INTRODUCTION

Biomedical signals are usually extracted from living organisms and in most applications from human beings. The measured signals are processed to establish the condition of the subject. Such processing finds extensive use in patient monitoring and management systems. Processing of biomedical signals are also done for transmission purposes and efficient storage.

Telemedicine

was primarily Teleradiology used for the transferring of high

resolution medical images, X- ray pictures, Ultrasound, CT, MRI pictures, Live transmission of ECGs and Echo- cardiograms. Today, a detailed clinical examination can be conducted remotely. A two way interactive communication occurs while a remote examination is being carried out.

A basic Telemedicine system consists of a Personal Computer, a modem, a telephone line, a scanner and a camera. Integrated Services Digital Network (ISDN) services are traditionally being used for Telemedicine. A leased line or a VSAT link can also be used. Actual choice would depend on cost, availability, reliability and necessity. The telemedicine facilities are being expanded from big metropolitan cities to even smaller cities. The increasing excellent telecommunications infrastructure, video conferencing equipment will help provide a physician where there was none before.

These telemedicine facilities must also be brought to the reach of rural people since there is a difficulty in retaining specialists in those areas. Also these facilities must be affordable by the poor. This paper throws light on a cost competitive alternative to telemedicine that utilises the normal telephone line and Dual Tone Multy Frequency (DTMF) Tones.

Telemedicine transfers the expert to the patient. It avoids unnecessary transfer of patients. Appropriate treatment was introduced before transfer. Transfer time is shortened and adverse events during transfer of patients significantly reduced.

DESCRIPTION

Bio- medical signals from patient monitoring aids such as single channel ECG and Electronic Stethascope are considered for transmission.

The signals are fed to an 8- bit Analog to Digital Converter ADC0816 with a conversion period of 100 micro seconds. Taking all other delays into cosideration, sampling of these signals is performed at a rate of 200 samples per seecond. i.,e. one for every 5 milli seconds.

The Analog to Digital Converter output which is in Hexa Decimal format is stored in the memory. This is converted further into BCD. Thus both BCD and Hex formats are available. The Hex data is further fed to a CRT interface for viewing a monitor or to a Digital to Analog converter (DAC) for observation on a Cathode Ray Oscilloscope (CRO). The details of medical examination in the form of signals are made available with the local Doctor or his associates.

The BCD data is further unpacked and fed to a DTMF Transmitter 8880. Two tones are produced for every digit. For 0- 9 , different sets of frequencies are produced. A digit is transmitted by sending the corresponding DTMF tone for 40 milli seconds. A delay of 40 milliseconds at the maximum and 20 milli seconds at the minimum will be allowed between transmisson of successive digits.

Thus to transmit data corresponding to 200 samples, with each sample represented by 3 BCD digits, a total of 600 BCD digits are to be sent on the line. At a transmission rate of 80 milli second per digit, the time required to transmit 600 BCD digits will be 48 seconds. Thus a cycle of one second signal can be transmitted in 48 seconds. Though the speed of transfer of signal is low, it can reach the expert within 200 kilometers radius costing only two calls according to the present tariff.

At the receiver, the tones received on the telephone line are converted back to BCD digits by a DTMF receiver and its associated circuitry. The BCD digits are packed into corresponding decimal numbers which are then converted to Hexadecimal form. The Hexadecimal data is fed to a personal computer on the expert's’disk for presentation in the form of a signal. In the absence of a PC, a Microcomputer with DAC interface may be used for observing the signal on a CRO.

The proposed system is primarily used for off-line signal transmission. The sampling rate adopted may be set by default or user may choose his own sampling rate synchronised with the receiver side. This step will ensure proper timing and reconstruction of the signal in the original form.

RESULTS
The above system has been implemented and tested. The sampled ECG values from ADC are fed to a Microprocessor trainer. The sampled signal is observed on a CRO for local monitoring. This signal is transmitted through DTMF tones and are received by a DTMF receiver on the Expert’s end. The reconstructed signal on the receiver side is shown in fig.2.

ECG WAVEFORM
5000 AMPLITUDE Series1 115 134 153 20 39 58 77 96 Series2 1 -5000 TIME msec

0

Fig. 2

CONCLUSION

The proposed system is cost effective and simple to use. A patient who requires monitoring at regular intervals can afford and use without travel. If this comes to practical use, it provides a way to offer first aid at the patients home by a family Doctor / a Local Hospital / a Primary Health care centre / an Ambulance Van .

REFERENCES

1.Bio - Medical digital signal processing - Willis J. Tompkins Prentice Hall of India Pvt. Ltd. 1999 Edition

2. Handbook of Bio – Medical Instrumentation Tata McGraw Hill R S Khndpur

1999 Edition

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