Web application for display and analysis of clinical data from a home telemonitoring platform

Abstract

We designed and developed a home telemonitoring instrument, and relatedWeb application for management of clinical data. The instrument directlymeasures important physiological parameters (blood oxygen saturation,pulse rate, and respiratory parameters related to the use of pulmonaryventilators). The instrument also connects to external instruments(spirometer, capnometer, non-invasive blood pressure measuring device),thus collecting the corresponding clinical parameters. The instrumenthas a flexible architecture, which allows insertion of the necessaryboards only, depending on the parameters that need to be measured andthe external instruments to be interfaced for each patient. The measuredand collected data are transmitted to a Web server, through directconnection to a local Internet POP (thanks to the TCP/IP protocolimplemented at the instrument firmware level), thus avoiding longdistance calls possibly occurring in traditional modem-to-modemconfigurations. Transmitted data are made available for consultationthrough a Web application from the health professionals, wherever theyare (if an Internet connection is available). The advantage of using aWeb application instead of a traditional one is that all installationproblems are avoided, and the latest application version is immediatelyavailable for all the users. Within the Web application, the clinicaldata can be displayed and analyzed both in numeric and graphic format.It is also possible to mark some portions of data with properindicators: for instance, for saturation curves all the desaturationevents can be marked manually or after identification through anautomatic algorithm. Furthermore, the Web application allows possibledefinition of a new instrument setup, which can be transmitted to theinstrument thanks to the bidirectional connection with the Web server.The system is under test on fifteen patients with amyotrophic lateralsclerosis and respiratory problems. In future, the system could also beused for telemonitoring of different categories of patients with chronicpathologies.