A novel codification scheme based on the "VITAL" and "DICOM" Standards for telemedicine applications

The field of interest discussed in this study is a novel codification scheme for (vital signs) medical device communication and patient monitoring data interchange, into the context of effective home care service provisioning. With medical technology having developed in isolation and major manufacturers developing their own proprietary communication protocols, which preclude connection to devices from different manufacturers, and with healthcare trends having evolved, pointing to primary care, telecare and home care monitoring, there is an increasing need for technical standardization in healthcare environments and the development of protocols that enable communication in a structured and open way. In this study, a novel codification scheme has been developed, based on two healthcare informatics standards, the VITAL and DICOM Sup. 30, in addressing the robust interchange of waveform and medical data for a home care application. Based on this scheme, we created a real-time facility, consisting of a base unit and a telemedicine (mobile) unit, that enables home telemonitoring, by installing the telemedicine unit at the patient's home while the base unit remains at the physician's office or hospital. The system allows the transmission of vital biosignals (3-lead ECG, pulse rate, blood pressure and SpO2) of the patient. This paper presents an object-oriented design with unified modeling language (UML) of a class hierarchy for exchanging the acquired medical data and performing alert management, and investigates the applicability of the proposed scheme into a commercial patient-connected medical device, thus addressing service and functionality requirements with focus on home-care applications. The system has been validated for technical performance over several telecommunication means and for clinical validity via real patient-involved pilot trials.