development of a platform dedicated to the telemedical ... · microcontroller, firmware, vb6,...

International Journal of Engineering & Technology IJET-IJENS Vol:15 No:03 20

152803-6969-IJET-IJENS © June 2015 IJENS I J E N S

Development of a Platform Dedicated to

The TeleMedical Practice under local architecture

USB-HID and distant TCP-IP A.Nemmiche

#1, M.Benabdellah

#2, N.Hamlil

#3, S. Rerbal

#4, G.Nassar *

5

#Biomedical engineering Department, AbouBekrBelkaidTlemcen University

BP 230, Tlemcen 13000, Algeria [email protected]

[email protected]

[email protected]

4Souhila

[email protected]

*Valenciennes University

UVHC - Campus Mont Houy - 59313 Valenciennes, France [email protected]

Abstract—The telemedical practice consists in taking from

patient a multidimensional and multimedia information

representative of its physiopathological state, to stream them to

a local computer terminal initially then to a distant computer

terminal in the second time.

We propose through this article :

1) The realization of a noninvasive and nonintrusive

telemedical platform dedicated to simultaneous

acquisition and in real-time up to sixteen

unidimensional physiological signals.

2) The realization of a hardware interface built

around the C.A.N series AD0830 of Analog Device

ensuring the digitalization of the signals and the

microcontroller 18F2550 of Microchip ensuring

their transfers from the patient towards the local

post under protocol USB with specifications HID.

3) The realization of a graphical interface under

environment Visual BASIC making profitable the

component Winsock compatible with the

operating system Windows and architecture

client-server allowing the connection of the

various terminals computer for the transfer of the

data through the telemedical networks under

protocol TCP-IP.

Index Term— Telemedicine, USB, HID, mcHID.dll, TCP-IP,

Microcontroller, firmware, VB6, socket

I. INTRODUCTION

The medico surgical practice (Diagnosis, therapeutic,

monitoring) brings the use of a panoply of technical

equipment The current power of the information and

communication technics enable us to think of the progressive

integration of this multitude of technical equipment in the

form of telemedical polyvalent platform, adaptive and

evolutive which would transform a computer terminal into a

true station of local practice medico surgical or distant and

which would lead in the long term to materialization of the

concepts of Tele hospital, of health smart home (H.S.H),

of medicalised domiciliation of the patients reached by a

chronic diseases or of shared Individual medical folder.

This infatuation is often represented by the term e-health on

the structural level and Telemedicine on the functional level

[1], [11], [14], [15], [18].

The originality of the device that we developed lies in

following facts:

The recourse to external converters A/D with the

microcontroller which work at the same time makes

it possible to optimize the speed of digitalization of

the various signals.

The simultaneous collection of several signals

representative of different physiological functions

makes it possible to establish their inter correlations

with the implementation of suitable algorithms

allowing to better pose the diagnosis and to better

carry the therapeutic indications.

The automatic calibration of display according to

the number of signals at the entry of the device

facilitates their exploitations by the actors of the

Telemedicine.

The integration of several complementary

examinations in a such system makes it possible to

avoid the systematic recourse to patient orientation

towards various specialized services and allows a

precious time gain for the patient, for the doctor

and for the medical management cost of this patient.

And finally the embarked character of the

telemedical platform allows:

■ The realization of complementary examinations

regardless the site where the patient is located and

consequently one better apprehension of the urgent

what to do.

■ The exemption of the care to all and much wider

coverage in rural and isolated areas.

We present through this article:

1- The implementation hardware and software of a

micro controlled platform able to take on patient several

unidimensional signals, to stream them to a local station

under the architecture of communication USB-HID

built under environment MPLAB [2]-[4].

2- The Implementation of an application allowing the

display, the filing and digital processing of the various

mailto:[email protected]



signals built under environment Visual BASIC witch

making profitable API (Programming Application

Interfaces) mcHID.dll for standard USB-HID

(Universal Serial Bus-Human Interface Device) [5].

3- The iimplementation of a telemedical network for

the transfer of the data under protocol TCP-IP using in

particular the component Winsock of Visual BASIC

which allows the implementation of Client-Server-

architecture [6]-[8].

II. STRUCTURE OF THE TELEMEDICAL PLATFORM

This one comprises (Fig. 1):

The patient source and recipient of the medical

information.

DTE (Data terminal equipment) in charge of collect

information on the patient.

The codec (Coder Decoder) in charge of make

forward information resulting from the DTE

towards the local computer terminals and

conversely.

Fig. 1 Structure of the telemedical platform

PC (Computer terminal) local or distant in charge of

present the medical information to the experts of

medicine in exploitable and convivial form, of store

this information and of lodge the various

applications and platforms software of digital

processing and of transfer the medical information

by means of environment programming given.

DCE (Dated Communication Equipment) in charge

of adapt the band pass of informational signal to the

band pass of transmission channel, of transfer the

medical data towards distant terminals via the

telemedical networks and of maximize the flows by

means of the techniques of high flow[9], [10], [13].

III. TECHNIQUES AND METHODS DEVELOPPED UNDER

PROTOCOL USB-HID

Figure 2 shows the stitching of the A.D.C with the

microcontroller (µC). (For reasons of clearness of the

diagram we represented only four A.D.C).

Fig. 2 Circuit of acquisition.

Although the microcontroller has an intern converter A/D

we choose a solution containing external converters for the

following reasons:

Four converters are faster than only one: indeed if

the choice were made on the intern converter the

total time of conversion is multiplied by four since

the time of this intern converter will be distributed

between the four analogical entries.

With this process, even if we want to increase the number

of analogical entries, the time of conversion is in fact that of

only one converter since the converters work in parallel.

During conversion the µC will be free to perform

the work of transfer of the data towards and since

the host.

As the figure 2 shows the choice was made on the

converters A/D of the type ADC0831.

They are converters with 8 bits and serial ports. The

transfer of the data with the µC is a synchronous type via

clock CLK. The bit most extremely b7 MSB will be the first

transferred.

The beginning of conversion will start immediately after

the selection of the component via the pine CS (chip select).

The time of conversion mentioned by the manufacturer is

32µs.

Consequently total time to acquire the four analogical

signals is also 32µs.

A. VREF and VIN (-)

To optimize the process of conversion it is necessary to

know in which margin varies the signal to digitalize. To do

this,the converter ADC0831 has two entries noted VREF and

VIN (-) to permit better frame the signal.

For example let us suppose that our signal fluctuates

between the limits.

vmin = 1.5 v and vmax = 2.5 v

CS1

VIN(+)2

VIN(-)3

CLK7

VREF5

DO6

U3

ADC0831

CS1

VIN(+)2

VIN(-)3

CLK7

VREF5

DO6

U1

ADC0831

CS1

VIN(+)2

VIN(-)3

CLK7

VREF5

DO6

U4

ADC0831

CS1

VIN(+)2

VIN(-)3

CLK7

VREF5

DO6

U5

ADC0831

RA0/AN02

RA1/AN13

RA2/AN2/VREF-/CVREF4

RA3/AN3/VREF+5

RA4/T0CKI/C1OUT/RCV6

RA5/AN4/SS/LVDIN/C2OUT7

RA6/OSC2/CLKO10

OSC1/CLKI9

RB0/AN12/INT0/FLT0/SDI/SDA21

RB1/AN10/INT1/SCK/SCL22

RB2/AN8/INT2/VMO23

RB3/AN9/CCP2/VPO24

RB4/AN11/KBI0/CSSPP25

RB5/KBI1/PGM26

RB6/KBI2/PGC27

RB7/KBI3/PGD28

RC0/T1OSO/T1CKI11

RC1/T1OSI/CCP2/UOE12

RC2/CCP113

VUSB14

RC4/D-/VM15

RC5/D+/VP16

RC6/TX/CK17

RC7/RX/DT/SDO18

RE3/MCLR/VPP1

U6

PIC18F2550

PROGRAM=adc_0831_7.HEX

F1

N1

F2

N2

F3

N3

F4

N4



See how we will position the two reference voltage

standards VREF and VIN (-):

VIN(-) = vmin = 1.5 v

VREF = vmax – vmin = 2.5 – 1.5 = 1 v

The n value resulting from conversion of the signalVIN (+)

is worth:

n = ( ) ( )

We propose as solution a simple tension divider as shown

in the figure 3.

Fig. 3. tension divider

Figure 4 shows the connection of the host to the

peripherals (biomedical Sensors).

Fig. 4. Connection of the host to the peripherals

B. Detail of the Descriptors

TABLE I

DESCRIPTOR OF PERIPHERAL

Nom Nb

octets Valeur

(hexa) Longueur 1 12

descriptorType 1 01

cdUSB 2 02 00

DeviceClass 1 00

DeviceSubClass 1 00

DeviceProtocol 1 00

MaxPacketSize0 1 20

IdVendor 2 14D8

IdProduct 2 0015

bcdDevice 2 00 01

Manufacturer 1 01

Iproduct 1 02

ISerialNumber 1 00

NumConfigurations 1 01

TABLE III DESCRIPTOR OF HID

Nom Nb

octets

Valeur

(hexa)

Longueur 1 09

descriptorType 1 21

HID 2 01 01

countryCode 1 00

NumDescriptors 1 01

DescriptorType 1 22

DescriptorLength 2 00 2F



C. Total Flow Chart of Transfer of the Data

FLOWCHART I

D. Programming Host on PC

1) The Interface on the PC: Our project has as a role to

visualize in real-time and simultaneously up to 16

physiological signals in order to make from it telemedical

practice exploitation. For that we implement a graphical

interface on PC which allows the piloting of a µC chart. The

PC sends to the chart the orders concerning the ways to be

converted and authorizes the sending of the conversion

results (Taking advantage of theWindows DLL mcHID.dll

which allows the exchanges of information between the PC

and the µc). We reserve in the frame sent to the µc a byte of

ways selection. After the reception of the data resulting from

the µc those are ordered and translated in the forms of plots

on the screen of the local PC. Figure 5 shows an overall

picture of the lodged interface by the local PC.

Fig.5 Interfaces on PC

a) Parameter part:

This part contains the boxes of entry ordering from

channel one to channel sixteen plus a scale which gives the

choice in order to calibrate the plot.

b) Value part

In this one we can visualize the number of bytes

transmitted to the PC and the numerical values of conversion

A/D for each sample corresponding to the selected

channel.These values are stored on a file.

c) Plot part

It is the greatest part in the interface. It permit to visualize

the signals of the channels selected in the menu parameter.If

several signals must be traced simultaneously, graphic space

is shared consequently.

The principal menu offers the following possibilities:

Analogical Entries: choice up to sixteen different

analogical entries.

Visualization: we can moreover choose to visualize

only certain ways among those previously selected.

According to the number of selected ways the program

makes calculation automatically suitable scale. If we wishes

to see only one plot, all the surface of the plan will be

reserved to it. On the other hand if the choice is made on four

ways, then reserved space to the plot of each analogical

signal is divided by four and the origin of the reference axis

of each graph is consequently given.

In all the cases of figures, the data received via USB are

stored in memory tables and will be saved in separate files.

This will allow to redisplay it or to do the spatio-spectro-

temporal analysis later.

View of data frame received by the PC

Code Octet1 Octet2 Octet3 Octet4 … Octet7 Octet8

Buffer of emission?

Sending of 64 bytes

Buffer of reception empty ?

Reading of the buffer reception

Awaited acquisition?

Launching of conversions

To put at zero 4 variables of reception

Reading of the b7 of the 4 variables of reception







Configuration of the PORTS

USB Task


Enumeration: Sending of the

Descriptors the host



View of data frame sent by the PC

code Value1 : CAG Value2 : channelsto be

treated

2) Flow chart host on PC:

FLOWCHART II

IV. RESULTS UNDER PROTOCOL USB-HID

The figure6 shows the display of only one signal (EKG)

Fig. 6. Viewing of only one signal (EKG)

The figure7 shows the display of six physiological signals:

1) Electrocardiogram EKG is acquired by

amplifier of instrumentation AD620.

2) Complex QRS Detected.

3) The photopléthysmogram PPG is acquired by

a molecular spectrophotometry of absorption in

the infra-red representative of the concentration

of oxyhemoglobin pulse HbO2 [17].

4) Pneumotachgram PTG is acquired by

Pneumotachography of Fleisch with variable

reluctance and representative of the ventilatory

flow [16].

5) The index of variation Pleth PVI obtained by

the averaging of PPG and representative of

respiratory variation of the PPG correlated with

the response to the vascular filling RVF.

6) Current volume Vt (Tidal volume) obtained by

integration of the inspiratory flow and

representative of the efficiency of the

ventilatory muscle function that might be

exploited during telemonitoring of the

mechanical ventilation.

Fig . 7. Viewing respectively ECG, QRS, PPG, PTG,

PVI and VT

The figure 8 shows the display of sixteen archived signals

taken randomly.

General initialization, Calculation of the

scales

Sending of the frame towards µC

Received data?

Reading of the reception frame

Sending of the frame towards µC

Procedure of plotting

valid IDVendor

IDproduct ?



Fig. 8. Showing of sixteen signals archived.

V. SOME FUNCTIONALITY OF THE GRAPHICAL USER

INTERFACE

This graphical user interface provides to the practitioners

of telemedicine a very large number of options relating to

operating signals (spatially, temporally and spectrally) which

provide an efficient and rapid diagnosis aid [12].

We present through the figures some of these possibilities.

The figure 9 shows the possibility of reversing any signal.

Fig. 9. Inversion of signal

The heart rate is obtained by simple selection of two

successive R peaks allowing immediate diagnosis of possible

cardiac arrhythmia, tachycardia, bradycardia....(Figure 10)

Fig. 10. Display of cardiac frequency

Figure 11 shows the superposition of two signals. This clearly

shows that the concentration of oxyhemoglobin pulsed increases

during inspiration and decreases during expiration in the case of

normal breathing. This allows detecting immediately any

respiratory failure.

Fig. 11. Superposition of two signals (PTG and PPG).

The figure 12 shows a spatial analysis which allows the

display of the maximal flow value and the Tidal volume

value by simple selection of corresponding waves.

Fc=65 bpm



Fig. 12. Spatial analysis.

The figure 13 shows a temporal analysis which allows

to display the duration of any waves by simple selection.

Fig. 13. Temporal analysis.

The figure 14 shows spectral content of EKG signal

Fig 14 Spectral analysis of EKG.

The figure 15 shows spectral content of PPG signal

Fig. 15. Spectral analysis of PPG.

VI. TECHNIQUES AND METHODS DEVELOPED UNDER

PROTOCOL TCP/IP.

FLOWCHART III

IMPLEMENTATION OF CLIENT-SERVER CONNEXION [12]

VII. RESULTS UNDER PROTOCOL TCP/IP

The multi-media interface of communication realised

under environment Visual l BASIC comprise:

The textual transfer window.

The vocal transfer window.

The video transfer window.

The file transfer window.

The figure 16 shows an example of image transfer.

Vmax=0.6335L Dmax=0.1785L/s

The line n°= 25 it's a max line

Signal frequency = 3,96428571428571 Hz

p=0.84 s p=0.9 s

p=5.43 s

p=3.49 s

p=0.84 s

p=0.97 s p=0.33 s p=0.43 s

The line n°= 76 it's a max line

Signal frequency= 12.0514285714286

Hz

T=0.819s

F=1.22Hz



Fig. 16. Example of transfer of scanographic images.

Figure 17 shows time between the start of complex QRS,

representative of systolic myocardial electrical activity, and

start of myocardial hemodynamic activity which represent

the response to the vascular filling RVF.

Fig. 17. Evaluation of the RVF by simple selection.

VIII. CONCLUSIONS

This work mainly revolves around a technological

development that allows at the disposal of telemedicine

actors a powerful hardware and software tools dedicated to

this new form of medical practice that is telemedicine.

The developed device involves a simple local computer

terminal that controls the biometric peripherals and hosts the

data collected on the patient and the spatio-spectro-temporal

processing applications of these data.

The different treatments that evaluate pertinent stochastic

parameters such as intercorrelation functions, interspectral

densities of energy, objectives morphological analysis can

be implemented according to the needs expressed by doctors

in relation with their specialties.

These different treatments are made possible through the

USB-HID protocol which allows archiving data and TCP-IP

protocol which allows conveying this data to the

implementation of the different telemedicine aspects:

teleconsultation, telediagnosis, tele-expertise and

telesurveilleance.

Furthermore the various digital processing of

physiological signal give the telemedicine practitioner a

valuable platform for diagnostic aid.

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RVF = 0 ,22s

http://automatepc.fr/?page=BusUsb

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http://www.google.fr/url?q=http://downloadbookz.com/e-health-telehealth-and-telemedicine-a-guide-to-startup-and-success-jossey-bass-health-series.html&sa=U&ei=vijlTJGdKI62hAfqt9G-DA&ved=0CAQQFjAAOAo&usg=AFQjCNFchdAgWfqDix0UKPxruaQshkfRkg

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