Title of Invention

A SYSTEM FOR REAL TIME ONLINE PROCESSING OF BIOSIGNALS USING A TELEPHONE LINE

Abstract 1. A system for real time online processing of bio-signals and images using a telephone line to process human physiological conditions from a remote distant place using dual use echo cardiograph (ECG) equipment of ECG diagnostic and monitoring equipment situated at a remote end , connected to a central server through a telephone line such that images, Bio-signals transmitted from remote end. on real time online consultation being offered from the server side to the remote end with the server having a clinical data base for Past, Present. Personal, Family, Medical history sent from the remote end to enable the doctor to diagnose and advice the patient appropriately. 2. A system for real time online processing of bio-signals and images using a telephone line according to claim 1, wherein the system is adopted to receive input from electronic 12 lead ECG signals, EEG, Spirometry, Heart and ling sounds being the output from an electronic stethoscope, SP02, NIBP. Temperature, Respiration, IBP, Et C02, 2D Echo, Ultra sound, X-ray, CT, MRI, Angiogram, digital images of any organ or any part of the body, subject's to clinical data.
Full Text



BACKGROUND OF THE INVENTION:
Telemedicine is a term used to describe a type of medical service involving monitoring of a patient's condition by a healthcare worker located at a healthcare facility, which is remote with respect to the location of the patient. Telemedicine is capable of providing enormous benefits to society by bridging the gap between the availability of the medical service by competent medical personnel as well as the acute need for the medical service in rural and remote areas.
India with majority of the population living in rural and remote areas do not have proper access to medical facilities and interpretation of bio*signals acquired during medical processes by competent medical personnel. A timely intervention by medical personnel in the process could be very helpful in delivering appropriate medical care saving lives in many cases.
In the event of non-availability of competent medical services in the remote, rural and semi-urban areas, the needy are required to travel long distances, spend valuable time and money in getting access to proper medical services. The situation could assume very difficult propositions when there are medical emergencies, which need to be attended to immediately.
The current telemedicine models being employed in the country do not provide relief to the needy by analyzing and interpreting their bio-signals. Hence, the current technology platform is invented which takes into account the available telecommunication infrastructure in the country and readily available information technology products and medical devices for processing of bio-signals on-line and real time mode.
OBJECTS OF THE INVENTION:
In developing countries there are three basic barriers,
1. Lack of telecommunication infrastructure.
2. Funds.
3. Trained medical practitioners & paramedical staff.

This invention has resolved the barrier of telecommunication infrastructure by a breal through technology using an ordinary telephone that is commonly available in rural areas today for transmission between both the ends.
This invention has broken the barrier of the cost by supplying the hardware and software to all the nursing homes & small clinics with very low of capital cost on pay-per-use model, making every nursing home & small clinics eligible to upgrade its services.
It is, however, true that the human factor is the biggest barrier-lack of knowledge and skills in telemedicine, lack of familiarity or discomfort with technology, lack of acceptance in clinical practice style. This technology is so user-friendly that doctors and paramedical staff feel very comfortable after 2 days of training. Continuous contact with specialist doctors shall improve the style of clinical practice of primary care doctors.
The subject invention provides methods of Acquiring, transmitting, receiving, viewing, forwarding, Reporting, Storing and retrieving all types of Bio-signals (like 12 Lead ECG Signals, EEG, Spirometry, Heart and lung sounds being the output from an electronic stethoscope, SPO2, NIBP, Temperature, Respiration, IBP, Et C02 etc.,) along with present, past personal and family medical history of subjects and images either stationery (or) mobile using Phone line, (pulse/tone phone) Mobile Phones (GSM, GPRS,CDMA) ISDN, leased line, VSAT, world wide web. The bio-signals (12 Lead ECG Signals) are sent either automatically (or) as chosen by user to a central server (or) a stand-alone computer for interpretation, review of the subject's clinical conditions either locally (or) from remote site for automatic retrieval of the interpreted bio-signals, offered informal clinical advise by the Remote center in a printable format chosen by the user
This system is the efficient convergence of medical, computer and telecommunication technologies to bring the medical expertise to the patient, irrespective of the place, distance and the time.

Medical technology - deploys the system enabled dual purpose ECG recorder-cum-monitor that saves time during the first critical moments of an emergency as both the applications are performed by the same system using a software switch.
Computer technology - uses proprietary interactive technology enabling transmission of bio signals and data online in real time using low and ultra low bandwidth telecommunication technologies. This software is scalable and adaptable to all kinds of communication networks.
Telecommunication technology - this system is designed to use the existing low and ultra low bandwidth telecommunication technology i.e., ordinary phone line for transmitting the ECG, vita! signs, text and online chat in real time.
ADVANTAGES OF THE INVENTION:
We have already discussed the objects, which are beneficial to the human kind by using this technology, and there exists unmatched benefits especially to the nursing homes, small clinics and primary care doctors,
1. While using this technology by the medical staff, nursing homes and clinics they are empowered to treat the patients more appropriate.
2. While using this technology by the medical staff, nursing homes and clinics they are upgraded to an emergency care center and ability to offer specialists' services anytime, without large capital investment.
3. While using this technology by the medical staff, nursing homes and clinics they are decreased morality and morbidity through improved quality of care.
4. While using this technology by the medical staff, nursing homes and clinics they is interaction with the specialists leads to improved local standards of health care in the rural areas.
5. While using this technology by the medical staff, nursing homes and clinics the primary care doctor becomes the value-adding partner in the treatment chain and can retain and attract more number of patients.
6. While using this technology by the medical staff, nursing homes and clinics they is increased market share resulting in better earnings.

7. While using this technology by the medical staff, nursing homes and clinics they serve as an informal continuous medical education programme for medical and paramedical staff and as a health education medium for the patients.
8. While using this technology by the medical staff, nursing homes and clinics they are in the process of professional interaction involving the data capture and transfer there is an automatic up gradation of medical documentation into electronic format.
BRIEF SUMMARY OF THE INVENTION:
The present invention provides methods of acquiring, transmitting, receiving, viev\/ing, forwarding, reporting, storing and retrieving all types of bio-signals and images. These can be acquired and transmitted either in a stationery status or in a mobile status for further processing. The signals are acquired either on a Desktop computer, Laptop computer etc., and, they are either sent in their native form or compressed and transmitted either to a stand-alone device or a central server.
The bio-signals and vital signs are sent either through a plain telephone line, GSM Mobile, GPRS Mobile, ISDN, Leased Line, VSAT and using WWW.
The bio-signals and intages thus received at the cezntral server are processed and interpretation provided either locally or from a remote location by professional interpreters. The bio-signais and images can be transferred from a phone server to a web server and from web server onward for further processing.
The platform provides for scheduled, automated and user-required transmission and retrieval of bio-signals and images. The bio-signals and images retrieved have the interpreter's name and interpretation center's name embedded in the name in addition to the interpretation details.
The technology platform also provides for the interpreters to selectively and exclusively provide the interpretation service to specified remote locations. The

technology platform takes ino account multiple users transmitting and receiving the bio-signals simultaneously.
DESCRIPTION OF THE FIGURES:
Figure 1 shows the block diagram of a system for real time online processing of biosignals using a telephone line.
Figure 2 shows the various steps involved in the end-to-end process concerned with the usage of the present system.
Figure 3 shows a page in the software indicating history of the patient.
Figure 4 shows the ECG viewed using the system
Figure 5 shows the ECG received at the remote end.
Figure 6 shows the ECG reported by the server
Figure 7 shows the page seen at the server side sent by the remote end with details of the patient's ciinicai history.
Figure 8 shows the entire system configuration having server and various preferred devices.
Figure 9 shows the entire process of real time online processing of biosignals using a telephone line.
Figure 10 shows the system software for biosignals transmission and reception.
Figure 11 shows the biosingal file being uploaded for transmission.
Figure 12 shows the biosignal file being downloaded after review and reporting at the server.

Figure 13 shows the clinically significant events being marked on the biosignal file received at the server for interpretation.
DESCRIPTION OF THE INVENTION:
Figure (1) illustrates the biosignal devices (1) connected to various remote centers (2), which in turn communicate through the communication network (3) like PSTN, GSM Mobiles, GPRS Mobile, CDMA Mobiles, Leased Line, ISDN, VSAT, Wireless and TCP/IP (www) with a central server (5) which are accessed by interpreters (22) to provide ECG interpretation services.
Figure (2) illustrates in detail the various steps involved in the end-to-end process concerned with the usage of the present invention from connection to the present upto the review by the consulting doctor.
The patient at a remote end which is the local end is connected using the medical device (1) and the medical device stats acquiring the ECG data and sends to the computer using serial port or USB port (2). Usually. Resting ECG is obtained followed by online ECG for monitoring. The details for electronic case sheet, emergency patient info (3) are entered in the system. The telemedicine software system takes over for transmitting the data (4). The data transmission is done using plain telephone line (POTS), ISDN, IP etc., (5), The data is received online, real tie at the monitoring end through the telecommunication medium (6).
The received data along with the clinical signs is reviewed b the specialist doctors at the monitoring end (7) and the specialist doctor conducts the review of the patient condition.
Figure (3) illustrates the Patient's Clinical History filled in with details of Age, Sex, Height, Weight, Vital signs data, presenting complaints and treating doctor (6), Symptoms (7), Past History ('3), Family History (9), Medication History (10), Personal History (11) and Clinical Examination (12).

Figure (4) illustrates the ECG viewed at the acquiring end giving the details of the hospital (13) at which the ECG is acquired, Patient's details (14), acquired ECG details (15), the ECG equired (16).
Figure (5) illustrates the ECG received from the Remote End when viewed on the server side by interpreting Consultant, giving the details of the Hospital (13) at which the ECG is acquired, Patient's details & Acquired ECG Details (14 & 15), the ECG acquired (16), the interpretation and informal ciinical advise box (17).
Figure (6) illustrates the details of the ECG reported by the server and received back at the acquiring end giving the details of acquiring hospital's name (1), the details of the ECG (14 & 15), Reporting hospital's monogram (18), the interpretation details as given by the interpreter (19), Name, signature of the reporting doctor with the date (20).
Figure (7) illustrates the details of the Patient's clinical history with the details having been sent by the acquiring end (21) as seen at the server side by the interpreting doctor.
Figure (8) illustrates the way the biosignals, images, data is received at the server (5) side through various modes of communication network (3), world wide web (TCP/IP) (4), and accessed by local interpreters (22) on the server side through LAN (23) and by remote interpreters (24) through various modes of communication network.
Figure (9) illustrates the flow chart (a to g) for End-to-End biosignal acquisition, transmission and reporting system with specific reference to ECG.
Figure (10) illustrates the telemedicine software for biosignal transmission and reception, in this case a 12-lead resting ECG with details of the software like schedule (25) for scheduling the transmission and reception timing, time intervals; connect (26) for automatic connection for transmission and reception or as and when desired connection and reception; options (27) tor phone and web server connectivity; the biosignal file details (28) like filename, urgency, upload and reported status, date and time of processing of file; the viewer (29) for viewing files before and

after interpretation; cover note (30) for giving further details on the biosignal file to be processed; ignore (31) when to details need to be included; File processing status (32) as urgent or normal with the visual upload and down load status given by (33).
Figure (11) illustrates the biosignal file being upload (34) for transmission.
Figure (12) illustrates the biosignal file being downloaded (35) after review and reporting at the server
Figure (13) illustrates the clnically significant events being marked on the biosignal file (in this case an ECG file) received at the server for interpretation, through event marking (36) feature through a time span-scrolling feature (37).
The present system shall empower the primary care doctors in rural and sub-urban nursing homes to overcome the constraints of place, time and availability of expert doctors, thus saving many lives through timely and appropriate care.
The present system moves the expertise to a patient through the local doctor to offer services in emergency care ECG reporting and consultations.
Remote emergency care through real time online emergency care specialists services are available whenever any patient visits the place of the connectivity of this system at a remote end during emergency, the cardio web is connected to the patient for obtaining either a resting ECG or for cardiac monitoring. The ECG signals acquired for monitoring is sent using phone line to central monitoring server for viewing by specialists doctors. The interactive software enables transmission of electronic case sheet, charting, online text chat between the nursing home and specialists. Periodic tele and video consulting sessions are conducted to review the progress and advice the primary care doctor on diagnosis and treatment.
Remote diagnosis & advice services are available when reporting of 12 channel rest ECG (ECG on phone) and advising primary care doctor based on data (symptoms, personal, past and family history, vital signs & medication details) provided to the specialist, to handle the cases more effectively.

Remote consultation services are through the software with extensive knowledge base guides the primary care doctor to gather medical history of the patient prior to the consultation with speciaiists. The output along with data of clinical examination by the primary care doctor is transmitted to the specialist, who upon review, shall have tele and or video interaction with the patient and doctor & empower the primary care doctor on the diagnosis and further treatment.
The present invention provides methods of acquiring, transmitting, receiving, viewing, forwarding, reporting, storing and retrieving all types of bio-signals and images. These can be acquired and transmitted either in a stationery status or in a mobile status for further processing The signals are acquired either on a Desktop computer, Laptop computer etc., and, they are either sent in their native form or compressed and transmitted either to a stand-alone device or a central server.
The bio-signals and vital signs are sent either through a plain telephone line, GSM Mobile, GPRS Mobile, ISDN, Leased Line, VSAT and using WWW.
The bio-signals and images thus received at the cezntral server are processed and interpretation provided either locally or from a remote location by professional interpreters. The bio-signals and images can be transferred from a phone server to a web server and from web server onward for further processing.
The platform provides for scheduled, automated and user-required transmission and retrieval of bio-signals and images. The bio-signals and images retrieved have the interpreter's name and interpretation center's name embedded in the name in addition to the interpretation details.
The technology platform also provides for the interpreters to selectively and exclusively provide the interpretation service to specified remote locations. The technology platform takes into account multiple users transmitting and receiving the bio-signals simultaneously.


We Claim,
1. A system for real time online processing of bio-signals and images using a telephone line to process human physiological conditions from a remote distant place using dual use echo cardiograph (ECG) equipment of ECG diagnostic and monitoring equipment situated at a remote end , connected to a central server through a telephone line such that images, Bio-signals transmitted from remote end. on real time online consultation being offered from the server side to the remote end with the server having a clinical data base for Past, Present. Personal, Family, Medical history sent from the remote end to enable the doctor to diagnose and advice the patient appropriately.
2. A system for real time online processing of bio-signals and images using a telephone line according to claim 1, wherein the system is adopted to receive input from electronic 12 lead ECG signals, EEG, Spirometry, Heart and ling sounds being the output from an electronic stethoscope, SP02, NIBP. Temperature, Respiration, IBP, Et C02, 2D Echo, Ultra sound, X-ray, CT, MRI, Angiogram, digital images of any organ or any part of the body, subject's to clinical data.
3. A system for real time online processing of bio-signals and images using a telephone line according to claim 1, wherein the input signal is acquired, transmitted, stored and forwarded for a specified & predetermined duration and inputted to the system.
4. A system for real time online processing of bio-signals and images using a telephone line according to claim 1, wherein the means for analyzing the

bio- signals and images is provided in time schedule fashion, time duration fashion either automatically or manually during the transmission process.
5. A system for real time online processing of bio-signals and images using a telephone line according to claim 1. wherein the transmitted bio-signals and images either in native format, or compressed format or further treated format, subject's clinical data automatically or chosen by the user from a remote site either in stationery mode or while mobile for interpretation.
6. A system for real time online processing of bio-signals and images using a telephone line according to claim 1, wherein the means for interaction between phone server for reception, transmission of bio-signals, images and clinical data being provided.
7. A system for real time online processing of bio-signais and images using a telephone line according to claim 1, wherein the means for forwarding the bio-signals, images and clinical data received to independent interpreters for review and interpretation is provided.
8. A system for real time online processing of bio-signals and images using a telephone line according to claim 1, wherein the means for access to the received bio-signals, images and clinical data to predetermined interpreters, forwarded for second opinion, receive second opinion is provided.
9. A system for real time online processing of bio-signals and images using a telephone line according to claim 1, wherein the means for remote logging

into the phone server for review of the bio-signals, images and clinical data and offer interpretation and clinical advise is being provided.
10. A system for real time online processing of bio-signals and images using a telephone line according to claim 1, wherein the means for review and analyse the bio-signals (12 lead resting ECG) received on individual lead basis, review the measurements, compare the individual leads against the previously obtained ECG for the same subject, review the 12 lead ECG across the time spectrum of acquisition for making events of clinical significance, enabling the marked event to be recorded and finalized as the printable form for the ECG received is being provided.
11. A system for real time online processing of bio-signals and images using a telephone line according to claim 1, wherein the means for providing for interpreted bio-signals, images and data being retrieved automatically or chosen by the user for reviewing, printing as per user chosen report format is being provided.
12. A system for real time online processing of bio-signals and images using a telephone line according to claim 1, wherein the means for receiving the specific clinically significant events marked at the server side in the bio-signal acquired and received is being provided.
13. A system for real time online processing of bio-signals and images using a telephone line according to claim 1, wherein the means for exchange any specific files of significance among multiple users is being provided.
14. A system for real time online processing of bio-signals and images using a telephone line according to claim 1, wherein the means for selectively of

generally assign users of specified interpreters through a private exchange Is being provided,
15. A system for real time onUne processing of bio-signals and images using a telephone line according to claim 1, wherein the means for receiving electronic records and offer text based consultation and foliow-up mechanism is being provided.
16. A system for real time online processing of bio-signals and images using a telephone line according to claim 1, wherein the means for obtaining or alerts as chosen by the user or interpreters is being provided.
17. A system for real time online processing of bio-signals and images using a telephone line according to claim 1, wherein the means for offering informal clinical advise based in the bio-signals and images and images acquired and received along with the patients clinical data is being provided.
18. A system for real time online processing of bio-signals and images using a telephone line according to claim 1. wherein the means for acquiring and transmitting bio-signals and images from PC based or stand - alone equipment is being provided.
19. A system for real time online processing of bio-signals and images using a telephone line according to claim 1, wherein the means for receiving, viewing the bio-signals and images using a viewer and print exactly what is viewed and or altered versions is being provided.

20. A system for real time online processing of bio-signals and images using a telephone line according to claim 1, wherein the means to set the alarm levels for various bio-signals at the acquiring end and also at the receiving end is being provided.
21. A system for real time online processing of bio-signals and images using a telephone line according to claim 1, wherein the means for entering data in the patients admission sheet while the monitoring of bio-signals is taking place is being provided.
22. A system for real time online processing of bio-signals and images using a telephone line according to claim 1, wherein the means for transmission of the 12 lead resting ECG taken while the monitoring is taking place is being provided.
23. A system for real time online processing of bio-signals and images using a telephone line according to claim 1, wherein the means for enabling to enter at the acquiring end the patients electronic case sheet details like vital signs data, and at both acquiring and monitoring ends the on-line electronic case sheet details like diagnostic tests record, treatment record, vital signs chart, ventilators chart, intake or out put chart is being provided.
24. A system for real time online processing of bio-signals and images using a telephone line according to claim 1, wherein the means for acquisition of 12 lead resting ECG as per the time duration specified by the central monitoring end is being provided.
25. A system for real time online processing of bio-signals and images using a telephone line according to claim 1, wherein the means for event analysis

and storage, tends analysis and storage, clinical significant event identification and storage for retrieval and transmission in store and forward fashion is being provided.
26. A system for real time online processing of bio-signals and images using a telephone line according to claim 1, wherein the means for receiving and storing bio-signals and electronic case sheejt on phone server or web server.
27. A system for real time online processing of bio-signals and images using a telephone line according to claim 1, wherein the means for retrieving and analyzing the bio-signals and electronic case sheets stored is being provided.
28. A system for real time online processing of bio-signals and images using a telephone line according to claim 1, wherein the means for storing and transmitting images of 2D echo, ultra sound, x-ray, CT. MRI, angiogram, digital images of any organ or any part of the body in native or altered form is being provided.
29. A system for real time online processing of bio-signals and images using a telephone line according to claim 1, wherein the means interactively chat between the remote monitoring site and remote acquiring site is being provided.
30. A system for real time online processing of bio-signats and images using a telephone line according to claim 1, wherein the means for sharing files is being provided.

31.A system for real time online processing of bio-signals and images using a telephone line according to claim 1, wherein the means for acquiring and transmitting bio-signals, images and data either in stationery or mobile status utilizing various computing devices like desktops, laptops, palmtops and PDAs is being provided.
32. A system for real time online processing of bio-signals and images using a telephone line according to claim 1, wherein the data is transmitted using a tone telephone, pulse telephone, GSM, GPRS, CDMA Mobiles phones, ISDN, Leased lines & VSAT systems, wireless communications networks for reporting by specialists.


Documents:

0947-mas-2002 claims.pdf

0947-mas-2002 correspondence-others.pdf

0947-mas-2002 correspondence-po.pdf

0947-mas-2002 description (complete).pdf

0947-mas-2002 description (provisional).pdf

0947-mas-2002 drawings.pdf

0947-mas-2002 form-1.pdf

0947-mas-2002 form-13.pdf

0947-mas-2002 form-19.pdf

0947-mas-2002 form-26.pdf

0947-mas-2002 form-3.pdf

0947-mas-2002 form-6.pdf


Patent Number 194052
Indian Patent Application Number 947/MAS/2002
PG Journal Number 35/2005
Publication Date 16-Sep-2005
Grant Date 26-Jul-2005
Date of Filing 17-Dec-2002
Name of Patentee M/S. GLOBAL HEALNET PRIVATE LIMITED
Applicant Address 3-6-287 HYDERGUDA, HYDERABAD 500 029
Inventors:
# Inventor's Name Inventor's Address
1 DR. C. DAYAKAR REDDY 3-6-287, HYDERGUDA, HYDERABAD -500029
PCT International Classification Number N/A
PCT International Application Number N/A
PCT International Filing date
PCT Conventions:
# PCT Application Number Date of Convention Priority Country
1 NA