Page 81 - ITU KALEIDOSCOPE, ATLANTA 2019

ICT for Health: Networks, standards and innovation

It is important to determine the emergency condition of a
patient from the alarm category and vital signs data at the
same time when an alarm is raised. We used five off-the-
shelf artificial ventilators. The experimental transmission of
vital signs data and alarms is shown in Figure 3. We have
implemented the delivery of physiological data and alarm
signals by the following three methods depending on
available interfaces. The first type uses a USB or UART
interface to send data and alarm signals to a gateway (HT-
70plus manufactured by COVIDIEN Co., Ltd.-USA, Vivo
50 manufactured by BREAS Co., Ltd, Sweden). The second
type has only a nurse call. We converted the nurse call signal Figure 5 - Medical IoT model and roles
to an alarm signal at a gateway and transmitted it to the
Internet (Monnal T50 manufactured by the IMI, France and In future medical IoT system, once consistent alarm
Trilogy 100 manufactured by Philips, Netherlands). The functions are standardized between medical devices used for
third type uses a LAN port to integrate physiological data the same purposes, information and instructions may go
and alarm signals and to send to a server. At the same time, directly to a medical device associated with the patient
the notification message is delivered to caregivers according through a caregiver such as a medical doctor and the patient
to the alarm level [5] (Figure 4). family member shown in Figure 5 [6]. The caregiver
analyzes data and information and sends instructions for the
device to the patient family member.

3. RELIABLE ALARM DELIVERY AND
OPTIMAL OPERATION

Reliability and efficiency are important for intractable-
disease patients in the hospital and at home. Alarms are used
to indicate when physiologic parameters monitored in
critically ill patients are abnormal. In typical cases, multiple
Figure 4 - Ventilators (left) and experimental ventilator alarms are raised but are not specific to patient treatments.
using LAN (right) in test They have a negative impact on the quality of patient care.
Caregivers of patients need minimal and specific alarms
In addition to the connection interface, we acknowledged relevant to their patients’ conditions.
differences in the alarm-call signal tone, the alarm action
procedure, the alarm signal duration and flexibility in the There are discussions on advantages of IoT devices in
alarm signal setting between them. These differences prevent medical use. A medical IoT application can change the
home use. We need to standardize the device hardware operating conditions of an artificial ventilator according to
interface to provide safer alarming and the software interface the instruction of a medical doctor referencing data received
to translate alarm events into common meanings between from various medical devices. At home, a family member is
medical devices used for the same medical purposes. close to his or her patient and can provide quick actions
anywhere in the house when a home network is provided.
2.3 Medical IoT system at home The family member may be in another room in the house and
an alarm is transferred from network connecting medical
A Medical IoT system for a patient with intractable diseases devices to a home device in another home IoT network.
at home is expected to provide easy-to-use interfaces to the
caregivers. In the system, a highly-controlled medical device 3.1 System configuration
sends not only vital data but also information which is used
to set optimal parameters of the device depending on An alarm delivery system consists of two components. LAN-
condition changes of the patient. The parameter changes enabled components are made up of highly-controlled
should be done by a medical doctor, but at home it may be medical devices, such as a pulse oximeter and artificial
difficult to work on them in a timely manner. ventilator, and a gateway in which an alarm platform
manages data and alarms including nurse call signals. The
alarm platform collects sensor data, alarm data and
emergency alerts, and it transfers this information to a smart
alarm IoT platform in a cloud. Alarms are transferred to the
home network IoT platform in the cloud and delivered to the
home network located in the same house that the LAN-
enabled system is in. Each medical device generates an alarm
event when conditions change, and those events come to the
gateway. The alarm and related information are analyzed and

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