Massimiliano Donati

Sensing Devices and Sensor Signal Processing for Remote Monitoring of Vital Signs in CHF Patients

Nowadays, chronic heart failure (CHF) affects an ever-growing segment of population, and it is among the major causes of hospitalization for elderly citizens. The actual out-of-hospital treatment model, based on periodic visits, has a low capability to detect signs of destabilization and leads to a high re-hospitalization rate. To this aim, in this paper, a complete and integrated Information and Communication Technology system is described enabling the CHF patients to daily collect vital signs at home and automatically send them to the Hospital Information System, allowing the physicians to monitor their patients at distance and take timely actions in case of necessity. A minimum set of vital parameters has been identified, consisting of electrocardiogram, SpO2, blood pressure, and weight, measured through a pool of wireless, non-invasive biomedical sensors. A multi-channel front-end IC for cardiac sensor interfacing has been also developed. Sensor data acquisition and signal processing are in charge of an additional device, the home gateway. All signals are processed upon acquisition in order to assert if both punctual values and extracted trends lay in a safety zone established by thresholds. Per-patient personalized thresholds, required measurements and transmission policy are allowed. As proved by first medical tests, the proposed telemedicine platform represents a valid support to early detect the alterations in vital signs that precede the acute syndromes, allowing early home interventions thus reducing the number of subsequent hospitalizations.

A flexible home gateway system for telecare of patients affected by chronic heart failure

Among chronic disease, Chronic Heart Failure (CHF) is recently attracting the attention of physicians and administrators, as it represents one of the most frequent cause of hospitalization, with a consequent considerable impact on patient quality of life and healthcare costs. This paper presents an integrated ICT solution to improve the management of CHF patients through the monitoring of vital signs at patient home. After a brief introduction of the overall system requirements and architecture, the paper will focus on the flexible home gateway. This represents the central node of the system, being responsible of data flow from the sensors to the server and the hospital information system and representing also the home patients interface. Hardware/Software architecture and implementation trade-offs will be presented. Home Gateway prototype features will be described and compared with respect to state-of-the-art solutions.

Operating Protocol and Networking Issues of a Telemedicine Platform Integrating from Wireless Home Sensors to the Hospital Information System

Chronic heart failure (CHF) is among the major causes of hospitalization for elderly citizens. Its considerable impact on patient quality of life, the resources congestion, and the related costs can be efficiently mitigated using remote wireless biosensors networks placed at patient home, able to communicate in secure way over the public Internet with the cardiology departmental Hospital Information System (HIS). In this way, physicians can monitor the situation of several patients at distance and quickly realize and act alterations in vital parameters. In this scenario, the Health@Home (H@H) platform is conceived. The pool of Bluetooth sensors enables patients to daily collect vital signs at home in noninvasive fashion. A home gateway receives and processes all signals before sending them to a server node in charge of interfacing with the usual HIS. The novel concept of operating protocol (OP) represents a list of actions, remotely configurable, that the domestic network has to follow (required measurements, transmissions, comparisons with personalized thresholds, etc.). The first medical tests on 30 patients (1 month) allowed to verify the model, both from the patient and the medical perspective. The main evaluation metrics were usability, flexibility, and reliability of the communication from sensors to HIS.

Improving Mobility of Pedestrian Visually-Impaired Users

Objective In the present paper the study, design and prototyping of a mobility aid system for visually impaired persons in outdoor scenarios is presented. The application scenario is autonomous mobility in urban context, and, in particular, the living of outdoor public places of tourist/cultural interest and urban routes. Main Content The basic idea behind the project is to realize a safe path that can be followed by the user thanks to a tactile vibration provided by a modified white cane (Smart Cane), potentially usable also as a traditional one; a smartphone provides the user with additional information about the route. The basic guidance function on a safe path is suitable also in an indoor scenario, e.g. in exhibitions, museums, public buildings. Final users were involved in the definition of mobility requirements and during system tests. The safe path is composed by tracks, branch points and points of interest, and is implemented by means of an electrical circuit generating a magnetic field detected by a receiver on the white cane tip. The Smart Cane is equipped with an electronic device (Smart Cane Controller) managing cane functions. The path electrical circuit may be buried in several kinds of ground or placed on ground surface. The user follows the path sweeping the white cane in front of him/her and perceiving a tactile vibration when the Smart Cane tip is in the range of a few tens centimeters from the track centre. The smartphone brought by the user is wirelessly connected to the Smart Cane Controller and to a small portable GPS receiver. The user queries the mobile phone by means of a switchbased user interface on the cane; thanks to GPS positioning information (strict positioning accuracy not needed), the mobile phone provides vocal information about possible destinations, directions and about points of interest. Results The system electronics and the firmware and software applications were completely developed and tested both in lab and in real operating conditions. For the test and Demonstration phase, a bastion on the Walls of Lucca city, Italy, was selected, and the system was tested also with final users. A second run of trials with other users is foreseen in late Spring and Summer 2011. Conclusion The proposed mobility aid system was completely designed, developed and partially tested. A Demonstration phase will allow final users to further test and validate the system, providing hints and feedbacks for a possible engineered future version.

Advanced multi-sensor platform for chronic disease home monitoring

Nowadays chronic diseases affect an ever-growing segment of population in developed countries; and the management of such kind of diseases requires a huge amount of resources. Chronic Heart Failure, Chronic Obstructive Pulmonary Disease, Diabetes, etc. are the main causes of hospitalization for elderly people, and considering the general aging of population this may lead sustainability problems in the near future. In the last years, clinicians and administrators have identified the telemedicine as strategy to improve the patient management, ensuring both a decreasing of hospital admissions and improving the patients quality of life. This paper presents a complete system for the management of the healthcare information related to the chronic patient treatment, integrating three main points: a configurable multi-sensor platform for the acquisition and transmission of vital signs, a dedicated server for the provisioning of centralized telemedicine services and the possibility of synchronizing with the electronic health record.

Enabling Technologies for the In-house Monitoring of Vital Signs in Chronic Patients

The in-house monitoring of vital signs represents a real opportunity to improve the effectiveness of the healthcare of chronic patients, integrating the traditional in-hospital healthcare model with a new out-of-hospital follow-up based on frequent monitoring of the clinical status. It allows clinicians and practitioners to realize and act promptly suspect aggravations, before they become irreversible and lead to hospitalization. This model relies on ICT, in particular biomedical sensors and concentrator devices (i.e. gateway) that enable to acquire vital signs at patient’s home and to transmit collected data in secure way, making them remotely available for medical personnel. This paper presents two gateway devices enabling the in-house monitoring of vital signs according to the kind and severity of the diseases, being the first conceived to be used by the patient while the second studied for professional caregivers. Moreover, it presents a novel sensor for the self-acquisition of the ECG signal.

A flexible ICT platform for domestic healthcare of patients affected by chronic diseases

The management of patients affected by chronic diseases impacts in significant way the resources of the Health System in developed countries. The traditional healthcare model based on periodic in-hospital visits leads to a high hospitalization rate, with consequences on patients quality of life and on the expense sustained by the Health System. The key to overcome the limits of this model is to rely on advanced ICT platforms for the management of the healthcare information, in order to change the direction of intervention from the hospital to the territory (patients home) and from the ex-post medicine to self-driven medicine. A frequent monitoring of vital signs and lifestyle allows an early diagnosis and treatment of possible destabilizations, often avoiding the hospitalizations. The proposed ICT platform is based on remote kits of biomedical devices operated by professional caregivers during the ordinary visits performed at patients home and a collection server transparently integrated with the electronic health record of the patient. In this way the specialists, the clinicians and the general practitioners can observe the evolution of multiple patients at distance and rapidly act before aggravations become irreversible.

User-friendly single-lead ECG device for home telemonitoring applications

Chronic Heart Failure is a chronic disease that often leads to frequent hospitalizations of patients, with consequences on their quality of life and on the expense sustained by the Health System. Enabling early diagnosis through a frequent monitoring performed directly by the patients can improve the management of such disease. This paper introduces a user-friendly single-lead ECG device conceived to be easily used at home by affected patients. The device requires few basic actions to be operated and it is able to send transparently the acquired ECG to the designated service centre exploiting a Bluetooth connection with an Internet gateway.

A New Space Digital Signal Processor Design

The increasing demand of on-board real-time processing represents one of the critical issues in forthcoming scientific and commercial European space missions. Faster and faster signal and image processing algorithms are required to accomplish planetary observation, surveillance, Synthetic Aperture Radar imaging and telecommunications, especially due to the importance of elaborate the sensing data before sending them to the Earth, in order to exploit effectively the bandwidth to the ground station. The only available space-qualified Digital Signal Processor (DSP) free of International Traffic in Arms Regulations restrictions (ATMEL TSC21020) faces a poor performance of 60 MFLOPs peak, and it is becoming inadequate to fulfill the computation demand of the space missions. For this reason, the development of a new generation of space-qualified DSP is well known in the European space community. The space-qualified DSP architecture proposed in this work fills the gap between the computational requirements and the available devices. Additionally, it has been implemented using technologies available in Europe without any restriction. The DSP processor leverages a pipelined and massively parallel core based on the Very Long Instruction Word paradigm, with 64 registers and 8 operational units. The rest of the System-on-Chip architecture consists in the instruction and the data cache memories, the memory controllers and two SpaceWire interfaces. The processor, implemented in CMOS 65 nm technology, reaches an operational frequency of 120 MHz and area occupation of around 350 Kgates. The correlated Software Development Environment (SDE), with compiler, assembler, linker, debugger and instruction-level simulator, allows for an easy programming of the device in C language.

A next generation digital signal processor for European space missions

Future European space missions are in critical need of a new digital signal processor (DSP) free of any International Traffic in Arms Regulations (ITAR) restrictions. We present a new, highly parallel, 8-slot Very Long Instruction Word (VLIW) DSP modeled in LISA, a high-level architecture description language. Necessary software development tools as well as a synthesizable hardware model are generated from this abstract model automatically, improving the productivity and stability significantly. To our best knowledge, it is the first processor aimed to be used in space modeled at a higher abstraction level than RTL. The synthesis of the generated VHDL code using a 180nm CMOS standard cell library results in an area of 380 kGates and shows an aggregated peak performance of 1.0 GOPS and 750 MFLOPS, outperforming the only available other option, Atmels TSC21020F processor, by an order of magnitude.