TrendofeTrend of e-Health System and stem and SoCSoC

Trend of eTrend of e--HealthHealthTrend of eTrend of e HealthHealthSystem and System and SoCSoCyy

2010 04 092010. 04. 09

Professor. Jaeseok Kim, Ph. D

IT-SoC Research LabYonsei University

ContentsContents

Introduction to e-Health system & SoC componentsPart 1 : Patient Monitoring Systems

ICD(Implantable Cardioverter Defibrillator) : 부정맥 진단 및 치료e-Health System for Diabetic : 혈당 제어y 혈당 제어PWV(Pulse Wave Velocity) : 맥파전달속도를 이용한 심혈관계진단Capsule Endoscope : 캡슐 내시경Lab-on-a-Chipp

Part 2 : Disability Assistance SystemsHearing aidArtificial noseArtificial noseArtificial Retina

Part 3 : HCI TechnologiesPart 4 : Wireless Body Area Network (WBAN)Part 4 : Wireless Body Area Network (WBAN)Concluding Remarks

YonseiYonsei UniversityUniversity IT IT SoCSoC Research Lab.Research Lab.[2]

What is eWhat is e--Health ?Health ?

What is e-health ?an emerging field in the intersection of medical informatics, public health and businessreferring to health services and information delivered orreferring to health services and information delivered or enhanced through the Internet and related technologies

u-healthid di l & h lth ti i ( tiprovides medical & health promotion services (prevention,

diagnosis, treatment, post control, etc) using ubiquitous IT• medical & healthcare services

using u-IT (sensor network)

I t t

Ubiquitous IT

• medical treatment using IT

network

• transmission of medical

• medical & healthcare services

though Internet

• A joint use of medical information,

remote healthcare etc.

using u-IT (sensor network)

• Intelligent healthcare services etc.

Internet

e-HealthRemote Healthcare

information, remote healthcare etc.

Wired network communication

u-Health


e HealthRemote Healthcare u Health

Six Components of eSix Components of e--HealthHealthpp

e-Health includes Content, Connectivity, Commerce, Clinical Care, Community and Computer application

The delivery of health services ( li i l d ti l d d i i t ti i )

Through the transfer of

(clinical, educational and administrative services)Decision supporting

clinical CareThrough the transfer of information, Including audio, video and graphic data on Internet

Using telecommunications , Internet and mobileAt a distance

e-Healthe-CommerceOnline shopping

Involving a range of health

ComputerapplicationTool for realization of e-Health

6th ‘C’ concept

g gprofessionals, patients and other recipientsSharing information between patients


Trend of eTrend of e--HealthHealth

Separated Healthcare system ☞ Integrated Healthcare system

HomeHealthcare

Health research

e-HealthMobile Healthcare

e-Health industry

P b d Healthcare yPaper based- Costly - Security risk

e-Hospital

e-GovernmentHealth policy

Information & Communication Technology- Cost-effective - Security


Service Means for eService Means for e--HealthHealth

A healthcare service and system that provides real time

H it l

y pinformation needed in the diagnosis of a patient through the internet and other wireless net work from a designated area away from the hospital such as the home or the office

e-Hospital

RemoteHealthcare

A service and system that offers optimal efficiency in the hospital management

H lthp y p g

system such as prescription delivery, patient booking, and diagnosis by applying ICT in the in‐hospital, hospital‐to‐hospital, hospital‐to‐pharmacy management procedures.

e-HealthIndustry

Mobile Healthcare

A healthcare service and system that enables users to manage their health when‐ever and where‐ever they

h h b l d h ll h dHealthcare want through mobile devices such as cell phones and PDAs with smart sensors


Remote HealthcareRemote Healthcare

Human Sensor technology Terminal device Hospital systemNetworkHuman Sensor technology Terminal device Hospital system

zig

bee Data CDMA-Internet

Network

WiBro Network

zig

be

e

Mobilephone

z

Data transmission

CDMA Internet

Indo

InternetOR Data

Blood sugar

ee

zig

bee

M d

Senior townU Home

oor /O

utd

InternetOR Data transmission

ModemU-Home, U-Apartm’t

EKG

-Patient Information Management-User Portal-SMS Service to Patients

oor

zig

be CDMA-Internet

zig

bee

DataEKG SMS Service to Patients-Administrator(Communication mode, ID setting, etc.)

ee

WiBro NetworkMobilephone

Data transmission


Mobile HealthcareMobile Healthcare

HealthPiaData Center A t i di N tifi ti

ResultsHealthcare Information Data CenterWeb(Wired)Customer

Auto‐periodic NotificationRemote Monitoring

ParentsGuardians

Nursing Agency

Direct Counsel/Management

WAP(Wireless) Ph i i

Customer Data Mgn’tWAP(Wireless)

Source : HealthpiaGlucose level Measurement

PhysiciansDM


ee--HospitalHospitalpp

Hospital Doctor

HIS/OCS Pharm Admin

Prescription Follow-up Consultation

HIS/OCS Pharm Admin

PrescriptionScreening

Prescriptiondata

Web serverinternet

KIOSK Server

Prescription

PharmacyPatientPrescription Follow-up

Prescription

Medicine

Source : BIT Computer

Prescription EDIPrescription


Trend of eTrend of e--Health system (1)Health system (1)y ( )y ( )

Trend of e-Health systemyNeed for Continuous Monitoring

Increase of chronic diseaseTransition to an aging societyTransition to an aging society

Wireless Communication TechnologyEstablishing data base of patient bio-informationR fi ti f h lth d iReconfiguration of e-health device

☞☞ Wearable / Implantable e-health DeviceWirelessCommunicationCommunication

small sizelow power


Trend of eTrend of e--Health system (2)Health system (2)y ( )y ( )

Integration into SoCgMiniaturization / Low power consumptionSIP(System-In-Package) of MEMS and CMOS chip


SoCSoC ComponentsComponentspp

CPU/DSP

Modem/

CPU/DSPCore

CIS/MEMS IP

Multimedia core

Digital IP

Embedded

Embedded S/W

Analog/RF IPEmbedded

Memory

Embedded S/W


SoCSoC Components for eComponents for e--Health Health SystemSystemSystemSystem

Analoganalog

SoC

Bio-sensor

Analog front-end circuit &

A/D

Bio-signalProcessor(Digital)

Modulator

analog

digital

RFsensor A/D converter

(Digital)

Demodulator

RF

Demodulator

Actuatoranalog

digital

analog


Part 1: Patient MonitoringPart 1: Patient MonitoringPart 1: Patient Monitoring Part 1: Patient Monitoring SystemsSystems

[14]

ICD(ICD(이식형이식형 제세동기제세동기) (1)) (1)((이식형이식형 제세동기제세동기) ( )) ( )

Arrhythmia(부정맥)y (부정맥)an irregular heart action caused either by physiological or pathological disturbance(too fast, too slow, irregular)T h di (빈맥) 100 b / iTachycardia(빈맥) : 100 beats/min or moreBradycardia(서맥) : less than 60 beats/minFibrillation(세동) : irregular heartbeat usually faster thanFibrillation(세동) : irregular heartbeat, usually faster than tachycardiaVerntricular Fibrillation(심실 세동) is the most serious

Arrhythmia can be treated by electronic shock (ICD, pacemaker, defibrillater)


ICD (2)ICD (2)( )( )

ICD(Implantable Cardioverter Defibrillator)( p )Effective therapeutic device for rescuing the patient with life-threatening arrhythmia (prevent sudden cardiac death)i l d i h b h h ki f h himplanted in a pouch beneath the skin of the chest or abdomen and continuously monitors a patient’s heart rhythms.If ICD detects dangerous rhythms, appropriate shocks are delivered to the heart within seconds.


ICD (3)ICD (3)( )( )

System componentsy pBody-implanted ICD module

Analog front-end circuitl BatteryBio-signal Processing

Diagnosis

Electronic lead

Body-implantedICD Module

Battery

Electronic leadCapacitor to chargefor shockB k ( 5 )Battery pack (≒ 5 yrs)Communication Module

CapacitorLead


ICD (4)ICD (4)( )( )

ICD and leadsHeart signal can be obtained by the lead which is attached to heart musclethe leads can be attached to the heart by one of twothe leads can be attached to the heart by one of two potential means:

active fixation leads : have a screw atthe tip that is deployed by turningthe tip that is deployed by turninga special wrench at a particular spot onthe other end of the lead remaining outside the bodypassive fixation leads : have specialtines on them, allowing them to hookon the many trabeculations(nooks and crannies)(nooks and crannies)Within approximately one month,the body will scar-down the tip of theleads fixing them to the inside of the heart

YonseiYonsei UniversityUniversity IT IT SoCSoC Research Lab.Research Lab.

leads, fixing them to the inside of the heart.

[18]

ICD (5)ICD (5)( )( )

Development of Body-implanted ICD module (ISL)p y p ( )Enhanced algorithm & BSP chip for arrhythmiaAbility to detected tachycardia, fibrillation, and bradycardia

ICD + Pacemaker

Wireless modem connects ICD to outside

ICD Board Pacing Module

(Single Chip Defibrilator

Bio-Signal Processing

Bl k

ADC

SystemController Modem RF

IA

Reference Circuit

DAC

Block

Biomedical SoC for ICD

ADCIA ADC


ee--Health System for Diabetic (1)Health System for Diabetic (1)y ( )y ( )

Closed-loop CGM(Continuos Glucose Monitoring) p ( g)System

Estimate the blood glucose level of human body and deliver i f i li b d h lappropriate amount of insulin based on the control

algorithmsContinuous glucose sensorg

Blood vs interstitialInvasive vs non-invasive

I li t l i l t blInsulin pump : external vs implantableEffective algorithms to vary insulin delivery dosage

Based on real-life circumstancesBased on real life circumstancesExercise / Variable mealtimes / Overnight

Avoid nocturnal hypoglycaemia(야간 저혈당 수면중 혈당 감소로 쇼크에 빠질수 있음)


(야간 저혈당- 수면중 혈당 감소로 쇼크에 빠질수 있음)

[20]


Closed-loop CGM System for Diabetic (1) p y ( ): External Sensor & External Pump

External continuous glucose sensorBSP(Bio-Signal Processor) & monitoringsystem

Estimate glucose levelEstimate glucose levelDetermine the appropriate dosage

Wireless modemConnects monitoring system to insulin pumpTransmit gathered bio-information to database

External insulin pumpCommercial

ProductExternal insulin pump Product(Medtronix)



Closed-loop CGM System for Diabetic p y: B. Body-implantable Sensor & Pump

Interstitial glucose sensorSensors &

SoC(BSP/WBAN)gBSP(Bio-Signal Processor) & monitoringsystemWireless modem (WBAN)Wireless modem (WBAN)Implantable insulin pump (MEMS)

Can be refilled through tube

SoC(WBAN)& Insulin

Pump

gon the surface

Wireless power transmission or Power generation from body-

Implantable Insulin Pump

Power generation from bodyheat / bio-rhythm

WirelessMonitoring

YonseiYonsei UniversityUniversity IT IT SoCSoC Research Lab.Research Lab.BSP&WBANSoC

MEMS Glucose Sensor

[22]


Algorithm DetailsgPre-processing for sensed glucose

Glucose level estimation : Calibration for glucose sensor output

Regression Calibration (MiniMed)Regression Calibration (MiniMed)MOE algorithm (GlucoWatch biographer)

C l l i h (i li d )Control algorithm (insulin dosage)PID(Proportional–Integral–Derivative) algorithmModel predictive controlp



BSP Algorithm Exampleg pGlucose Level

InsulinInsulin


ee--Health System for Diabetic (6)Health System for Diabetic (6)

Development of Closed-loop CGM System for

y ( )y ( )

p p yDiabetic (ISL)

Enhanced algorithm & BSP chip for diabeticAttached to insulin micro-pump Wireless modem connects designed chipto outsideto outside

Initial Design ResultBasic block diagram Micro Pump

DACBio-Signal Processing

BlockADC

SystemController

ZigbeeModem RFDDA

DAC

ADC

Glucose Sensor


PWV (PWV (맥파전달속도를맥파전달속도를 이용한이용한 심혈관계진단심혈관계진단) (1)) (1)

Pulse Wave Velocity(맥파 전달 속도) can be used as y(맥파 전달 속도)scale for early diagnosis of adult diseases

PWV : How fast blood delivers to peripherals (심장 ⇒ 사지)Evaluate stiffness(경화도), elastic(탄력성), sternosis(혈관 협착) of blood vesseladult diseases : metabolic syndrome (대사증후군)adult diseases : metabolic syndrome (대사증후군), hypertension (고혈압), arteriosclerosis (동맥경화), cardiovascular disorder (심장혈관 장애)

여기에 무슨 일이


여기에 무슨 일이…

심근경색과 동맥경화

PWV (2)PWV (2)( )( )

심전도(ECG)심전 ( )ECG

Processing

심음(PCG)PCG

맥파(PPG)

Processing

맥파( )PPG

ProcessingPEP (pre-ejection period, 구혈전기): R파(좌심실의

등장수축)부터 대동맥 밸브의 열림까지의 기계적 지연VTT (vessel transition time, 혈관 전이 시간)PTT (pulse transition time, 맥파 전이 시간)

PWV can be estimated by processing of three bio-infromations (ECG, PCG, PPG)


PWV (3)PWV (3)( )( )

ECG(Electrocardiogram)( g )a transthoracic interpretation of the electrical activity of the heart over time captured and externally recorded bycaptured and externally recorded by skin electrodesConsist of 5 waves (P,Q,R,S,T)Real time QRS detection algorithm

Used in various cardiovascular field

DELAY

LOW-PASSFILTER

TWO-DIMENSIONAL

MAPPING

MODIFIEDSPATIAL

VELOCITY

PEAK DETECTION&

QRS DECISIONRULES

ECG QRSEVENT


PWV (4)PWV (4)( )( )

PCG(Phonocardiogram)( g )Recording of the sounds made by the heart during a cardiac cycle with the help of the machine called phonocardiographD l i f i b i f h d iDelay information between contraction of heart and opening of aortic valve(대동맥 판막)

PCG result from vibrations created by closure of the heart valveyClosure of the atrioventricular valves at the beginning of systoleClosure of the aortic valve at the end of systole (심장 수축기)

LPFLPF DecimationDecimationEnvelopedetectionEnvelopedetection

P kP k H t tH t t

Pitchdetection

Pitchdetection

Stethoscopesignal

Stethoscopesignal

H tH tSmoothingSmoothing

PeakpickingPeak

pickingHeart ratedecisionHeart ratedecision

Heartrate

Heartrate

P i dP i d


WindowWindow FFTFFTPeriodo-

gramPeriodo-

gram

Capsule Endoscope (1)Capsule Endoscope (1)p p ( )p p ( )

A capsule fitted with a disposable mini video p pcamera

It can examine parts of the small intestine that standard scopes can’t reachscopes can t reachThe video data is wirelessly transmitted and stored in a recorder worn on a belt, and is later downloaded to a computer that the doctor can studycomputer that the doctor can study

What it can showStomach, small & large intestineg

AdvantagesPainlessN d tiNo sedationProvides 3-D, color images without surgery


g y

[30]


Basic componentspA micro CMOS or CCD image sensor with lens, light source and basic processing circuitAn RF transmitter that transmits the camera images or videoAn RF transmitter that transmits the camera images or video images to external receiversA small volume, high capacity battery that powers the camera

d i i iand transmitter circuitryBiocompatible capsule enclosure casing with a transparent camera imaging windowg g

Required technologiesHigh quality image sensorHigh data rate wireless communication systemPower supply technique (battery or wireless power transmission)Low-power and low-complexity circuit design


Low power and low complexity circuit design

[31]


State-of-the-artInstitute Model Target Size(mm2) Duration Rate Sensor Etc.

PillCam ESO2

esophagus 11 x 26 20 min. 18 fps 2 CMOSGiven

Imaging(Israel)

ESO2esop agus 6 0 . 8 ps C OS

PillCam SB2 small intestine 11 x 26 8 hrs. 2 fps CMOS 256x256 pixel

COLON large intestine 11 x 31 10 hrs 4 fps 2 CMOSCOLON large intestine 11 x 31 10 hrs. 4 fps 2 CMOS

Olympus(Japan)

Endo Capsule

small intestine 11 x 26 8 hrs. 2 fps CCDReal-Time

Video Stream

RF System Lab.

(Japan)

NORIKA 3 small intestine 9 x 23 WPT 30 fps CCD rotation

Sayaka small intestine 9 x 23 WPT 30 fps CCD 2MB/mm2

Jinshan S&TJinshan S&T(China)

OMOM small intestine 11 x 25.4 7 hrs. 30 fps CMOS

KIST(Korea)

MIROsmall/large intestine

11 x 24 11 hrs. 3 fpsMicro optic

320x320 pixel,RTVS


(Korea) intestine optic. RTVS


<Controlling and processing ASIC>

<System block diagram>

<Controlling and processing ASIC>

<PMU>

<wireless wake-up subsystem>


<PMU> subsystem>


<Chip micrograph of the controlling ASIC>

<Wireless endoscope capsule prototype (left) and data recorder (right)>





Challengesg1) “Active” capsule endoscope

Design of a new active wireless capsule endoscope with wireless communication internal/external guidance and 3D location andcommunication, internal/external guidance, and 3D location and orientation determination capabilitiesLegged locomotion or external guidance system

2) Wireless power transmissionInductive coupling or RF scheme

3) Higher data rate for enhanced resolution3) Higher data rate for enhanced resolutionHigher than 10Mbps for HD images

4) Multi-purpose robotic capsuleTissue-cell gathering and multiple bio-info sensing capsule


LabLab--onon--aa--Chip (1)Chip (1)p ( )p ( )

Lab-on-a-Chip (LoC)p ( )a subset of MEMS devicesoften indicated by "Micro Total Analysis Systems" (µTAS)integrates one or several laboratory functions on a chip

analysis, isolation/dispense, synthesis, mixer, detection, reactionof test fluids (blood protein DNA )of test fluids (blood, protein, DNA, …)

with size of only millimeters to a few square centimetersdeal with the handling of extremely small fluid volumes down to less than pico liters(10-12)

integratesynthesisanalysis isolation/

dispense integratedispense

mixer detection reaction


LabLab--onon--aa--Chip (2)Chip (2)p ( )p ( )

Advantage of LOCsghigher throughputminimal human interventionsmaller sample/reagent consumptionhigher sensitivityincreased productivityincreased productivity

Lab-on-a-chip

Shrink

Lab on a chip

AutomationAutomation

Integration

Miniaturization


Part 2: Disability AssistancePart 2: Disability AssistancePart 2: Disability Assistance Part 2: Disability Assistance SystemsSystems

[39]

Hearing aid (1)Hearing aid (1)g ( )g ( )

Basic conceptspA hearing aid is an electronic, battery-operated device that amplifies and changes sound to allow for improved communicationcommunication. Electro-acoustic body worn apparatus which typically fits in or behind the wearer’s earIt is designed to amplify and modulate sound for the wearerImplementation technology

A l S tti d S d b th d i lAnalog: Settings and Sound are both processed via analog technology.Digital Programmable: Settings are processed digitally, Sound i d i l h lis processed via analog technology.Full Digital: Both Settings and Sound are processed digitally

※ most hearing aids in the future will be full digital !


g g

[40]


History of hearing aidsy gThe earliest hearing aid was the ear trumpet. (horn)

In the 1950s, transistors replaced amplifier tubes and smaller

magnetic microphones became availablemagnetic microphones became available.



Operating principlesp g p pAll hearing aids are alike

1. Sound goes in the microphoned l f d2. Sound gets amplified

3. Sound comes out the speaker into your ear



Block diagram (Schematic)g ( )How hearing aids works?

1. After switching S to ‘on’ position2. the condenser microphone (COND. MIC) detects the sound signal.p g3. It amplified by transistors T1 and T2.4. Now the amplified signal passes through coupling capacitor C3 to the base of transistor T3.5. The signal is further amplified by pnp transistor T4 to drive a low impedance earphone.6. Capacitors C4 and C5 are the power supply decoupling capacitors.p p pp y p g p



Types of hearing aidsyp gThere are many types of hearing aids

Vary in size, power and circuitryh d ff d d lAmong the different sizes and models are:

Behind the ear aids (BTE)In the ear aids (ITE)Receiver in the Canal/Ear (RIC/RITE)In the canal (ITC), mini canal (MIC)Completely in the canal aids (CIC)



Research trendsCurrent situation

83% of all hearing aids sold today are digitalDigitally processed not inherently better than analog processedDigitally-processed not inherently better than analog processedComplicated processing easier to design in digitalSignal processing easier to modify in digital

Open canal fitting, BTE(Behind the ear) with receiver in canal,Open canal fitting, BTE(Behind the ear) with receiver in canal, Surgical pathway for sound delivery to canal, noise reduction

New technologiesH b id l t i l ti d iHybrid electrical-acoustic devices

Short-electrode cochlear implant combined with hearing aid

New types of middle-ear implantsMEMs transducersMEMs transducersRechargable batteriesDSP chips will continue to get faster Wi l i ti th h Wi l b d t k (WBAN)


Wireless communication through Wireless body area networks(WBAN)

[45]


Consumer productsp


Artificial nose(Artificial nose(eNoseeNose) (1)) (1)(( ) ( )) ( )

Basic conceptspAn electronic nose is a device intended to detect odors or flavors“I i i hi h i f l i“It is an instrument which comprises an array of electronic chemical sensors with partial specificity and an appropriate pattern recognition system, capable of recognizing simple or complex odors,” , Gardner and Bartlett (1944)Application areas

The most common use at the present time for the eNose isThe most common use at the present time for the eNose is within the food and drink industries.eNose can be used in other areas such as petroleum qualitative and quantitative analysis detection of explosives classificationand quantitative analysis, detection of explosives, classification and degradation studies of olive oils, development of a field odor detector for environmental applications.



Operating principles (1/2)p g p p ( / )An electronic nose system primarily consists of four functional blocks. 1 Od h dli d d li t1. Odour handling and delivery system2. Sensors and interface electronics3. Signal processing and intelligent pattern analysis and recognition.g p g g p y g4. Pattern analysis and identified.

Sensor



Operating principles (2/2)The array of sensors is exposed to volatile odour vapourthrough suitable odour handling and delivery that ensures constant exposure rate to each of the sensors.pThe response signals of sensor array are conditioned and processed through suitable circuitry Th i l f d i lli i i iThe signals fed to an intelligent pattern recognition engine for classification, analysis and declaration



Research trendsA higher sensitivity is often demanded to open up new application fields where trace components are the subject of interestinterest.Benchmark established by human perception is the target for an electronic nose.The detection of explosives is of special interest in recent research and a further example of the need of highly sensitive systemssensitive systems.



Consumer productspPortable electronic nose (i-PEN, AIRSENSE Analytics)

Smart nose using mass spectrometer (http://smartnose.com)g p ( p // )


Artificial Retina (1)Artificial Retina (1)( )( )

ObjectivesjDevelop and implant a device containing an array of microelectrodes into the eyes of people blinded by retinal diseasediseaseRestore limited vision that enables reading, unaided mobility, and facial recognition

History1988 :: Dr. Mark Humayun’s foundational work – optic

li b hi d h i di i i h d li h f d k bganglion behind the retina distinguished light from dark by current flow2002 :: successfully implanted the first device (16 electrodes) y p ( )of its kind into the eye of a patientSince then, a lot of volunteers around the world have had devices implanted


devices implanted

[52]


How It Works :1) A miniature camera

mounted in eyeglasses captures images and sendscaptures images and sends the information to a microprocessor

2) The microprocessorconverts the data to an electronic signal and gtransmits it to a receiver on the eye

3) The receiver sends the signals through a tiny thin cable to the3) The receiver sends the signals through a tiny, thin cable to the microelectrode array, stimulating it to emit pulses

4) The pulses travel to the optic nerve and, ultimately, to the brain



Components pExternal (On-body)

Image Capturing UnitlImage Signal Processor

Wireless Communication Unit (Transmitter)Power Supply (Wireless Power Transmission)pp y ( )

Implant (In-body)Wireless Communication Unit (Receiver)Wireless Communication Unit (Receiver)StimulatorMicroelectrode



TechnologiesgImage Processing Software System

Real-time image processing and enhancement to improve the limited vision afforded by the camera driven devicelimited vision afforded by the camera-driven device

Microscale EnablersIC and MEMS to take signals from the external camera and gconvert them into stimuli

Bio-compatible MicroelectronicsMEMS and CMOS electronics with a flexible biocompatibleMEMS and CMOS electronics with a flexible, biocompatible microelectrode array

Microchip DevelopmentMinimizing the size and power requirements of the implanted device, optimizing power delivery, and managing reliable communication between implanted and external components



State-of-the-artApproach Institute/Company Advantages Disadvantages

Intelligent Implants (Germany),

- Injection of electrical charge is adaptable

- Long term stability of the attachment has not been demonstrated

Epiretinal

Boston Retinal Implant Project

(USA),

Artificial Retina

- Individual amplification of the transmitted current

- Applicable also under unfavorable optical conditions

- Danger of proliferative vitreous reaction (PVR)

- So far only a modest optic resolution

- Problem of fiber stimulationProject

(USA)

- Feasibility of epiretinal electro-stimulation has been shown in patients

- External camera necessary

- High costs

Optobionics - Already implanted in 6 patients - No “active” chip, requires very high

subretinal

(USA) levels of brightness

- Requires additional visual aids

- Cannot function under normal light conditions

Retina Implant

(Germany)

- Amplification of the signalsthrough additional external energy supply

- No external camera necessary

- More complex implant procedure


No external camera necessary


<Example Block Diagram of the

<Example Block Diagram of the Overall System>

<Example Block Diagram of the Image Acquisition Block>

y



Chips and Devicesp

<Electrode Array><Stimulator Chip>

<Implanted AR><Surgery>


<Implanted AR><Surgery>


ChallengesgHigher Resolution

Unaided Mobility256-600 pixels256 600 pixels

Recognizing faces1024 pixels

Reading regular printReading regular print10,000 pixels

Stimulus ThresholdElectrode SizeElectrode Size

Best Case: 6 uA -> 15 micron diameter (irOx, 1 mC/cm2)Conservative: 100 uA - > 200 micron diameter (Pt, 0.1 mC/cm2)

Image ProcessingImage ProcessingEye tracking system, digital zooming, digital saccading, and automated optimization


h lh lPart 3 : HCI TechnologiesPart 3 : HCI Technologies

[60]

Human Computer Interface (1)Human Computer Interface (1)p ( )p ( )

Basic conceptspStudy of interaction between people (user) and computersIntersection of computer science, behavioral sciences, design

d l h fi ld f dand several other fields of study.Interaction between users and computers occurs at the user interface, which includes both software and hardware,The basic goal of HCI is to improve the interactions between users and computers by making computers more usable and receptive to the user’s needsreceptive to the user s needs.



Map of human computer interactionp pUse and Context

Human-Machine Fit and AdaptationSocial Organization and Work

Dialogue Techniques

Application AreasHuman

Human

pg

ComputerComputer Graphics

Input and O t t D i

Techniques

Dialogue Genre

E iLanguage,

Communication d I t ti

Human Information Processing

p

Dialogue Architecture

A a

pOutput DevicesErgonomics

Example Systems

and Interaction

Evaluation Techniques

Design Approaches

Implementation Techniques and Tools

Example Systems and Case Studies

Development Process


eve op e ocess


Design principlesg p pEarly focus on user(s) and task(s)

Establish how many users are needed to perform the task(s) and determine who the appropriate users should beand determine who the appropriate users should be

Empirical measurementTest the interface early on with real users who come in contact ywith the interface on an everyday basis.Establish quantitative usability specifics such as:

The number of users performing the task(s), the time to complete e u be o use s pe o g t e tas (s), t e t e to co p etethe task(s), and the number of errors made during the task(s)

Iterative designAfter determining the users tasks and empirical measurementsAfter determining the users, tasks, and empirical measurements to include, perform the following iterative design steps.Design ->Test -> Analyze results -> Repeat



Research trends (1/3)Body worn application

MITHril (MIT Media Lab)Next-generation wearables research platformNext generation wearables research platformHardware platform : It combines body-worn computation, sensing, and networking in a clothing-integrated designSoftware platform : It is a combination of user interface elements pand machine learning tools built on the Linux OSThe MIThril team is constructing a new kind of computing environment and developing prototype applications for health,

d f d lcommunications, and just-in-time information deliveryGoal : Development and prototyping of new techniques of human-computer interaction for body worn applications



Research trends (2/3)( / )Microsystems platform for mobile services and applications

Research project involving 15 partners from 8 different European countriesEuropean countriesTo Make ambient intelligence a reality by developing a mobile-phone centric open technology platformIt employs a mobile phone as the user-carried interface device.



Research trends (3/3)( / )Distributed gesture recognition system

The Wireless Sensor Node for a Motion Capture System with Accelerometers(WiMoCA)Accelerometers(WiMoCA)

Project at several Italian universities is concerned

The sensing modulesEach made up of a tri-axial accelerometerIt can be put on multiple parts of the body for motion detection

Radio modules of all nodes work in the 868 MHz (European license exempt band), with up to 100 kb/sA Java-based graphical user interface (GUI) at the processing unit side interprets the data stream for posture recognitionp p g



Consumer electronicsApplications by IR Light Source

Using human body instead of mouse or keyboard)

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Part 4 : Wireless Body AreaPart 4 : Wireless Body AreaPart 4 : Wireless Body Area Part 4 : Wireless Body Area Network (WBAN)Network (WBAN)

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Wireless Body Area Network (1)Wireless Body Area Network (1)yy

PurposepTo provide a short range, low power and highly reliablewireless communication for use in close proximity to, or inside, a human body, yData rates, typically up to 10Mbps, will be offered to satisfy an evolutionary set of entertainment and healthcare servicesCurrent PANs do not meet the medical and relevantCurrent PANs do not meet the medical and relevant communication regulations for some application environments

ClassificationClassificationWith aspect of device location

In-body (Implant device) vs. On-body (Wearable device)y p yWith aspect of application

Medical (Implant/Wearable) vs. Non-medical(Wearable)



StandardizationIEEE 802.15 TG6 WBAN

May 2006 :: Interest Group (IG) for BANk fNov 2007 :: Task Group (TG) for BAN

Jul 2008 :: TRD, Channel Model approvalMay 2009 :: 30 Proposals for PHY and MACy pJul 2009 ~ Present :: Proposals Merging

Standard categoriesR l ti (f b d )Regulation (frequency bands)Channel ModelingTechnical Requirement for PHY and MACApplications



Technical Requirementsq

ParameterValue

In-body (LDR) In-body (HDR) On-bodyy ( ) y ( ) y

Frequency Band MICS Sub-GHz ISM, UWB

Transmission Range Less than 3m At least 3m

Data Rate 10kbps~1Mbps 1Mbps~20Mbps 10kbps~10Mbps

Power Consumption Ultra-low power Low power Low power

QoS Link success probability of 95%

SAR TX power < 1.6mW

Coexistence At least 10 BANs in a volume of 6x6x6 meters

Performance Less than 10% PER



Research TopicspUltra low power communication scheme and device implementation

Ult l PHY l ith hUltra low-power PHY algorithm researchUltra low-power transmission scheme for in-body WBANEfficient demodulation scheme for on-body WBAN

High-performance MAC protocol researchEfficient wake-up mechanismAdaptive controlling protocol minimizing thermal influence

Low-complexity SoC architecture researchWake-up circuit designHardware architecture optimizationp



State-of-the-artContributors

USA :: TI, Zarlink, Motorolah lEurope :: CSEM, IMEC, CEA, FT, Thales

Japan :: NICT, YNU, Meiji Univ., FujitsuKorea :: ETRI, Samsung, KETI, KORPA, Inha Univ., g, , ,

Strong Candidate TechnologiesUltra wideband (UWB) scheme

I l di (IR) UWBImpulse radio (IR) UWBFrequency modulation (FM) UWB

Narrowband (NB) schemeFSK, (G)MSK modulation for LDR WBANA new modulation scheme for HDR in-body WBAN



Example UWB PHY TX/RX architecturep /

Example narrowband PHY TX/RX architecture


Wireless Body Area Network (7) Wireless Body Area Network (7) yy

<Chip micrograph of receiver>

<Chip micrograph of transmitter> <Verification system for WBAN BB/RF>

<Body-implantable t i hi


transceiver chip>


ApplicationsppMedical

Non-medicalImplant BAN Wearable BAN

Pacemaker EEG/ECG/EMG Real-time video streaming

ICD Vital signal monitoring Real-time audio streaming

Insulin pump Glucose sensor Data file transfer

Retina implants Hearing aid Smart Key / Identification

Capsule endoscope Pulse oximeter SpO Gaming applicationsCapsule endoscope Pulse oximeter SpO2 Gaming applications

Deep brain stimulator Disability assistance Social networking

Brain computer interface Human performance management Emergency alarmBrain-computer interface Human performance management Emergency alarm


Concluding RemarksConcluding Remarksgg

e-Health system ⇒ u-health systemy yIntegrated with ubiquotous IT system

SoC(System-on-chip) is very suitable for e-health y p ysystemAccurate and continuous monitoring bio-sensors issuesNeed more understanding and accurate modeling f bi i l ( l i l PPG t )of bio-signals (neural, visual, PPG, etc)

Bio-signal processing algorithms and SoCarchitecturearchitectureBody-adaptability issues (Bio-nano materials)L i


Law issues

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Documents

TrendofeTrend of e-Health System and stem and SoCSoC