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EMPIRICAL STUDY OF MEDICAL IOT FOR PATIENTS WITH
INTRACTABLE DISEASES AT HOME

1

3
1,2
Kentaro Yoshikawa ; Masaomi Takizawa ; Akinori Nakamura and Masahiro Kuroda 4
1 Shinshu University School of Medicine, Japan
2 Nagano Prefectural Kiso Hospital, Japan
3 Central Corridor Communications 21, Japan Goleta Networks Co. Ltd
4
yoshikaw@shinshu-u.ac.jp; takizawa@ccc21.co.jp; anakamu@shinshu-u.ac.jp; marshkamakura@yc5.so-net.ne.jp
ABSTRACT assistance [1], even though there are still legal issues
associated with remote patient care. In cases of monitoring
Telemedicine for chronic disease management is extending those patients remotely, critical events are false positive
to the home through the use of medical devices and ICT alarms and floods of similar alarms generated by highly-
technologies. Patients with intractable diseases, such as controlled medical devices. These events cause alarm fatigue
amyotrophic lateral sclerosis (ALS) and lethal not only in professional caregivers but also in families. There
neurodegenerative diseases, have been returning to their have been trials reducing the number of these events in
homes rather than remaining hospitalized. Reliable alarms hospitals intensive care units (ICUs), but the need for home
for condition changes of patients and burden reduction of care means that we also need to deal with intractable-disease
their families are taking root as foundations of telemedicine patients at home. There are investigations and discussions on
for patients with intractable diseases. This paper discusses alarms at ICU in hospitals [2-3]. Along with the trend to
reliable alarm delivery and expected medical IoT features extend the use of highly-controlled medical devices, such as
for those patients. A patient’s family has difficulty in setting an artificial ventilator, to the patient’s home, we need to
optimal parameters of life-support medical devices following tackle technical issues on alarms and also the management
patient condition changes. Also, caregivers and patients’ of the devices.
families expect reliable alarms and false alarm reduction
from tele-alarm systems used at home. We need to provide Medical devices have been developed for hospital use and
both anxiety relief for patients’ families and patient safety by have proprietary functions to output alarm sounds and to
reliably monitoring the patients. We designed and provide nurse calls via a wired interface [4]. When these
implemented an alarm delivery system for patients with devices are used at home, users need to carefully integrate
intractable diseases, and here we propose a prototype false- and operate them in their home network. A user needs to
alarm reduction mechanism for highly-controlled medical know the detailed meanings of functions in sophisticated
device systems including an artificial ventilator. We devices provided by manufacturers and to understand the
investigated alarms of a patient for one year, cooperating meaning of the data. In hospitals, medical doctors and
with the patient’s family. We need both hardware standard engineering staff take care of these issues, whereas at home
interfaces and consistent alarm functions between artificial it is difficult for them to be taken care of by the patient’s
ventilators. We conclude with our further work for patients family. There are two ways to develop standard interfaces
with different types of intractable diseases and for and procedures reducing the burden that artificial ventilators
standardization of medical IoT networks integrating false- impose upon medical doctors, visiting nurses and patient
alarm reduction systems. families. One is to integrate any artificial ventilator
following a standard operating interface and the other is to
Keywords – Artificial ventilator, crying wolf, false alarm, provide consistent alarm functions between ventilators.
intractable disease, medical IoT, telemedicine
In this paper, we first introduce a tele-alarm system and
1. INTRODUCTION explain real alarm-related issues. We explain issues that must
be dealt with when managing a highly controlled medical
The number of patients with intractable diseases is device, such as an artificial ventilator, at home. We then
increasing worldwide. The increasing number of ventilator- describe and discuss an approach to integrate various
dependent patients is exceeding the capabilities of hospitals ventilators manufactured by different companies expecting
and health organizations, shifting the burden of chronic care standard operating interfaces. We propose a software
to patients’ families. The need to reduce the burden on framework to integrate with a home IoT network and
caregivers and to increase safety has accelerated the describe our implementation of an alarm delivery system for
development of remote monitoring for home ventilator patients with intractable diseases and of a prototype false-

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