Medical Device Link.

Originally Published EMDM March/April 2002

WEB WATCH

A browser-based vital-sign-monitoring program can be coupled with medical devices

Benjamin Lichtman

In a development marking the beginning of a new phase in telemedicine, a company reports that its browser-based vital-sign-monitoring software recently enabled the first remote anaesthesia monitoring process managed via the Internet.

The open-architecture software engine and toolkit is called VitalWeb, and it was developed by TeleVital Inc. (San Jose, CA, USA). Using VitalWeb, which monitors and records physiological data in real time over the Internet, a consulting anaesthesiologist at the Virginia Commonwealth University's (VCU) Medical College of Virginia Hospital (Richmond, VA, USA) monitored the breathing and heart rhythms of a young woman undergoing a gall bladder operation 3000 miles away in Sucua, Ecuador.

Not only was the operation a success, but according to the company, VitalWeb technology was further validated when the anaesthesiologist, Lynne Gehr, detected an anomaly in the patient's heart rhythm. The surgeon, Ronald C. Merrell, who is chairman of surgery at VCU's School of Medicine, corrected the potentially life-threatening condition in the fully equipped mobile operating room—a converted delivery truck.

"TeleVital was founded with the goal of empowering medical practitioners to reduce pain, trauma, and potentially provide life-saving services to geographically dispersed patients," says Kishore Kumar, president of TeleVital. VitalWeb supports the real-time streaming and remote viewing of raw and interpreted vital-sign data, along with audio and visual communication. The program receives and stores patient data using a secure database server. The current release of VitalWeb supports several wired and wireless EKG, blood pressure, spirometry, and pulse oximetry devices, as well as several interpretation protocols. Data encryption and HIPAA compliance will be supported in a future release.

The December field test in Ecuador was part of a programme in ongoing telemedicine evaluations conducted by the VCU-based Medical Informatics and Technology Applications Consortium (MITAC), a commercial space centre sponsored by NASA, the US National Aeronautics and Space Administration.

How It Works

VitalWeb represents an improvement over traditional store-and-forward telemedicine in that it supports the real-time streaming and viewing of raw and interpreted vital sign data. The application also offers synchronous real-time audio and video communication.

VitalWeb's browser-based open architecture can Web-enable any PC-compatible medical device on any platform that supports a browser. VitalWeb requires a computer with an Internet connection, a Web browser, and a medical device with a serial, parallel, or customized communications port. "Because it's completely browser-based, there's never any need to download, install or upgrade software," says Kumar.

The operation in Ecuador, which was performed in a remote area, exemplifies how easy it is to connect to VitalWeb. Using a laptop computer, a member of the surgical team logged into the TeleVital Web site. Using medical devices manufactured by QRS Diagnostics (Plymouth, MN, USA), a two-lead EKG affixed to the patient's extremities and a pulse oximetry clip fastened to the patient's index finger were attached to the computer. The streaming data from the devices were then transmitted via a 64K satellite uplink from the mobile operating room to the consulting anaesthesiologist in Richmond, Virginia, for real-time viewing on a single computer screen.

While real-time data viewing enables remote monitoring, VitalWeb also simultaneously stores the information in a permanent electronic medical record on its secure database server for easy retrieval or forwarding.

TeleVital describes itself as "a world leader in the healthcare industry with the integration of emerging medical, wireless and Internet technologies." The company plans to operate solely as an application service provider (ASP). In addition to offering VitalWeb on an ASP basis, the firm is eager to partner with medical device manufacturers interested in private-label services.

"We know from our market research and initial sales activities that a significant opportunity exists for partnering in the device sector," says Kumar. TeleVital is currently in the process of Web-enabling medical devices from several manufacturers of equipment for the collection of vital-sign data such as blood pressure, stethoscopic parameters, heart rate, temperature and weight. Kumar adds that the company can develop custom applications for device manufacturers working in a variety of fields. For more information, readers can contact TeleVital Inc. via e-mail at info@televital.com, or visit them on the Web at www.televital.com.

Copyright ©2002 European Medical Device Manufacturer