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1. Research Objective

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1. Research Objective

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  1. Business-Perspectives Study for Lung Diseases Diagnosis Application TjahjonoDjatmiko, Ria Lestari Moedomo, M. Sukrisno Mardiyanto, MunawarAhmad, Bachti AlisjahbanaTelkom Institute of Management School of Electrical Engineering and Informatics, Institut Teknologi BandungTriple Helix International Conference 2012 School of Business and ManagementInstitut Teknologi Bandung

  2. 1. Research Objective This research describes the business perspective study of The Lung Diseases Diagnosis Application: (A) Application overview (B) Preliminary feasibility study (B.1) Legal aspect (B.2) Management and resources aspect (B.3) Technology aspect (B.4) Marketing aspect (B.5) Environmental aspect The financial aspect, including the invesment and return-on-investment aspect is not within the scope of this first business research

  3. 2. Application Overview This application was inspired by Auscultation, which is the paramedics/doctors’ skill for listening to the internal sounds of the body, usually using a stethoscope; based on the Latin verb auscultare "to listen". The act of listening to body sounds for diagnostic purposes has its origin further back in history, possibly as early as Ancient Egypt. Auscultation term was introduced by René-Théophile-Hyacinthe Laënnec. Auscultation is a skill that requires substantial clinical experience, a fine stethoscope and good listening skills [8]. By listening to the lung sound, we would know what type of lung sound occurs such as: crackles, wheezes, stidor, rhonchi, etc. and identified which part of lung needs further investigation/treatment.

  4. 2. Application Overview: Process Flow (1) 3 4 5 2 1 From research [18]-[21], the process flow of the lung disease diagnosis application is depicted in the following Fig.1: Fig. 1 The process flow of the lung disease diagnosis application

  5. 2. Application Overview: Process Flow (2) The lung/respiratory disease diagnosis process flow is as follows: (1) Upon a lung diseases suspect report, the paramedic would come to the remote/rural area and do the diagnosis. The breath sound is recorded by a handphone with a sensitive microphone and voice recording. (2) The breath-sound file is sent the central server. (3) The breath sound file is processed and classified into the lung sound and the trachea/upper-respiratory sound. (4) After these frequencies has been obtained, both the lung sound and trachea/upper-respiratory sound frequencies are stored into the central server, to be analyzed and compared with the lung-sound and upper-respiratory-sound database from past patients. The software would diagnose whether the suspect is infected the respiratory diseases or not from the lung-sound and upper-respiratory-sound diagnosis. (5) The diagnosis result is sent back to the paramedic’s cellular phone for immediate curative actions.

  6. 2.Application Overview : Frequency comparison Fig. 2 Sound-frequency comparison process

  7. 3.1Feasibility Study: Legal Aspect • The legal feasibility study investigates all the information sources which inspired this research and learn about the legal consequences with these information sources. • The first source is about auscultation, which was studied from various sources in internet, including [10a] and [10]. These first references discusses about the auscultation only, by using stethoscope, as the primary and the only way to diagnose the lung sounds. • Other reference [7] discusses about the principle of how to record the human breath-sound and tranform it into lung-sound utilizing mobile phones. This reference gives knowledge to alternate the stethoscope with sound recording system, however the scope of this research is only for asthma diagnosis. • There is another computer-based application developed by research firm STAR Analytical Services [23], which diagnoses respiratory illnes by analyzing coughs, and will be developed into mobile-phone version as well. However this application analyzes coughs only, while our application analyze breath sounds which hopefully would give a broader range of diseases and a more accurate result. • Because all of these references and information are public domain and accessible through internet, there is no legal obligation pursued for our research and application development.

  8. 3.2 Feasibility Study: Management and resources aspect • Application software to assist in: • Breath sound frequency analysis • Breath sound frequency separation • Breath sound frequency pattern matching and comparison Application business model Central Hospital with Specialists/Doctors who assists diagnosis of the lung diseases Paramedics/Doctors who examines Patients 2nd users layer 1st users layer Patients/suspects with lung diseases symptomps 3rd users layer Fig. 3 Application business model

  9. 3.2 Feasibility Study: Management and resources aspect The management of application service provisioning STEI ITB reseach team Responsibility: Research and developement of the application (research and application owner) Telkom Institute of Management team Responsibility: -Business research -Application service provisioning Fig. 4 Partnership scheme

  10. 3.3 Feasibility Study: Technological aspect Study of existing lung diagnostic tools:

  11. 3.3 Feasibility Study: Technological aspect • Study of available and most suitable telecommunication platform (1) • The implementation would be conducted in CDMA infrastructure for several reasons: • CDMA infrastructure allows mobility and offers good quality of data and voice infrastructure. PT. Telkom’s infrastructure for CDMA, Telkom Flexi coverage has reached to overall Indonesia including rural area • There are several middle-end handphone with sophisticated voice recording has already been implemented in CDMA infrastructure such as: • (1) ZTE Blade N880 • (2) Huawei Ideos U8150 • (3) IVIO DE-88 Plus • These handphones have been equipped with Qualcomm MSM- 7277 • chipset which offers excellent voice recording capability, with embedded, • and if required add-on microphone with sensitiviity of 98 dB + 3 dB at 1 Khz. • CDMA operational cost is affordable, therefore it is suitable to send high volume of breath-sound recording and sound frequency image data.

  12. 3.3 Feasibility Study: Technological aspect • Study of available and most suitable telecommunication platform (2) • Telkom CDMA Infrastucture, Telkom Flexi, provides 2 ways of data communication: • PDN: communication media to gateway internet utilizing Packet Data Network (PDN) access through Telkom Flexi network. Dial-up access is supported by CDMA 2000-1x with data speed of 153,6 Kbps. • Flexi Mobile Broadband: utilizing EVDO (Evolution Data Only/Optimized) with data speed of 3.1 Mbps. The coverage of Telkom Flexi EVDO in Indonesia is in the following map:

  13. 3.4 Feasibility Study: Marketing aspect • The marketing feasibility study briefly describes about this application’s target market, which is the 1st users layer, from Fig.3 (Application business model), including: • (1) Balai Besar Kesehatan Paru Masyarakat Kota Bandung (Council of Public Lung Health in Bandung). This council is also the main user who will be within the research and development team • (2) Hospitals • (3) Puskesmas • (4) Red Cross council • (5) Registered council/group of doctors/paramedics

  14. 3.5 Feasibility Study: Environmental aspect The environmental feasibility study is about the business and operational environment of this application. Because there will be a partnership between School of Electrical Engineering and Informatics (STEI ITB) as the research and application owner, and Telkom Institute of Management as business researcher and application service provisioner, then all the application service provisioning will be based on Telkom infrastructure and platform. With this scheme, consequently, all the 1st, 2nd and 3nd users layers (in Fig. 3) will utilize application services hopefully provided by STEI ITB, Telkom Institute of Management and PT. Telkom

  15. 4. Conclusions and Further Business Study • This business perspective study has been conducted to obtain a different point of view from global and business point of view. This paper has described some preliminary feasibility study: legal aspect, environmental aspect, marketing aspect, technology aspect, management and resources aspect. • Further study would include the financial feasibility study and a more detailed feasibility studies.

  16. 5. References Grimes, Anja. 2010. Influenza: Seasonal Flu and H1N1. Symptoms, Treatment, and Prevention. Continuing Education Courses for Healthcare Professionals, Wild Iris Medical Education, Inc, Online news source: Maros, South Sulawesi, Bird flu widespreads in 10 regions. http://birdflucorner.wordpress.com/2011/07/. Uyeki, Timothy M. 15 July 2009. Human Infection with Highly Pathogenic Avian Influenza A (H5N1) Virus. Review of Clinical Issues, Emerging Infections, CID 2009:49,. Burhan, Erlina, Pulmonologist Dr. May 2008. Cardiorespiratory function and radiological changes in lung structure in Indonesian patients who survive highly pathogenic influenza A/H5N1 - a 3 years prospective study (Post bird flu function). Department of Pulmonology Persahabatan Hospital, Jakarta, Indonesia. Online Medical Dictionary, (http://medical-dictionary.thefreedictionary.com/breath+sounds) Charbonneau G., Racineux J.L., Sudraud M. and Tuchais E.. October 1983. An accurate recording system and its use in breath sound spectral analysis. Journal of Applied Physiologyvol. 55 no. 4 1120-1127. Anderson K., Qiu Y, Whittaker AR. et.al. 2001. Breath sounds, asthma, and the mobile phone. The Lancet, Elsevier. Auscultation, Wikipedia, http://en.wikipedia.org/wiki/Auscultation Fluid in the Lungs – Causes and Treatment, HealthHype.com, Dr. Chris, http://www.healthhype.com/fluid-in-the-lungs-causes-and-treatment.html 10a. Assessing Lung Sounds, Youtube, http://www.youtube.com/watch?v=GP8Gqb9-saY Easy Auscultation website, http://www.easyauscultation.com/ Dorland, Dorland’s Medical dictionary: Respiratory sounds. Wikipedia, (http://en.wikipedia.org/wiki/Respiratory_sounds#cite_note-1#cite_note-1) Journal Watch. November 2009. H1N1 Rapid Tests: Poor Sensitivity, vol. 12 no. 11 Voice Analysis, Wikipedia, http://en.wikipedia.org/wiki/Voice_analysis Pulmonary tuberculosis, Medline Plus, U.S. National Library of Medicine, National Institutes of Health, http://www.nlm.nih.gov/medlineplus/ency/article/000077.htm. K.W. Becker, Research into Adventitious Lung Sound Signals Originating From Pulmonary Tuberculosis Using Electronic Auscultation, Department of Mechanical and Mechatronic Engineering, Faculty of Engineering, Stellenbosch University, 2009. WHO, Avian influenza – situation in Indonesia – update, January 19th, 2012, http://www.who.int/csr/don/2012_01_19/en/index.html Dr. Moussavi, Dr. Hans Pasterkamp and Dr. Gina Rempel, “Respiratory and Swallowing Sound Analysis”. University of Manitoba, (http://www.bme.ee.umanitoba.ca/?a=26) Ria Lestari, Munawar Ahmad, Bachti Alisjahbana, Tjahjono Djatmiko. The Lung Diseases Diagnosis Software: Influenza Case Study, International Conference on Rural Information and Communication Technologi 2011, School of Informatics and Electrical Engineering, Institut Teknologi Bandung, November 2011. Ria Lestari, Munawar Ahmad, Bachti Alisjahbana, Tjahjono Djatmiko The Lung Diseases Diagnosis Software: Influenza and Tuberculosis Cases Study, International Conference on Biomedical Science 2012, School of Life Science and Technology, Institut Teknologi Bandung, February 2012. Ria Lestari, Munawar Ahmad, Bachti Alisjahbana, Tjahjono Djatmiko. The Lung Diseases Diagnosis Software: Influenza and Tuberculosis Case Studies in Cloud Computing environment, International Conference on Cloud Computing and Social Networking 2012, School of Informatics and Electrical Engineering, Institut Teknologi Bandung, April 2012, 26-27 April 2012. Ria L. Moedomo, M.Sukrisno Mardiyanto, Munawar Ahmad, Bachti Alisjahbana, Tjahjono Djatmiko. The Breath Sound Analysis: For Diseases Diagnosis and Stress Measurement, International Conference on System Engineering and Technology 2012, School of Informatics and Electrical Engineering, Institut Teknologi Bandung, September 2012 (submitted). Suliyanto, Dr. Studi Kelayakan Bisnis, Pendekatan Praktis. Penerbit Andi Yogyakarta, 2010. Tom Chivers. Cough into your mobile phone for instant diagnosis. The Telegraph online, 9 November 2009 (http://www.telegraph.co.uk/health/healthnews/6530704/Cough-into-your-mobile-phone-for-instant-diagnosis.html).

  17. 6. Acknowledgement • Sincere thank you to Triple Helix Committee who has kindly given opportunity for this research paper

  18. 7. Thank.You THANK.YOU

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