Life Sciences. White Paper. Real-time Patient Health Monitoring with Connected Health Solutions

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1 Life Sciences White Paper Real-time Patient Health Monitoring with Connected Health Solutions

2 About the Authors Ashok Khanna Global Head, Presales and Solutions, Engineering Industrial Services, Life Sciences Ashok Khanna has over 19 years of industry experience in the field of healthcare, hi tech and telecom. As a business leader his expertise spans across multiple medical and pharmaceutical domain areas including new product development, product lifecycle management, manufacturing operations management, R&D and quality, regulatory and product sustenance. Diwakar Punith Consultant, Presales and Solutions, Engineering Industrial Services, Life Sciences Diwakar Punith has more than 17 years of experience working in the healthcare (medical devices) and automotive domains with expertise in product development, project management and business development. Diwakar is an accomplished professional with success in business planning, end-to-end product development of embedded medical devices. He has worked for over six years on new product design and development of medical devices including ECG transmitters and charging stations, infusion pumps, patient monitors and Endoscope CAE analysis with various DFX methodologies. Chandrakant Aknurwar Solution Architect, Engineering Industrial Services Chandrakant Aknurwar has more than nine years of experience working in the field of mobility and healthcare with experience in product design and development. He has three years of experience in the disease management software product design and development domains. He has executed complete product development cycles from requirements to product design and global integration.

3 An increase in the aging population, incidence of chronic lifestyle diseases and huge costs incurred to provide healthcare to citizens, are driving healthcare stakeholders worldwide to pursue remote monitoring and personal health management seriously. A connected healthcare environment enables access to critical medical parameters across the healthcare ecosystem, thereby facilitating remote health monitoring. This means that health service providers can access the patient health data remotely and prescribe medicines or diagnosis tests without the patient being personally available in the hospital, thus reducing the overall healthcare expenses. Connected health solutions offer a home care environment wherein patients are monitored for their vital health parameters using medical devices that can capture these health parameters and send it to the aggregator over wired or wireless communication. The data in the aggregator is further securely processed as per the standardized medical data format and stored in commercially available Health Vaults, which the health care service professionals can retrieve for an accurate diagnosis, prognosis and to prescribe the right medicines to the patient. This paper presents our thoughts on the suggested framework for connected health solutions using Bluetooth low energy that will establish wired or wireless communication between the personal medical health devices like blood pressure monitors (BPM), weighing scales, pulse oximeters, digital thermometers and glucometers among others. It can have an application layer that could take care of data aggregation, compilation and finally converting it into a HL7 format before it is uploaded to a Health Vault.

4 Contents Introduction 6 Challenges With Connected Healthcare 6 Suggested Connected Health Solution Framework 7 Who Will Benefit From This Framework 8 Conclusion 9

5 List of Abbreviations GDP PHR EMR EHR COPD CHF CHD PTSD IEEE Gross Domestic Product Personal Health Record Electronic Medical Record Electronic Health Record Chronic obstructive pulmonary disease Congestive heart failure Coronary heart disease Posttraumatic stress disorder Institute of Electrical and Electronics Engineers Hl7 Health level 7 PHI OEM USB IP HDP Patient Health Index Original Equipment Manufacturer Universal Serial Bus Intellectual Property Health Device Profile

6 Introduction Increase in aging population, lifestyle diseases and healthcare costs are driving global healthcare providers towards adopting tele-health technologies, also referred to as connected health solutions, which makes personal health monitoring and management cost-effective. More than one billion people across the globe are overweight, and at least 300 million of those are clinically 1 2 obese. Without action, more than 1.5 billion people are expected to be overweight by Over 600 million people worldwide have chronic diseases, and the spending on chronic diseases is expected to 3 increase. For example, in the US alone, spending is expected to increase from $500 billion a year to $685 billion by Globally, the number of persons 60 and older was 600 million in It is expected to double to 1.2 billion 4 by These high costs are forcing healthcare payers to reduce hospital stay and drive them to move from clinical care to home care, so individuals can manage their health expenses efficiently. This will lead to the development of intelligent medical devices that remotely monitor the patient's health parameters and enable the health service providers to take an informed decision on diagnosis, prognosis and medicine prescriptions to the ailing patient. Connected Health solutions enables people with critical illness to transmit vital health signs to the health care professionals and receive real-time feedback thus empowering them to better manage their own health and wellness. This paper presents our thoughts on current challenges and a suggested framework for Connected Health Solutions using Bluetooth low energy that would establish wired/wireless communication between the personal medical health devices. Continua, an alliance formed by the group of medical device manufacturers, formalizes the industry standards in harmonizing the data communication between various medical devices that will be used in the remote 5 monitoring of patient health parameters. Challenges with Connected Healthcare Continua Health Alliance specifies that the medical devices should have wired as well as wireless connectivity, so that data from these devices can be collected and aggregated on a handheld device such as a mobile or a tablet, which is called an Aggregator device. Subsequently, this data can be converted into medical industry standard format and uploaded to a PHR or EMR of the patient. Family members, caregivers as well as health service providers can subsequently use this data for diagnosis, analysis, path of treatment decision making, and insurance purposes. Hospitals and patients tend to use a variety of medical devices, and the manufacturers of such medical devices face many challenges in managing and transmitting the acquired medical data. Most medical devices do not collate data in the standard format specified by the Continua Health Alliance. [1] World Health Organization, Obesity and Overweight: Dr. P. Puska, Dr. C. Nishida, Mr D. Porter, 2013 [2] World Health Organization,Ten Facts About Chronic Disease,2005, Retrieved May 19, 2006, from [3] The Pfizer Journal, Global Edition Volume 1I, Number 2,4-9, Scaling Mount Proteome to Bring Down Chronic Disease., 2001 [4] World Health Organization,The world is fast ageing - have we noticed?, 2006, Retrieved May 19, 2006, from [5] Continua Health Alliance, Retrieved Feb 4, 2014 from 6

7 Once the data is collected from different medical devices, aggregating it and presenting it as a medical report with clear indicators such as Green, Yellow and Red (Personal Health Indicator) becomes an uphill task for different segments. Currently, most medical device designers do not have an integrated framework, which can work seamlessly before, during and after the hospitalization period. Additionally, cost effective multimode connectivity with wireless and wired options for multiple PHR and EHR are currently not available in the market. High power consumption by these medical devices makes it challenging for the patient to move around impacting their mobility and quality of life. Suggested Connected Health Solution Framework Considering the challenges described in section 2 and in order to contribute to the enhancement of global healthcare landscape, we suggest a connected health connectivity and interoperability framework. Suggested Framework Description Personal medical health devices should connect to handheld devices such as phones, tablets or personal computers, via wireless (For e.g. Bluetooth, Bluetooth low energy) communication technologies. The suggested framework should offer a standardized software interface for easy plug-and-play integration of Continua compliant personal medical health devices, data aggregation, data upload or download and data display. The overall mobile health setup supported by the suggested Connected Health solution framework is depicted in Figure 1. User Sensor Blood Pressure Weighing Scale Glucose Monior Health Thermometer Heart Sensor 4. Aggregator Personal Health Indicator Wired or Wireless Medical Health Record Data Server Medical Data Analytic Wired or Wireless Hospital Doctor Care giver Other Devices Figure 1: Suggested Connected Health Solution Framework 7

8 An ideal communication framework should work with personal medical devices using a proprietary or standardized protocol on top of an interface such as Bluetooth or Bluetooth low energy. The suggested application should include components which provide basic services and functionalities, allowing for maximum software re-use and unified access to common mechanisms. n User Interface Services n Report generation (text, pdf) n Threshold monitoring n Database connectivity (User Data Management) n Data upload or download services for MS Health Vault and Electronic Health Record Portal n XML and HL7 Processing Applications Generic Access Profile Generic Attribute Profile Attribute Protocol Security Manager Logical Link Control & Adaptation Protocol H O S T The suggested Connected Health solution framework should leverage Bluetooth Low Energy. This offers low power (90% power savings), low cost, higher speed, and higher range up to 100m. Who will benefit from this framework? Provided by H/W Host Controller Interface Provided by BlueZ Stack Controller Changes on top of BlueZ Stack for profile Dev Figure 2: Connected Health Bluetooth Low Energy Stack TCS Developed With the unique ecosystem for connected health, one can achieve connectivity and interoperability of medical devices to ensure consistent medical data is available to patients, OEMs, and care providers. Patients: Patients will benefit from better outcome by aggregated data from multiple medical devices and sensors available at a lower cost. Experts may not be required at all times, and family members or a caregiver can be trained to interpret the PHI, thus reducing the cost of care. OEMs: OEM devices can interface with standard framework for faster time to market, low cost and proven system. As the list of devices grows, OEMs could integrate their products with such systems and develop standard for the respective product lines for medical devices that are not part of Continua. This will help OEMs increase their market share while reducing the cost of integrating output of its devices with devices from other OEMs and achieve industry harmonization. Care Providers:. Having a device that can offer a PHI would make it easy for caregivers to know when the patient is healthy (Green), needs some attention (Yellow) or needs immediate intervention (Red) from a physician. With aging population in developed countries and economically challenged developing countries, such a solution will improve patient care and may lead to wide adoption of such systems. 8

9 Conclusion The Connected Health Solution can be one of the means to reduce the healthcare liability on patients as well as on the governments providing public health systems. By enabling remote monitoring and aggregating vitals, there will be a significant cost reduction and improved quality of life for these patients. A Connected Health Framework integrated with Bluetooth low energy devices benefit patients, caregivers and health service providers by offering: n Seamless and instant data connectivity. n Data security and confidentiality using secured network protocols and auto-synchronization even when the health data is uploaded to medical industry-specific cloud servers. n Communication through standardized protocols with wider support and security n Innovative, cost-effective features like PHI, real-time graphical data display, data archiving and feedback. 9

10 About TCS Life Sciences Top Global Life Sciences organizations derive value from TCS' full services play in IT, Consulting, KPO, Infrastructure and Engineering Services as well as new age business solutions including Mobility and Big Data. TCS' rich industry experience, domain expertise and global footprint ensures that it partners with its Life Sciences customers to help them advance clinical trial efficiencies, accelerate drug discovery, maximize manufacturing productivity and improve sales and marketing effectiveness. In addition, TCS has a dedicated Life Sciences Innovation Lab which ensures that its customers have the tools and innovative solutions they need to solve complex business challenges. Contact For more information, contact Subscribe to TCS White Papers TCS.com RSS: Feedburner: About Tata Consultancy Services (TCS) Tata Consultancy Services is an IT services, consulting and business solutions organization that delivers real results to global business, ensuring a level of certainty no other firm can match. TCS offers a consulting-led, integrated portfolio of IT and IT-enabled infrastructure, engineering and TM assurance services. This is delivered through its unique Global Network Delivery Model, recognized as the benchmark of excellence in software development. A part of the Tata Group, India s largest industrial conglomerate, TCS has a global footprint and is listed on the National Stock Exchange and Bombay Stock Exchange in India. For more information, visit us at IT Services Business Solutions Consulting All content / information present here is the exclusive property of Tata Consultancy Services Limited (TCS). The content / information contained here is correct at the time of publishing. No material from here may be copied, modified, reproduced, republished, uploaded, transmitted, posted or distributed in any form without prior written permission from TCS. Unauthorized use of the content / information appearing here may violate copyright, trademark and other applicable laws, and could result in criminal or civil penalties. Copyright 2014 Tata Consultancy Services Limited TCS Design Services I M I 02 I 14

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