Bringing the Artificial Pancreas Home: Telemedicine Aspects

Abstract

The design and implementation of telemedicine systems able to support the artificial pancreas need careful choices to cope with technological requirements while preserving performance and decision support capabilities. This article addresses the issue of designing a general architecture for the telemedicine components of an artificial pancreas and illustrates a viable solution that is able to deal with different use cases and is amenable to support mobile-health implementations. The goal is to enforce interoperability among the components of the architecture and guarantee maximum flexibility for the ensuing implementations. Thus, the design stresses modularity and separation of concerns along with adoption of clearly defined protocols for interconnecting the necessary components. This accounts for the implementation of integrated telemedicine systems suitable as short-term monitoring devices for supporting validation of closed-loop algorithms as well as devices meant to provide a lifelong tighter control on the patient state once the artificial pancreas has become the preferred treatment for patients with diabetes.

Improved Outcomes from Diabetes Monitoring: The Benefits of Better Adherence, Therapy Adjustments, Patient Education, and Telemedicine Support

“…21 Modular architecture technology is being developed to monitor CGM results and insulin dosages of study subjects remotely. 22 Telemedicine systems are being developed to monitor various measures continuously and to contact study subjects immediately if necessary. 23 On July 22, 2008, at a Food and Drug Administration (FDA)/National Institutes of Health/Juvenile Diabetes Research Foundation workshop on artificial pancreas in Bethesda, I proposed a remote system to diagnose and fix problems of a closed-loop system.…”

Remote Blood Glucose Monitoring in mHealth Scenarios: A Review

“…The study team (at least one clinician and one bioengineer) was constantly attending the experiment, limiting the need for a telemedicine system. Nevertheless, a first prototype version of the remote monitoring system was designed [40], and eventually deployed and tested [41]. This first study proved that the AP was safe in a controlled environment, and thus we moved our research towards testing in less controlled environments, more closely resembling real-life [42,43].…”

Monitoring Artificial Pancreas Trials Through Agent-based Technologies

“…In the following sections we describe the design and implementation of the remote monitoring infrastructure following the work described in Lanzola et al 11 …”