Diabetes Internet Appliance

1
Diabetes Internet Appliance

• Bamdad Afra
• Faisal Karmali
• Wallace Leung
• Gordon Li
• Faculty Mentor Rob Gorbet
• University of Waterloo
• Waterloo, Ontario, Canada
• IEEE Computer Society International Design
  Competition June 25-27, 2000

2
Facts

• There are more than 2 million people diagnosed
  with diabetes in Canada and more than 15.9
  million in U.S. (CDA and ADA 1997)
• Daily Diagnosis 2200 people in U.S. (ADA 1997)
• Annual incidents of causing blindness in U.S
• 12000-24000 (ADA 1997)
• Direct Cost in U.S. 44 billion (ADA 1997)
• Indirect Cost in U.S. 54 billion (ADA 1997)

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Outline

• Introduction
• Objectives
• Design Overview
• Prototype Implementation
• Mobile
• Server
• Wireless Link Simulation
• Product Concept and Economic Model
• Conclusions
• Future Directions

4
Background

• What is Diabetes?
• How is it treated?
• What are problems with the current state of
  diabetic care?
• What are the components of an office visit?

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Problem Statement

• To improve the quality and efficiency of
  diabetic health-care delivery through the use of
  portable, wireless communications technology

6
Existing Solutions
1. Basic Diabetic Telemedicine (Hawaii)
3. Diet Software

• 2. Electronic Diaries

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Objectives

• A comprehensive, user-friendly diary system
• Acquire blood glucose readings directly from the
  patients meter
• Wirelessly make the patients diary and diet plan
  available to their endocrinologist
• Global wireless messaging between the patient and
  doctor

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System Overview
Blood Glucose Meter
Information Appliance
Web and Database Server
Physicians Web Browser
Serial or infrared link
Wireless link
Internet
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DemoDiabetic PatientJohn Smith

• Scenario
• John Smith uses the glucose meter and the mobile
  unit of the DIA

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DemoEndocrinologistDr. Ryan

• Scenario
• Dr. Ryan uses the Internet to interact with his
  diabetic patient John Smith

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DemoServer Administration

• Scenario
• The Server Administrator is used to monitor the
  users of the DIA

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Performance Measures
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Design Methodology

• Waterfall model with staged-delivery and
  iterative design
• Microsoft Project used for project management
• Respective components on Mobile and Server
  implemented in parallel

14
Overall System Design

• Mobile
• Wireless Link Simulation
• Server Administrator
• Internet

Internet
Server Administration
Wireless Link Simulation
Mobile
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DIA - Mobile Implementation
User N
User ...
User 1

• Multi-user support
• Diary Blood Glucose database
• Diet Plan database
• Database synchronization
• Text Messaging
• Blood Glucose Meter Module

DIA
WLS
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DIA - Mobile ImplementationMulti-user Support

• Multiple users can have their own Diet Plan
  database, Diary Blood Glucose database and
  Inbox
• Object-Oriented Design
• For user verification Double MD5 algorithm is
  used

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DIA - Mobile ImplementationDiary Blood Glucose
Database

• Nature of database entries Ordered in time
• Database security Triple DES in CFB mode
• Database Record Redundancy
• Synchronization with server database

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DIA - Mobile ImplementationDiet Plan Database

• Automatic synchronization with server database

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DIA - Mobile ImplementationDatabase
Synchronization

• Asynchronous function calls on the remote
  Mobile/Server.
• Function parameters are recorded in as many
  packets as necessary.
• Along with time stamp and database record ID,
  packets are sent to Mobile/Server (destination)

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DIA - Mobile ImplementationText Messaging

• Each message is recorded in users mailbox
• Messages are tagged with sent or received flags

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DIA - Mobile ImplementationBlood Glucose Meter
Module

• Compliance with LifeScan Inc. Protocol
• Sending commands
• Parsing the output

22
Server Implementation

• Server makes the user information available to
  their endocrinologist over the WWW.
• CGI Server
• Database (Diary and Diet Plan)
• Messaging
• Server Administrator

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Server Implementation
Internet
CGI Server
Databases
Function Manager
WLS Packet Manager
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Wireless Link Simulation

• Physical Layer and Network Layer
• Request/Reply protocol
• Packet Size 64 bytes
• Round-trip 490 ms
• Encryption Triple DES in CFB mode
• Encryption Time 0.13ms per packet

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Product Concept

• Software-only component for wireless devices on
  the market
• WAP-enabled phones
• 2-way pagers
• Wireless palmtops
• Common server software

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Economic Model

• Cost of software to patient?
• Cost of device?
• Doctor reimbursement for time spent
• Will HMOs and insurance companies cover the costs?

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Conclusion

• The Diabetes Internet Appliance can be
  implemented using todays wireless technology.
• It has the potential to improve the quality of,
  and to reduce the cost of, diabetic health care.

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Future Directions

• 911-emergency
• Warn physician if patient misses diary entries
• Implement for a wireless device
• Conduct clinical trials
• FDA approval

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Q A
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