TELEMEDICINE TECHNIQUES AND APPLICATIONS docx

TELEMEDICINE TECHNIQUES AND APPLICATIONS Edited by Georgi Graschew and Stefan Rakowsky Telemedicine Techniques and Applications Edited by Georgi Graschew and Stefan Rakowsky Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2011 InTech All chapters are Open Access articles distributed under the Creative Commons Non Commercial Share Alike Attribution 3.0 license, which permits to copy, distribute, transmit, and adapt the work in any medium, so long as the original work is properly cited. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published articles. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Ana Pantar Technical Editor Teodora Smiljanic Cover Designer Jan Hyrat Image Copyright 26kot, 2010. Used under license from Shutterstock.com First published July, 2011 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org Telemedicine Techniques and Applications, Edited by Georgi Graschew and Stefan Rakowsky p. cm. ISBN 978-953-307-354-5 free online editions of InTech Books and Journals can be found at www.intechopen.com Contents Preface IX Part 1 Theoretical and Practical Foundations of Telemedicine Techniques 1 Chapter 1 Innovative Medical Devices for Telemedicine Applications 3 Agostino Giorgio Chapter 2 Pervasive Homecare Monitoring Technologies and Applications 45 Demosthenes Vouyioukas and Alexandros Karagiannis Chapter 3 Wireless Telemedicine System: An Accurate, Reliable and Secure Real-time Health Care 71 Huyu Qu, Le Yi Wang, Christopher M. Klaus, Qiang Cheng, Ece Yaprak and Hong Wang Chapter 4 Design Criteria for Large eHealth Infrastructure Systems 99 Thomas Grechenig, Barbara Avana, René Baranyi, Wolfgang Schramm and Anna Wujciow Chapter 5 QoS in Telemedicine 119 Phumzile Malindi Chapter 6 On Redefining Telemedicine Paradigm: An Innovative Integrated Model for Efficient Implementation of Healthcare Delivery in Developing Countries 139 K.V.Sridhar and K.S.R.Krishna Prasad Chapter 7 Novel Prediction Based Technique for Efficient Compression of Medical Imaging Data 169 Josip Knezović, Mario Kovač, Martin Žagar, Hrvoje Mlinarić and Daniel Hofman VI Contents Chapter 8 Clinical Decision Support Systems 185 Dejan Dinevski, Uroš Bele, Tomislav Šarenac, Uroš Rajkovič and Olga Šušteršič Chapter 9 A 2.4GHz Non-Contact Biosensor System for Continuous Monitoring of Vital-Signs 211 Donald Y.C. Lie, Ravi Ichapurapu, Suyash Jain, Jerry Lopez, Ronald E. Banister, Tam Nguyen and John Griswold Part 2 Application Scenarios and Case Studies 239 Chapter 10 Mobile Web Application Development to Access to Psychiatric Electronic Health Records 241 Isabel de la Torre Díez, Míriam Antón-Rodríguez and Francisco J. Díaz-Pernas Chapter 11 Clinical Psychology and Medicine for the Treatment of Obesity in Out-patient Settings: the TECNOB Project 257 Gianluca Castelnuovo, Gian Mauro Manzoni , Stefania Corti, Paola Cuzziol, Valentina Villa and Enrico Molinari Chapter 12 The Role of Standard 12-lead ECG in a Telecardiology Consultation Service 269 Kjell Nikus, Vesa Virtanen, Samuel Sclarovsky and Markku Eskola Chapter 13 Tele Oncology for Cancer Care in Rural Australia 289 Sabe Sabesan and Sean Brennan Chapter 14 Telemedicine in the Diagnosis and Management of Congenital Heart Disease 307 Brian McCrossan and Frank Casey Chapter 15 Telemedicine for Managing Patients on Oral Anticoagulant Therapy 331 Sophie Testa, Oriana Paoletti, Anke Zimmermann, Laura Bassi and Emilia Cancellieri Chapter 16 Telemedicine for Chronic Digestive Diseases: A Systematic Qualitative Review 347 Sandra M. Quezada and Raymond K. Cross Chapter 17 Teledermatology: Outcomes and Economic Considerations 363 Akhilesh S. Pathipati and April W. Armstrong Chapter 18 Screening for Retinopathy of Prematurity 379 Claire Hartnett and Michael O’Keefe Contents VII Chapter 19 Teleophthalmology 393 Manoj Kulshrestha, Simon P Kelly and Usman Mahmood Chapter 20 Telemedical Solutions - Practical Approach in Bulgaria 413 Polina Mihova Chapter 21 Practical Results of Telemedicine System Between Antarctic Station and Japan 439 Giichiro Ohno Chapter 22 Telestroke for the Long-term Management of Risk Factors in Stroke Survivors 453 Joubert J, Medeiros de Bustos E, Decavel P, Chopard JL, Joubert LB and Moulin T Chapter 23 The Role of Telemedicine in the Management of Acute Trauma Referrals to a Regional Plastic and Hand Surgery Unit in the South East of England 475 David Wallace and Mark Pickford Preface Telemedicine is not a novelty. The first transmission of patient-relevant data dates back several decades. Respective technologies have been developed rapidly since their introduction and extended application of digital medicine, so today medical data are more and more stored digitally. As we increasingly speak of the paperless hospital, it has become easier to use services such as the Internet and the newly established Web 2.0 as well as Ipv6 to enable the use of applications such as eHealth, ePrescription, and homecare. Several chapters (1-9) in Part I of this book are devoted to practical and the- oretical foundations of telemedicine techniques. A number of chapters (10-23) in Part II demonstrate impressive and manifold application examples from practice as well as case studies. Part I. Theoretical and Practical Foundations of Telemedicine Techniques The first chapter Innovative Medical Devices for Telemedicine Applications describes several devices which were invented, especially designed, successfully tested and pa- tented by the author. The first applications are remote health monitoring via a wireless (bluetooth/Zigbee and UMTS/GPRS) transmitter of vital parameters acquired by sev- eral probes for ECG, Blood Glucose, physical activity, breathing frequency, blood pressure, etc.). The use of a tele-stethoscope for the objectivation of cardio-pulmonary auscultation, a Pain Button / Wireless Pain Button for the provision of extended moni- toring of patients with high risk, an RFID-based system allowing doctors easier and quicker access to patient data and PC-based system for remote medical visits allowing the doctor a complete cardio-respiratory control of a remote patient in real-time are important for advanced homecare. The chapter Pervasive Homecare Monitoring Technologies and Applications gives a comprehensive overview of homecare technology, applications and implementation of wireless technologies which enable pervasive homecare monitoring of elderly, chroni- cally ill (and children). Most existing solutions include a BAN of sensors carried by the patient and environmental sensors forming a PAN connected to the monitoring site by a gateway. The chapter presents detailed analysis of wireless sensor standards (IEEE802.15.4, ZigBee, etc), sensor types including physiological, biokinetic and ambi- ent sensors and signal processing as well as techniques to reduce energy consumption. X Preface A mathematical model for the accuracy and reliability of a communication system for the transmission of vital patient signals in remote health monitoring is given in the chapter Wireless Telemedicine System: An Accurate, Reliable and Secure Real-time Health Care. Transmission errors are analysed based on a WLAN (802.11b) integrated system. The relationships are studied in a simulation of a remote medical diagnosis of typical lung sounds yielding a trade-off between resource consumption and information accuracy. The chapter analyses the security of wireless channels in case of attacks and discusses the enhancement of security. In Design Criteria for Large eHealth Infrastructure Systems the authors analyse the criteria to be considered before the setup of a nationwide or large eHealth infrastructure. The authors distinguish between the political, institutional, operational and technical level and respective design criteria. On the political level cultural aspects, innovation, healthy growing of the intended system, fears and acceptance by the users and representation in parliament and legislative measures have to be considered. On the institutional level the system acceptance by primary and secondary healthcare centers, health insurance companies, hospitals, pharmacies, nursing homes and patients was analysed. Benefits and costs of the intended system have to be considered against requirements and wishes. On the operational level the actual administration of the eHealth system comes into play through adaptability of the system, accessibility of patient data, maintainability of the network, interoperability of heterogeneous systems and transparency of data transmission. In the chapter QoS in Telemedicine we learn that Quality of Service (QoS) in IP-based telemedicine systems is required for the delivery of services like tele-consultation, tele- diagnosis, tele-monitoring or tele-education. QoS is determined by delay, jitter, bit rate and packet loss of the network. The author analyses the methods for ensuring quality transmission: traffic differentiation, traffic engineering, error control and data encoding. The emphasis is on traffic differentiation using DiffServ and MPLS and the evaluation of the performance of the proposed solutions. In the chapter On Redefining Telemedicine Paradigm: An Innovative Integrated Model For Efficient Implementation Of Healthcare Delivery In Developing Countries, by taking into account the healthcare situation in highly populated developing countries such as India and China, the authors redefine the goal of telemedicine as increasing the doctor to patient ratio. It will also be important to reduce the number of patients by introducing preventive healthcare which is also supported by telemedicine. To achieve this, the authors suggest a new approach to keep medical records and start to develop it. They propose a secure and interoperable Electronic Health Record, collecting data in a single file, allowing real time updates, compression of medical data and dynamic transmission of data. In Novel Prediction Based Technique for Efficient Compression of Medical Imaging Data a predictive model for lossless image compression is described and evaluated. Predictive image coding can be formulated as composed of prediction of a pixel based [...]... Approach in Bulgaria standard medical practices contrasted with telemedical solutions are discussed and an overview of telemedicine in Bulgaria is given Strengths, weaknesses, opportunities and threats of telemedicine are analysed A review of definitions of telemedicine and a comparison and differentiation of telemetry, telematics and telemedicine is given The status of Bulgarian telemedicine is compared... remote areas and small hospitals The chapter analyses future developments and provides economic evaluation In The Role of Telemedicine in the Management of Acute Trauma Referrals to a Regional Plastic and Hand Surgery Unit in the South East of England the establishment of a store -and- forward telemedicine system at a regional hospital in SE England is reported to assist the referrals of hand and burn injured... Hz and 600 Hz With increasing age there is a small increase in power in the band between 330 Hz and 600 Hz Spectral differences exist between women and men in general, women have tones of breath sounds higher than men The best frequency band to obtain the average power is the band between 100 Hz and 600 Hz, because here we have a probability of error less than the band between 100 Hz and 800 Hz, and. .. through the server PC of the monitoring centre The management software is also designed to display graphs and maps on handhelds, smartphones and Linux-based PCs 8 Telemedicine Techniques and Applications Fig 4 Location of the patient and the nearest first-aid station 2.3 Diagnostic equipment 2.3.1 ECG and heart frequency monitoring An electrocardiogram (ECG) is a recording of the electrical activity on... aspects and cost-effectiveness are analysed Congenital Heart disease is a highly specialized field with great distances between few experts and patients and non-specialist physicians, therefore suited to telemedicine In the chapter Telemedicine in the Diagnosis and Management of Congenital Heart Disease the authors analyse the situation of pediatric cardiology in UK and discuss hardware, network and personnel... Table 1 Coefficients useful to determine the 12 derivations of the standard ECG by the EASI ECG 10 Telemedicine Techniques and Applications The EASI ECG front end consists of an instrumentation amplifier together with an integrator (low frequency – 0.05 hz - noise filter) and an active low pass filter (for limiting the bandwidth – 40 hz - and the amplitude of the signal) that are the building block for... benefit of telemedicine is that it is capable of allowing a patient to be examined more often than would be possible if the patient were required to travel to a healthcare facility due to the ease with which it can be administered 4 Telemedicine Techniques and Applications The only drawback of telemedicine is the risk to dramatically reduce the human contact and the feeling between the patient and the... for Molecular Medicine and Experimental and Clinical Research Center Charité - University Medicine, Berlin, Campus Berlin-Buch, Germany Dr Stefan Rakowsky, Charité Comprehensive Cancer Center, Tele-Video-Tumorkonferenzen, Charité Campus Mitte, Berlin, Germany Part 1 Theoretical and Practical Foundations of Telemedicine Techniques 1 Innovative Medical Devices for Telemedicine Applications Agostino Giorgio... like telephone and facsimile machines Nowadays, telemedicine integrates network and medical technology, generally comprising remote diagnosis, expert consultation, information service, online checkups, remote communication, etc Based on computers and network communication, it implements remote transfer, storage, query, comparison, display, and sharing of video and audio information and medical data... each impact of foots on ground 12 Telemedicine Techniques and Applications This signal includes a contribute coming from the gravity that is gcosθ where θ is the angle between the sense direction of the accelerometer and the gravity The angle θ is not constant at all when the accelerometer is fixed on the clothes of a patient, and varies widely when a subject bows or stand up Fortunately the power spectrum . TELEMEDICINE TECHNIQUES AND APPLICATIONS Edited by Georgi Graschew and Stefan Rakowsky Telemedicine Techniques and Applications Edited by Georgi Graschew and. administered. Telemedicine Techniques and Applications 4 The only drawback of telemedicine is the risk to dramatically reduce the human contact and the feeling between the patient and the doctor. Homecare Monitoring Technologies and Applications 45 Demosthenes Vouyioukas and Alexandros Karagiannis Chapter 3 Wireless Telemedicine System: An Accurate, Reliable and Secure Real-time Health