TELEMEDICINE

SYSTEMS
SYSTEM ARCHITECTURE
This shows the architecture for the interface between the complete body scanning
system, the database server, the access terminal and the mobile phone.
The user interface application at the front end, which is written in MS Visual
Basic 6.0, will interface with the database server via !B". #ll data that the application
accessed and manipulated with are stored in a relational database system is an MS access
database system which is a repository to store the $"%, heart beat, respiratory
temperature, body temperature, saline level, clinicians& attendance, in the case of
abnormal readings form the patient, short messages are sent to clinicians mobile phone by
using MS utloo'.
()#*+

The functions of the complete body scanning 'it are the following
ECG: This is a three lead $"% monitoring system voltages from two sensors 'ept at
various parts of the body all signal conditioned by an e,ternal card and all given to the
*" through an add on card.
Heartbeat: The heartbeat of the patient is measured by using the heartbeat sensor. The
result will be sent to the *".
Body & Respiratory Temperature: Thermistors are used to measure the body and
respiratory temperature. The inputs are given to the *c
Saline e!el: The saline level monitor system used to monitor the saline level. nce the
saline got e,haust the sensor will give an alert sound
"o#tors$ Attendan#e: This is used for doctors& attendance. -our .$! sensors are used
for this.
MB/.$
B!0
T$M*
$""
S#./1$
.$V$.
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*/"
%atient Callin& S'it#(: The switch is useful for the patient. )henever he2she needs any
help or emergency can use the switch, so that the duty doctor2nurse will attend the
patient.
The above inputs are ta'en and given to the *". These inputs are used for
monitoring and analysis.
This module is responsible for communication with and control of the patient
monitoring hardware, which includes the body temperature sensor, respiration
temperature sensor, $"%, patient calling system and saline monitoring system.
/t comprises of the */" micro controller, a power supply unit, and filtering unit, rectifying
unit, regulators, step3down transformers and op3amps.
The Thermistors are used for the measurement for the body temperature and respiratory
temperature.
SYSTEM HAR")ARE
Hard'are ar#(ite#ture
The hardware architecture of the "BSS consists of four modules. They are */"
micro controller, 4S565 interface, and power pac' and ac7uisition devices. The detailed
architectural design is illustrated below.
%IC MICR*C*+TR*ER B*AR" "ESCRI%TI*+
The pic micro controllers are supported with a full range of hardware and software
development tolls. The used */"86-9:: device comes in ;0pin pac'age to communicate
with the pic we are using rs565 port of the computer.
The */" micro controller board consists of circuits necessary to operate a micro
controller with *" interface. To have a *" interface for a heart beat rate3monitoring
system we have used a */" micro controller /" */"86-9::.
The board contains provisions for interfacing 9 analog inputs and 56 digital level
signals.
Analo& inputs: *in no5 to 80 can be used to connect any analog signals of range 03<v. /n
pic 6-9:: port # and port $ can be used as analog port.
"i&ital si&nals: #s mentioned in the circuit the pin outs from the port is ta'en to a 563pin
-4" connector through which we can connect our !igital level signals 0 or < volts.
Clo#,: The */" 86-9:: can be operated in four different oscillator modes. The user can
program two configuration bits -S"8 and -S"0 to select one of these four modes
MCR-.%%: This is master clear input pin to the /". # logic low signal will generate a
reset signal to the micro controller. So we have tied this pic to V"" for the proper
operation of the micro controller.
T/" and R/": To communicate with the outside world the micro controller has an
inbuilt =S#4T. The output and input line from the =S#4T is ta'en and given to a M#>
565 /" for having communication with the *". Since we have used comport for
interfacing the micro controller.
.CC and Ground: *in no.65, 88 are tied to V"" and pin no 68, 85 are grounded to
provide power supply to the chip.
RS010: The most common communication interface for short distance is 4s55. 4S 565
defines a serial communication for one device to one computer communication port, with
speeds up to 8?500 baud. Typically : or 9 bits (on2off+ signal is transmitted to represent a
character or digit. The ? in connector is used. The pin details are given below.
MA/ 010: The M#> 565 is a dual 4S 565 receiver 2 transmitter that meets all $/#
4S565 specifications while using only a @<v power supply. /t has 5 on board charges
pump voltage converters, which generate 80v, and A80v power supplies from single <v
power supply. /t has ; level translators, two of which are 4S565 transmitters that convert
TT.2 "MS input levels into @?v 4S565 outputs. The other two level translators are
4s565 receivers that convert 4S565 inputs to <v.
TT. 2"MS output level. These revivers have a nominal threshold of 86v, a typical
hysteresis of .<v and can operate up to @60v or A60v input
Transmitter se#tion: $ach of the 5 transmitters is a "MS inverter powered by 80v
internally generated supply. The input is TT. and "MS compatible with a logic
threshold of about 56B of V"". The input / an unused transmitter section can be left
unconnectedC an internal ;00 ' ohms pull up resistor connected between the transistor
input and Vcc will pull the input high forming the unused transistor output low.
The open circuit out put voltage swing is guaranteed to meet the 4S565
specification <v output swing under the worst of both transmitters driving the 6 ' ohms.
Minimum load impedance, the Vcc input at ;.<3v and ma,imum allowable
ambient temperature typical voltage with <3'ilo ohms and vcc3@. ?v
The slow rate at output is limited to less than 60v2 microsecond and the powered
done output impedance will be a minimum of 600ohms with 5v applied to the output with
VccD0v. The outputs re short circuit protected and can be short3circuited to ground
indefinitely.
Re#ei!er se#tion: The two receivers fully conform to 4S565 specifications. They re
input impedance is between 6 ' ohm either with or without <v power applied and their
switching threshold is within g the 6v of 4S565 specification. To ensure compatibility
with either 4S565 //* or TT82"M!S input. The M#> 565ers have V/. of .9v and V/E
of 5.; v the revivers have .<v of hysterisis to improve noise reFection.
The TT.2"MS compatible output of receiver will be low whenever the 4S565
input is greater than 5.;v. The reviver output will be high when input is floating or driven
between .9v to A60v.
%*)ER %AC2
%o'er supply unit: #s we all 'now any invention of latest technology cannot be
activated without the source of power. So it this fast moving world we deliberately
need a proper power source which will be apt for a particular re7uirement. #ll the
electronic components starting from diode to /ntel /cs only wor' with a dc supply
ranging from <v to 85v. )e are utiliGing for the same, the cheapest and commonly
available energy source of 560v A<0EG and stepping down, rectifying, filtering and
regulating the voltage. This will be dealt briefly in the forth3coming sections.
Step do'n trans3ormer: )hen ac is applied to the primary winding of the power
transformer it can either be stepped down or up depending on the value of dc needed. /n
our circuit the transformer of 560v 2 8<3038<v is used to perform the step down operation
where as 560v ac appears as 8<v ac across the secondary winding. ne alteration of input
causes the top of the transformer to be positive and the bottom negative. The ne,t
alteration will temporarily cause the reverse. The current rating of the transformer used in
out proFect is 5#. #part from stepping down ac voltages, it gives isolation between the
power source and power supply circuitries.
Re#ti3ier unit: /n the power supply unit, rectification is normally achieved using a solid3
state diode. !iode has the property that will let the electron flow easily in one direction at
proper biasing condition. #s ac is applied to the diode, electrons only flow when the
anode and cathode is negative. 4eversing the polarity of voltage will not permit electron
flow.
# commonly used circuit for supplying large amounts of dc power is the bridge
rectifier. # bridge rectifier of ; diodes (;H /1;00:+ is used to achieve full wave
rectification. Two diodes will conduct during the negative cycle and the other two will
conduct during the positive half cycle. The dc voltage appearing across the output
terminals of the bridge rectifier will be somewhat less than ?0B of the applied rms value.
1ormally one alteration of the input voltage will reverse the polarities. pposite ends of
the transformer will therefore always be 890 degrees out of phase with each other.
-or a positive cycle, two diodes are connected to the positive voltag;e at the top
winding and only one diode conducts. #t the; same time one of the other two diodes
conducts for the negative voltage that is applied from the bottom winding due to the
forward bias for that diode. /n this circuit due to positive half cycle !8 and !5 will
conduct to give 80.9v pulsating dc. The dc output has a ripple fre7uency of 800EG. Since
each alteration produces a resulting output pulse, fre7uencyD5H<0 EG. The output
obtained is not a pure dc and therefore filtration has to be done.
4ilterin& unit: -ilter circuits, which usually capacitor is acting as a surge arrester, always
follow the rectifier unit. This capacitor is also called as a decoupling capacitor or a
bypassing capacitor, is used not only to Ishort& the ripple with fre7uency of 850EG to
ground but also to leave the fre7uency of the dc to appear at the output. # load resistor 48
is connected so that a reference to the ground is maintained. "848 is for bypassing
ripples. "545 is used as a low pass filter, i.e., it passes only low fre7uency signals and
bypasses high fre7uency signals. The load resistor should be 8B to 5.<B of the load.
AC5UISITI*+ "E.ICES
Temperature sensors: Thermistor is used for the measurement of body temperature.
This Thermistor is a passive transducer where output depend son the e,citation voltage
applied to it. )e have arranged the Thermistor in the form of potential driver in the
circuitJ this Thermistor e,hibits a large change in resistance with a change in the body
temperature. /nitially hardware part is calibrated to room temperature. .ater on the
patient where temperature has to be measured, the Thermistor part is attached to him2her
which changes the resistance value and thus the corresponding change in the temperature
is displayed on the monitor. /f the temperature e,ceeds the limit the alarm, indicates it.
Eere in our proFect we use bed Thermistor.
Ele#tro#ardio&ram 6ECG7: This is a three lead $"% monitoring system voltages from
two sensors 'ept at various parts of the body all signal conditioned by an e,ternal card
and all given to the *" through an add on card, program in Visual Basic is developed to
read the voltage signals and in a waveform pattern. The three lead used is silver electrode.
Saline monitorin& system: -or saline monitoring the infrared emitter and detector are
placed in a portion such that the saline bottle passes between them. They are placed near
the nec' of the saline bottle. #s long as saline is present. The infrared rays& path is
bloc'ed and the infrared detector is bloc'ed from collecting infrared rays from the
infrared emitter. #nd so the output will be logical low otherwise output is given to the
**/.
Saline level monitoring is most important compared with any other automation.
This is one type of advanced and precious automation to avoid human errors and paralla,
errors. /n our proFect we are monitoring the saline level as soon as the saline goes lower
level Kfinishing stageL and information passes to the centraliGed computing center for
further actions li'e changing to a new bottle or stop the flow permanently, otherwise if
the bottle is empty due to body pressure blood may go up which is very dangerous
because they are patients.
/t is 7uite comple, to differentiate the saline color and bottle color because both
are sane only by viewing molecular density of the materials we can able to achieve the
differentiation between them. -or e,ample if rays passed a glass material the o2p will be
li'e beam, if the same rays passed to li7uid whose viscosity is less than, / will be specter.
%atient #allin& system
*atient call switch is 7uite useful for total automation. The reason is while
automating the body temperature ac7uiring $"% and B* the manpower is not at all
re7uired for ac7uiring. So people won&t be aware of what is happening inside the patient
room if in case of assistance re7uired for the patient they can use the switch to call the
hospital personals. )e have forced four switches to logical high state through 8' resistor.
So when the switch is not pressed, switch contact will be logical high. The other end of
the switches the connected to the ground so whenever the switch is pressed, port will get
a logical low.
)e have designed the software in such ways that it will produce a call message
whenever the port receives a low logic circuit. )hen two or more switches are
simultaneously pressed all the messages will be displayed one after another and will be
holded as long as the switch is pressed.
# warning alarm also raised while the switch is pressed. This enables easy
understanding and annunciation. #nnunciation means providing legible and audible o2p
for the failure. (*roviding a video is called animation and providing of audio is called
enunciation+
The patient calling system in our proFect consists of four switches which when
pressed gives on display on the screen and activates a buGGer indicating that a patient is
calling. The circuit consists of a switch connected to port of */". )hen the patient
presses the switch acts as a short and high input is given to the port to a buGGer, which
gives an alarm sound.
+eed to (a!e span ad89
/n general the output from the thermistors won&t have a constant value always.
The output may differ from one thermistor to another. $ssentially you must have an
adFustment circuits to 'eep all the outputs as constant as possible to provide legible
information on the computer screen. )e have provided 80 M potentiometer in series
with a 66 M resistor, which provides gain between 50360. )hat we want is 5< gains as
per our calculation, which can be obtained by adFusting the span potentiometer. The span
in instrumentation is called ma,imum operating point or upper threshold.
Nero adFustments are necessary to eliminate balancing errors a compensation error
of the operational amplifier. /n our circuit we have forced a <6M resistor to the @85 and
A85 along with a 5M multi turn potentiometer. #ccording to the calculation we may get
@600mV to A600mV across the potentiometer.
The Geroing circuit gain is unity. The reason is finite adFustment re7uired for this
operation. Because the whole Geroing circuit source is driven by power supply which we
are providing and it may have a good enough current and voltage.
4ilterin&
)e have used 5 types of filters.
/ntegrative -ilter
.ow pass filter
Inte&rati!e 4ilter
/n general the integrative filters are high3speed filters having fastest discharge rate
li'e sweep signals. This provides high3speed noise filtering and different levels of
harmonic and provides clear noise free output but with the constant fre7uency
appro,imately 800 hertG which can be arrested by using our ne,t circuit called low pass
filter.
)e have designed a low pass filter whose value is 80 =-. /t is 7uite enough to
arrest 800 EG signed a produce 0 EG signal.
/n this stage of the :;8 is noise free, ripple free, output if the input is constant.
S*4T)ARE M*"UE
Introdu#tion
)e have written the code in VB to show the $"%, body temperature, respiratory
temperature, heartbeat and doctor&s attendance obtained from the hardware 'it in the
computer screen and the database used in MS3#ccess to store the above data.
So3t'are used:
-ront end C Microsoft Visual Basic 6.0
Bac' end C MS3#ccess 5000
perating system C Ms3 )indows ?9.
4ront:end desi&n:
/n VB we designed 6 screens. $very screen is a from in VB. The first form is
main menu form. /t has the options to select which select which detail the user want to
see. There are command buttons to select the appropriate lin'. /f the user clic's one
command button this form ends and the selected form appears.
The second form is body scans form. This is for displaying all the inputs obtained
from the 'it. There is separate te,t bo, control for every input. #nd there are two image
controls. ne is for display the temperature Vs time graph and another one is for display
the $"% reading in graphical waveforms. -our select option controls re used. The user
can select any one at a time and can view the appropriate reading in the te,t bo, control.
"atabase desi&n
/n MS3#ccess we created ; tables. The tables and fields are
*atient detail C *Oname, *Oid, #ge, Se,, !isease, !ocotorOname,
#dmissionOdate, *atOcondition
*atient 4eadingsC *Oid, !te, Time, Temp8, Temp5, $"%8, $"%5, $"%6,
$"%;,EOBeat.
!octO#ttnC !octOname, !ate, Time
!igitalC !ate, Time, p8call, p5call, Temp