)• Arythmia• Respiratory diseases• COPD follow-up
TTeC 2006, Tromsö, Sven Jonsson, Karolinska
Engineering Trials ProgramEngineering Trials Program
Usability tests
Communication tests
Reliability tests
Security and safety tests
Interoperability tests
TTeC 2006, Tromsö, Sven Jonsson, Karolinska
Engineering Trials ResultsEngineering Trials ResultsUsability tests
• Handling TMW through application
• Assigning TMW to patients
• Managing updates to TMW work very well towards end-users
• Error handling in TMW and detection by TP and technical staff was smooth as well.
Note: usability of TeleMedIS System will be conducted also during Clinical trials
TTeC 2006, Tromsö, Sven Jonsson, Karolinska
Engineering Trials ResultsEngineering Trials Results
Communication tests• Sending data from 250 simulated TMWs• Processing time took only 28 seconds for FTP Server
Procesing time only 74 seconds for Ensemble.
Conclusion:• Clinical and technical staff at Karolinska will be able to look
at patient information of 250 patients after 2 minutes from the time when TMW sends patient information to Karolinska.
TTeC 2006, Tromsö, Sven Jonsson, Karolinska
Engineering Trials ResultsEngineering Trials ResultsReliability tests
• 1000 Simulated users =>909 simulated patients = OK (Test case:6:01, Reliability, security and saftey test)
• If TMW won’t have GPRS connection:Save measurements for up to 48 hours = memory full.
• Red: Number of users logged in, Green : Incoming traffic (byte/s)• Blue: Outgoing traffic (byte/s), Black: Total traffic (byte/s)
TTeC 2006, Tromsö, Sven Jonsson, Karolinska
Engineering Trials ResultsEngineering Trials Results
Security and Saftey tests• Implemented state-of-the-art security solutions from TMW
to TeleMedIS Gateway. • All messages are sent through encrypted channels. • And in addition, no names and personal identification
numbers are sent through those channels. • Therefore, even if intruder gets down to the information
sent from TMW, he/she won’t pinpoint the actual patient.• Once the message is decrypted at TeleMedIS Gateway, it
is sent to the TP in plain text. This is a normal practice in Karolinska, where the network is already secured. This is part of Sjunet security service.
TTeC 2006, Tromsö, Sven Jonsson, Karolinska
Engineering Trials ResultsEngineering Trials Results
Interoperability tests• TeleMedIS System comprises of:
• TMW• Gateway• TP• Clinical and TMW Manager Applications.
Tests have been performed to identify interoperability issues, and any deviations from current standards.
Conclusion:At its current state, TeleMedIS System is interoperable.
TTeC 2006, Tromsö, Sven Jonsson, Karolinska
Engineering Trials ResultsEngineering Trials ResultsBack draw
• TMW Manager and Clinical applications that are hosted in TP were developed in early phases of the project and therefore lacked user-friendliness towards clinical staff.
• Small interoperability issues between Gateway, and TP, which was mostly due to software updates between partners. => Once latest releases were integrated => OK
• Some issues between TP and Clinical and TMW Manager Applications, due to incompatible Java Interface at TP. => This has been solved by implementing new Java Interface at TP.
TTeC 2006, Tromsö, Sven Jonsson, Karolinska
Resume Enineering TrialsResume Enineering Trials
The results were positive and necessary towards further improvement of TeleMedIS System.
System can be used at its current stage, without further upgrade of hardware and software.
Conclusion:
Therefore, the system is ready to be rolled out for Clinical Trials.
TTeC 2006, Tromsö, Sven Jonsson, Karolinska
Clinical Trial ObjectivesClinical Trial Objectives
INSIDE TRIAL:
Compare the measured values with conventional equipment
Testing of the TeleMedIS system in real life situations
To control the usability of the TMW and the TP
TTeC 2006, Tromsö, Sven Jonsson, Karolinska
Clinical Trial ObjectivesClinical Trial Objectives
OUTSIDE TRIAL:
Testing of the TeleMedIS system in real life situations
To control the usability of the TMW and the TP
TTeC 2006, Tromsö, Sven Jonsson, Karolinska
Patient characteristicsPatient characteristics
Male or female patient suffering from severe COPD
Subjects must be enough healthy to be able to handle the TMW
Subjects must have a prescribed oxygen treatment at home
Subjects must sign the written informed consent
TTeC 2006, Tromsö, Sven Jonsson, Karolinska
Trial procedure Inside HospitalTrial procedure Inside Hospital
Approximately 24 hours
Compare to conventional equipment
Perform Pulse rate, ECG and SpO2 measurements once an hour
Information will be sent to the TP at least once a day (Automatically, TP request or patient selection)
TTeC 2006, Tromsö, Sven Jonsson, Karolinska
Trial procedure, Outside Trial procedure, Outside HospitalHospital
One week
Perform Pulse rate, ECG and SpO2 measurements once an hour
Information will be sent to the TP at least once a day (Automatically, TP request or patient selection)
TTeC 2006, Tromsö, Sven Jonsson, Karolinska
Clinical TrialClinical Trialss Program (1) Program (1)
Evaluation of Information Quality Success:
• Accuracy
• Presentation
• Flexibility
Evaluation of System Use Success:
• Usefulness
• Easy of learning
• Convenience
• User support
TTeC 2006, Tromsö, Sven Jonsson, Karolinska
Clinical TrialClinical Trialss Program ( Program (22))
Evaluation of User Satisfaction Success:
• Patients
• Healthcare professionals (HCP)
Evaluation of Service Impacts Success:
• Service quality for patients, relatives and HCP
• Monitoring accuracy
TTeC 2006, Tromsö, Sven Jonsson, Karolinska
Sweden – Potential BenefitsSweden – Potential BenefitsGovernment/Public:
• Economical:• Possible cost reduction in healthcare systems• Enabling process oriented healthcare services• Assisting nurses and medical staff
• May be integrated with future systems, like: Sjunet (the Swedish national health information network)
Patients:
• Better healthcare – long arm of the hospital• Increasing patient’s involvement
Physicians:
Effective information for efficient medical treatmentMore efficient medication management
TTeC 2006, Tromsö, Sven Jonsson, Karolinska
CConclusiononclusionBased on the trial outcomes and the expected results of the clinical trials we recognized the potential benefits for patients, physicians, administrators and other stakeholders using the TeleMedIS system as follows:
• On-line contact with medical center
• More efficient medical treatment
• Better post hospital treatment and recuperation
• Cost savings to providers and users by reduction the numbers of visits at the clinic
• Enhanced, timely information for physicians & patients
• Eliminate the need to travel to clinic forunnecessary visits
• Enhanced lifestyle and peace in mind
TTeC 2006, Tromsö, Sven Jonsson, Karolinska
Result of Result of TTTeC 2003TeC 2003Based on face to face meetings between Tadiran and Karolinska at the Tromsö Telemedicine Conference 2003, the outcome resulted with a international project in the area of telemedicine, in the project TeleMedIS:
• Banquet atForskningsparken in Breivika =>
• 15-17 Sept 2003
• 380 people 32 nations
• Network building
• Face to face meeting
• TeleMedIS project
TTeC 2006, Tromsö, Sven Jonsson, Karolinska
QuestionsQuestions
Contact:
Sven Jonsson sven.jonsson@karolinska.se
Phone:08-585 807 55
www.karolinska.se/mta