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Problems and solutions in the introduction of wireless communication technology to the clinical medicine setting DOI:10.15199/48.2016.02.10

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The introduction of wireless communication technology into large Japanese hospitals is rapidly progressing. However, many hospitals are having problems, such as inadequate signal range, electromagnetic interference by waves generated inside/outside the hospital, or by devices carried in by the staff or patients, and some have problems with network security. Here we show illustrations of these problems and give solutions that might be considered. Streszczenie. Wprowadzanie technologii komunikacji bezprzewodowej w dużych szpitalach w Japonii postępuje bardzo szybko. Jednak w wielu szpitalach występują problemy, takie jak niedostateczny poziom sygnału, zakłócenia w postaci fal elektromagnetycznych wytwarzanych wewnątrz i na zewnątrz szpitali lub generowanych przez urządzenia noszone przez personel lub pacjentów, a w niektórych przypadkach problemy z zabezpieczeniem sieci. W artykule zaprezentowano te problemy oraz zaproponowano rozwiązania, które mogą być zastosowane. (Problemy i rozwiązania w związku z wprowadzeniem technologii komunikacji bezprzewodowej w jednostkach opieki medycznej). Keywords: Electromagnetic environment; Electromagnetic Noise; Security. Słowa kluczowe: środowisko elektromagnetyczne; szum elektromagnetyczny; bezpieczeństwo. Introduction The introduction of wireless communication technology by large Japanese hospitals is rapidly progressing and expanding. Typical examples of how wireless LAN data is currently used include communication between the servers and terminals of hospital information systems and voice communication between patients and nurses that uses a weak output mobile phone system (PHS, Personal Handyphone System) as part of a nurse call system. Portable radiological imaging equipment that transmits images to a Picture Archive and Communication System (PACS) through wireless LAN has been commercialized and is widely equipped in wards. In Japan, the diffusion rate of mobile phones is close to 100%, of w[...]

Newly identified electromagnetic problems with medical telemetry systems DOI:10.15199/48.2018.02.06

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In Japan, "wireless medical telemetry systems" have been developed that continuously monitor inpatient vital signs, including heart rate with cardiac waveform, blood pressure, respiration rate, oxygen saturation rate in blood, and others. These systems consist of a monitor at the patient's bedside (bedside monitor) or affixed to the patient (patient monitor) that gathers vital signs and communicates them wirelessly to a monitor located in the staff station (central monitor). The Japanese government assigned the 420 MHz to 450 MHz frequency band for such use in 1989. If the output power does not exceed 1 mW, under the rules of the Japanese Radio Law, hospital staff can use the device without a license. The wireless communications of almost all medical telemetry systems used in Japan are divided into frequency band "channels." Systems can be configured with a variety of bandwidths per channel, but a maximum of 480 channels can be used. Each bedside and patient monitor is assigned a unique channel; thus, 480 bedside monitors can be used in one area. Fig.1. Medical Telemetry System In other countries, the assigned frequencies differ. Some countries have assigned a band for MBAN (Medical Body Area Network), and some systems use the same frequency as wireless LAN. At present, almost all Japanese hospitals have adopted telemetry systems that use analogue signal communication. The functions of the first medical telemetry system were continuous measurement and a warning system. For functions other than communication, the systematization of telemetry systems has progressed and more advanced functions have been added. Current telemetry systems connect to the hospital information system (HIS) and can send data to it to be stored. In addition, they have a function that can show a series of numerical values or cardiac waveforms for several seconds, including before and after a warning is sent. Although wireless medical telemetry syst[...]

Improving the clinical physiological examination environment - Avoiding EMD on medical equipment used for detecting biological signals -

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Shimane University Hospital constructed an electromagnetic shielded room to do electromyogram examinations. However, the quality of physiological examinations to detect weak biosignals was not acceptable. To create a safer environment, we re-installed the electric grounding and shortened the power cable to the minimum. And, we covered the power cable using electromagnetic shielding material. Also, we used an electromagnetic shielded mesh tent with shielding capacity of 20-30 dB. As a result, the electromagnetic noise was much reduced Streszczenie. Szpital Uniwersytecki Shimane zbudował ekranowane elektromagnetycznie pomieszczenie do badań elektromiograficznych. Jednak jakość badań fizjologicznych podczas detekcji słabych biosygnałów nie była zadowalająca. W celu poprawy środowiska badań zainstalowano uziom, skrócono i zaekranowano przewody zasilające oraz zastosowano namiot z siatki ekranującej o skuteczności ekranowania 20-30 dB. W rezultacie znacznie zredukowano szum elektromagnetyczny. (Poprawa środowiska elektromagnetycznego klinicznych badań fizjologicznych - Unikanie wpływu zaburzeń elektromagnetycznych na urządzenia medyczne do detekcji sygnałów biologicznych). Keywords: Medical Devices, EMG, Electromagnetic Environment, Shielding Mesh Tent. Słowa kluczowe: urządzenia medyczne, EMG, środowisko elektromagnetyczne, namiot z siatki ekranującej. Introduction Shimane University Hospital (hereafter, SUH) constructed a room with electromagnetic shielding in which to do electromyogram examinations (hereafter, the target room) in 1979. When using electromyogram (EMG) [1], noise reduction has been a serious problem for decades because the voltage is of micro-volt order. Many problems and solutions for dealing with noises related to EMG have been proposed [2]. Noises are categorized by their frequency, and most are filtered or have calculations done when processing waveforms. Reducing environmental electromagnetic noise is essential for i[...]

Electromagnetic compatibility of wireless medical telemetry systems and light-emitting diode (LED) lamps DOI:10.15199/48.2018.02.07

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In Japan, with the increasingly widespread use of lightemitting diodes (LEDs), electrical goods manufacturers have substantially downscaled traditional lighting, such as incandescent electric lamps and fluorescent light tubes. Additionally, the Japanese government has established policies to prohibit the manufacture and importation of traditional lighting by the end of 2020 [1]. Moreover, Baumgartner et al. predicted that LEDs will account for almost 70% of the general lighting market and over 70% of the outdoor and residential lighting markets by 2020 [2]. Therefore, hospitals will be entirely lit by LED lamps in the near future. LED lamps have been widely introduced in clinical settings to save energy and reduction of cost. Until recently, LED lamps were more expensive than traditional lighting devices, but their prices have gradually decreased. Additionally, the introduction of LED lamps reduces the total operating cost. In hospitals, in addition to room lighting, LEDs are used for shadowless lamps, oral cavity lighting, and lighting goggles used in operations. However, electromagnetic interference (EMI) by LED lamps has been reported. In 2010, poor reception of analogue television and radio broadcasting signals occurred after the installation of LED lamps along shopping streets in north-eastern Japan [3]. In hospitals, EMI with wireless medical telemetry systems may occur. Wireless medical telemetry systems are medical devices that transmit patient vital signs, such as electrocardiograms, respiratory waveforms, blood pressure, electromyograms, and oxygen saturation of arterial blood, to a patient monitor by radio waves. In Japan, the 420 to 450 MHz frequency band and 2.4 GHz band, commonly known as, Industrial, Science and Medical band, "ISM band" are assigned for such use. However, ISM bands are also used for various purposes, such as wireless local area network, microwave oven and cordless phone. To prevent interfer[...]

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