mobile monitoring... the fastest way to improved health

Transcription

1 mobile monitoring... the fastest way to improved health 1

2 topics } telozo the company behind the clue series } general information - clue series } clue - overview } clue medical - overview } modes of data transmission, modes of data access, types of data reports } device specifications 2

3 telemedicine future 3

4 } the company behind the products: } founded in August 2008, spin-off of the privately owned Austrian high-tech company Telovital Telemedicine } innovates, develops and globally markets effective, high quality brand-name telemedicine products } main focus is cardiac, neuro and stress diagnostic via pocket sized devices } device can reliably transmit relevant scientific data via web or mobile phone to central server or directly via IR or bluetooth to PCs or notebooks } a team of highly experienced international top experts 4

5 Vision: } We are recognized as leading and innovative telemedicine company } Top people want to work with telozo and contribute to its purpose Mission: } We work for effective health management at any place and any time } We develop and market telemedicine products which are: } very versatile } technologically highly advanced } yet easy to operate and widely affordable Key brands: 5

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7 Product Focus - USP Diagnostic devices focusing on the most common disease area, heart disease: Medical relevance and evidence brillant quality top mobility easy to use instant data availability, locally and world wide State-of-the art technology, evidenced in the participation in the inclusion into the space program MARS 500 7

8 } innovative state of the art, telemetric event recorder } extremely light (56 grams), small and multifunctional, high quality } mobile health measuring device pocked sized } capable of telemetric data transfer anytime & anywhere, worldwide } easy to operate one button only } clue - lifestyle product, focused on private use } clue medical - advanced product, focused on use by medical professionals 8

9 Product Portfolio clue medical Medical Device CE /42/EWG class II a clue Health / Lifestyle Device 9

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12 } One measurement, } three different representations of the same evaluation } I. The simplified, easy for the patient to understand conversion as a PDF, can be called up via the user s computer or the Telozo server } II. The mobile assessment, can be called up at any time but only via the Telozo server } III. The detailed report, a complex representation which can be read by the physician with more in-depth information, with precise information about the recording time and duration; is directly transmitted to the computer and evaluated there or in a mobile manner via the central Telozo server, with simultaneous archiving 12

13 I. Simplified Report III. Detailed Report II. Mobile Report 13

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15 } records a complete one-channel 2 minute ECG anytime and anywhere } can provide you with a possible clue about your current health and/or fitness condition } makes stress visible and can help you to optimize your personal performance and quality of life } instantly calculates and visualizes important stress parameters 15

16 clue your personal benefits: } very economical state of the art technology without equal } is able to record up to 30 measurements between transmissions } makes stress visible } calculates your personal stress level and be warned of a possible burnout stress management } reliably identifies your personal fitness rating } regain your balance more quickly energy management 16

17 Report HR HRV Balance 17

18 Terminology Heart Rate (HR): heart beats per minute Heart rate variability (HRV): variations in the heart rate over a shorter or longer measurement period in a heart beat to heart beat analysis - a measure of the hearts ability to regulate itself ( Heart Fitness Level ) Balance: balance of sympathetic to parasympathetic (vagal) actvity a measure of stress ( Stress Level ) 18

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21 } records a complete one-channel ECG over a period of 2 minutes at a sampling rate of 1 KHz, anytime & anywhere, in real life conditions } is able to record up to 30 ECGs between transmissions } analyzes heart rate variability (HRV) and sympathicus/parasympathicus activity as well as their balance } transfer of data to medical centers/medical professionals is independent of time and place, simplifying diagnosis and monitoring } enhances health risk prevention and fitness improvement programs 21

22 } monitors outpatients with cardiac or neurological risks } for follow up of patients with heart failure and post mi } helps in the diagnosis and treatment of stress, burn-out, in diagnosis of rhythm disturbances never seen before } can help evaluate different training methods in the field of sports medicine } instantly calculates heart rate variability & important stress parameters 22

23 e.g. Heart Rhythm Disturbances The basis for the before mentioned HRV analysis, the 2 minute high-resolution ECG, is also an additional and important tool for the physician when it comes to disrhythmia. Since many heart rhythm disturbances are not easy possible to detect with conventional examination methods, clue medical allows the person concerned to record and therewith document these events when they appear, irrespective where and when. Possible heart rhythm disturbances are e.g.: atrial fibrillation atrial flutter ventricular tachycardia superventricular tachycardia extrasystoles bradycardia 23

24 In the two minute recording, the following data and values are recorded and displayed: } 1. The average heart period and heart rate (HR) } 2. Absolute [SDNN] and relative [CV] heart rate variability (HRV) } 3. A spectral analysis [FFT] including surface measures derived from it for sympathetic and parasympathetic activity and their balance } 4. A tachogram of the heart period including cardiovascular assessment } 5. A complete 1 channel ECG section over a 2 minute period } 6. A signal-averaged ECG with the characteristic time values 24

25 Terminology Tachogram If you determine, for each heart action µ, within a given measurement time (e.g. 2 minutes with clue medical) the associated cardiac cycle duration TH (µ) (e.g. the applicable RR interval) and plot it as a function of the corresponding heart action, you get the tachogram of cardiac cycle durations as a characteristic cardiovascular function. The beat to beat variations and thus the heart rate Variability (HRV) are illustrated in a tachogram. 25

26 Heart Rate Variability (HRV) From ECG to the tachogram of the heart beat periods ECG t 1 t 2 t 3 t 4 R R R R R Tachogramm Time between R peaks Time (ms) t 1 t 2 t 3 t 4 Number 26

27 Terminology Spectral Analysis Calculated from the tachogram of cardiac cycle durations, made up of characteristic frequency ranges LF, HF, VHF LF: low frequency, predominantly sympathetic cardiovascular activity HF: high frequency, typical for vagal (parasympathetic) cardiovascular activity VHF: very high frequency, a cardiac risk marker Areas under the LF and HF curves represent sympathetic and vagal activity, respectively and their ratio is a measure of Balance ( Stress / Recovery ) 27

28 Spectral analysis: 28

29 References } AKH General Hospital / Vienna, Austria } Psychosomatic Institute (Burnout Center) / Vienna, Austria } Center for Sports Sciences / Frankfurt a.m., Germany } Harvard University / Cambridge, USA } IMBP / Moscow, Russia 29

30 Project MARS JK/09

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32 Modes of Data Transmission Modes of Data Access Types of Data Reports 32

33 Modes of Data Transmission via Infrared-USB stick to PC/notebook Recorded data can be transmitted to the server-center via the provided IR-USB stick using a PC/ notebook with internet-access as interconnection. This solution is usually favored with in-patients at the medical center, and also generally very popular 33

34 Modes of Data Transmission via mobile phone with Internet-, and Bluetooth- or Infrared-connection capability Alternatively, recorded data can be transmitted to the server-center for visualization and storage via a mobile phone, whereas the data are conveyed from clue medical to the mobile phone using Bluetooth- or Infrared-Connection. This solution is often used by outpatients recording and transmitting data on a regular basis at home for supervision by physicians. 34

35 Modes of Data Transmission 35 35

36 Modes of Data Access Access with User ID and Password To get access to the visualized recordings is with User ID and Password. With these the physicians / users are able to access via Internet all devices / patients with its recordings, e.g. stored in the server-center of the hospital or telozo. That means any medical center of a group of hospitals has access to certain patient recordings, if the patient has its clue medical # filed in his patient file. 36

37 Modes of Data Access Access to individual devices and recordings By clicking on the device # of the patient, the physician/user can see when and at what time recordings have been transmitted, together with its actual reports, if clicked on the Adobe Reader symbol. This information allows precise billings regarding patients, medical centers, and health care insurances, as applicable. Furthermore, the stored reports can be used as additional input for various medical departments. 37

38 Modes of Data Access Further details of recordings In addition, with clicking on the journal #, it is possible to see further information like the details of a certain recording. 38

39 Modes of Data Access Device details In addition, with clicking on the device #, it is possible to see additional information like the latest transmission, total number of transmitted recordings, plus e.g. the address, the visualized reports are sent to. The conveying of reports via e- mail is an additional way of obtaining recordings to be evaluated. 39

40 Modes of Data Access List of all devices List of all devices within a user account 40

41 Data Reports General The Output: Data Reports Privacy protection of personal vital data is fully guaranteed, since all recordings/visualized reports in the server-system are anonymous and only handled by the device number. The allocation of the outputs to a person/patient takes place only during print-out. An earlier allocation is disallowed by the system. 41

42 Data Reports - Standard Reports for each recording 1 - The average heart period and heart rate (HR) 2 - Absolute [SDNN] and relative [CV] heart rate variability (HRV) 3 - A spectral analysis [FFT] including surface measures derived from it for sympathetic and parasympathetic activity and their balance 4 - A tachogram of the heart period including cardiovascular assessment 5 - A complete 1 channel ECG section over a 2 minute period 6 - A signal-averaged ECG with the characteristic time values

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44 Data Reports - Standard Reports for each recording: 120 seconds of ECG data (in 3 pages) 5 44

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47 Data Reports Special Analysis It is also possible to provide the physician additionally with a trend analysis over certain periods of time, whereas the basis for it is continuously updated Example: Trend-Analysis over a period of 24 days Sympathicus/Parasympathicus Activities Changes of sympathetic and parasympathetic activities of the cardiovascular system under prescribed medication (35 year old patient) during 24 days (averaged values per daily measurings) Sympathetic - and Parasympathetic Activity [ms 2 ] Sym pathetic- Activity LF day Parasym pathetic- Activity HF 47

48 Data Reports Special Analysis Balance Sympathicus/Parasympathicus Activities 35 year old patient under prescribed medication, recorded during 24 days, average value per day Changes in cardiovascular balance 2 1,5 Balance 1 0, day 48

49 Data Reports Heart Rate 35 year old patient under prescribed medication, recorded during 24 days, average value per day Changes in average heart frequency 75 heartrate [min -1 ] day 49

50 Data Reports Heart Rate Variability (HRV) 35 year old patient under prescribed medication, recorded during 24 days, average value per day Changes in Heart Rate Variability (HRV) Heart Rate Variability CV [%] day 50

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52 General Summary 52 clue medical are state-of-the-art systems for one-channel recording of application-specific ECG sections for the purpose of determining heart rate variability (HRV) as well as the activity of the autonomic nervous system (sympathetic and parasympathetic activities) as indicators of cardiovascular stress, recovery and its balance. The recorded data can be sent telemetrically using a PC/ notebook with internet-connection or mobile phone to a server-center

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54 Device Specifications Measurements L/D/W 76 mm x 72 mm x 15 mm Weight with battery 56 g Weight without battery 49 g Operating temperature range 10 C to 45 C Storage temperature range -20 C to 60 C Transport temperature range -20 C to 60 C Relative humidity 10% to 95% non-condensed Operating time w/o change of battery >400 measurements Risk class II a Degree of protection BF / IP 20 ECG lead 2 x 1 channel ECG recording bipolar and neutral electrodes Input voltage 10 mv p-p DC offset correction < 300 mv Frequency range: adhesive electrodes Hz (-3dB) Frequency range: fixed electrodes Hz (-3dB) Scanning rate 1000 Hz Resolution of AD conversion 12 Bit Memory 30 recordings max. Battery type AAA alkaline (1,5V), rechargeable types allowed (NiMh 1.2V) Battery display Optical Electrode monitoring Yes IrDA Transmission Modem (IrComm) to central server over Internet connection IrDA Transmission Obex push (PDF file) directly to recipient Method of heart rate measurement Average ECG over 2 minutes Bluetooth module LMX

55 THANK YOU! 55