Franchi D, Palagi G, Bedini R, Ripoli A and Belardinelli A.
CNR Institute of Clinical Physiology,
Via P. Savi 8, 56100 Pisa, Italy.

Telemedicine is the delivery of care to patients anywhere in the world by combining communications technologies with medical expertise. This is an emerging field that could have a revolutionary impact on health management. The main goal of this approach, namely to improve access to high quality medical care at affordable cost, can be pursued by means of an effective integration of Hospital and Home Care. In this work we report about a developed system for the home and hospital monitoring and surveillance of patients. The subject is equipped with a palmtop datalogger based on a 16 bit RISC, C native, processor. The device, provided with 8 analogic channels for the acquisition of physiological parameters such as electrocardiogram, blood pressure etc., is connected by telephone with a central specialistic station; the connection between the device and the public telephone line is accomplished by a modem, embedded in the telephone plug, communicating with the patient terminal through an IR link. The communication between the patient and the hospital is managed by a reliable developed protocol; the linkage may be previously programmed or accomplished on request both by the central station or the patient or the device itself. The computing power of the used processor makes possible to place a local intelligence, for on-line analysis, directly in the patient terminal. As an example we have developed a programme for the analysis of the RR variability of the electrocardiogram, in such a way that alarms and special connections procedures are activated by pre-selected threshold values and computed parameters of the processed signal.