"Smart Healthcare": A Brief Analysis of the Three Core Technologies of Smart Experience

In early 2009, an organization called "IBM Healthcare Industry Solutions Lab" was established, which brought us an attractive word - smart healthcare. Smart healthcare involves the latest and hottest technology fields such as unified communications, video, wireless networks, sensor technology and RFID, thus creating an information platform that integrates various applications and provides patients with an unprecedented smart experience.

Medical Neuron

The core of smart healthcare is the transmission and sharing of patient information, including the transmission of this information between different departments of the hospital, between hospitals, and even between hospitals and communities, medical insurance, government departments, etc. This has made a concept called Wireless Sensor Networks (WSNs) a hot topic in the industry. The concept of WSNs originated from a research project in the Defense Advanced Research Projects Agency of the United States. This wireless sensor network combines the capabilities of sensing, computing, and network connection. Different sensors are deployed throughout the hospital to monitor and detect the real-time status of the surrounding environment and specific targets within its sensing range, and transmit this status information back to the main processing system through the wireless network. When the system manager receives this information, he can make appropriate treatments for changes in the patient's condition.

Medical wireless sensor networks require that sensor nodes distributed in hospitals, doctors, patients, and equipment have wireless communication capabilities. Currently, wireless sensor network technology mainly uses the ZigBee protocol. ZigBee is an emerging short-range, low-complexity, low-power, and low-cost wireless network technology, mainly used for short-range wireless connections. Through ZigBee, various devices can be easily online in real time. Its low data rate and small communication range determine that ZigBee technology is suitable for carrying services with small data traffic such as disease monitoring. ZigBee technology coordinates thousands of tiny sensors to achieve communication. These sensors require very little energy and transmit data from one sensor to another through radio waves in a relay manner, and their communication efficiency is very high. Compared with various existing wireless communication technologies, ZigBee technology will be the technology with the lowest power consumption and cost. The starting point of ZigBee is to realize an easy-to-implement low-cost wireless network. At the same time, its low power consumption performance can enable battery-powered products to maintain a working time of 6 months to several years. This is very important for hospital applications. It can ensure that thousands of sensors deployed throughout the hospital work stably for a long time without causing information loss and maintenance troubles due to power supply problems.

Image by the bed

Different from the traditional network construction requirements, the network foundation for realizing smart medical care is no longer bandwidth and transmission speed, but network mobility and flexibility. Therefore, wireless broadband will become a key carrier technology in the realization of smart medical care. The wireless mobile network that fully covers modern hospitals can ensure diversified applications anytime and anywhere. When an emergency occurs, experts do not need to look for computers to find information to help diagnose, but can search on the move at the time to ensure that there is no delay of one minute.

This wireless information recording and access technology at the bedside has even been applied to the processing of medical images in Shanghai Chest Hospital. The hospital mainly treats clinically critical patients, orthopedic traction patients and pediatric rescue patients. These patients often need to collect image data at the bedside, which puts very high demands on the mobility of the equipment and the wireless transmission of information. The Chest Hospital uses a new mobile CR system for real-time X-ray image collection at the patient's bedside. This is a mobile CR system that contains a single-board CR reader, an X-ray generator, a PC workstation (with a touch screen display) and a portable power supply. However, the mobile CR equipment still needs to save the digital images in its PC workstation. After the operator has checked all the scheduled patients, he returns to the radiology department and uploads all the image data to the PACS system at one time through a wired method. After that, the attending doctors of the relevant patients can review the image data. The result of this is that when there are many patients, the cycle of reviewing the image data is long. In addition, when encountering special emergency patients, the needs cannot be met.

Ye Jianding, Director of the Radiology Department of Shanghai Chest Hospital, said: "In response to this new demand, we proposed a solution to digitize bedside radiological images and connect them to PACS using wireless transmission. This is a new application pioneered by our hospital in China. Due to the particularity of mobile bedside photography and the standard requirements of image data transmission formats, the selected radiological equipment and wireless receiving and transmitting devices have relevant data interface and exchange requirements. The principle of selection is to have reliable safety and anti-interference capabilities while maintaining sensitive and high-speed transmission characteristics."

The smart wireless solution deployed by Shanghai Chest Hospital includes a Zojisi MX-200R smart wireless controller in the central computer room and 30 MP-422A wireless access points distributed in the nurse stations of 17 wards in the inpatient building. RingMaster is responsible for the planning, configuration, deployment, monitoring and optimization of the wireless network, and accurately controls all aspects of access management, including users, content, time, location, reason, and access method. To complete the client deployment, a wireless network card supporting 802.11a/b/g needs to be installed on the PC workstation equipped with the mobile CR device, so that the mobile CR system has wireless transmission capabilities.

Digital medical images contain a huge amount of data, which puts forward new requirements for the network throughput. According to Sun Kefen, director of the computer room, "Usually, the data file of a chest X-ray image is about 5MB. This is because clinicians have very high requirements for chest X-ray auxiliary diagnosis, and slight changes may affect the diagnosis results. In order to ensure that the inspectors can quickly upload the collected image data to the PACS system at each nurse station, we use a unique intelligent wireless architecture Smart Mobile, and the wireless access points used have sufficient data processing capabilities.

[page]

While executing encryption/decryption and policies, the AP also handles data forwarding. That is, the AP is responsible for forwarding this type of high-data-transmission-rate image data traffic to the switch, and then directly to the PACS, without the need for centralized forwarding through the WLAN controller, thereby improving the upload speed and the scalability of the overall wireless network. On the other hand, since the 2.4GHz electromagnetic wave interference of 802.11b/g is very serious, and the 5GHz frequency band of the 802.11a standard can not only effectively avoid interference, but also achieve the same data transmission rate as 802.11g, therefore, this wireless network deployment uses the 802.11a Wi-Fi standard to ensure high-speed and stable PACS access capabilities.

Optimizing medical experience

Another key to smart healthcare is to provide patients with a better medical experience. For example, in some special wards, patients are susceptible to external infections due to their serious illnesses. At the same time, the patients' own diseases are highly contagious and cannot have direct contact with the outside world. For example, patients in the intensive care unit (ICU) are all postoperative patients and critically ill patients with low resistance and prone to complications and serious infections. However, this type of patients often need the company and comfort of their family the most.

To solve this problem, future smart hospitals will implement remote visits through network video surveillance systems, which can not only protect patients from external infection or cross-infection, but also enable "face-to-face" communication between patients and their families.

The video encoders, cameras, microphones, speakers, and televisions in the special wards can collect and transmit the patient's condition, images, and sounds at any time. At the same time, a remote visiting room is set up outside the isolation area, equipped with video encoders, cameras, PCs, and headsets. These facilities are connected to the monitoring center management platform through the hospital LAN. Family members or friends can see the patient's condition in real time at the outdoor visiting point and communicate with the patient. The patient can also see the video of the family members outside. If the management platform is connected to the Internet, family members or friends can log in remotely through the PC even if they are at home or away. The combination of the video encoder and the relevant medical facilities in the ward can also provide more intelligent and more humane services. For example, when the patient is connected to the infusion alarm, the alarm linkage of the monitoring system will automatically alarm the nurse station when the infusion is completed. It is connected to blood pressure monitors, electrocardiographs, bedside monitors and other instruments to realize automatic alarms and superimposed display of data parameters and monitoring images. When abnormalities occur, the alarm will be promptly notified to the nurse station medical staff.

Overseas, video-based telemedicine applications have begun to be realized. According to statistics, more than 700,000 people in the United States suffer from stroke every year, and most of them become disabled as a result. An FDA-approved drug can help some patients prevent disability caused by stroke, but this drug must be taken within three hours after the stroke occurs. The earlier a stroke patient receives treatment, the greater the chance of recovery.

At Partners HealthCare, a Boston-based medical alliance group, video conferencing technology was integrated with the healthcare system for the first time. The video conferencing solution deployed by Partners HealthCare for its TV medical plan division allows users in various locations to communicate face-to-face in real time, and also supports a variety of presentation programs, such as PowerPoint, 35mm slides, and high-level projection. The organization has also deployed multi-location technology, which allows users in up to 32 different locations to conduct video conversations together. In addition, bridging technology enables Partners HealthCare to network freely inside and outside the company, and if necessary, it can also allow variable H.323 (IP) and H.320 (ISDN) protocols to participate in the same video conversation at different line speeds.

In the Partners video network, 30% is used for the management of the medical system; 10% is used to provide medical services in emergency situations or for inpatients and outpatients. Partners uses three specific video methods to provide medical services to patients, namely, the teledermatology application, medical consultations around the world, and the TeleStroke Center of Massachusetts General Hospital (MGH). For example, a hospital called Nantucket has fewer patients and cannot afford the cost of a physician or a regular fixed clinic. After using video conferencing technology, Nantucket can arrange a three-hour consultation time per week to provide medical services for sudden or necessary patients. "Video conferencing technology removes the barriers of time and distance, allowing us to provide the opinions of acute stroke experts from MGH to more patients in the United States and the world in real time. The key to the future development of the healthcare industry is to provide targeted treatment to patients within an effective time." A person related to the hospital said.

Partners HealthCare video network technology mainly includes the full line of VSX series products, which include Siren audio and StereoSurround technology to provide the best audio and video effects in the industry. The hospital also deployed VSX 3000 personal conference video systems and PVX desktop conferencing software applications to enable users to start desktop video, and for multi-location calls and IP and ISDN hybrid network calls, the hospital used Polycom MCG-50 bridging technology. PathNavigator advanced supervision program is used for network management and call routing. By using video conferencing technology to provide on-demand neurologist clinics, patients can obtain professional stroke medical services at any time, no matter where they are, and can quickly get their condition diagnosed and start treatment.