Accessibility to pacemaker monitoring.

Development of a heart rate monitoring sensor integrated to the digital control platform for patients using pacemakers through low-cost IoT (Internet of Things) technology.

According to the World Health Organization, the leading cause of death in the world is related to cardiovascular disease. This statistical mapping reflects the number of pacemakers that are implanted annually, due to cardiac complications. Currently, more than 300,000 people use pacemakers in Brazil and, each year, around 50,000 new devices are implanted, according to the Department of Artificial Cardiac Stimulation. Given these data, we realize that the Brazilian population is considerably affected by cardiac factors that worsen the quality of life, thus showing the impact of proposals aimed at solving problems in this area. The Unified Health System (SUS) is a government program that provides free access to health services for the needy population. This mechanism is based on 5 principles: universalization, equity, integrality, decentralization and popular participation. One of the procedures offered by SUS is the implantation and recurrent evaluation of pacemakers. This program is indispensable to the Brazilian reality, since the vast majority of the population lives in vulnerable conditions, jeopardizing the treatment of heart diseases. Based on the principle of popular participation, proposals such as ours that seek to integrate government measures and innovative ideas from citizens are of great social relevance. Through this, we will improve care for pacemaker users to ensure quality monitoring of this device, enabling greater control over the history of cardiac alterations, in addition to reducing the burden on the SUS and increasing the quality of life of users. 

In this project, we will use an IoT (Internet of Things) system that monitors the heartbeat of patients using a pacemaker, through a web application. The aforementioned web application monitors the heartbeat, collects and stores this information in beats per minute, and sends it to a cloud server database. Next, a deep learning algorithm programmed via Python analyzes the data and sends preventive information from the patient to the doctor in charge.

The solution serves patients with pacemakers who need the Brazilian public health system for cardiac monitoring. Faced with so many demands and the scrapping of the SUS (Sistema Único de Saúde), we seek viable and low-cost alternatives to streamline medical care, maintaining a more promising doctor-patient relationship. Currently, approximately 16,108,951 pacemaker evaluations were carried out by the public service in the Southeast region of Brazil in the last 6 months. More specifically in the city where we live, 105,559 assessments were carried out in the same period. This epidemiological data has an impact on the local reality, as the academic center where we studied is a regional reference, but it depends on government funds to subsidize procedures, consultations and surgeries that serve the socioeconomically disadvantaged population. Therefore, our proposal is aimed at a poor population, which depends on a weakened health system, precisely to try to bring quality monitoring to those who depend on recurrent pacemaker monitoring. 

The authors of the project are students of the medical course, and will have the support of the coordinator of the Technology Center of the Vale do Sapucaí Foundation: Poliana Custódio Zampollo – one-year medical student at the University of Vale do Sapucaí and second author of the project “Accessibility to pacemaker monitoring”, which seeks to bring more quality to the care provided by the Brazilian public health service. I am on the board of the university's Academic Directory, with the aim of promoting and mediating solutions to problems experienced by students. I am active in Academic Leagues in the area of Trauma Surgery and Clinical Pathology. I won the position of secretary of the institution's Semiology League. I provide voluntary work focused on palliative care for the national NGO “Atados” with the intention of positively transforming the lives of other people. Maria Fernanda Silva Junho - three-year medical student at the University of Vale do Sapucaí and author of the project “Accessibility to pacemaker monitoring”. I am treasurer of the university's Academic Board and a member of the Cardiovascular Surgery and Gastroenterology and Digestive Surgery Leagues. I was a Physiology monitor for a year. I have certificate of participation in Minicurso de Tecnologia 4.0, taught by advisor Flávio
Vilela. Prof. Dr. Flávio Fraga Vilela is PhD from the Institute of Production Engineering and Management of the Federal University of Itajubá (2022). He is currently Research Coordinator at the University of Vale do Sapucaí, Coordinator of the Hospital Technology Center at Hospital das Clínicas Samuel Libânio and professor of undergraduate courses in Production Engineering, Industrial Production Management Technology and Administration at the University of Vale do Sapucaí (UNIVAS). Its main areas of expertise are: HealthCare 4.0, Computational Simulation, Virtual Reality, Artificial Intelligence and IoT. It also has several software and patents registered at the National Institute of Industrial Property (INPI). Its objective is to incorporate cutting-edge technologies into hospital processes, bringing innovation, development and cost reduction. It recently had its Entrepreneurship and Innovation Project approved by the State Secretariat for Economic Development of Minas Gerais, which aims to create innovative projects and businesses involving science and technology within Higher Education Institutions. 

At first, in partnership with our university, we are developing a
scientific research project aimed at creating all the technological mechanisms necessary for the consolidation of our proposal. We seek to create a device that enables the long-term monitoring of the cardiac history of patients in the city of Pouso Alegre - MG, together with the aid of Artificial Intelligence. Our project seeks to serve a sector that needs great attention, as the impacts of possible complications and poor management of pacemakers negatively affect patients who are already socially vulnerable. 

Innovation: collecting information in real time and processing and analyzing data using artificial intelligence through a low-cost hardware and software solution. 

1- Develop a virtual prototype of the device, using virtualization techniques and 3D simulation, through the Tinkercad® platform.
2- Develop a physical prototype of the device, using easy-to-interface microcontrollers with the help of Arduino®, and an adapted heart rate sensor.
3- Develop the electronic circuit of the new sensor, using the Eagle® software, and test it in a controlled environment
4- Produce the new pacemaker sensor on a small scale for testing and validation.
5- Develop a physical prototype of the device, using easy-to-interface microcontrollers and the new skin sensor.
6- Test the physical prototype of the device and the new sensor, on the “dummy” in the laboratory of practical classes of the medical course at UNIVÁS.

The project aims to develop a heart rate monitoring sensor integrated to the digital control platform for patients using pacemakers through IoT (Internet of Things) technology. Thus, we will use an IoT (Internet of Things) system that monitors the heartbeat of patients using the pacemaker, through a web application. The web application, which will be developed with responsiveness using HTML, CSS and JavaScript, will monitor the heartbeat, collect and store this information in beats per minute, and send it to a database on a cloud server. Next, a deep learning algorithm programmed via Python will analyze the data and send preventive information about the patient's health and well-being to the doctor in charge. 

Currently, the solution is in the early development stage. In the municipality where our main target audience is located, 105,559 pacemaker evaluations were registered in the last 6 months, according to data published by the government. Thus, we intend to meet an estimate that encompasses regional demands. 

- Lack of project visibility;
- Lack of initial financial resources;
- Insufficient dissemination of the proposal for the purpose of increasing the population's adherence;
- Lack of subsidy (proof material) to consolidate the product. 

Business to Business (B2B)
Business to Customer (B2C)
Business to Government (B2G)
REVENUE MODEL
1. About the design and construction of the pacemaker
2. Pacemaker installation in a study population
3. Income generation with our device
4. Consulting
5. Training and Instruction
TARGET AUDIENCE
1.Patients with pacemakers from the public health network
2. Pacemaker patients from the private health network
VALUE OFFER
The product influences the patient's quality of life. In this way, after performing the pacemaker implant surgery, control will be facilitated, avoiding adverse problems and collaborating for an early diagnosis since the patient has cardiovascular problems. The product helps physicians and other healthcare professionals to assess each specific patient and their history, so if anything unusual occurs, the device will send a message directly to the professional.
CHANNELS
The product will be known because the idea is to implant it in the Unified Health System, thus being available to all cardiac pacemaker carriers. Media disclosures, scientific initiation, publication of articles in journals in the area, presentation at congresses will be made.
MARKET SEGMENTS
The project patients will have a cardiac pacemaker. At first, the project will start in the city of Pouso Alegre - Minas Gerais - Brazil, however we are thinking of expanding to larger regions. The patients in the project have in common the use of a cardiac pacemaker device, which controls the electrical conduction system of the heart. Patients, at first, will be from the public health network.
COST STRUCTURE
The amount spent on the device has a low cost, thus increasing the population's access even more. The cost price is, on average, 20 reais for each device.
SOURCES OF INCOME
The product will be paid with the amount available for investment in  technology, through the MIT challenge and employee promotion.

The main point of action of the project is the low cost. To bring the financial balance between income and expenditure, we design the entire product, from the sensor to the board, using regional raw materials, guaranteeing a low cost and, in this way, achieving financial sustainability.