DISCLAIMER: This application is used for demonstrative and illustrative purposes only and does not constitute an offering that has gone through regulatory review. It is not intended to serve as a medical application. There is no representation as to the accuracy of the output of this application and it is presented without warranty.

Introduction, Inspiration and Problem

The Current COVID-19 pandemic changed everything. From the way we do business, congregate, transport and most specially the way we go to the doctor and take care of our health. This made Telemedicine one if not the way to move forward regarding simple patient care. So, we decided to research what kind of solutions we are adopting.

Sometimes telemedicine software is offered as a standalone platform, but these days it's not unusual to find it also provided within existing medical practice management (PM) software. Even standalone telemedicine platforms will often easily integrate with other medical software, such as for Electronic Health Records (EHR) or to make it easier to work with patient histories, making it easier to diagnose or treat medical conditions. (1).

But that's the main problem. The sophistication of a system does not matter if few people are using it (at sometimes prohibitive costs) and it has no reach to zones where it was intended to operate. Also, most systems are way too cumbersome to use, have very old UI's and are not adaptable to modern needs.

To validate these past hypotheses, we decided to do some field research and ask Medical Doctors first hand, several questions, regarding their use of Telemedicine platforms and the way we can improve them.

We made a series of interviews with Medical Doctors, you can find the full documentation in this repository: https://github.com/altaga/Scup/tree/main/Interviews

We have to add that these tests were performed with Doctors just from Mexico City, where telehealth solutions are almost non-existent or have not reached the numbers that are needed today.

And this is where we see the main problem.

Most doctors were using Zoom or Teams for their telemedicine needs!

Yes, that is indeed the current situation regarding telehealth, at least in Mexico. We also spoke with several MD's in the US and most of them were doing the same.

Even though we have several, very sophisticated systems they have not reached mass market, are too hard to use and do not provide useful data.

And that's the second problem, the current meeting apps do not meet the healthcare needs regarding just taking Biometrics or following up patients.

But what if we can change that?

Why 5G?

5G has grabbed the attention of people everywhere (both good and bad), but most people only have heard of its promises at giving more speed, better coverage and reduce congestion. But 5G is much more than just fast downloads; its unique combination of high-speed connectivity, very low latency, and ubiquitous coverage will support smart vehicles and transport infrastructure such as connected cars, trucks, and buses, where a split-second delay could mean the difference between a smooth flow of traffic and a 4-way crash at an intersection. This of course, is vital for Telemedicine applications.

5G will enable us to control more devices remotely in applications where real-time network performance is critical, such as remote surgery. To be fair for the IoT promise to become a reality it needs of 5G and mesh networks which is the only other viable option for the billions of devices that will be connected to the internet in the coming years.

So, in essence we have two main problems for this application nowadays, Scalability and congestion of 4G networks and both are solved with 5G networks.

Solution

SCUP is a Smart telemedicine platform, based on IoT devices that provides Vital signs and historical values. This to transform the way telemedicine is provided and solve the biggest problem in relation to distance check-ups, which is taking biometrics. Our current version consists of an Oxygen Saturation Thimble, an ECG sensor and a contactless Thermometer that can send real time information to a web application. This allows distance consultations and follow ups to become more seamless and to grab real biometrics and vital signs while doing them.

Here is our current development:

Click on the image please as markup cannot embed videos.

Demo

How we built it

This is the main diagram of the system:

Through several cloud services we can get important biometric data from the patient. First through MQTT and AWS IoT we are collecting the sensor data that is sent through an AWS API to a Database. Then though another couple API's we are using that data and filling the required slots on our webapp.

This is the Architecture of the system at a "server" glance:

In the EC2, T3 type medium virtual machine we are deploying SCUP5G, with the AWS code pipeline module to complete the CircleCICD. At the same time the VM is in a virtual private cloud subnet deployed at the AWS Wavelength network with a carrier gateway (Our was on the Wavelength SF). Of course, we were using the NOVA service, allowing us access to Verizon's 5G network.

The devices are developed by us using off the shelf components and are mostly 3D printed. The temperature Sensor and the Oxygen Saturation Thimble are very self-explanatory as they are just wireless (WiFi powered) and only send their data to the Database.

The ECG sensor is much more complicated as we continue developing a past project: https://www.hackster.io/386896/ehm-electrocardiography-holter-monitor-06a4f3

The innovation we are bringing to the table regarding this sensor is the use of Dry electrodes and integration into everyday clothing, making it indeed much easier to use and very comfortable.

Real World Alpha Test

This is perhaps the most important part of the project as we decided to test it with real doctors in a real* clinical setting. *We avoided attending emergency and terminal patients and chose patients without many symptoms.

The Alpha Test involved 9 medical doctors from different areas to use the SCUP’s Application. They also got the opportunity to see in action the wireless medical devices. All of them spent time in the application with a patient, some of them recreated a normal medical consultation. The rest of them used the application as an experiment of the new technology. In the end, all of them were amused with the software. They haven't seen any Telemedicine software like this one and were surprised about the devices. They gave us valuable feedback which we used to improve the UI and the medical reports in to make it useful and user friendly. The testers also gave us ideas about the next devices we could integrate to SCUP’s Application. We are thinking of expanding this to 50 MDs for our Beta test and continue testing, while exploring business models for the IoT devices and applications.

Here is a compilation of the most important aspects of said Alpha test:

Click on the image please as markup cannot embed videos.

Alpha

TRIAL

To run a trial of the application first go to this link and choose your preferred way to run it whether it is with 5G, Nova, or others:

https://github.com/altaga/Scup-5G/blob/master/test.md

As this application requires the physical devices to work, we have prepared a virtual device simulator that you can find in our Github. In addition, with Step by step instructions on how to use it:

https://github.com/altaga/Scup-5G#simulator-tab

Or this video: Click on it, we are on Markup.

DEMO

We are always up for a live demonstration of our projects, if you are a judge of this contest, please contact us via Devpost or Github!

What's next for SCUP

Testers gave us ideas about the next devices we could integrate to SCUP’s Application. We are thinking of adding blood pressure smart devices. It is the last primary measure for vital signs and there are some other medical devices we can continue adding. By now the public's emotions towards telemedicine is that it is somewhat useless (in some regards) and not well focused.

We are thinking of expanding this to 50 MDs for our Beta test and continue testing, while exploring business models for the IoT devices and applications. We will show telemedicine is no longer science fiction, by continuous testing and improvement within the medical community.

Final Commentary

This is perhaps the first telehealth application of this kind to have potential to reach mass market and become a part of a Doctor's repertoire. Most medical Doctors, even in the US and Europe, not to mention developing countries (such as Mexico) are NOT using determined applications for their telehealth needs, but the common meeting applications such as Teams or Zoom. We are just using an add-on that aims to overcharge their capabilities with biometric reading and patient follow ups, which is the way to go. It's much easier to adopt many more users this way than to expect them to learn to use a new application from scratch.

5G is essential for the future of applications such as this as the current 4G infrastructure and even other kind of networks is not up to par with the number of devices that several industries will be asking of them in the coming years.

We envision a future in which Healthcare is invisible and seamless, where you are getting the attention of experts but only engage if necessary. Using Machine learning and IoT to monitor symptoms to a condition with every process improving so it becomes error-free. With emphasis on the preventive side and with the patient as the point of care, YOU become the point of care.

References:

(0) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4193577/ (1) https://www.techradar.com/best/best-telemedicine-software (2) https://doxy.me/en/ (3) https://www.amchealth.com/ (4) http://swymed.com/software-cloud-server/ (5) https://www.teladochealth.com/ (6) https://www.mendfamily.com/ (7) https://www.advancedmd.com/patient/telemedicine-software/ (8) https://www.acetiam.eu/acetiam-solutions/telemedicine/ (9) https://mdlnext.mdlive.com/ (10) https://physicianvisit.com/ (11) https://www.thera-link.com/pricing/ (12) https://www.theraplatform.com/ (13) https://www.sofiasalud.com/ (14) https://www.ncbi.nlm.nih.gov/books/NBK207146/ (15) https://telemedicine.arizona.edu/blog/7-telemedicine-concerns-and-how-overcome-them (16) https://docs.aws.amazon.com/wavelength/latest/developerguide/get-started-wavelength.html (17) https://www.youtube.com/watch?v=rp4ELaaodCU

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