Practical Biomonitoring using

Wireless Technology

Thomas F. Budinger M.D., Ph.D. Department of Nuclear medicine and Functional Imaging, Lawrence Berkeley National Laboratory; Departments of Bioengineering and Electrical Engineering and Computer

Science, UCB; Department of Radiology, UCSF.

NAE / IOM Workshop“Engineering and the Health Care System” Mar 11-12,, 2003

Health care improvements which require better engineering and in some cases new engineering in the area of monitoring

Concepts of This Presentation

How wireless interfaces can simplify hospital and home care (e.g., pO2, apnea)

What current engineering can do to assist the care-giver

What near future nano-technology might do

If we could do everything or anything, what would we do -- for infants, for home care?

BiomonitoringThree areas of development:

Medical Alert NetworkFallsCardiac arrest Trauma Missing persons

Bio MEMS Devices

Personal Health Status

Medication and Physiologic Status

Home Care System

(No reliable user-friendly system)

(Innovations needed)

(Major contemporary industry)

Biomonitoring Benificial to

High Risk Health Patients & Search and Rescue

Personnel

Patient-centered focus of eHealth

Wellness promotion as part of healthcare continuum which includes illness treatment

Aging population

Forces for Home Telecare

Development of a Home Telecare System

CSIRO Telecommunications and Industrial Physics

Laurie Wilson PhDRobert Gill PhD

Sydney, Australia

Daily on-line measurements

Hospital Without Walls

Vital signs monitoring

Alerts

Activity monitor

Video-conferencing

Visiting nurse

On-line call centre

Distributed, electronic

record

Map display

Receiver

Cell phone on arm band

641 MHz

HAM Radio Transceiver

A customized tracking system for private automobile or a wandering family member can be a major household appliance but currently relies on HAM radio licensed operations.

Current Epidemic of

RSV

BeeeepBeeeepBeeeep

O2

WirelessTechnology

zzzzzz

O2

Sleep Apnea Monitoring

BeeeepBeeeepBeeeep

Sleep Apnea Monitoring

Wireless Technology

zzzzzz

The portable Minolta Pulsox 3 wrist pulse oximeter (~$580 US).

Wireless Breathing

Sensor

Wrist Worn Accelerometer

Integrated Activity

Fall

Heart Rate + Waveform

12:0

0

General concept of a wearable accelerometer or motion detector which allows continuous monitoring of a subjects daily activity as well as detection of a fall. Wireless communication of information can be stored in a local network node or the belt worn transmitter can be used to transmit alert signals or as a relay for actual data.

Illustration of a self contained, wrist worn blood pressure device similar to that marketed by OMRON Inc (~$75 US)

Wrist Blood Pressure

Monitor

12080

PTT

Signals from the ECG and pulse pressure changes provide different physiologic information and can be used together to gain additional data such as the pulse transit time (PTT). Rapid pulse timing can be

from a pulse pressure monitor or from a pulse oximeter in the reflectance mode or conventional transmission mode.

Capsule Endoscope 11mm x 26mm

Data Recorder with Batery pack

which can be downloaded onto laptop computer

Antennae

Wireless endoscopy using a disposable self contained camera in an available capsule (11m x 26mm) which is tracked by an antennae

array fastened to the torso (GIVEN IMAGING Ltd., http://www.givenimaging.com/usa).

What Wireless Network(s) ?PROBLEMWhat Wireless Networks?

Enabling TechnologiesSWAP 2.4 GHz 30 meter range

Bluetooth 2.4 GHz Your home computer to appliance network

HIPERLAN 5.15-5.25 GHz Kilometer range power requirements

Europe

Ultra Wideband (UWB)

Kilometer range, low power, low cost. FCC is a partial barrier

Biomonitoring

Accelerometer

A. Chemistry chip pendant(saliva sampling)

B. Skin electrodes(cardiac & respiratory)

D.

E. Phone / Camera / GPS

F. Chemistry(p02, pCO2, sugar)

G. Local area network

GPS

A

D, E, GD, F, H

C

D

B

Strain guage & Heart Rate MonitorC.

H. Pulse Pressure

Contemporary Activities by OthersDODDARPANSFEmil Jovanov (Univ of Alabama)Laurie Wilson (CSIRO, Australia)Agilent TechnologiesSiemens AGAmbulatory Monitoring Inc.Digital Angele Worldtrack

Acknowledgements

Support by CITRIS (California)

BER of DOE

NIH

Dr. Kathleen Brennan

Dr. Jonathan Maltz