Dispositivi bio-elettronici: sensori per la salute e il benessere STMicroelectronics Festival dell Innovazione Bari, 1 Dicembre 2010 Andrea Vitali andrea.vitali@st.com
2 Outline STMicroelectronics company presentation MEMS sensors MEMS biomedical systems Remote monitoring: scientists and patients needs The wearable unit BODY GATE WAY Other Devices (holters, patches, bracelets)
3 Company Presentation STMICROELECTRONICS
STM: bio-electronics Lab on chip In-vitro analysis Wearable bio-electronics In-vivo analysis
5 ST hardware and software Electrocardiogram Bioimpedance Microcontrollers Radio modules Linear components Linear components Firmware Processing IPs Heart rate, beat classification, blood analytes from morphology, metabolic activity Heart/breathing rate, fluids, stress, glucose level Acceleration MEMS acc/gyro Body position/activity, gait analysis, fall detection (with barometer) Phonocardiogram MEMS microphone MEMS accelerometer Heart/breathing rate, blood pressure (alone or with electrocardiogram) Photoplethysmogram CMOS camera SPAD Heart rate, blood analytes, blood pressure (with electrocardiogram) Temperature/heat flux Linear components Metabolic activity
6 Accelerometers, Gyroscopes, Pressure sensors, Microphones MEMS SENSORS
STM: silicon and beyond Microelectronics Systems on a Chip (SoC) Wireless Micro sensors Micro Electro Mechanical Systems (MEMS) Low-power fault-tolerant processing/memory Analog-to-digital input, power output Accelerometers, Gyroscopes Pressure sensors, Microphones
Micro Electro Mechanical Systems Micron-sized transducer Analog Front End Dedicated package and calibration + = Transducer: from linear/angular acceleration to diff C charge, micro-machining (THELMA process) Front-end: from diff C charge to output V, high performance with embeddded trimming features Stacked dual-die configuration MEMS ASIC advantages low-cost smaller package faster time-to-market
Accelerometer/Gyroscope Transducer Accelerometer for Linear acceleration + moving mass C1, C2 varying capacitance C1 moving mass C2 Moving Fixed Linear acceleration Gyroscope for Angular acceleration Linear acceleration Balanced variation C1=C1 C2=C2 C1 C2 Coriolis motion Vibrating masses Vibrating masses Angular acceleration Imbalanced variation C1> C1 C2 < C2 C1 C2 C1 C2 C1 C2 Coriolis motion
3x3mm (2x2mm in 2010), dual/tri axis, analog/digital output Accelerometer Portfolio selected selected
5x5mm, yaw single/dual axis pitchroll-pitchyaw, analog output Gyroscope Portfolio stabilizer In-plane axis: pitch, roll Out-of-plane: yaw selected
12 MEMS sensors and bio-electronic system MEMS BIOMEDICAL SYSTEMS
Vital sign detection 13
14 Implantable sensors/actuators Medtronic
15 Diabetes management: nanopump ST and Debiotech Small, precise and safe
16 Glaucoma: pressure monitor in contact lens ST and SensiMed
Lab-on-chip: real-time DNA/RNA analysis 17
18 Congestive heart failure: electronic patch ST and Mayo Clinic
19 The need for wearable devices REMOTE MONITORING
20 Remote monitoring context Ambient, socioeconomic factors Aging of population Globalization Urbanization Risk factors Cannot be modified Aging Genetics Can be modified Bad diet No/low physical activity Smoking Common Overweight - obesity Hypertension Hyperglycemia Blood anomalies Diseases Chronic Diabetes Long term trend Cardiac pathologies Ictus Tumours Breathing anomalies
21 The need of The need of the Scientist Heart electric signal (ECG) Heart sounds Breathing activity Blood Oxygen (SpO2) Blood pressure (mmhg) Blood glucose Body temperature Body activity/position holters (1-3-8-12 leads) digital stethoscopes chest bands photoplethysmographs (PPG) pressure cuff invasive
22 The need of The need of the Scientist The need of Patients Need for comfortable wearable devices to enable remote monitoring and care: micro detectors and micro infusion pumps
This future? Confinement, discomfort or this? BodyGateWay Rare but significant events are not captured during short visits Long term monitoring do capture all events
24 Without remote monitoring Hospital Visit Check up Healty At risk No symptoms Symptoms
25 With remote monitoring Life Style Control Early detection Home point of care Healty At risk No symptoms Symptoms
Remote monitoring applications Other possible targets Early detection on large scale Life style control (fitness) Comfortable remote monitor Our target Symptoms (today in hospital) No symptoms (today not treated) At risk (genetics, aging, bad diet, no/low activity, smoking..) Healthy
27 BODYGATEWAY THE WEARABLE UNIT
Miniaturized, portable, wearable devices Mobile Components maker (STM) Device manufacturer (NOKIA) Service provider (VODAFONE) : BodyGateWay
First prototype (2008) Desired features Wearable non invasive easy-to-use low cost...
30 First prototype 2010 low cost for large scale comfort for long term use robustness for every day life easy to use for common people long term monitoring multi parameter monitoring automatic classification (intelligence)
System overview BodyGateWay BodyGateWay Mobile phone Storage cuff Internet scale User PC Doctor PC Care provider
Mobile touch interface Main screen Body activity Heart Rate Breathing Rate Battery level ECG screen Raw ECG signal Symptoms screen Patient is prompted
Device block scheme Electrogram Bioimpedance Accelerometer (Gyroscope) Electro Cardio Gram muscles activity Imped. Cardio Gram Breath Rate Fluids Pressure Glucose Phono Cardio body Gram activity position Signals and parameters ECG: Heart beats, heart rate ICG: Breathing rate XYZ: Body position, body activity fusion Examples of fusion: Reliable heart rate by combining all cardio grams Does heart rate match physical activity? Active noise cancellation of motion artifacts
Device block scheme AMBIENT Temp, Press, Sounds, Light, Hygro, Smoke, CO Electrogram Bioimpedance Accelerometer (Gyroscope) Microphone (Accelerometer) Red/IR LED + PD/CMOS Temperature Heat Flux Electro Cardio Gram muscles activity Imped. Cardio Gram Breath Rate Fluids Pressure Glucose Phono Cardio body Gram activity position Phono Cardio Breaths Gram Pressure Photo SpO 2 PlethysmCO/CO2 Gram Bilirubin Pressure Meta bolic activity fusion Other signals Blood oxygen (PPG) Blood pressure (PCG/PCG/PPG, +ECG) Glucose level (ICG/ECG/PPG Raman)
35 Impact on existing infrastructure Need for changes Data storage and processing Emergency / support call centers Different admission / dismission protocols Medical staff / patient training Can it be used in the real world? Critical issues (crying wolf/bomb penalty) Cost of false pos/neg: does it saves lives? Cost ($$$): does it save money? Time: does it save time? Is it worth using?
Smart ECG processing good easy signal disconnected electrode Premature ventricular contractions deep breathing motion artifacts Premature atrial contraction paced beats muscle noise Supraventricular tachycardia
Signals Electrogram Bioimpedance Accelerometer ECG Driving in car Walking up/down stairs Sleeping (2 hrs) Gym session ECG ECG ECG XYZ XYZ XYZ Low activity when sitting in car and driving. High activity when walking up/down stairs. No activity. Body position can clearly be seen. ECG is good even while exercising in the gym. Heartbeats Breaths Walking Heartbeats (after 1 hr) ECG ECG ECG X Y Z X Y Z X Y Z X Y Z Heartbeats from ECG and accelerometer. Breaths from ECG (R peak amplitude modulation) and accelerometer. Steps can be counted from accelerometer. After 1 hour ECG signal is affected by high-freq noise. Z0 Breathing and holding (zoom on held breath) Walking DZ vs spirometer Z0 DZ DZ DZ DZ vs spirometer DZ Breaths ECG Heart beats ECG Breaths/min Litres (spirometer)
Signals Red/IR led + Photodiode R&D broad spectrum LED can be compensated inexpensive camera gives slipping motion for active noise cancellation two infrared LEDs for black skin with melanin Microphone Heartbeats Red 12bits 100Hz Infrared 12 bits 100Hz Heartbeats Optical 8bits 20x20 150fps red red red infrared infrared infrared ECG Photodiode on finger, reflective mode. ECG CMOS camera (optical mouse), transmissive mode. ECG ECG ECG Photodiode on finger, reflective mode. Photodiode on wrist, reflective mode. Photodiode on chest, reflective mode. Heartbeats Heartbeats Heartbeats Heartbeats and coughs and noise Microphone placed on wrist Microphone placed on arm Microphon placed on neck Microphone placed on chest Microphone placed on chest, coughing Artifacts caused by slipping mic.