Image acquisition technology enables remote monitoring

To what extent can remote access devices be used in the medical field? It is not surprising that people are very interested in this. Remote guidance, remote diagnosis and remote surgery are just some of the many applications that can be realized using remote medical monitoring devices that transmit video over Ethernet. Such devices allow doctors to view and analyze patient information regardless of their location.

Remote technology is often an integral part of medical diagnosis and treatment, helping doctors bring high-quality, ongoing medical care closer to patients. Remote devices used in the medical field successfully integrate multiple settings and scenarios, meeting the needs of ease of use and convenience. Remote diagnosis is one of the main areas where remote monitoring devices are widely used. Image acquisition technology is a core component that drives telemedicine, and this article will review image acquisition technology.

Learn more about remote diagnostics

Figure 1. Connection diagram showing how to connect a frame grabber to a piece of medical equipment with a VGA or DVI output port.

People can now diagnose specific diseases and difficult symptoms remotely.

In the past, patients had direct contact with doctors who ran clinics. However, with remote monitoring medical devices, patients and doctors can live far away from each other. Although some systems use wired connections, most systems work wirelessly. Of course, patients need to be properly trained so that they can perform the necessary operations themselves. Thus, the consulting physician can get accurate and clear feedback in real time. Ideally, for remote interaction, both pictures and video streams are required.

Devices that capture video and images from source outputs - Frame grabbers provide video. The captured video content can be recorded to a computer and then transmitted over the Internet. Depending on the model of the frame grabber, data can be acquired from the source output of any medical diagnostic device. Capturing high-resolution images or videos ensures that remote diagnostic experts can obtain high-quality images that can be used for diagnostic analysis.

For example, VGA2Ethernet captures single-link DVI or VGA signals at up to 120 frames per second. Its maximum resolution is 1900 × 1200 and transmits the video content losslessly over Ethernet. It has a regular RJ45 Ethernet port for connecting to the target computer, supporting transfer rates up to 1Gb.

The exact number of frames per second that can be achieved with this method depends on the resolution of the screen, the screen refresh rate and the change in pixels of the screen content, the operating system running on the computer, and the speed at which the computer can capture images. Generally, it is slower to transmit an uncompressed frame than to transmit a compressed frame. The latest technology can capture and transmit raw VGA frames in RGB format. This provides better picture quality than VGA-to-video converters with composite or S-video capture cards.

It is possible to connect two or more frame grabbers to capture multiple signals simultaneously. However, if multiple frame grabbers are used, the frame rate (the number of frames or images shown or displayed per second) of each frame grabber will be different. The frame rate that can be achieved depends on the performance of the computer. Frame compression does not reduce the quality of the output image. Some frame grabbers can be used through an Ethernet switch. This allows the LAN and the frame grabber to be connected through a single Ethernet interface.

By using switches, the Ethernet cable can be extended and the distance between the frame grabber and the diagnostic device can be greater. These features allow the user to send data from the diagnostic device without any loss. The VGA content is digitized. The acquired VGA or DVI signal is transmitted via Ethernet. A stereo audio input for sound acquisition is essential, for example, for (remote) auscultation.

Telemedicine: Real-world use cases

VGA2Ethernet can capture single-link DVI or VGA signals at 120 frames per second.

Frame grabbers are very useful in emergency situations or in complex geographic environments. For example, in 2008, Henry Ford Hospital used frame grabbers to capture images of the Canadian Mount Everest rescue expedition. The images were captured using GE's LOGIQ book-type portable ultrasound device and then transmitted to doctors at the expedition base in real time via satellite. Remote monitoring equipment can not only perform remote diagnosis, but also remotely guide a trained operator.

Remote guidance

Remote evaluation is acceptable for examinations or surgeries. In some cases, timely professional consultation from a remote expert is essential. Various injuries, such as knee or shoulder injuries, bone fractures, bleeding, muscle atrophy, etc. can be evaluated remotely by experts.

Remote guidance allows a minimally trained operator to collaborate with highly skilled medical specialists. This type of remote guidance application benefits emergency responders and battlefield medics. Using a frame grabber to capture images and then sending them to the Internet allows specialists to quickly assess the extent of a patient's injuries and decide whether to transport the patient to a hospital or provide care on the spot.

NASA researchers have optimized the method to allow non-medical operators to obtain ultrasound images, including images of musculoskeletal injuries. The transmission device collects video from the source output (any diagnostic device with a signal output or a common digital camera), dynamically compresses it, and transmits it via the Internet.

Figure 2. Diagram showing how a VGA printer can be connected to a medical device and how it can be used.

During the Turin Winter Olympics, Henry Ford Health System Hospital Department of Surgery used frame grabbers to allow the Olympia team to connect with doctors at the center and transmit real-time, high-definition images of treatment procedures taking place on site to remote doctors via video streaming.

Remote patient monitoring. As telemedicine systems become more reliable and integrated, they can meet the needs of the elderly in an increasingly effective way. Most of these systems are aimed at elderly patients with chronic diseases (diabetes, hypertension, congestive heart failure, etc.) who are unable to go to traditional medical treatment points for treatment. The range of technologies used to improve the autonomy of the elderly and assist in the medical care of chronic diseases is wide, including remote monitoring, telemedicine, and medical services enabled by other technologies.

Remote patient monitoring uses a variety of technologies. These technologies are designed to manage and monitor a range of health conditions. Point-of-care monitoring devices may become part of a comprehensive, integrated health data collection, analysis and reporting system that communicates between multiple nodes in the health system. These devices will sound an alarm when a patient's health condition deteriorates.

Remote patient monitoring technology provides effective support for doctors to comprehensively consider nursing cooperation, behavioral changes, and make evidence-based diagnostic decisions. There are remote patient monitoring functions for patients, caregivers, and hospitals. An ideal remote patient monitoring system will fully consider the needs of these three parties. The collected information includes vital signs (blood sugar, blood pressure, weight, pulse oximetry, etc.), as well as assessments of the patient's emotional and physical condition.

Remote monitoring devices collect this data and transmit it via low-bandwidth phone lines, the Internet, or a local or wide area network. The collected patient information is used in the patient's treatment. This strengthens communication between patients, caregivers, and hospitals, improves nursing coordination and care support, and improves patient medication compliance (taking medication as prescribed). This program reduces the need for patients to be hospitalized and go to the hospital for treatment. Compared with telephone surveys conducted by nurses, this program provides another lower-cost option.

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The success of remote device monitoring depends on human communication. This new technology combines existing self-management principles. Remote patient monitoring is growing rapidly because it brings convenience and simplifies the requirements for both healthcare providers and patients. In the future, it is expected that remote patient monitoring devices will expand in scope and functionality. The widespread use of common broadband technology and wired networks in homes, hospitals and other care facilities has driven the development of remote patient monitoring applications.

As broadband technology becomes more prevalent, the skills of healthcare providers (hospitals) are tested not only by the quality of doctor-patient interactions, but also by technology access and proficiency. Healthcare organizations face new challenges in preparing adequate personnel. Given its huge potential, remote patient monitoring applications continue to grow rapidly and play an important role in the future of medical care and treatment.

Cardiac monitoring devices. Cardiac monitoring systems are used in medical professions where remote monitoring devices are particularly important. Remote cardiac monitoring systems can improve the quality of life of patients and avoid hospitalization. These remote systems provide non-invasive assessment of cardiac function and are not subject to any vibrations or sudden shocks in the case of ambulance rescue operations.

The role of image acquisition cards in telemedicine

The underlying technology of these remote diagnostic systems includes frame grabbers, which capture images and video content from diagnostic equipment and send them out over Ethernet.

For example, a frame grabber can acquire signals from any VGA source, including personal computers, medical devices, embedded systems, or scientific research equipment. It supports multiple VGA modes, with resolutions up to 2048 × 1536 and a maximum sampling rate of 2.3 million pixels/second.

A dual-mode frame grabber is used to capture and transmit high-quality images for diagnosis from a VGA or DVI source output. The maximum frame rate supported by the dual-mode frame grabber is 32 fps at a resolution of 1920 × 1200, which can be used for remote diagnosis. All of these frame grabbers can capture and transmit high-quality images that can be used by doctors for diagnosis.

Evolving technology allows for the acquisition of images from a variety of medical devices. For example, the MAC 1600 electrocardiograph from GE Healthcare is a modern system that includes configuration modes such as resting ECG, heart rhythm, and arrhythmia. Its 7-inch WVGA color display allows for VGA output.

To obtain ECG recordings or stress test results and send them over Ethernet, the VGA IN port of the frame grabber is connected to the VGA port of the electrocardiograph via a VGA cable. The frame grabber is then connected to the network, through which the images can be recorded to a video acquisition workstation. When the images are captured and recorded normally, they can be received remotely and used for diagnosis.

Remote diagnostic imaging. Diagnostic image capture is critical to healthcare at all levels of care. The ability to obtain MRI, X-ray, thermal, and acoustic images directly from the diagnostic device’s VGA output and send them for printing will improve the efficiency of diagnostic investigations. In both therapeutic and preventive medicine, effective decision making depends on the correct diagnosis. In remote diagnostic situations, imaging is paramount to properly assess and diagnose the condition. Digital printing systems are generally not optimal because they resample the video signal based on their internal algorithms. Resampling results in a loss of contrast and resolution, and the image may be corrupted by aliasing. It is critical to ensure that the system can deliver lossless images to a standard printer.

VGA printers are designed primarily for PostScript compatible printers. VGA printers can be connected to any model of medical equipment equipped with a VGA output port (ultrasound machines, X-ray machines, PET scanners, etc.). VGA printers are able to print VGA content, whether it is a video or a series of snapshots provided by the system. Such systems acquire VGA images and can print them to a standard or network printer.

The DRE FS-32P is a digital ultrasound diagnostic imaging system from DRE. The system uses advanced beamforming technology (for more details on beamforming technology, see the article on page 34). It has a 10.2-inch display that provides the best ultrasound images for applications such as obstetrics, gynecology, and urology. The VGA IN port of a VGA printer is connected to the VGA output of the DRE FS-32P. After connecting the printer to the VGA Ethernet, the acquired images can be printed anywhere they are connected. The acquired images can be viewed on a widescreen monitor that is connected (usually via a VGA interface) to the VGA printer.

Frame grabbers: medical applications

The medical center makes extensive use of the frame grabber's ability to acquire VGA and DVI signals and transmit them to target computers.

For example, the Institute for Surgical Innovation (Cleveland, Ohio, USA) uses frame grabbers to provide educational presentations and webinars to students and physicians. Lecturers and experts capture live lectures, videos, and computer output and stream the videos to the Internet for interested students and physicians to view. This allows the institute to offer webinars on a regular basis without using a third-party commercial vendor, which also means cost savings.

Maquet Gmbh & Co. also uses frame grabbers. The company, which develops medical products for use in operating rooms, uses frame grabbers to display the output of its ventilator products on a video screen. The output is then used for internal training demonstrations. These demonstrations eliminate the need for travel because the technology does not require employees to be in the same room as customers.

The National Surgical Center is a pioneer in the use of video streaming in the operating room. Frame grabber devices are used to transmit video from the surgical operating room to a remote personal laptop or handheld device. For example, video is acquired from a DVI signal source from a laparoscope camera. To ensure image quality, this data is first saved.

Medtronic products are among them and must be checked or adjusted regularly. These checks are performed using devices such as laptops that communicate with the implanted device. Training requires a lot of equipment and logistics support and must be led by an instructor. These challenges make training expensive, especially because the training must be practical and because the equipment can be damaged during travel, installation and removal. Devices such as laptops used to communicate with implanted products can also capture real-time information about the patient at the same time. It can simulate patient information with simulators, create realistic use scenarios, run them, obtain information in real time, and incorporate it into software demonstrations or branched learning applications.

Obstetricians and gynecologists often need to examine detailed images of the fetus. The frame grabbers they use can transfer the highest quality fetal images from the ultrasound machine to the computer for the specialist to examine. The frame grabber allows the gynecologist to obtain high-definition video images and store the captured images on the computer so that they can be viewed at the highest resolution.

A company that develops products and services for the radiation oncology services (also known as radiotherapy) market uses frame grabbers to provide read-only support for radiation therapy machines. Remote support techniques that require the installation of third-party software are available. They are not as attractive as standalone frame grabbers, but do not require any installation or download to the treatment machine.

in conclusion

Remote guidance, remote diagnosis, and remote surgery are just some of the applications for remote medical equipment monitoring that transmits video over Ethernet. Devices that acquire video and images from source outputs may be using frame grabbers. Video content can be recorded on a computer and transmitted over the Internet. Depending on the type of frame grabber, the acquired data can be used to enhance and improve medical diagnosis, etc.