INTRODUCTION

Biomedical signals are usually extracted from living organisms and in most

applications from human beings. The measured signals are processed to establish the

condition of the subject. Such processing finds extensive use in patient monitoring

and management systems. Processing of biomedical signals are also done for

transmission purposes and efficient storage.

Telemedicine was primarily Teleradiology used for the transferring of high

resolution medical images, X- ray pictures, Ultrasound, CT, MRI pictures, Live

transmission of ECGs and Echo- cardiograms. Today, a detailed clinical examination

can be conducted remotely. A two way interactive communication occurs while a

remote examination is being carried out.

A basic Telemedicine system consists of a Personal Computer, a modem, a

telephone line, a scanner and a camera. Integrated Services Digital Network (ISDN)

services are traditionally being used for Telemedicine. A leased line or a VSAT link

can also be used. Actual choice would depend on cost, availability, reliability and

necessity. The telemedicine facilities are being expanded from big metropolitan cities

to even smaller cities. The increasing excellent telecommunications infrastructure,

video conferencing equipment will help provide a physician where there was none

before.
 These telemedicine facilities must also be brought to the reach of rural people

since there is a difficulty in retaining specialists in those areas. Also these facilities

must be affordable by the poor. This paper throws light on a cost competitive

alternative to telemedicine that utilises the normal telephone line and Dual Tone

Multy Frequency (DTMF) Tones.

Telemedicine transfers the expert to the patient. It avoids unnecessary transfer of

patients. Appropriate treatment was introduced before transfer. Transfer time is

shortened and adverse events during transfer of patients significantly reduced.

DESCRIPTION

Bio- medical signals from patient monitoring aids such as single channel ECG and

Electronic Stethascope are considered for transmission.

The signals are fed to an 8- bit Analog to Digital Converter ADC0816 with a

conversion period of 100 micro seconds. Taking all other delays into cosideration,

sampling of these signals is performed at a rate of 200 samples per seecond. i.,e. one

for every 5 milli seconds.

 The Analog to Digital Converter output which is in Hexa Decimal format is stored

in the memory. This is converted further into BCD. Thus both BCD and Hex formats

are available.

The Hex data is further fed to a CRT interface for viewing a monitor or to a Digital

to Analog converter (DAC) for observation on a Cathode Ray Oscilloscope (CRO).

The details of medical examination in the form of signals are made available with the

local Doctor or his associates.

The BCD data is further unpacked and fed to a DTMF Transmitter 8880. Two

tones are produced for every digit. For 0- 9 , different sets of frequencies are

produced. A digit is transmitted by sending the corresponding DTMF tone for 40

milli seconds. A delay of 40 milliseconds at the maximum and 20 milli seconds at the

minimum will be allowed between transmisson of successive digits.

 Thus to transmit data corresponding to 200 samples, with each sample represented

by 3 BCD digits, a total of 600 BCD digits are to be sent on the line. At a

transmission rate of 80 milli second per digit, the time required to transmit 600 BCD

digits will be 48 seconds. Thus a cycle of one second signal can be transmitted in 48

seconds. Though the speed of transfer of signal is low, it can reach the expert within

200 kilometers radius costing only two calls according to the present tariff.

At the receiver, the tones received on the telephone line are converted back to

BCD digits by a DTMF receiver and its associated circuitry. The BCD digits are

packed into corresponding decimal numbers which are then converted to

Hexadecimal form. The Hexadecimal data is fed to a personal computer on the

expert's’disk for presentation in the form of a signal. In the absence of a PC, a

Microcomputer with DAC interface may be used for observing the signal on a CRO.

The proposed system is primarily used for off-line signal transmission. The

sampling rate adopted may be set by default or user may choose his own sampling

rate synchronised with the receiver side. This step will ensure proper timing and

reconstruction of the signal in the original form.

 RESULTS

The above system has been implemented and tested. The sampled ECG values

from ADC are fed to a Microprocessor trainer. The sampled signal is observed on a

CRO for local monitoring. This signal is transmitted through DTMF tones and are

received by a DTMF receiver on the Expert’s end. The reconstructed signal on the

receiver side is shown in fig.2.

ECG WAVEFORM

5000
AMPLITUDE

Series1
0
Series2
115
134
153
20
39
58
77
96
1

-5000
TIME msec

Fig. 2
 CONCLUSION

The proposed system is cost effective and simple to use. A patient who requires

monitoring at regular intervals can afford and use without travel. If this comes to

practical use, it provides a way to offer first aid at the patients home by a family

Doctor / a Local Hospital / a Primary Health care centre / an Ambulance Van .

REFERENCES

1.Bio - Medical digital signal processing

- Willis J. Tompkins

Prentice Hall of India Pvt. Ltd. 1999 Edition

2. Handbook of Bio – Medical Instrumentation

- R S Khndpur

Tata McGraw Hill 1999 Edition