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Patient Triage & Telemedicine Post COVID19: Sensors and Solutions for Monitoring and Management in Hospital and at Home

A special issue of Sensors (ISSN 1424-8220). This special issue belongs to the section "Physical Sensors".

Deadline for manuscript submissions: closed (30 September 2021) | Viewed by 39312

Special Issue Editors

Dr. Gaetano D. Gargiulo

E-Mail Website
Guest Editor
School of Computing, Engineering and Mathematics (SCEM), Western Sydney University, Penrith, NSW 2751, Australia
Interests: Wearable and electrode-less physiological monitoring, Brain-computer interface, Biomedical engineering, clinical engineering
Special Issues, Collections and Topics in MDPI journals
Dr. Ganesh R. Naik

E-Mail Website1 Website2
Guest Editor
College Medicine and Public Health, Flinders University, Bedford Park 5042, Australia
Interests: biomedical engineering; signal processing; sleep, cardio respiratory research; BCI; wearables
Special Issues, Collections and Topics in MDPI journals
Dr. Tara Julia Hamilton

E-Mail Website
Co-Guest Editor
School of Electrical and Data Engineering, University of Technology, Sydney (UTS), Broadway, NSW 2007, Australia
Interests: biomedical engineering; neuromorphic engineering; mixed-signal integrated circuit design; medical devices; machine learning; circuits and systems for implantable and wearable biomedical devices
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Patient triage has always played a key role in emergency treatment and hospital admission. Providing accurate and timely assessments of seriously ill patients, based on urgency, is what makes the triage system work. However, triage nurses need to make decisions and initiate the correct patient journey among hundreds of possible presentation scenarios in the shortest timeframe possible. The recent COVID19 pandemic has dramatically increased the importance of correct triage and radically changed the concept of triage. In first instance the modality to approach patients has changed i.e. PPE requirements and continues monitoring of hospital/triage personnel. Secondly the necessity of triaging patients outside of the hospital and avoid presentation of COVID19 patients in a crowded Emergency Department is now paramount. In third instance, tele-triaged patients receiving therapy at home have dramatically increased the demand on the telemedicine systems.

In the last couple of decades, wearable and personal technologies have opened new scenarios for patient/personal health monitoring and patients are now carrying their devices upon hospital admission allowing for objective and quantitative assessment of physical conditions inclusive of past data. These devices are so widespread that also nurses/doctors might use one during their workhours. Some of these devices are now integrated (or integration is underway) into telemedicine solutions.

This Special Issue will explore new solutions in this vast emerging scenario, contributions that address (but not restricted to) the following topics are welcome:

  • Telemedicine
  • Case studies addressing the use of already available solutions repurposed to address the novel needs
  • Triage aided by wearable sensors
  • Integration of pervasive ubiquitous monitoring system into traditional triage systems and decision making
  • Management of triage
  • Tele-triage
  • Triage suitable sensors
  • Precision Triage
  • Triage during pandemic outbreak
  • Triage of triage personnel
Dr. Gaetano D. Gargiulo

Dr. Tara Hamilton

Dr. Ganesh R. Naik

Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Sensors is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Triage
  • Wearable systems
  • Integration of multiple sensors information
  • Continuous sensing data synthesis
  • Patient monitoring

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Published Papers (6 papers)

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Research

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22 pages, 5012 KiB  
Article
Secure Telemedicine System Design for COVID-19 Patients Treatment Using Service Oriented Architecture
by Asadullah Shaikh, Mana Saleh Al Reshan, Adel Sulaiman, Hani Alshahrani and Yousef Asiri
Sensors 2022, 22(3), 952; https://doi.org/10.3390/s22030952 - 26 Jan 2022
Cited by 9 | Viewed by 5368
Abstract
The coronavirus pandemic, also known as the COVID-19 pandemic, is an ongoing virus. It was first identified on December 2019 in Wuhan, China, and later spread to 192 countries. As of now, 251,266,207 people have been affected, and 5,070,244 deaths are reported. Due [...] Read more.
The coronavirus pandemic, also known as the COVID-19 pandemic, is an ongoing virus. It was first identified on December 2019 in Wuhan, China, and later spread to 192 countries. As of now, 251,266,207 people have been affected, and 5,070,244 deaths are reported. Due to the growing number of COVID-19 patients, the demand for COVID wards is increasing. Telemedicine applications are increasing drastically because of convenient treatment options. The healthcare sector is rapidly adopting telemedicine applications for the treatment of COVID-19 patients. Most telemedicine applications are developed for heterogeneous environments and due to their diverse nature, data transmission between similar and dissimilar telemedicine applications is a difficult task. In this paper, we propose a Tele-COVID system architecture design along with its security aspects to provide the treatment for COVID-19 patients from distance. Tele-COVID secure system architecture is designed to resolve the problem of data interchange between two different telemedicine applications, interoperability, and vendor lock-in. Tele-COVID is a web-based and Android telemedicine application that provides suitable treatment to COVID-19 patients. With the help of Tele-COVID, the treatment of patients at a distance is possible without the need for them to visit hospitals; in case of emergency, necessary services can also be provided. The application is tested on COVID-19 patients in the county hospital and shows the initial results. Full article
(This article belongs to the Special Issue Patient Triage & Telemedicine Post COVID19: Sensors and Solutions for Monitoring and Management in Hospital and at Home)
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20 pages, 58875 KiB  
Article
Wearable Bluetooth Triage Healthcare Monitoring System
by Caitlin Polley, Titus Jayarathna, Upul Gunawardana, Ganesh Naik, Tara Hamilton, Emilio Andreozzi, Paolo Bifulco, Daniele Esposito, Jessica Centracchio and Gaetano Gargiulo
Sensors 2021, 21(22), 7586; https://doi.org/10.3390/s21227586 - 15 Nov 2021
Cited by 20 | Viewed by 4945
Abstract
Triage is the first interaction between a patient and a nurse/paramedic. This assessment, usually performed at Emergency departments, is a highly dynamic process and there are international grading systems that according to the patient condition initiate the patient journey. Triage requires an initial [...] Read more.
Triage is the first interaction between a patient and a nurse/paramedic. This assessment, usually performed at Emergency departments, is a highly dynamic process and there are international grading systems that according to the patient condition initiate the patient journey. Triage requires an initial rapid assessment followed by routine checks of the patients’ vitals, including respiratory rate, temperature, and pulse rate. Ideally, these checks should be performed continuously and remotely to reduce the workload on triage nurses; optimizing tools and monitoring systems can be introduced and include a wearable patient monitoring system that is not at the expense of the patient’s comfort and can be remotely monitored through wireless connectivity. In this study, we assessed the suitability of a small ceramic piezoelectric disk submerged in a skin-safe silicone dome that enhances contact with skin, to detect wirelessly both respiration and cardiac events at several positions on the human body. For the purposes of this evaluation, we fitted the sensor with a respiratory belt as well as a single lead ECG, all acquired simultaneously. To complete Triage parameter collection, we also included a medical-grade contact thermometer. Performances of cardiac and respiratory events detection were assessed. The instantaneous heart and respiratory rates provided by the proposed sensor, the ECG and the respiratory belt were compared via statistical analyses. In all considered sensor positions, very high performances were achieved for the detection of both cardiac and respiratory events, except for the wrist, which provided lower performances for respiratory rates. These promising yet preliminary results suggest the proposed wireless sensor could be used as a wearable, hands-free monitoring device for triage assessment within emergency departments. Further tests are foreseen to assess sensor performances in real operating environments. Full article
(This article belongs to the Special Issue Patient Triage & Telemedicine Post COVID19: Sensors and Solutions for Monitoring and Management in Hospital and at Home)
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32 pages, 3271 KiB  
Article
E-Triage Systems for COVID-19 Outbreak: Review and Recommendations
by Fahd Alhaidari, Abdullah Almuhaideb, Shikah Alsunaidi, Nehad Ibrahim, Nida Aslam, Irfan Ullah Khan, Fatema Shaikh, Mohammed Alshahrani, Hajar Alharthi, Yasmine Alsenbel and Dima Alalharith
Sensors 2021, 21(8), 2845; https://doi.org/10.3390/s21082845 - 17 Apr 2021
Cited by 14 | Viewed by 11565
Abstract
With population growth and aging, the emergence of new diseases and immunodeficiency, the demand for emergency departments (EDs) increases, making overcrowding in these departments a global problem. Due to the disease severity and transmission rate of COVID-19, it is necessary to provide an [...] Read more.
With population growth and aging, the emergence of new diseases and immunodeficiency, the demand for emergency departments (EDs) increases, making overcrowding in these departments a global problem. Due to the disease severity and transmission rate of COVID-19, it is necessary to provide an accurate and automated triage system to classify and isolate the suspected cases. Different triage methods for COVID-19 patients have been proposed as disease symptoms vary by country. Still, several problems with triage systems remain unresolved, most notably overcrowding in EDs, lengthy waiting times and difficulty adjusting static triage systems when the nature and symptoms of a disease changes. In this paper, we conduct a comprehensive review of general ED triage systems as well as COVID-19 triage systems. We identified important parameters that we recommend considering when designing an e-Triage (electronic triage) system for EDs, namely waiting time, simplicity, reliability, validity, scalability, and adaptability. Moreover, the study proposes a scoring-based e-Triage system for COVID-19 along with several recommended solutions to enhance the overall outcome of e-Triage systems during the outbreak. The recommended solutions aim to reduce overcrowding and overheads in EDs by remotely assessing patients’ conditions and identifying their severity levels. Full article
(This article belongs to the Special Issue Patient Triage & Telemedicine Post COVID19: Sensors and Solutions for Monitoring and Management in Hospital and at Home)
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15 pages, 5727 KiB  
Article
Forcecardiography: A Novel Technique to Measure Heart Mechanical Vibrations onto the Chest Wall
by Emilio Andreozzi, Antonio Fratini, Daniele Esposito, Ganesh Naik, Caitlin Polley, Gaetano D. Gargiulo and Paolo Bifulco
Sensors 2020, 20(14), 3885; https://doi.org/10.3390/s20143885 - 13 Jul 2020
Cited by 37 | Viewed by 5105
Abstract
This paper presents forcecardiography (FCG), a novel technique to measure local, cardiac-induced vibrations onto the chest wall. Since the 19th century, several techniques have been proposed to detect the mechanical vibrations caused by cardiovascular activity, the great part of which was abandoned due [...] Read more.
This paper presents forcecardiography (FCG), a novel technique to measure local, cardiac-induced vibrations onto the chest wall. Since the 19th century, several techniques have been proposed to detect the mechanical vibrations caused by cardiovascular activity, the great part of which was abandoned due to the cumbersome instrumentation involved. The recent availability of unobtrusive sensors rejuvenated the research field with the most currently established technique being seismocardiography (SCG). SCG is performed by placing accelerometers onto the subject’s chest and provides information on major events of the cardiac cycle. The proposed FCG measures the cardiac-induced vibrations via force sensors placed onto the subject’s chest and provides signals with a richer informational content as compared to SCG. The two techniques were compared by analysing simultaneous recordings acquired by means of a force sensor, an accelerometer and an electrocardiograph (ECG). The force sensor and the accelerometer were rigidly fixed to each other and fastened onto the xiphoid process with a belt. The high-frequency (HF) components of FCG and SCG were highly comparable (r > 0.95) although lagged. The lag was estimated by cross-correlation and resulted in about tens of milliseconds. An additional, large, low-frequency (LF) component, associated with ventricular volume variations, was observed in FCG, while not being visible in SCG. The encouraging results of this feasibility study suggest that FCG is not only able to acquire similar information as SCG, but it also provides additional information on ventricular contraction. Further analyses are foreseen to confirm the advantages of FCG as a technique to improve the scope and significance of pervasive cardiac monitoring. Full article
(This article belongs to the Special Issue Patient Triage & Telemedicine Post COVID19: Sensors and Solutions for Monitoring and Management in Hospital and at Home)
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27 pages, 1330 KiB  
Article
Towards Real-Time Heartbeat Classification: Evaluation of Nonlinear Morphological Features and Voting Method
by Rajesh N V P S Kandala, Ravindra Dhuli, Paweł Pławiak, Ganesh R. Naik, Hossein Moeinzadeh, Gaetano D. Gargiulo and Suryanarayana Gunnam
Sensors 2019, 19(23), 5079; https://doi.org/10.3390/s19235079 - 21 Nov 2019
Cited by 48 | Viewed by 4316
Abstract
Abnormal heart rhythms are one of the significant health concerns worldwide. The current state-of-the-art to recognize and classify abnormal heartbeats is manually performed by visual inspection by an expert practitioner. This is not just a tedious task; it is also error prone and, [...] Read more.
Abnormal heart rhythms are one of the significant health concerns worldwide. The current state-of-the-art to recognize and classify abnormal heartbeats is manually performed by visual inspection by an expert practitioner. This is not just a tedious task; it is also error prone and, because it is performed, post-recordings may add unnecessary delay to the care. The real key to the fight to cardiac diseases is real-time detection that triggers prompt action. The biggest hurdle to real-time detection is represented by the rare occurrences of abnormal heartbeats and even more are some rare typologies that are not fully represented in signal datasets; the latter is what makes it difficult for doctors and algorithms to recognize them. This work presents an automated heartbeat classification based on nonlinear morphological features and a voting scheme suitable for rare heartbeat morphologies. Although the algorithm is designed and tested on a computer, it is intended ultimately to run on a portable i.e., field-programmable gate array (FPGA) devices. Our algorithm tested on Massachusetts Institute of Technology- Beth Israel Hospital(MIT-BIH) database as per Association for the Advancement of Medical Instrumentation(AAMI) recommendations. The simulation results show the superiority of the proposed method, especially in predicting minority groups: the fusion and unknown classes with 90.4% and 100%. Full article
(This article belongs to the Special Issue Patient Triage & Telemedicine Post COVID19: Sensors and Solutions for Monitoring and Management in Hospital and at Home)
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Review

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35 pages, 10503 KiB  
Review
Domiciliary Hospitalization through Wearable Biomonitoring Patches: Recent Advances, Technical Challenges, and the Relation to Covid-19
by André F. Silva and Mahmoud Tavakoli
Sensors 2020, 20(23), 6835; https://doi.org/10.3390/s20236835 - 29 Nov 2020
Cited by 28 | Viewed by 6665
Abstract
This article reviews recent advances and existing challenges for the application of wearable bioelectronics for patient monitoring and domiciliary hospitalization. More specifically, we focus on technical challenges and solutions for the implementation of wearable and conformal bioelectronics for long-term patient biomonitoring and discuss [...] Read more.
This article reviews recent advances and existing challenges for the application of wearable bioelectronics for patient monitoring and domiciliary hospitalization. More specifically, we focus on technical challenges and solutions for the implementation of wearable and conformal bioelectronics for long-term patient biomonitoring and discuss their application on the Internet of medical things (IoMT). We first discuss the general architecture of IoMT systems for domiciliary hospitalization and the three layers of the system, including the sensing, communication, and application layers. In regard to the sensing layer, we focus on current trends, recent advances, and challenges in the implementation of stretchable patches. This includes fabrication strategies and solutions for energy storage and energy harvesting, such as printed batteries and supercapacitors. As a case study, we discuss the application of IoMT for domiciliary hospitalization of COVID 19 patients. This can be used as a strategy to reduce the pressure on the healthcare system, as it allows continuous patient monitoring and reduced physical presence in the hospital, and at the same time enables the collection of large data for posterior analysis. Finally, based on the previous works in the field, we recommend a conceptual IoMT design for wearable monitoring of COVID 19 patients. Full article
(This article belongs to the Special Issue Patient Triage & Telemedicine Post COVID19: Sensors and Solutions for Monitoring and Management in Hospital and at Home)
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