Electronic Design

Imaging, Telemedicine Help Physicians Save Lives

The days of the simple country doctor are over. Physicians have an arsenal of high-tech tools at their disposal, diagnosing ailments long before they become dangerous—even from miles away.

Thanks to improvements in processing, medical imaging saw some significant advances this year. For example, students at the University of Calgary developed the most complete 4D (3D over time) model of a human being yet (see the figure).

Dubbed CAVEman, the object-oriented hologram can provide a view of up to 3000 distinct body parts that can be manipulated with a joystick. This technology will enable physicians to plan more accurately for complex surgeries. It also will allow patients to view a map of their body before surgery, giving them more insight about the procedure and calming any fears they may have.

Physicians access the CAVEman via the CAVE, or “research holodeck.” In this cube-shaped virtual-reality room, projections from three walls and the floor build the 4D human model to create the perception of a selected set of body parts floating in space within the holographic human.

Students based the 4D human atlas on material from basic anatomy textbooks. Then graphic artists rendered these body systems and organs in 3D. These images were converted into Java objects to be brought to life in the CAVE environment. For more about medical imaging, see “Architecting New Dimensions Of Medical Imaging” at www.electronicdesign.com, ED Online 15795.

Even just a few years ago, robotic doctors seemed decades away. But many physicians now use a remotely controlled robot with a built-in video-conference system to provide medical care. The RP-7 from InTouch Health provides a “remote presence” that allows physicians to interact with patients regardless of their physical location.

Such developments could revolutionize the way diagnostics are delivered, especially when specialists are required. Even rare diseases could be diagnosed and possibly treated remotely, perhaps using experts to provide instructions to local physicians who may not be able to accurately diagnose and effectively treat the problem on their own.

The RP-7 has two fundamental pieces: a control station and a robot. The remote physician controls the robot with a joystick attached to a laptop. The physician and patient can see each other in real time thanks to video cameras with 5X optical zoom and 24-bit color, 320- by 240-pixel resolution at 30 frames per second.

The physician has a headset, and the robot is equipped with speakers. The robot also comes with a digital stethoscope for remote patient vitals, a privacy handset for doctor/nurse interaction, and a printer. And thanks to the system’s “many to many” system architecture, physicians at any control station can connect to any RP-7 robot anywhere.

Millions of Americans have been diagnosed with congestive heart failure (CHF), a condition where the heart doesn’t send the proper electrical signals to beat in a normal rhythm and thus doesn’t supply the body with enough blood to function. Yet four key technologies from Boston Scientific work together to manage CHF with great success.

First, the Contak Renewal 3RF cardiac resynchronization therapy defibrillator (CRT-D) is implanted in the patient’s pectoral region with gold contacts placed in three of the heart’s four chambers. It primarily functions as a pacemaker, but it also can stop and restart a heart using a 41-joule burst of energy when the pulse is too high or low. Additionally, it includes RF communication capabilities via the industrial, scientific, and medical (ISM) band in the 902- to 928-MHz range.

Second, the CRT-D works with the Internet-connected Latitude Communicator. This device sits under the patient’s bed and continuously monitors and awaits data from the CRT-D at times specified by the physician during the CRT-D’s original programming. (The CRT-D is normally programmed when it is implanted.)

Third, a Bluetooth-enabled scale and a sphygmomanometer monitor the patient’s weight and blood pressure daily. Subsequent to each reading, the data is transmitted to the Latitude device. When the system finds a pulse, weight, or blood pressure anomaly, it lets the patient know.

Finally, the Latitude device takes the information it collects and sends it via modem to a secure server accessible through the Latitude Web site every day. The combined technologies keep physicians informed, giving doctors the data they need to more quickly react to anomalies that may indicate an impending crisis—and possibly save lives.

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