Telemedicine Slips Into A T-Shirt

Oct. 1, 2003
Right now, society is witnessing wireless technology's transformation of the medical field. As the primary vehicle of this change, most people can easily imagine a small, intricate device like a pacemaker. No one imagines a T-shirt. Yet the first...

Right now, society is witnessing wireless technology's transformation of the medical field. As the primary vehicle of this change, most people can easily imagine a small, intricate device like a pacemaker. No one imagines a T-shirt. Yet the first "nomadic" medical T-shirt has been born. Known as V-TAM, it was spawned by four laboratories and an equal number of manufacturers in France. By pooling their skills, they created a T-shirt that's arrayed with small physiological and medical measurement sensors. It's then linked via the GSM mobile communications network to a specialized monitoring center.

The idea of merging sensors with a textile framework was spawned by TAM-Télésanté (www.tamtelesante.com). It successfully incorporated electronic components to link the T-shirt with the outside world. Heart rate, respiratory rhythm, and cutaneous temperature are all recorded. Via the GSM network, an electronic device then transmits the data to the doctor on duty in the specialized monitoring center.

If that doctor wants to communicate with the patient, he or she can do so through a microphone-loudspeaker that's incorporated into the garment. If necessary, an ambulance can be quickly dispatched to the patient's location. The patient is easily found with the built-in Global Positioning System (GPS).

To complete this project, TAM-Télésanté faced many unusual issues. For instance, it was vital that the cotton T-shirt or undergarment retain its traditional functions. It had to absorb perspiration and provide comfort and ergonomic qualities. The company also wanted the garment to be dry-cleanable.

For this requirement, ITECH Enterprise (www.itech.fr)—the Textile and Chemical Institute of Lyons—made its weaving machines available. By adjusting and operating the machines, it put the final touches on the different parts of the garment. It also incorporated the conductive wires and the miniaturized electrodes that were developed by TAM-Télésanté.

Different companies supplied the sensors. The electrocardiograms came from MEDIAG (www.visiocor.com). RBI (www.rbi-instrumentation.com) supplied the system that processes the signals and records the movements of the rib cage and thus the breathing rate. INSA (www.insa-lyon.fr) of Lyons contributed the cutaneous-temperature sensor. For the fall-detecting sensor, the project relied on the Imaging, Modeling, and Cognition Techniques Laboratory (www-timc.imag.fr) of the Informatics and Applied Mathematics Institute at the Grenoble Faculty of Medicine. This sensor guarantees the remote monitoring of patients in a non-invasive and non-intrusive manner.

All of these sensors need a data-transmission and visualization system, which was developed by INSERM's Paris-based SPIM Laboratory (www.spim.jussieu.fr). That laboratory finalized the entire transmission chain—from sensor to command box—right down to the screen on which the doctor views the information (see figure).

Finally, MEDES (www.medes.fr) took responsibility for the clinical evaluation of the garment. It carried out all of the necessary tests based on a representative example. MEDES also developed the portable telemedicine station, which was designed to improve the handling of patients in isolated locations (ships, aeroplanes, areas that are sparsely populated, etc.).

TAM-Télésanté expects the product to be manufactured and made available in 2004.The V-TAM T-shirt is particularly aimed at older people. Using it, they could regain their independence or continue living at home with the security of permanent medical assistance. The people who will benefit the most from this T-shirt are patients with an unstable cardiovascular pathology following real or suspicious episodes; persons presenting symptoms of temporal-spatial disorientation, such as those suffering from Alzheimer's; and even competitive athletes whose heart rate is being monitored. Professionals in high-risk industries, such as fire protection or the military, also could benefit from its use.

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