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ABSTRACT

This thesis has to do with the transfer of medical records taken remotely to a doctor via GSM wireless communication link.

Specifically it makes use of the Short Messaging System (SMS) of the Global System for Mobile communication (GSM). The records will be taken by a nurse and stored in the hospital database via a visual basic developed user-interface. Whenever the threshold for a certain parameter set by the doctor is exceeded an SMS alert is sent to the doctor indicating an emergency to which the doctor sends back a reply giving directives to the caregiver on procedures to undertake pending his arrival. On the doctor’s visit, the history of records taken during his time of absence can be accessed by him for proper prescriptions for the patient which is equally stored in the database. Also if there is a new patient, the record is sent automatically to the doctor.

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Worldwide, people living in rural and remote areas struggle to access timely, quality specialty medical care. Residents of these areas often have access to substandard specialty healthcare, primarily because specialist physicians are more likely to be located in areas of concentrated population. There is also the challenge of having very few experts especially those managing chronic diseases even in the urban areas. Effective management of diseases especially chronic diseases can result in improved health outcomes and increased quality of life since more than 80% of primary care visits and two thirds of medical admissions into hospital emergency departments are related to chronic diseases. For example, controlling a parameter such as blood pressure in people with diabetes and hypertension has been shown to reduce mortality and incidence of severe and costly complications such as renal and cardiovascular disease. 

Health care systems are now changing due to the dynamic nature of technological and scientific medical practices. The health care providers are now swiftly adopting these technologies into their health care procedures. Because of innovations in computing and communication technologies, many elements of medical practice can be accomplished when the patient and health care provider are geographically separated. The separation can be as small as across a town, across a state or even across the world. 

Remote patient monitoring is relatively a new area of interest which enables medical professionals to monitor a patient remotely using various technological devices. It is primarily used for monitoring chronic diseases or specific diseases like heart diseases, diabetes mellitus, and hypertension e.t.c. These services can provide comparable health outcomes to traditional inpatient encounters, supply greater satisfaction to patients and is cost effective. Monitoring a patient at home or in a clinic without a resident expert using known device like blood pressure monitors, glucose meters e.t.c. and transferring the information to a caregiver is a fast growing emerging service.

In developing countries like South Africa, Primary Remote Diagnostic Consultation [1] not only monitors an already diagnosed chronic disease but has the promise to diagnosing and managing the disease a patient will typically visit a general practitioner for. Remote patient monitoring can also be applied in electrocardiography, radiology, to mention but a few.

The transfer of these medical data can be done through a variety of telecommunication technologies including ordinary telephone lines, ISDN, internet, intranets, satellites and mobile phones to mention but a few. This project has to do with the transfer of medical records taken remotely to a doctor via GSM wireless communication link. Specifically it makes use of the Short Messaging System (SMS) of the Global System for Mobile communication (GSM). The records are taken by a nurse and stored in the hospital database via a visual basic developed user-interface. Whenever the threshold for certain parameters set by the doctor is exceeded an SMS alert is sent to the doctor indicating an emergency to which the doctor sends back a reply giving directives to the caregiver on procedures to undertake pending his arrival. On the doctor’s visit, the history of records taken during his time of absence can be accessed by him for proper diagnosis and prescriptions for the patient which is equally stored in the database. Also if there is a new patient, the record is sent automatically to the doctor.

1.2 AIMS OF THE PROJECT

The major aim of this project is to make health care services available to isolated communities and remote regions like military bases, ships and the like. It is also aimed at reducing mortality rate especially in developing countries like Nigeria where the needed expertise is limited. The system should be able to significantly reduce the time taken in making health care accessible to them. The burden of inferior healthcare will be taken care of through this system. This system can be extended in its application to areas like fine-tuning the management and allocation of rural health care emergency services by transmitting images to key medical centres for long distance evaluation by appropriate medical specialists, permitting physicians doing clinical research to be linked together despite geographical separation, sharing patients’ records and diagnostic images. Generally speaking, this project is aimed at transmission of medical data for diagnosis or disease management and also health advice by telephone in emergency cases.

Finally since the cost of complete remote patient monitoring system which incorporates the sensors used for capturing biometric data is very high, this system goes a long way in making remote monitoring accessible to the common masses who cannot afford the cost of services rendered by those complete systems as they can take their readings manually.

1.3 JUSTIFICATION OF THE WORK

The system does not require any prior computer knowledge for the user to be able to implement it. The requirement is basic understanding of English language, it is user friendly. Taking of the medical measurements are easy procedures that can be easily undertaken by anyone after simple explanations.

Moreover in a nation like Nigeria where there are few experts especially those managing chronic diseases like diabetes, hypertension etc. this systems comes as a big relief to those in the regions where the experts are not located as they can still access the expertise of those experts. Recently there was a case of relocation of many doctors from a city in Nigeria because of frequent cases of kidnapping. The result of course was poor health care services to those in that locality. With a system like this, doctors can still offer healthcare services to their patients from a secure location. Also this work will help to sensitize the populace on the usefulness of remote patient monitoring using mobile phones which according to a study by Boston University School of Public Health [2] is yet to be embraced by the developing countries. This work can be further justified by the following advantages of using a mobile phone as a health care intervention.

•      Low start-up cost: - living in resource-poor environment is not a barrier to the use of wireless system for several cultural and economic reasons. The existence of a so-called “digital divide” along the socioeconomic gradient is less pronounced in mobile phones than in other communication technologies such as the internet. To make the system affordable to all especially those in the remote villages of Africa, the system was built independent of the instruments for measuring the needed parameters.

•      Functionally mobile phones are easier to use for people with lower level

of skills.

•      User friendly-SMS: Pricing polices may enhance certain mobile uses in particular use of short message system (SMS) text. Text message is less expensive than a phone call and can reach people whose phones are switched off. It is silent which means it can be sent and received in places where it may not be practical to have a conversation

•      Forms of payment: In developing countries a prepayment system is used, this involves buying cards which provide phone time from five minutes to an hour. Customers can use credit as they like over a period of week and so keep control over their spending and enjoy a very cheep service. Once the pre-paid outgoing call budget is exceeded, the user can still receive SMS and calls. Thus the doctor does not need to have credit in his phone to receive alerts and the system does not cost much to send an alert.

Finally, the rate of mortality in remote places due to lack of adequate monitoring by medical experts especially for chronic disease which is increasing at an alarming rate justifies the need for the system which is not limited by distance so far there is a telecommunication network available in that area. With this system doctors spends less time going to see patients and utilises more time treating them. It also means real time monitoring without high staff or capital cost.

1.4 SCOPE OF THE WORK

This system will be able to manually capture doctor-specified vital health data like heart rate, blood pressure, temperature, and plasma glucose level of a patient which is stored in the hospital database and can be transmitted to a doctor when a set threshold is exceeded for better management of diseases. +The system will monitor patients diagnosed with chronic or long-term illness such as diabetes or cardiovascular diseases and stable victims. It can acquire vital information about a patient who lives far away from a medical expert. It can alert medical staff if there is a change in patient’s status that is critical. 

The system will have a user interface to be developed using VB.net through which the nurse or caregiver feeds in the data to the system which is stored in the database. The database will include a medical data manager (MDM) that automatically checks patient’s new data against patient’s record and doctor’s comment. If there is a disturbing change in the patient’s vital signs, for example high blood pressure for a hypertensive patient, an alert is sent directly to the physician. This ensures rapid response by a doctor or medic to any problem that arises. The database stores all patients’ data. The workflow system controls overall system processes while the user interface dynamically format and presents the patient’s data.  The SMS alert is sent through a GSM modem connected to the computer.

ABSTRACT

This thesis has to do with the transfer of medical records taken remotely to a doctor via GSM wireless communication link.

Specifically it makes use of the Short Messaging System (SMS) of the Global System for Mobile communication (GSM). The records will be taken by a nurse and stored in the hospital database via a visual basic developed user-interface. Whenever the threshold for a certain parameter set by the doctor is exceeded an SMS alert is sent to the doctor indicating an emergency to which the doctor sends back a reply giving directives to the caregiver on procedures to undertake pending his arrival. On the doctor’s visit, the history of records taken during his time of absence can be accessed by him for proper prescriptions for the patient which is equally stored in the database. Also if there is a new patient, the record is sent automatically to the doctor.

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Worldwide, people living in rural and remote areas struggle to access timely, quality specialty medical care. Residents of these areas often have access to substandard specialty healthcare, primarily because specialist physicians are more likely to be located in areas of concentrated population. There is also the challenge of having very few experts especially those managing chronic diseases even in the urban areas. Effective management of diseases especially chronic diseases can result in improved health outcomes and increased quality of life since more than 80% of primary care visits and two thirds of medical admissions into hospital emergency departments are related to chronic diseases. For example, controlling a parameter such as blood pressure in people with diabetes and hypertension has been shown to reduce mortality and incidence of severe and costly complications such as renal and cardiovascular disease. 

Health care systems are now changing due to the dynamic nature of technological and scientific medical practices. The health care providers are now swiftly adopting these technologies into their health care procedures. Because of innovations in computing and communication technologies, many elements of medical practice can be accomplished when the patient and health care provider are geographically separated. The separation can be as small as across a town, across a state or even across the world. 

Remote patient monitoring is relatively a new area of interest which enables medical professionals to monitor a patient remotely using various technological devices. It is primarily used for monitoring chronic diseases or specific diseases like heart diseases, diabetes mellitus, and hypertension e.t.c. These services can provide comparable health outcomes to traditional inpatient encounters, supply greater satisfaction to patients and is cost effective. Monitoring a patient at home or in a clinic without a resident expert using known device like blood pressure monitors, glucose meters e.t.c. and transferring the information to a caregiver is a fast growing emerging service.

In developing countries like South Africa, Primary Remote Diagnostic Consultation [1] not only monitors an already diagnosed chronic disease but has the promise to diagnosing and managing the disease a patient will typically visit a general practitioner for. Remote patient monitoring can also be applied in electrocardiography, radiology, to mention but a few.

The transfer of these medical data can be done through a variety of telecommunication technologies including ordinary telephone lines, ISDN, internet, intranets, satellites and mobile phones to mention but a few. This project has to do with the transfer of medical records taken remotely to a doctor via GSM wireless communication link. Specifically it makes use of the Short Messaging System (SMS) of the Global System for Mobile communication (GSM). The records are taken by a nurse and stored in the hospital database via a visual basic developed user-interface. Whenever the threshold for certain parameters set by the doctor is exceeded an SMS alert is sent to the doctor indicating an emergency to which the doctor sends back a reply giving directives to the caregiver on procedures to undertake pending his arrival. On the doctor’s visit, the history of records taken during his time of absence can be accessed by him for proper diagnosis and prescriptions for the patient which is equally stored in the database. Also if there is a new patient, the record is sent automatically to the doctor.

1.2 AIMS OF THE PROJECT

The major aim of this project is to make health care services available to isolated communities and remote regions like military bases, ships and the like. It is also aimed at reducing mortality rate especially in developing countries like Nigeria where the needed expertise is limited. The system should be able to significantly reduce the time taken in making health care accessible to them. The burden of inferior healthcare will be taken care of through this system. This system can be extended in its application to areas like fine-tuning the management and allocation of rural health care emergency services by transmitting images to key medical centres for long distance evaluation by appropriate medical specialists, permitting physicians doing clinical research to be linked together despite geographical separation, sharing patients’ records and diagnostic images. Generally speaking, this project is aimed at transmission of medical data for diagnosis or disease management and also health advice by telephone in emergency cases.

Finally since the cost of complete remote patient monitoring system which incorporates the sensors used for capturing biometric data is very high, this system goes a long way in making remote monitoring accessible to the common masses who cannot afford the cost of services rendered by those complete systems as they can take their readings manually.

1.3 JUSTIFICATION OF THE WORK

The system does not require any prior computer knowledge for the user to be able to implement it. The requirement is basic understanding of English language, it is user friendly. Taking of the medical measurements are easy procedures that can be easily undertaken by anyone after simple explanations.

Moreover in a nation like Nigeria where there are few experts especially those managing chronic diseases like diabetes, hypertension etc. this systems comes as a big relief to those in the regions where the experts are not located as they can still access the expertise of those experts. Recently there was a case of relocation of many doctors from a city in Nigeria because of frequent cases of kidnapping. The result of course was poor health care services to those in that locality. With a system like this, doctors can still offer healthcare services to their patients from a secure location. Also this work will help to sensitize the populace on the usefulness of remote patient monitoring using mobile phones which according to a study by Boston University School of Public Health [2] is yet to be embraced by the developing countries. This work can be further justified by the following advantages of using a mobile phone as a health care intervention.

•      Low start-up cost: - living in resource-poor environment is not a barrier to the use of wireless system for several cultural and economic reasons. The existence of a so-called “digital divide” along the socioeconomic gradient is less pronounced in mobile phones than in other communication technologies such as the internet. To make the system affordable to all especially those in the remote villages of Africa, the system was built independent of the instruments for measuring the needed parameters.

•      Functionally mobile phones are easier to use for people with lower level

of skills.

•      User friendly-SMS: Pricing polices may enhance certain mobile uses in particular use of short message system (SMS) text. Text message is less expensive than a phone call and can reach people whose phones are switched off. It is silent which means it can be sent and received in places where it may not be practical to have a conversation

•      Forms of payment: In developing countries a prepayment system is used, this involves buying cards which provide phone time from five minutes to an hour. Customers can use credit as they like over a period of week and so keep control over their spending and enjoy a very cheep service. Once the pre-paid outgoing call budget is exceeded, the user can still receive SMS and calls. Thus the doctor does not need to have credit in his phone to receive alerts and the system does not cost much to send an alert.

Finally, the rate of mortality in remote places due to lack of adequate monitoring by medical experts especially for chronic disease which is increasing at an alarming rate justifies the need for the system which is not limited by distance so far there is a telecommunication network available in that area. With this system doctors spends less time going to see patients and utilises more time treating them. It also means real time monitoring without high staff or capital cost.

1.4 SCOPE OF THE WORK

This system will be able to manually capture doctor-specified vital health data like heart rate, blood pressure, temperature, and plasma glucose level of a patient which is stored in the hospital database and can be transmitted to a doctor when a set threshold is exceeded for better management of diseases. +The system will monitor patients diagnosed with chronic or long-term illness such as diabetes or cardiovascular diseases and stable victims. It can acquire vital information about a patient who lives far away from a medical expert. It can alert medical staff if there is a change in patient’s status that is critical. 

The system will have a user interface to be developed using VB.net through which the nurse or caregiver feeds in the data to the system which is stored in the database. The database will include a medical data manager (MDM) that automatically checks patient’s new data against patient’s record and doctor’s comment. If there is a disturbing change in the patient’s vital signs, for example high blood pressure for a hypertensive patient, an alert is sent directly to the physician. This ensures rapid response by a doctor or medic to any problem that arises. The database stores all patients’ data. The workflow system controls overall system processes while the user interface dynamically format and presents the patient’s data.  The SMS alert is sent through a GSM modem connected to the computer.


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