Let's take a look on some of the problems that appear during implementation of remote health monitoring systems. There are many challenges that health monitoring systems face. Effective use of mobile devices in health systems requires additional research and investigation of both hardware and software solutions. Among the most common difficulties, organizational and technological barriers, both patient and doctor skeptic attitudes, threats to confidentiality and privacy of patient's personal information, legal, ethical, and administrative barriers, large costs of system implementation and maintenance. There are also factors related to telecommunication and hardware, which include reliability problems, sudden interruption of telecommunication networks, scalability in terms of data rate and power consumption, energy inefficiency, weight of wearable devices, difficulty in some data processing due to the devices used in patient monitoring, and the needs of user training to use wearable system. Despite some progress in this area, many problems remain unresolved. Today, many companies offer portable devices for recording of various biomedical signals. Most of which are intended for sport purposes and fitness and much smaller amount for medical diagnostic. Such devices can be structurally divided into two main groups: separated wearable devices, made in the form of a belt, a bracelet or a smartwatch, or asserts connected directly to the smartphone. Pulse monitoring devices for sport and fitness usually consist of a chest belt, the ECG signal is recorded using the built-in electrodes of wearable device, and the watches mated with it. Usually, there is an ANT interface protocol designed for a special sport equipment or a smartphone Bluetooth Low Energy. One of the first companies to offer such a solution was Polar, but today a large number of solutions from other companies are now also available on the market. Risks monitors or fitness trackers are less accurate, and they use optical sensors for detecting the pulse wave, signal operating in reflecting light. Similar sensors are also integrated into most modern smartwatches, where the heart rate measurement is not the main goal, but only one of it's features. Among the second category of such devices, we can highlight the following popular models: a LifeCore allows you to record ECG from one lead; there are also many solutions based on a pulse wave rather than on ECG: A complicated solution, Scatter scout combines a heart rate monitor with the saturation index registration and an infrared thermometer. Data registration is carried out through a touch to the user's head, and it's transmitted to the smartphone via bluetooth interface. Another example of a telemedicine application are the home blood pressure monitoring systems. Since registration of pulse wave propagation time is the heart of the entire blood pressure monitoring algorithm, it's calculation requires synchronous recording of pulse wave signal and ECG with at least one channel. Based on these considerations, a block diagram of the continuous blood pressure monitoring system consists of the following main parts: breast-located sensor, a bracelet on the wrist, and an oscillometric tonometer for correction of blood pressure measurement results. The signals from all sensors and a tonometer are synchronized together with the data transmitted wirelessly to the user's smartphone. As we have chosen the development of a prototype of remote ECG monitor, we will focus on this signal in the next videos. Here are some examples from the market. QardioCore is a wireless electrocardiogram monitor that continuously records ECG data along with heart rate variability, body temperature, respiration rates, stress levels, and activity reading. Another solution, KardiaMobile device, is a single-lead ECG monitoring system available as a special console for any smartphone tablet supported with the bluetooth interface and so on, and it is strapped to the Apple Watch. There are also applications in diabetes monitoring, including portable glucose meters and continuous blood glucose monitoring systems, just as an example, Medtronic iPro or Decor G6 continuous glucose monitoring systems. Lots of scientists and engineers are now working towards the development of non-invasive blood glucose meters. It is not always necessary to develop and certify your own hardware to implement such a system. For example, in a remote gestational diabetes monitoring system that I'm currently working on at Almazov Medical Center, I use certified blood glucose meters and continuous glucose monitoring systems to collect the data. I'm mainly concentrated on the development of the software for patients' smartphone and desktop computers, and the development of the software application that integrates data from different sources. I also work on the physician's decision support system with data-driven models created with machine learning.
