Frame Grabbers: Making Remote Monitoring Possible

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It is no wonder that the possibility of applying remote access equipment to the medical field has provoked much interest. Remote guidance, remote diagnostics, and teleoperations are only some of the practices that can be employed using remote medical equipment monitoring that transmits video over Ethernet. Such equipment enables physicians to view and analyze information no matter where they are physically located.

Remote technology is often an integral component of medical diagnosis and treatment, and it helps doctors bring high-quality consistent healthcare closer to patients. Remote equipment applied to the medical field successfully integrates into a variety of settings and situations, substantiating the ease of implementation and claims of convenience. Remote diagnostics is one of the primary areas in which remote monitoring equipment is broadly applied. This article provides an overview of frame grabber technology, which is a key component in driving remote care.

A Closer Look at Remote Diagnostics

It is now possible to diagnose given issues, problems, and symptoms distantly.

Figure 1. This connection diagram shows how a frame grabber connects to the medical equipment featuring VGA or DVI output.

Traditionally, a patient has direct contact with a physician who operates a diagnostic system. With the ability to monitor medical equipment remotely, however, patients and physicians can reside far from each other. Although some systems are wired, many are now operated wirelessly. Of course, a patient should be properly trained to be capable to perform necessary operations. As a result, a consulting physician is provided with an accurate and clear real-time video feed.
Ideally, both imagery and video stream should be available for remote interaction.

This video can be provided by frame grabbers—equipment that captures both video and images from the source output. After being captured, the content can be recorded on a computer and transmitted over the Internet. Depending on the frame grabber type, the data are captured from the source output from any medical diagnostic equipment. High-resolution images or video are captured, ensuring that remote diagnosticians will obtain and analyze diagnostic-quality images.

For example, the VGA2Ethernet captures single-link DVI or VGA signals at rates up to 120 frames per second. It features maximum capture resolution of 1900 × 1200 and transmits quality lossless video over Ethernet. It has a common RJ45 Ethernet port for connection with the target computer and allows for up to 1 Gb transfer rates.

The exact quantity of frames per second that can be captured by this method depends on the screen resolution, screen refresh rate, amount of changes on the screen, operating system on which the computer is run, and the speed of the computer acquiring the images. Usually, uncompressed frame transfer yields lower results than compressed frame transfer. The latest technology captures and transfers the original VGA frame in RGB format. It provides better quality than a VGA-to-video converter paired with a composite or S-video grabber.

It is possible to connect two or more frame grabbers and capture several signals simultaneously. However, there will be a difference in frame rate for each additional active frame grabber. The possible frame rate depends on computer performance. The frame compression does not reduce the image quality of the output.  Some frame grabbers can be used through an Ethernet switch. This allows connection to a LAN and frame grabbers through a single Ethernet port.
By using a switch, the length of the Ethernet cable can be extended, providing a larger distance between the frame grabber and the diagnostic equipment. These characteristics allow the user to transfer the data from diagnostic equipment without any loss of quality. The VGA content is digitized. Captured VGA or DVI signals are transmitted via Ethernet. A stereo audio input captures sound that is essential, for instance, in 
auscultation.

Remote Medicine:
Real World Examples

Frame grabbers such as the VGA2Ethernet can capture single-link DVI or VGA signals at rates up to 120 frames per second.

Frame grabbers can be of great use during emergency situations or in difficult terrain. The Henry Ford Hospital used frame grabbers to capture medical images from the Canadian Mount Everest Medical Operations Expedition in 2008, for example. The images were captured from GE’s LOGIQ Book portable ultrasound device and then transmitted in real time via satellite to doctors at the base of the expedition. Remote monitoring equipment allows not only performing remote diagnostics but also guiding a trained operator from a remote location.
Guidance from a Remote Location. Guidance allows for tests or procedures to be performed from a remote location. In some cases, it may be critical to get timely and competent consultation of an expert who resides far away. Various injuries such as trauma to the knee or shoulder, fractured or broken bones, and hemorrhaging or muscle atrophy can be assessed 
remotely. 

Remote guidance allows a minimally trained operator to cooperate with a highly skilled medical expert. Such application of the remote guidance is beneficial to emergency responders and battlefield medics. Using frame grabbers for capturing images and having them connected to the Internet enables an expert to quickly assess the injury severity and make a decision as to whether to transport a patient to a hospital or treat injuries on site.

NASA researchers have optimized methods allowing nonphysician operators to obtain ultrasound images, including images of musculoskeletal injury. Broadcasting equipment captures video from the source output (any diagnostic equipment featuring a signal output or a common digital camera) and broadcasts it via the Internet using motion compression. 

The surgical department at a Henry Ford Health System hospital used frame

Figure 2. This connection diagram shows how a VGA printer connects to the medical equipment and how it can be used.

grabbers during the Olympic Games in Torino to give the Olympic team access to physicians located at the center. Real-time, high-resolution images of treatment procedures occurring on-site were transmitted via streaming video to a physician at a remote location.

Remote Patient Monitoring. Long-term healthcare systems have become more reliable and integrated as they address the needs of older adults in a more-effective and more-efficient way. These systems are mostly targeted at elderly patients suffering from chronic diseases: diabetes, hypertension, congestive heart failure, etc., who have trouble accessing traditional sites of care. Technologies improving the independence of older adults and assisting in the care of chronic conditions generally cover a wide spectrum that comprises telemonitoring, telehealth, and other technology-enabled 
services.
Remote patient monitoring includes a wide variety of technologies. These technologies are designed to manage and monitor a range of health conditions. Point-of-care monitoring devices may become part of a fully integrated health data collection, analysis, and reporting system that communicates to multiple nodes of the health system. These devices would provide alerts when health conditions decline.

Remote patient monitoring technologies deliver effective support for the coordination of care, behavior change, and evidence-based decision support for patients. There are features of remote patient monitoring that can be used by patients, caregivers, and providers. An ideal remote patient monitoring system will take into account the needs of all three. Data collected may include vital signs (glucose meters, blood pressure, weight, pulse oximeters, etc.) as well as emotional and physical well-being assessments.

Remote monitoring equipment collects these data and transmits them over low-bandwidth phone line, Internet, or local- or wide-area networks. The obtained patient information is used in treatment. The results include enhanced communication between patients, caregivers, and providers, leading to improvements in care coordination and caregiver support as well as to improving medication compliance. This approach reduces the need for hospitalizations and office visits. It is a much less-expensive option than organizing telephone surveys conducted by nurses.

Remote equipment monitoring success depends on person-to-person communication. The new technology is combined with existing principles of self-management. Remote patient monitoring catches on quickly as it brings convenience and simplifies care for both healthcare professionals and patients. In the future, remote patient monitoring is expected to expand in terms of the variety of applications and offerings. An increase in the use of general broadband technology and the wiredness of homes, hospitals, and other care settings facilitates the growth of remote patient 
monitoring.

As the prevalence of broadband technology increases, the skills of providers are tested not only by the quality of the patient-provider interaction, but by technological access and proficiency. Medical facilities encounter new challenges in preparing adequate personnel. Given its enormous potential, remote patient monitoring continues its rapid growth, playing a large role in the future of medicine and treatment.

Cardiac Equipment Monitoring. Cardiac monitoring systems are among the specialized areas of medicine in which remote monitoring equipment is particularly valuable. Remote cardiac monitoring systems can improve patients’ quality of life and prevent hospital admissions. Such remote systems provide a noninvasive assessment of cardiac function that is unaffected by any vibrations and sudden impact possible during medical treatment in an ambulance.

The Role of Frame Grabbers in Remote Medicine

The underlying technology for these remote diagnostic systems includes frame grabbers. These frame grabbers are capable of capturing imaging and video content from the diagnostic equipment and then transmitting this content over Ethernet.

One frame grabber, for example, can capture a signal from any VGA source, including PCs, medical devices, embedded systems, or scientific equipment. It supports multiple VGA modes up to 2048 × 1536 and features maximum sample rate of 
230 Mpixels/sec.

A dual-mode frame grabber captures and broadcasts diagnostic-quality images from VGA or from a DVI source output. It supports maximum frame rate 32 fps at a resolution of 1920 × 1200, enabling remote diagnosis. All of these frame grabbers provide capture and transferring of diagnostic-quality images.
Evolving technologies have made it possible to capture images from multiple medical devices. The MAC 1600 electrocardiograph from GE Healthcare, for example, is a modern system with configuration modes that include resting ECG, rhythm, and arrhythmia. Its 7-in. WVGA color display features a VGA output.

To capture ECG records or stress testing protocol results and send it over Ethernet, the VGA IN port of the frame grabber is connected to the VGA port of the electrocardiograph using a VGA cable. Then the frame grabber is connected to the network, where it can record images to the video capture working station. When the image is properly captured and recorded, it can be received in a remote location and used in diagnostics.

Remote Diagnostic Imaging. Diagnostic image capture is crucial in all medical settings and at all healthcare levels. The possibility of obtaining magnetic resonance, x-ray, thermal, and acoustic images directly from the VGA output of the diagnostic equipment and sending them for printing increases the efficiency of a diagnostic survey. Both in curative and preventive medicine, making effective decisions depends on making the correct diagnosis. In the case of remote diagnostics, imaging is paramount in correctly assessing and confirming disease processes. Generally, digital printing systems do not yield optimal results because they resample the incoming video signal according to their own internal matrix. This resampling leads to a loss of contrast and resolution, and the image may be corrupted by aliasing artifacts. It is essential to ensure that the system is capable of transmitting lossless images to a standard printer.

A VGA printer is designed primarily for PostScript-compatible printers. It connects to all types of medical equipment (ultrasound machines, x-ray machines, PET scanners, etc.) featuring a VGA output. It allows for printing the VGA content whether it be video or a series of shots provided by system. This type of system captures VGA images and allows for printing on a standard or network printer.
DRE FS-32P is a digital ultrasonic diagnostic imaging system from DRE Inc. that features advanced beam-forming technology (for more on beam-forming technology, see the article that begins on p. 34). It has a 10.2-in. display that provides optimal ultrasonic images for applications such as obstetrics, gynecology, and urology. The VGA IN port of the VGA printer is connected to the VGA output of the DRE FS-32P. After connecting the VGA printer to Ethernet, the captured frames can be printed wherever it is connected. The frames can be viewed on a wide monitor connected to a VGA printer, which is typically done via a VGA port.

Frame Grabbers:
Applications in Medicine

The frame grabbers’ capability to capture VGA and DVI signals and transmit them to the target computer is widely used in medical centers.
The Institute for Surgery and Innovation (Cleveland, OH), for example, uses frame grabbers to offer educational presentations and Webinars to students and physicians. The lecturers and specialists capture presentations, videos, and computer output from live symposiums and transmit video on the Web to interested students and physicians. This enables the institute to offer Web events on a regular basis without using a third-party commercial vendor, which also means cost savings.

Maquet Gmbh & Co. uses frame grabbers also. The company develops medical products for operating rooms. It uses frame grabbers to display the output of a mechanical ventilator product on a video screen. The output is then used to develop internal training presentations. These presentations eliminate travel because the employees and customers don’t need to be present in the same room as the technology.

The American Surgical Center is pioneering the use of streaming video in the operating room. Frame grabber devices are used to stream video from a surgical operating room to a remotely located individual’s laptop or handheld device. For example, video was captured from the DVI source of a laparoscopic tower. These data are saved to ensure quality control.

Medtronic products are implanted and must be periodically checked or adjusted. These checks are done using laptop-like equipment designed to communicate with the implanted devices. The training requires a great deal of equipment and logistics, and it must be led by an instructor. These challenges lead to high training costs, in particular because the training must be realistic and because the equipment can be damaged during travel, setup, and tear-down. The laptop-like device used to communicate with the implanted products also captures real-time patient information as well. It is possible to mimic the patient information with a simulator, create realistic use scenarios, run them, capture them real time, and incorporate them into software demonstrations or branched learning applications.
Gynecologists often need to examine images of fetuses in detail. The frame grabbers that they use enable the transfer of fetal explorations from an ultrasound machine of the highest quality to a computer where a specialist can examine them. Frame grabbers allow gynecologists to obtain high-resolution video images and to store the captured explorations in the computer where the images can be examined in the highest 
distinction.

A company developing products and services for the radiation-oncology (also known as radiotherapy) market uses frame grabbers to provide remote read-only support for radiation therapy machines. Remote support technologies that can be applied require installation of the third-party software. They are less attractive than stand-alone frame-grabbers and do not require any installations or downloads to the therapy machine.

Conclusion

Remote guidance, remote diagnostics, and teleoperations are only some applications for which remote medical equipment monitoring that transmits video over Ethernet can be used. Equipment that captures both video and images from the source output is possible using frame grabbers. Content can be recorded on a computer and transmitted over the Internet. Depending on the frame grabber type, the captured data can enhance and improve medical diagnostics and much more.

Sergey Vedelev is product marketing manager at Epiphan Systems Inc. (Ottawa, ON, Canada).