Brief Overview

The evolution of communication networks over the years along with the simplicity of mobile application development have given way to highly effective remote monitoring systems. These systems have today become significant in numbers and applications especially in production, fleet logistics, surveillance, access control, automation projects etc. Almost all of these systems have a common factor of providing a mechanism of getting real time feeds of activities happening on a remote location and providing a way to take practical decisions as an when required.
Industry divergence of technologies has revolved around the concept of exposing a certain process / workflow data to the internet and accessing the same from a remote location by a single or multiple individuals. This seemingly innocuous technology has but
provided array of options including:
Remote Decision Making
Collaboration of ideas between individuals sharing the process expertise
Quicker System Response Time

Apart from the above, the increase in mobility and location based services provide the next level of dimensions to process workflow monitoring by providing a context sensitive relevance to the process and adapting the decision making as per the context.

Concept of Real Time Tele Health Monitoring System and Application Scenarios

“The delivery of health care services, where distance is a critical factor, by all health care professionals using information and communication technologies for the exchange of valid information for diagnosis, treatment and prevention of disease and injuries, research and evaluation, and for the continuing education of health care providers, all in the interests of advancing the health of individuals and their communities” – WHO Global Observatory for eHealth series.
“In comparison to care managed by primary physicians and consulting specialists, intensivist managed care has been associated with decreased mortality, decreased length of stay (LOS) in both the ICU and on general care floors that ICU patients are eventually discharged from, and increased number of ICU admissions due to decreased LOS. However, a nationwide shortage of Intensivists has prevented a large proportion of hospitals and their patients from reaping the benefits of care by Intensivists.” Jeffrey Heyman – ECRI Institute
According to Kalorama Information one of the biggest medical market research firms in the American and European Markets, the age old problem of very low doctor to patient ratio has gone up by the day.

One of the causes of the problem lies in the fact that the combined world population of Intensivists (A physician who specializes in the care of critically ill patients, usually in an intensive care unit (ICU)) is less than the total population of individuals with coronary diseases in countries like India.
By applying the principles of Remote Monitoring and Telemedicine the above problems can be overcome.
Application in ICU - Typically the ICU environment continuously assails clinicians with distractions, alarms, and interruptions that produce alarm fatigue and the potential for increased error rates. While addressing the needs of 1 patient, a busy nurse or physician may be unaware of a second patient’s change in status that requires immediate attention. The Real Time Tele Health Monitoring System is that “second set of eyes” that provides additional clinical surveillance and support. By collaborating with the bedside team, the system can support care without distraction and deliver timely interventions when minutes may make the difference. The purpose of the system is not to replace bedside clinicians or bedside care, but to provide improved safety through redundancy and enhance outcomes through standardization.
Application in Critical Patient Consultation - Outside the ICU environment the first set of caregiver can actually service a patient in the hospital premises or the patients and based on the patient’s condition may elect to collaborate with the specialist. This enhances the chances of better treatment of the patient at the first level of the medical topology.
Application in ambulatory conditions – In urban conditions where the evolution of the communication networks and mobile patient care is best seen, the effect of real time transmission of patient vitals and waveforms will enable specialists at the hospitals to evaluate patient conditions real time with respect to conditions such as drug administration, application of Defibrillator etc on the patient. Along with the store and forward mechanism, this technology can further help the doctors at the hospitals to be better prepared for in coming patients.
Application in Critical Home Monitoring – As with the case with critical patient care monitoring, the right level of medical parameters as and when needed can be escalated by the primary caretaker or the patient as and when needed to the specialist for remote monitoring.
Application in eICU and HMS systems – With bigger multispecialty and multibedded hospitals coming up, the prevalence of Hospital Management Systems and integration with eICU systems for maintaining complete audit trails of patient right from the time of entry to the discharge is increasing. These systems typically handle the daily vital reports of the patients, inter ward transfer process of patients, IVS and other drug information being administered to the patient etc. The marriage of real time remote health monitoring systems with these systems can provide better patient management by increasing the human interaction with the patient electronically.
Proposed Platform Architecture 
Broadly the system design follows a traditional cloud based collaborative system. Our platform will essentially extend the rhythms24x7 platform. The basic aim of the design will be to provide an online platform for enabling medical devices to share their real time data with multiple viewers.   

Typical Workflow Pattern