This self-managed digital health-monitoring framework can be applied in several use cases, some of which are described below:

Use case 1: Remotely monitoring patients at home

Home monitoring involves monitoring of non-critical patients, patients in the recovery stage after being discharged from hospital, proactive health monitoring, or monitoring the health of the elderly within their homes or care facilities.

Joe, 68 years old, has recovered from open heart surgery and has been discharged from the hospital. Lately, Joe has become forgetful and forgets even basic tasks like taking his medicines on time. Joe's children are working and are concerned about Joe's health when they are at work. Dr. Smith wants to remotely monitor Joe's recovery as Joe performs his daily activities to ensure that his recovering cardiovascular system is not subject to a sudden stress. Joe is fitted with a wireless ECG device, a NiBP device, and a Pulse Oximetry device for monitoring his blood oxygen saturation. The devices connected to Joe are miniature, lightweight, and they do not interfere with his daily activities.

Joe has a Wi-Fi-enabled desktop PC in his living room which is also used by Joe to watch TV. The PC continuously monitors Joe's vital parameters in the background and sends data to the hospital in real-time. Wireless webcams fitted in different rooms of his home also send streaming video data to the PC. Joe's PC is connected to the Internet using a broadband link.

While sitting at his laptop in the hospital, Dr. Smith connects to Joe's PC and runs the pre-designed protocol for remotely monitoring open heart surgery patients like Joe. Dr. Smith runs the protocol and then leaves for an urgent operation. The protocol remotely and autonomically programs Joe's ECG device to continuously monitor a 3-lead ECG, the NiBP device to take a blood pressure reading once every hour, and the Oximetry device to monitor only in critical situations. The protocol automatically sends a reminder audio-visual message on Joe's PC screen asking him to undergo the morning exercise on his home treadmill and also programs the treadmill to limit the maximum speed to 2 miles per hour and limit the exercise time to 10 minutes. The reminder message alerts Joe in the midst of his TV program. Joe starts walking on the treadmill and during his exercise session, his heart rate increases to 130 beats per minute (bpm). The increased heart rate is monitored by the PC, and the PC triggers the NiBP device to take frequent blood pressure measurements and it also automatically stops the treadmill as a precautionary measure to prevent excessive stress. The increased heart rate condition also turns on the Pulse Oximetry device to monitor Joe's oxygen saturation. When Joe's heart rate returns to normal after his exercise session, the NiBP device again increases the BP measurement interval to 1 hour while the Oximetry device turns OFF. Since Dr. Smith had set the mobile phone alert limit for heart rate to 150 bpm, BP limits to 150/100 mmHg, and the SpO2 limit to 94%, he was not alerted on his mobile phone since Joe's vital signs were within the limits. When Dr. Smith returns from his operation he examines the stored vital parameters of Joe and he is happy with Joe's increased stress-handling capability. Meanwhile, Joe's son is also able to remotely keep an eye on Joe from his office by monitoring the streaming webcams and Joe's vital parameters. Dr. Smith has remotely also fed the medicine schedule on Joe's PC. Joe's PC flashes audio-visual messages on its screen in a timely manner to remind Joe to take his medicines.

Use case 2: Wireless fetal monitoring during labor

Judy is pregnant and has been admitted to the hospital for delivery. Dr. Willy expects a normal delivery but decides to monitor Judy's Uterine Contractions (UC) and Fetal Heart Rate (FHR). The fetal heat rate variability is an important parameter to asses fetal well being and to assess whether the fetus would be able to sustain the stress of uterine contractions during delivery. Dr. Willy fits Judy with a wireless ultrasound sensor and a uterine pressure sensor by means of a belt around her abdomen. The ultrasound sensor monitors the FHR while the pressure sensor monitors Judy's UCs and sends the data wirelessly to the central server of the labor ward, where a number of patients are being monitored simultaneously. Judy is still not in labor and is able to take frequent walks around her room and in the ward, while still being closely monitored. Judy does not feel the subtle UCs, indicating the start of labor. However, minute uterine pressure changes are picked up by the pressure sensor and are evident in the graphical tracing at the central monitoring terminal. There is a sudden and steep drop in the FHR which goes unnoticed by the busy hospital staff. However, the FHR analysis software on the server detects the sudden drop in FHR, and the software automatically sends alert messages and FHR tracings to Dr. Willy and the chief nurse on their mobile phones. Dr. Willy is out of hospital when he receives the message on his mobile phone. Dr. Willy immediately rings up the chief nurse and instructs her to be prepared for an emergency cesarean operation by the time he reaches the hospital. Judy undergoes an emergency cesarean operation and delivers a healthy baby. During delivery Dr. Willy notices the umbilical cord entangled around the fetus's neck resulting in partial suffocation and thereby decreasing the FHR. Dr. Willy is thankful that the timely alerts by the central monitoring system saved the baby's life.

Use case 3: Critical patient monitoring in an Intensive Care Unit

Dr. Bill is a resident doctor currently managing the 16-bed ICU in a hospital. A patient, Jack, operated on via angioplasty, is brought to Dr. Bill's ICU. Dr. Bill tags Jack's admission time in ICU by using a RFID reader to read Jack's RFID wrist strap and also wirelessly transfers a softcopy of Jack's medical record file from inside the wrist strap to the central station for study. Dr. Bill rubs the wireless patient monitoring devices on Jack's RFID wrist strap and connects them to his body. The wireless monitoring devices read Jack's Patient-ID from his wrist-strap to form a BAN and get associated to Jack's backend database on the central station. The computer screen of the ICU's central monitoring station automatically re-adjusts itself to display, monitor, and store Jack's vital signs along with the parameters of other patients. Dr. Bill prepares a monitoring schedule and a drug administration schedule for Jack using the central monitoring application software. The monitoring and drug administration profile for Jack is immediately transmitted to the hand-held devices given to nurses on duty in the ICU. The central station performs periodic diagnostic tests using the attached wireless devices and also sends timely reminders to the nurses to administer drugs to patients, depending on individual patient profiles. Once a nurse administers a drug to a patient she mutes the generated reminder and logs the event, which also gets logged in the central station. The central monitor also runs intelligent algorithms on patient's vital physiological signals and generates alerts, sends alerts to doctors' mobile phones, and prints important events on locally connected printers. Dr. Bill is relieved that the central monitoring station manages most of his mundane tasks and helps him in effectively managing large numbers of patients.