System description

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Operational Description

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 Document type:                                              Document reference                    Dept. internal ref.
 Technical Note                                                 MISC444B                                      -
 Project:               Department:                                              Reserved to the assistant filing the document
                                                      Filed in IntraELA by :                 on
 RMS                    R&D
                                       Original in: Clamart
 Title: Smartview Monitor and IMD System Description




Abstract: High-level description of the structure and operation of the Smartview Monitor
and associated Implantable Medical Device




                                Name                      Function                   Signature                     Date

   Prepared by           Fabio Belletti               SM project leader                                      Nov. 1st, 2011


   Reviewed by           Philippe Barou              IMD project leader


   Reviewed by          Thierry Scordilis            RF Function Leader

                                                      SM & Syndeli RF
   Reviewed by           Cecile de Jeso
                                                        RA Engineer
   Reviewed by
                                                       RF team
   Approved by           Daniel Kroiss
                                                       Manager




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duplicated, or disclosed in whole or in part without the prior written consent of Sorin Group.


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                                               REVISION HISTORY

      Rev.       Sect.                            Change                                     Author             Release date

  A          1            Initial release                                            Fabio Belletti              09-Mar-2009

             2            Functional description added                                    Fabio Belletti         25-Feb-2010

             3            IMD description add-on                                         Philippe Barou          01-Mar-2010

             4            SM software test scheme                                         Fabio Belletti         05-Mar-2010

             5            Transfer in FF929 format                                        Cecile de Jeso         18-Mar-2010

             6            New ICD image, approver                                         Fabio Belletti         19-Mar-2010

  B                       § 1.3.3 Block Diagram removed (FCC req)                     Georges Wanderstok
                          Everywhere: Home Monitor (or SM) updated to
                          Smartview Monitor (or SM)
                          Everywhere: MICS updated to MedRadio




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                                                TABLE OF CONTENT
1.      Introduction ............................................................................................................... 4
     1.1. Purpose ................................................................................................................. 4
     1.2. Acronyms ............................................................................................................. 4
     1.3. System description ............................................................................................... 5
        1.3.1. SM Operating modes .................................................................................... 5
        1.3.2. IMD Operating modes .................................................................................. 5
        1.3.3. IMD Hardware .............................................................................................. 6
2.      Smartview Monitor Functional Descritption ......................................................... 6
     2.1. Smartview Monitor Operation ............................................................................. 6
     2.2. Smartview Monitor Main Features ...................................................................... 7
        2.2.1. Functional Description of the Smartview Monitor software ........................ 7
        2.2.2. User Interface ................................................................................................ 9
        2.2.3. Normal Operation ......................................................................................... 9
        2.2.4. On-Demand Follow-Up ................................................................................ 9
        2.2.5. Alerts ........................................................................................................... 10
        2.2.6. SM-BO communication .............................................................................. 10
        2.2.7. SM-IMD communication ............................................................................ 11
        2.2.8. Self test........................................................................................................ 11
        2.2.9. Upgrades ..................................................................................................... 12
3.      Smartview Monitor Test......................................................................................... 12
     3.1. Smartview Monitor TEST Utilities .................................................................... 13
     3.2. Smartview Monitor Basic operation .................................................................. 13
     3.3. FailureS and recovery......................................................................................... 15
        3.3.1. Admitted failures ........................................................................................ 15
        3.3.2. Not Admitted failures ................................................................................. 15
        3.3.3. Faults Recovery .......................................................................................... 15
4.      IMD Test .................................................................................................................. 16




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1. INTRODUCTION

1.1. PURPOSE
The purpose of the present document is to provide a high-level description of the
structure and operation of the following sub-systems of Sorin Remote Monitoring
System: the Smartview Monitor and the Implantable Medical Device.

The Smartview Monitor (SM) is intended to collect patient’s clinical data from an
Implantable Medical Device (IMD) and transfer them to data management system (Back
Office server).
The IMD is implanted into the patient’s body. The Smartview Monitor is installed at
patient home and is intended to collect data from the IMD remotely in absence of
physician according to scheduled operation. It is not intended to act as emergency
response system.
The connection between the Smartview Monitor and the implant is achieved through
Radio-Frequency (RF) telemetry while the connection to the server is performed through
the telephone line (fix or mobile net).


                                                  Smartview Monitor
                          Wired or wireless                                                               Paradym RF
                          Telephone line


                                                                                                RF

     Remote Monitoring
                                                         Mains supply



1.2. ACRONYMS
Acronyms                           Definition
IMD                                Implantable Medical Device
SM                                 Smartview Monitor
RF                                 Radio-Frequency
RMS                                Remote Monitoring System
BO                                 Back Office
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Acronyms                           Definition
ISM                                Industrial Scientific Medical band
MedRadio                           Medical Device Radiocommunication Service (previously MICS)
FU                                 Follow-up
OD                                 On demand
CCA                                Clear Channel Assessment


1.3. SYSTEM DESCRIPTION

In the following sections, the Smartview Monitor and the Implantable Medical Device are
described, highlighting their hardware functionalities and features.


1.3.1. SM OPERATING MODES

The Monitor unit shall have two configurations to fit two different cases of use:
     1) Home Monitoring. When it is installed at patient home in the context of RMS,
        with two different Back Office (BO) connection options
           a. PSTN modem when it is connected to BO through the fix telephone line
           b. GPRS modem when it is connected to BO through the mobile cellular
               telephone net.
     2) Programmer RF Head. When it is installed in hospital and connected to the
        Orchestra Plus programmer through USB port for adding the RF telemetry feature
        to the Programmer itself. This mode is currently out of scope

The Smartview Monitor communicates with the implanted device on two wireless RF
bands:
o ISM band (2.45- GHz) for communication initialization (implant wake-up)
o MedRadio (402-405 MHz) band for data transfer


1.3.2. IMD OPERATING MODES
The IMD communicates with the Smartview Monitor on two wireless RF bands:
   o ISM band (2.45 GHz) for communication initialization (implant wake-up)
   o MedRadio (402-405 MHz) band for data transfer




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1.3.3. IMD HARDWARE
RF bi-band communication is done using the same ultra low consumption transceiver
module connected through a stripe line and a hermetic bipolar feed-thru to a unique RF
antenna loop embedded to the external connector of the device. The transceiver is driven
by the CPU of the device upon dedicated interrupt request raised by the RF module.

2. SMARTVIEW MONITOR FUNCTIONAL DESCRITPTION
In the following sections the Smartview Monitor is described, highlighting its Features
and Operation.
Note: IMD is also described through this section as a slave of the SM.

2.1. SMARTVIEW MONITOR OPERATION
The summary of mission / operation of the Smartview Monitor is the following:
         SM is a device to be installed in Patient Home.
            o Connection to telephone line (RTC version)
            o Connection to power line (wall plug adapter)
         SM shall be activated after connecting it to power supply. Executes:
            o bootstrap;
            o self-diagnostic;
            o implant pairing (at first boot)
         SM is paired through an automatic procedure to the Implant present at first boot
         SM shall collect patient’s clinical data from Implanted device and transfer them to
          data management system (Back Office server).
         The Implant data collection shall be performed according to 3 use cases:
             o Scheduled Patient Remote Follow-up
             o On Alert event/status evidenced by the Implant diagnostic features
             o On-Demand by Patient (if enabled)
         SM shall give indication to user about its correct operation and the function in
          progress:
             o SM health is ok (HW and code)
             o Patient should stay close to SM
             o Communication to IMD or BO is in progress
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                o Error in IMD or BO communication


2.2. SMARTVIEW MONITOR MAIN FEATURES

2.2.1. FUNCTIONAL DESCRIPTION OF THE SMARTVIEW MONITOR
    SOFTWARE




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                            BO                                                                   IMD


                                     - Check for new config file
                                                                               Check for IMD
                                     - Check for new firmware
                                     - Check for On Demand authorization
                                     - IMD Clinical data files
                                     - SM Status and Log files
                                                                                        Gather IMD Clinical Data

                     - New Configuration File
                     - New Firmware




                                                        SM Software




                                                                            Manage LEDs

                     Manual trigger of IMD data gathering




                           On Demand Button                                           LEDs


                                                        User Interface




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2.2.2. USER INTERFACE
         Status LED
          o Amber during boot and self-test
          o Green if self-test passed
          o Off on failure
         On-Demand Button
          o Button for patient request to execute a FU (collect FU IMD Clinical Data)
         On-Demand LED
          o Green during communication with IMD or BO in progress (flashing on Pairing
             request)
          o Red when communication with IMD or BO fails (flashing on pairing error)
         Progress LEDs
          o During OD IMD Data gathering, progress LEDs will turn on, one after the
             other in a rotating manner, and all on once done

2.2.3. NORMAL OPERATION
         SM shall collect Clinical Data from the IMD at the scheduled FU date in the SM
          Configuration File.
         If the scheduled date is passed SM shall collect the FU at next available time slot.
         SM shall periodically check and gather Alerts IMD Clinical Data if the IMD has
          Alerts. If no Alerts are present, SM shall close communications instantly to
          minimize RF activity.
               o Period defined in the SM Configuration File.
         SM shall periodically check into the BO.
               o Period defined in the SM Configuration File.
         If the scheduled date is passed (SM was left off for too long), SM will connect
          instantly to BO for a check in.
         SM shall instantly initiate a BO communication to upload FU, OD, Alert and
          Log/Stat/Trace data after the following events:
           successful data gathering of any of the 3 triggers (FU, OD or Alert) or of their
               eventual retry pattern
           retry pattern of a given trigger has expired completely

2.2.4. ON-DEMAND FOLLOW-UP
In short, an On-Demand (OD) Sequence is:
     Verification of OD Authorization
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         Gathering of IMD Clinical data
         Scheduling an instant BO Communication

 SM shall check the SM Configuration File for a positive On Demand Authorization.
  If negative, the Smartview Monitor shall connect to BO to check for Authorization
  status.
 Possible configuration are:
           o Always
           o One Time
           o Never
 Given On Demand Authorization and trigger, SM shall instantly connect to the IMD
   to gather IMD Data.
 This Data consists of:
       o Full memory dump
       o Configured EGM duration


2.2.5. ALERTS
    The SM shall connect to the IMD on a periodic basis to check for Alerts.
    If Alerts are present, the SM shall gather the relative Alerts IMD Clinical data, and
     send them to the BO.
    SM shall store log files in a non volatile memory.
    SM shall have failsafe mechanisms for storing and retrieving data from a non volatile
     memory.
    SM shall keep all stored data in separate non volatile memory blocks, in order to stop
     improper overwriting of data.
    In case of SM is unable to store the data in non volatile memory then it shall be able
     to log a failure status and cause of failure.
    SM shall store a minimum of 4 IMD Clinical Data Files in a non volatile memory
     immediately after collecting it from the IMD.


2.2.6. SM-BO COMMUNICATION
    SM shall connect/authenticate and communicate with the BO over internet using a
     dial up modem or a cellular data connection depending on hardware configuration.
    SM shall log-into the internet service provider server using the user name and
     password specified in the SM Configuration File.
    This interface shall include an acknowledgement mechanism when exchanging data
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    SM shall transfer all stored IMD Clinical data files to the BO.
    SM shall have error detection mechanism to detect any error in communication with
     the BO.


2.2.7. SM-IMD COMMUNICATION
    SM shall communicate with IMD using the Sorin RF Protocol.
    Communications shall always be initiated by the SM.
    SM shall scan all available channels in MedRadio band before initiating the
     communication with the IMD.
    Relevant Clear Channel Assessment (CCA) data shall be collected, and recorded for
     analysis.
    The CCA algorithm shall be used to open the most suited communication channel
     with the IMD.
    The SM-IMD communication protocol shall include an acknowledgement mechanism
     when exchanging data
    SM shall have error detection mechanism to detect any error in communication with
     the IMD.


2.2.8. SELF TEST
    SM shall perform daily following tests of the system during self diagnostics:
         o Memory Test
         o Button test (verify that the Button is not permanently pressed)
         o RF Transceiver communication test (for example: check that the CC2550 and
             the Zarlink are operational)
         o Modem / Cellular communication test (and tonality check)
         o Phone line tonality shall be tested before opening any communication. (Same
             for GPRS).
             In case of failure of this test, SM shall turn off the SM Status LED.
         o RTC test
         o Non volatile Data memory test
     As part of the self test, SM shall test correct connection of Phone line cable, or
      correct functioning of the Cellular modem.
     SM Logs, traces and IMD Data shall be stored in non volatile memory and be
      protected against power outages.
     SM boot code shall be able to verify the application code using checksum
      mechanism before executing it.
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2.2.9. UPGRADES
    SM shall download new firmwares from the location specified in the SM
     Configuration File, when it is available.
    SM shall always report the running firmware.
    The firmware switching mechanism shall revert to the old firmware in case of
     detected firmware errors



3. SMARTVIEW MONITOR TEST

This section describes the rationale for the implementation of the Smartview Monitor
operation to be used during the Qualification test.
For EMC / environmental test a dedicated functional loop has been implemented in order
to reproduce the basic operation of the SM in the same way the normal Application
Program does but with an accelerated and simplified sequence. The rationale for this is:
         The normal SM operation is based on task scheduler programmed by Back Office
          (RMS)
         The SM is mainly in idle state for the main part of the day waiting for OD FU
          requests and to execute scheduled Alerts check or Follow-up IMD data collection
         The BO server / application are not available during the SM Qualification test and
          it is anyway more convenient to not be BO dependent.




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3.1. SMARTVIEW MONITOR TEST UTILITIES
Smartview Monitor test utilities vs. Program application layers:



                         SM Application
                         (high sw layer)
                                                                          Test software
                                                                          (test utilities)


                             Drivers
                          (low sw layer)




                            Hardware
                        (Electronic board)


The Smartview Monitor standard compliance Qualification test is managed through
dedicated software utilities including Basic Operation simulation and specific utilities to
put the SM in specific operational condition.


3.2. SMARTVIEW MONITOR BASIC OPERATION
Keeping into account what is described here above, the test functional loop involves:

         SM installation (as for Patient Home).
            o Connection to telephone line (RTC version)
            o Connection to power line (wall plug adapter)
         SM activation after connecting it to power supply. Executes:
            o bootstrap;
            o self-diagnostic;
         SM opens a communication with Implantable device:
            o Check Alert execution
         SM communicate the result to data management system (Back Office server).
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         SM shall give indication to user about its correct operation and the function in
          progress:
             o SM health (HW and code) is ok on (Status LED)
             o Operation is in progress (OD LED)
             o Error in IMD or BO communication

The SM tasks not included in the functional loop do not add operating conditions which
are significant versus the test itself.




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3.3. FAILURES AND RECOVERY

3.3.1. ADMITTED FAILURES
The following failures caused by external events (interferences, stress defined by the
applicable standards) are admitted during the SM operation:
    Detected IMD communication either errors or interruptions
         Detected BO communication errors
         System reset (excluding ICD)


3.3.2. NOT ADMITTED FAILURES
The following failures, caused by external events (interferences, stress defined by the
applicable standards) are not admitted during the SM operation:
         Unrecoverable electronic or mechanical components failure
         Unrecoverable software crashes
         Code or configuration corruption
         ICD reset


3.3.3. FAULTS RECOVERY
Strategy for recovering the admitted faults:
    IMD communication errors: retry and then communication to BO or user
    Detected BO communication errors: retry
    System reset: reboot and self diagnostic to check board and SW corruption




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4. IMD TEST

This section describes the rationale for the implementation of the IMD operation to be
used during the Qualification test. Even-though IMD could be tested in the same way the
SM will be, for planning matter IMD shall be tested before SM and dedicated tools
availability.
For EMC / environmental test it has been implemented a dedicated RF Tool consisting-in
connecting a RF head (SM + option) to a laptop via USB and running a special software
tool. This tool consist-in providing every second a link called “ping” including
identification header data control according to the private protocol. In this way and even
though the application doesn’t require a continuous radio link (see below), we
significantly increase the likelihood to trap any potential link stop during the immunity
test time by raising a dedicated pop-up and confirm the RF communication can be
restarted (only possible if no ICD reset occurred; reset being not admitted referring to
section 3.3.2).
Therefore, this feature reproduces the basic operations the IMD is designed to respond
but with a continuous and simplified sequence. The rationale for this is:
         The IMD operation is based on daily SM requests
         The IMD is mainly in RF idle state for the main part of the day waiting for SM
          request and potential data sending when appropriate (Alert ready or Follow-up
          forced request).
         The BO server / application is not available during the IMD Qualification test and
          it is anyway more convenient to not be BO dependent.




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Document Created: 2012-01-10 14:55:56
Document Modified: 2012-01-10 14:55:56

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