Staff shortages and an increasingly aging population are straining the ability of emergency departments to provide high-quality care. Additionally, there is a growing concern about the ability of hospitals and EMS responders to provide effective care during disaster events. To automate the patient monitoring process and improve efficiency, quality of care, and the volume of patients treated, we have developed MEDiSN, a wireless sensor network for monitoring patients’ vital signs in hospitals and disaster events. MEDiSN has been deployed at the Emergency Department at the Johns Hopkins Hospital, at the University of Maryland's Trauma Center, and at the Washington Hospital Center. Recently, MEDiSN has been featured in the Discovery Channel Tech.
Overview of MEDiSN:
Given the U.S. demographic trends (aging population, increasing prevalence of chronic diseases), nursing staff shortages, and decreasing hospital capacities, it is no surprise that the U.S. healthcare system faces immense challenges on a daily basis. Moreover, there is growing concern about the hospitals’ ability to provide effective care during disasters when the surge of patients can be overwhelming. Multiple studies have shown that the use of inefficient tools in the patient care process is one of the root causes behind overcrowded and inefficient hospitals. Thereby, tools that automate the patient monitoring process will greatly improve the quality and effectiveness of health care both on a daily basis and during disasters. While these needs are widely accepted, a multitude of problems confront technology developers. First, a multi-stage infrastructure, including sensing devices, wired and wireless networks, and back-end servers, is necessary to generate medically relevant results. Second, healthcare providers have understandably little time and patience to work with untested technologies and engineering prototypes. Finally, healthcare facilities and research with human subjects present unique technical, administrative, and ethical challenges that few technologists have encountered.
In response to this challenge, we are developing miSense, an end-to-end platform for medical sensing applications. miSense includes all hardware and software components to design, develop, and deploy compelling sensing applications in the healthcare field. Specifically, we are developing the miTag (medical information Tag), an embedded wireless sensing device customized for healthcare applications. The miTag’s extensible design allows the easy integration of medical sensors (e.g., heart and respiration rate, blood pressure, ECG, etc.) and application-level software. The miTag has a small form factor, is battery-powered, and includes a wireless network interface allowing the persistent tracking of patients’ data throughout clinical facilities. Moreover, we are developing the miNet wireless network infrastructure that transports the miTags' measurements and allows administrators to remotely configure them. Finally, we are developing the miStore and miView servers that persistently store the collected measurements and deliver them to authenticated end-users.
An early prototype of miSense was deployed at the operating room and post anesthesia care unit of the Shock Trauma Center of the University of Maryland Medical Center and the emergency rooms of the Johns Hopkins Hospital and the Washington Hospital Center.
In collaboration with our partners at the Johns Hopkins Hospital, we selected the task of monitoring unattended Emergency Room patients as the first application for miSense. Specifically, patients waiting to be seen at the Emergency Room were given miTags that continually monitored their heart rate and blood oxygen levels. Medical staff remotely monitored the patients’ vital signs and were able to promptly respond to signs of deterioration. The results from the initial deployment at the Johns Hopkins hospital were very encouraging: the wireless network was successful in delivering the collected vital signs despite a challenging radio environment and patient mobility. Moreover, the average patient satisfaction level was 3.47 (on a 1-4 scale) and 91% of the patients indicated that they would be willing to use the device in the future.
- Andreas Terzis, JHU
- Richard Rothman, JHU
- JeongGil Ko, JHU
- Yin Chen, JHU
- Andong Zhan, JHU
- Jong Hyun Lim, JHU
- Razvan Musaloiu-E., JHU
- Tia Gao, AID Networks
- Walt Destler, AID Networks
- Leo Selavo, University of Latvia
Publications and Posters:
- JeongGil Ko, Kevin Klues, Christian Richer, Wanja Hofer, Branislav Kusy, Michael Bruenig, Thomas Schmid, Qiang Wang, Prabal Dutta, Andreas Terzis, “Low Power of High Performance: A Tradeoff Whose Time Has Come (and Nearly Gone)”. In Proceedings of the 9th European Conference on Wireless Sensor Networks (EWSN). Pages 98-114. February 15-17, 2012. Trento, Italy.
- William Bianchi, Andrea F. Dugas, Yu-Hsiang Hsieh, Mustapha Saheed, Peter Hill, Cathleen Lindauer, Andreas Terzis, Richard E. Rothman, “Revitalizing a Vital Sign: Improving Detection of Tachypnea at Primary Triage”. To Appear in Annals of Emergency Medicine.
- Jong Hyun Lim, Andong Zhan, JeongGil Ko, Sarah Szanton, Laura Gitlin, Andreas Terzis, “A Closed-Loop Approach for Improving the Wellness of Low-Income Elders at Home Using Game Consoles”. IEEE Communications Magazine special issue: Communications in Ubiquitous Healthcare: Wireless Sensors, Networked Devices, Protocols and Solutions. Pages: 44-51. Vol: 50(1). January 2012.
- W. Bianchi, Y. Hsieh, P. Hill, M. Saheed, A. Terzis, R. Rothman, Revitalizing a Vital Sign: Measurement of Respiratory Rate With a Thoracic Belt Improves Detection of Tachypnea at Primary Triage. Annals of Emergency Medicine, 2011. 58 (4S): p S305-S306. Oct 15, 2011. San Francisco, CA. PDF
- JeongGil Ko, Joakim Eriksson, Nicolas Tsiftes, Stephen Dawson-Haggerty, Jean-Philippe Vasseur, Mathilde Durvy, Andreas Terzis, Adam Dunkels, David Culler, “Beyond Interoperability: Pushing the Performance of Sensor Network IP Stacks”. In Proceedings of the 9th ACM Conference on Embedded Networked Sensor Systems (SenSys). Pages: 1-11. Nov 1-4, 2011. Seattle, WA.
- JeongGil Ko, Joakim Eriksson, Nicolas Tsiftes, Stephen Dawson-Haggerty, Jean-Philippe Vasseur, Mathilde Durvy, Andreas Terzis, Adam Dunkels, David Culler. Demo Abstract: An Interoperability Development and Diagnosis Environment. Appeared in ACM Sensys 2011.
- JeongGil Ko, Joakim Eriksson, Nicolas Tsiftes, Stephen Dawson-Haggety, Andreas Terzis, Adam Dunkels, David Culler, ContikiRPL and TinyRPL: Happy Together. in proceedings of the Workshop on Extending the Internet to Low power and Lossy Networks (IP+SN), 2011. PDF
- JeongGil Ko, Stephen Dawson-Haggerty, Omprakash Gnawali, David Culler, Andreas Terzis, Evaluating the Performance of RPL and 6LoWPAN in TinyOS. in proceedings of the Workshop on Extending the Internet to Low power and Lossy Networks (IP+SN), 2011. PDF
- JeongGil Ko, Stephen Dawson-Haggerty, Jonathan W. Hui, David E. Culler, Philip Levis, Andreas Terzis, Connecting Low-Power and Lossy Networks to the Internet. IEEE Communications Magazine, April 2011. PDF
- Andong Zhan, Jong Hyun Lim, Andreas Terzis, “DailyAlert: A Generic Mobile Persuasion Toolkit for Smartphones”. Appeared in the International Workshop on Sensing Applications for Mobile Phones (Phone Sense) 2011.
- JeongGil Ko, Qiang Wang, Thomas Schmid, Wanja Hofer, Prabal Dutta, Andreas Terzis, Egs: A Cortex M3-based Mote Platform. to appear as a demo in the IEEE Communications Society Conference on Sensor, Mesh and Ad Hoc Communication and Networks (SECON 2010) pdf
- JeongGil Ko, Andreas Terzis, Power Control for Mobile Sensor Networks: An Experimental Approach. To Appear in the proceedings of the IEEE Communications Society Conference on Sensor, Mesh and Ad Hoc Communication and Networks (SECON 2010). PDF
- JeongGil Ko, Chenyang Lu, Mani B. Srivastava, John A. Stankovic, Andreas Terzis, Matt Welsh, Wireless Sensor Networks for Healthcare. To Appear in the special issue of the Proceedings of the IEEE on Sensor Network Applications. PDF
- JeongGil Ko, Tia Gao, Richard Rothman, Andreas Terzis. Wireless Sensing Systems in Clinical Environments: Improving the Efficiency of the Patient Monitoring Process. IEEE Engineering in Medicine and Biology (EMB) Magazine, Volume 29, Issue 2, Pages 103-109, March/April 2010. pdf
- JeongGil Ko, Jong Hyun Lim, Yin Chen, Razvan Musaloiu-E., Andreas Terzis, Gerald Masson, Tia Gao, Walt Destler, Leo Selavo. MEDISN: Medical Emergency Detection in Sensor Networks. To appear in ACM Transactions on Embedded Computing Systems (TECS), Special Issue on Wireless Health Systems, 2009. pdf
- JeongGil Ko, Tia Gao, Andreas Terzis. Empirical Study of a Medical Sensor Application in an Urban Emergency Department. In Proceedings of the 4th International Conference on Body Area Networks (BodyNets) 2009, Los Angeles, CA. April 2009. pdf
- JeongGil Ko, Razvan Musaloiu-E., Jong Hyun Lim, Yin Chen, Andreas Terzis, Tia Gao, Walt Destler, Leo Selavo. Demo Abstract: MEDISN: Medical Emergency Detection in Sensor Networks. In Proceedings of the 6th ACM Conference on Embedded Networked Sensor Systems (SenSys) 2008, Raleigh, NC. November 2008. pdf
- JeongGil Ko, Yin Chen, Jong Hyun Lim, Razvan Musaloiu-E., Andreas Terzis, Tia Gao, Walt Destler, Leo Selavo. Wireless Sensor Networks for Patient Monitoring. Poster Abstract. Appeared in International Conference on Mobile Systems, Applications, and Services (MobiSys) 2008. Breckenridge CO. June 2008. pdf
- Tia Gao, Christopher Pesto, Leo Selavo, Yin Chen, JeongGil Ko, JongHyun Lim, Andreas Terzis, Andrew Watt, James Jeng, Bor-rong Chen, Konrad Lorincz, and Matt Welsh. Wireless Medical Sensor Networks in Emergency Response: Implementation and Pilot Results. In Proceedings of the 2008 IEEE International Conference on Technologies for Homeland Security. Waltham, MA. May 2008. pdf
User Interface (miView) Code:
- The miView code can be accessed here.
- You will need proper permissions to access the data collected from the miTags.
All of the code contributed to TinyOS from the MEDiSN project is part of the main TinyOS 2.x tree (link) .
- TinyRPL: IETF RPL Implementations in TinyOS (JeongGil Ko) -- /tos/lib/net/rpl/
- ARM Cortex-M3 (Atmel SAM3U) Microcontroller Support in TinyOS 2.x (JeongGil Ko, Thomas Schmid, Wanja Hofer, Kevin Klues) -- /tos/chips/cortex/m3/sam3/u/
- TI CC2520 Radio Driver Support for TinyOS 2.x (JeongGil Ko, Thomas Schmid) -- /tos/chips/cc2520/
- TI/Chipcon CC2420 Hardware Security Support for TinyOS 2.x (JeongGil Ko) - /tos/chips/cc2420/
This project is partially funded by the National Science Foundation under project #0855191.