Volume 7, Issue 5, May 2017 ISSN: 2277 128X International Journal of Advanced Research in Computer Science and Software Engineering Research Paper Available online at: www.ijarcsse.com Comparative Analysis of the Traditional Medical Monitoring of Vital Signs of Patients and Remote Medical Monitoring Ifeoma V. Ngonadi Department of General Studies (Computer Science Unit) Petroleum Training Institute, Effurun Nigeria DOI: 10.23956/ijarcsse/V7I5/01506 Abstract: A traditional medical monitoring involves monitoring the vital signs of patients in the hospital by the nurses using the different monitoring devices while remote medical monitoring is concerned with fitting the patients with monitoring devices which have sensors that monitor the patients vital signs while the patients can be outside the clinical setting and sending the results to the central station where it can be viewed by the doctor who proffers solution and medical procedures administered. This paper conducts a comparative analysis of the traditional medical monitoring and the remote medical monitoring. This was achieved by administering questionnaire to two hundred respondents out of which one hundred and eighty was returned. The weighted average was used for the analysis of the questions in the questionnaire. The result of this research work shows that the remote medical monitoring offers more advantage than the traditional medical monitoring. Keywords: Traditional Medical Monitoring, Questionnaire, Weighted Average, Remote Medical Monitoring, Vital Signs. I. INTRODUCTION A traditional medical monitoring system involves the monitoring of patients vital signs in the hospital and storing the result for the doctor to view and proffer solution. In the traditional medical monitoring system, the nurses monitor the vital signs of patients. The nurses check these vital signs two times in a day record the results and keep for the doctors to come around and see the readings. Vital signs are measures of various physiological statistics, often taken by health professionals, in order to assess the most basic body functions. Vital signs are an essential part of a case presentation. The act of taking vital signs normally entails recording Body temperature, Pulse rate (or heart rate), Blood pressure, and Respiratory rate, but may also include other measurements. Vital signs often vary by age.the equipment needed are: a thermometer, a sphygmomanometer, and a watch. Though a pulse can often be taken by hand, a stethoscope may be required for a patient with a very weak pulse[1]. Remote medical monitoring of patients requires monitoring the physiological state of patients with acute or chronic conditions or chronic disease states which predominantly derive decided prognosis advantages from intensive condition tracking. More particularly, the invention is directed to a condition monitoring system which includes one or more remote modular testing units and a central station. The remote units include physiological parameter testing modules to acquire data from one or possibly many patients and communicate with a central station typically capable of interfacing with a large number of patient-operated units or clinician-operated units testing many patients. The central station, in turn, may interface and communicate with any number of other devices as by networking. Parameters checked may include but are not limited to blood pressure, pulse rate, blood oxygen saturation, weight, blood glucose, temperature, prothrombin (clotting) time and pulmonary function, including respiratory rate and depth. Other functions, such as ECG (electrocardiograph) traces and infant breathing monitoring for detection of SIDS (sudden infant death syndrome) onset are also contemplated[2]. A remote monitoring system operates with an instruction set to provide automated administration of health care to a patient. In a preferred embodiment of the invention a central monitoring station receives data from a plurality of patients connected with vital sign monitoring sensors which is sent to the server at the central location preferably in the hospital. The doctor can view the server from anywhere to see the results of the patients vital signs. Medical procedures are then administered to the patient and results taken as data. The data is made available to the central monitor so that proper medical interpretation is enabled. A number of novel steps in the programming of the system are taken to assure that the right patient is being monitored, that the patient is being tested properly and that the system is being monitored appropriately. II. MEDICAL MONITORING A medical monitor or physiological monitor is a medical device used for monitoring. It can consist of one or more sensors, processing components, display devices (which are sometimes in themselves called "monitors"), as well as communication links for displaying or recording the results elsewhere through a monitoring network. 2017, IJARCSSE All Rights Reserved Page 887
In medicine, monitoring is the observation of a disease, condition or one or several medical parameters over time. It can be performed by continuously measuring certain parameters by using a medical monitor (for example, by continuously measuring vital signs by a bedside monitor), and/or by repeatedly performing medical tests (such as blood glucose monitoring with a glucose meter in people with diabetes mellitus). The traditional medical mode which employs a single medical treatment has the hospital as the centre and the patient as the treated object. In the traditional medical mode, the nurses use different monitoring devices to monitor the vital signs of patients and record the readings in the individual patients file. The results are kept in the patients files until the doctors come around to see them and proffer solutions. The traditional medical mode is shown in the diagram below: Fig. 1: Traditional Medical Monitoring System In the remote medical monitoring mode, the patients may not necessarily be in the hospital, they can be in their homes or in other remote locations while their vital signs are monitored. The patients wear the monitoring devices which collect their vital signs and send the results through the internet to the server located in the hospital. The doctor in turn can view each patient s readings stored in the server anywhere he is and proffer a solution. In the remote medical monitoring system, there is continuous monitoring of the patients vital signs. Remote monitoring, also known as selfmonitoring/testing, enables medical professionals to monitor a patient remotely using various technological devices [3]. This method is primarily used for managing chronic diseases or specific conditions, such as heart disease, diabetes mellitus, or asthma. These services can provide comparable health outcomes to traditional in-person patient encounters, supply greater satisfaction to patients, and may be cost-effective. Zimmerman [4] [5] from Massachusetts Institute of Technology proposed the concept of Body Area Network (BAN). Nowadays, the body area network technology has made a remarkable progress among many international universities and scientific research institutions. The remote medical monitoring system is shown in the diagram below: Bluetooth Wireless Protocol W eb S ervices The Internet Web Services Authorized viewer S ensors Mobile Devices Sensor Data Fig. 2: Remote Medical Monitoring System Source: IEEE Computer Society. April 2008 Vol. 41 No.4 2017, IJARCSSE All Rights Reserved Page 888
III. THE ANALYSIS A survey type questionnaire was used for this analysis. The questionnaire was given out to two hundred respondents which included doctors, nurses, patients and caregivers. A. The Use of Questionnaire Questionnaires were administered to a total of two hundredrespondents but a total of one hundred and eighty was collected back. The questions in the questionnaire were analyzed and grouped under the following headings: Doctor s response to emergency calls Efficiency Redundancy Cost Effectiveness Commitment to duty Dependence on power Life Saving Doctor s on call Reliability Disturbance Faulty Instruments Number of times a day the blood pressure and pulse rate is checked Failure to check the blood pressure and pulse rate The users responses are entered in the following table. Table I: Attributes of the Users Responses S/N ATTRIBUTES VERY OFTEN NOT SO OFTEN NOT AT ALL TOTAL 1. Response to emergency calls 94 28 58 2. Efficiency 56 112 12 3. Redundancy 90 6 84 4. Cost Effectiveness 91 29 60 178 5. Commitment to duty 50 22 24 96 6. Dependence on power 28 0 152 7. Life saving 152 4 12 168 8. Doctor s on call 90 42 48 9. Reliability 100 64 16 10. Disturbance 68 23 5 96 11. Faulty Instruments 56 30 16 102 12. Number of times a day the vital 148 12 20 sign is checked 13. Failure to check Bp and Pulse rate 0 78 30 108 The weighted average is used to analyze the results of the questionnaire. The weight 3 is assigned to represent very often, 2 to represent not so often and 1 to represent not at all. The response for each of the attributes is entered in a table and the weighted average is calculated. The option that is nearest to the result is the option taken and conclusion is drawn for that attribute. The weighted average is given by the formular: B. Calculation of the Different Attributes Doctor s response to emergency calls Table II: Doctor s Response to Emergency Calls F 94 28 58 Fx 282 56 58 396 3: Doctors respond very often to emergency calls 2: Doctors do not respond very often to emergency calls 1: Doctors do not respond to emergency calls at all. 2017, IJARCSSE All Rights Reserved Page 889 (1)
Ngonadi International Journal of Advanced Research in Computer Science and Software Engineering 7(5), 396 = 2.2 Therefore we conclude that doctors do not respond very often to emergency calls. Efficiency Table III: Efficiency F 56 112 12 Fx 168 224 12 404 3: The manual method of monitoring patient s blood pressure and pulse rate is very efficient 2: the manual method of monitoring patient s blood pressure and pulse rate is not very efficient 1: the manual method of monitoring patient s blood pressure and pulse rate is not efficient at all. 404 = 2.24 Therefore we conclude that the manual method of monitoring patient s blood pressure and pulse rate is not very efficient. Redundancy Table IV: Redundancy F 90 6 84 Fx 270 12 84 366 3: the nurses will feel redundant if the job of monitoring the vital signs are taken away from them 2: the nurses will not feel so redundant if the job of monitoring the vital signs are taken away from them 1: the nurses will not feel redundant at all if the job of monitoring the vital signs are taken away from them 366 = 2.03 Therefore we conclude that the nurses will not feel so redundant if the job of monitoring the vital signs are taken away from them. Cost Effectiveness Table V: Cost Effectiveness F 91 29 60 Fx 273 58 60 391 3: the remote medical monitoring will be very cost effective 2: the remote medical monitoring will not be very cost effective 1: the remote medical monitoring will not be cost effective at all To calculate the weighted average 391 = 2.17 Therefore we conclude that the remote medical monitoring will not be very cost effective. Commitment of the nurses to duty Table VI: Commitment of the Nurses to Duty F 50 22 24 96 Fx 150 44 24 218 3: the nurses are so committed to their duty of monitoring the vital signs 2: the nurses are not so committed to their duty of monitoring the vital signs 1: the nurses are not committed to their duty of monitoring the vital signs at all. 2017, IJARCSSE All Rights Reserved Page 890
Ngonadi International Journal of Advanced Research in Computer Science and Software Engineering 7(5), To calculate the weighted average 218 = 2.27 96 Therefore we conclude that the nurses are not so committed to their duty of monitoring the vital signs of the patients. Dependence on power Table VII: Dependence on Power F 28 0 152 Fx 84 0 152 236 3: the instrument for the manual monitoring of blood pressure and pulse rate depends on power all the time. 2: the instrument for the manual monitoring of blood pressure and pulse rate does not depend on power all the time. 1: the instrument for the manual monitoring of blood pressure and pulse rate does not depend on power at all. To calculate the weighted average 236 Therefore we conclude that the instrument for the manual monitoring of the blood pressure and pulse rate does not depend on power at all. Life saving Table VIII: Life Saving F 152 4 12 168 Fx 456 8 12 476 3: the remote monitoring of the vital signs of patients will very likely save the lives of the patients 2: the remote monitoring of the vital signs of patients will not likely save the lives of the patients 1: the remote monitoring of the vital signs of patients will not save the lives of the patients at all. To calculate the weighted average 476 168 Therefore we conclude that the remote monitoring of the vital signs of patients will very likely save the lives of the patients. Doctors on call Table IX: Doctors on Call F 90 42 48 Fx 270 84 48 402 3: the doctors on call stay in their offices very often 2: the doctors on call do not stay in their offices very often 1: the doctors on call do not stay in their offices at all. To calculate the weighted average 402 = 2.23 Therefore we conclude that the doctors on call do not stay in their offices very often. Reliability Table X: Reliability F 100 64 16 Fx 300 128 16 444 2017, IJARCSSE All Rights Reserved Page 891
Ngonadi International Journal of Advanced Research in Computer Science and Software Engineering 7(5), 3: the instruments for the manual monitoring of the vital signs are very reliable 2: the instruments for the manual monitoring of the vital signs are not very reliable 1: the instruments for the manual monitoring of the vital signs are not reliable at all. 444 = 2.46 Therefore we conclude that the instruments for the manual monitoring of the vital signs are not very reliable. Disturbance Table XI: Disturbance F 68 23 5 96 Fx 204 46 5 255 3: Patients feel disturbed every time their blood pressure and pulse rate are measured 2: Patients do not feel disturbed every time their blood pressure and pulse rate are measured 1: Patients do not feel disturbed at all when their blood pressure and pulse rate are measured. 255 = 2.65 3 96 Therefore we conclude that patients feel disturbed every time their blood pressure and pulse rate are measured. Faulty Instruments Table XII: Faulty Instruments F 56 30 16 102 Fx 168 60 16 244 3: the instruments for measuring the blood pressure and pulse rate can be faulty all the time 2: the instruments for measuring the blood pressure and pulse rate can be faulty sometimes 1: the instruments for measuring the blood pressure and pulse rate cannot be faulty at all. 244 102 Therefore we conclude that the instruments for measuring the blood pressure and pulse rate can be faulty sometimes Number of times a day the blood pressure and pulse rate is checked Table XIII: Number of Times the Blood Pressure and Pulse Rate are Checked F 148 12 20 Fx 444 24 20 488 3: the blood pressure and pulse rate of the patients are checked two times a day 2: the blood pressure and pulse rate of the patients are checked three times a day 1: the blood pressure and pulse rate of the patients are checked more than three times a day 488 = 2.71 Therefore we conclude that the blood pressure and pulse rate of the patients are checked two times a day. Failure to check blood pressure and pulse rate Table XIV: Failure to Check Blood Pressure and Pulse Rate F 0 78 30 108 Fx 0 156 30 186 2017, IJARCSSE All Rights Reserved Page 892
3: the nurses fail to monitor the blood pressure and pulse rate of the patients all the time 2: the nurses fail to monitor the blood pressure and pulse rate of the patients sometimes 1: the nurses do not fail to monitor the blood pressure and pulse rate of the patients at all. 186 = 1.72 2 108 Therefore we conclude that nurses fail to monitor the blood pressure and pulse rate of the patients sometimes. IV. RESULTS From the analysis of the questionnaire, the following inference is made: Monitoring the patients manually cause a lot of disturbance to the patients as they may be sleeping at the time or they may be very weak and may need to be allowed to rest. So in a remote medical monitoring system where the signs are monitored without the patient knowing it, it gives the patients enough time to relax and recuperate. High performance and fault tolerant wireless devices can now be employed to eliminate medical errors, to reduce workload and increase the efficiency of hospital staff, and to improve the comfort of patients. Records from individual monitoring sessions in a remote medical monitoring system can be integrated into research databases that would provide support for data mining and knowledge discovery relevant to specific conditions and patient categories. Death rate is drastically reduced to the barest minimum since the patients are attended to at the appropriate time in a remote medical monitoring system. Continuous monitoring of the patients tell a much deeper story about what is going on with the patient, revealing early signs of trouble that can trigger life-saving intervention. Remote medical monitoring enables villagers and chronically ill patients to have their vital signs monitored since they can be anywhere other than the hospital and their vital signs will still be checked. More hospital beds will be made available since the patient s do not need to be in the hospitals before their vital signs can be monitored. The hospital beds can thus be reserved for emergency situations. Doctors do not respond very often to emergency calls in a traditional medical monitoring system. The manual method of monitoring patient s blood pressure and pulse rate is not very efficient. The nurses will not feel so redundant if the job of monitoring the vital signs are taken away from them. The remote medical monitoring will not be very cost effective. The nurses are not so committed to their duty of monitoring the vital signs of the patients. The instrument for the manual monitoring of the blood pressure and pulse rate does not depend on power at all. The doctors on call do not stay in their offices very often. The instruments for the manual monitoring of the vital signs are not very reliable. The blood pressure and pulse rate of the patients are checked two times a day. This is shown in the chart below: 120 100 80 60 40 20 0 NOT AT ALL NOT SO OFTEN VERY OFTEN VERY OFTEN NOT SO OFTEN NOT AT ALL Fig. 3: Chart representing the analysis of the questionnaire 2017, IJARCSSE All Rights Reserved Page 893
Fig.4: Data Flow Diagram of the traditional medical monitoring system 2017, IJARCSSE All Rights Reserved Page 894
Fig.5: Dataflow diagram of the remote medical monitoring system V. CONCLUSION A comparative analysis of the traditional medical monitoring system and the remote medical monitoring system was done with a view to determining which of them is better. A survey type questionnaire was sent out to the nurses, patients and caregivers because they are the people directly involved and concerned with medical monitoring. Analysis was done on the questionnaire and it was discovered that remote medical monitoring has more benefits than the traditional medical monitoring because the remote medical monitoring offers a continuous medical monitoring, the doctors have real time information on each patient because they can access each patient s file at any point in time and from anywhere. The remote medical monitoring also give greater satisfaction to the patients and their caregivers because they are assured that their vital signs are monitored at all times and they are not disturbed in any way by the monitoring. 2017, IJARCSSE All Rights Reserved Page 895
REFERENCES [1] T. Gao, Vital Signs Monitoring and Patient Tracking Over a Wireless Network, inieee-embs 27th Annual Int. Conference of the Eng. in Medicine and Biology, 2005,p. 102 105. [2] S. Park, S. Jayaraman, Enhancing the Quality of Life Through Wearable Technology, in IEEE Engineering in Medicine and Biology Magazine, vol.22, pp. 41 48, 2003. [3] K. Traynor, Navy takes Telepharmacy Worldwide, in American Journal of Health-System Pharmacy, vol. 67, pp. 1134-1136, 2010. [4] T. G. Zimmerman, Personal area Networks (PAN): Near-Field Intra-Body Communication. PhD thesis, Massachusetts Institute of Technology, 1995. [5] T. G. Zimmerman, Personal area networks: Near-Field Intra-Body Communication, inibm Systems Journals, vol. 35, pp. 609 617, 1996. 2017, IJARCSSE All Rights Reserved Page 896