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notambiguous

join:2005-03-24

VoIP and pacemaker monitor compatibility?

My brother's wife has a pacemaker so they have a POTS line so that the doctor's office can call to check it. It seems like it is nothing more than an acoustic modem.

I wondered if anyone knows if there are compatibility issues with VoIP? If not he could just get a inexpensive DID and cancel the POTS line.

Any experience/ideas appreciated.


voipMatt

join:2008-07-30
Birmingham, AL

I have worked with a few of these companies and it seems the devices that have adjustable BAUD rates have a better history of connection.

I do not recommend a voip line for a device like this, but it can be done.


nitzan
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reply to notambiguous

Assuming the connection failed - would it put his wife in danger/at risk?

If yes- do not do this. VoIP is not reliable with data/modems.

If no, and it's just informational, it should probably work if the modem speed is adjusted to be low. Keep in mind that it's going to be hit-or-miss and unreliable.
--
Nitzan Kon, CEO
Future Nine Corporation



N9MD
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3 edits
reply to notambiguous

said by notambiguous:

... pacemaker ... compatibility issues with VoIP?
The responding posters are wise, indeed. As a physician and as a son-in-law of a 95 year old gent who has biannual pacemaker checkups by phone (PSTN) --- I look at the OP's issue thusly.

A pacemaker check is not an acute life or death situation. It is simply designed to confirm that the battery is still charged and that the continuous or demand pacing function is operating properly. The "phone" device at the patient's end is just a modem, as others have stated, where the connection/transmission depends on the baud rate of the modems on each side (patient and doctor/tecnician) as well as the quality and reliability of the phone/VoIP line when the hook-up is made. Keep in mind that the pacemaker checkup is generally initiated by the doctor/hospital's office at a specific pre-arranged time months in advance ... so the VoIP connection better be working when the call comes in.

I would suggest keeping a PSTN line in service for at least two upcoming checkups so that, if the VoIP link is unsatisfactory, you have the PSTN line to fall back on. Keep in mind that, if you only have VoIP and it fails during the pacemaker checkup, the patient will need to reschedule at a another time which may be well into the future, given the very busy "pacemaker check" schedules in most cardiology offices.

-=-=-=

Incidentally, for those who are wondering, Colonoscopy does not work well over a VoIP connection (CoIP)!


ptrowski
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reply to notambiguous

This is always an interesting topic when it comes up. I have said this before but I would NEVER trust VoIP for a situation such as pacemaker monitoring.



burris
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reply to N9MD

said by N9MD:

said by notambiguous:

... pacemaker ... compatibility issues with VoIP?

-=-=-=

Incidentally, for those who are wondering, Colonoscopy does not work well over a VoIP connection (CoIP)!
Sure!...but I'll bet it sounds like you're in a tunnel.

mazilo
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Lilburn, GA
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1 edit
reply to notambiguous

said by notambiguous:

If not he could just get a inexpensive DID and cancel the POTS line.
I know this may sound weird.

Has your brother's wife ever thought of how much it will cost her to keep the PSTN line/year for a single checkup and how much it will cost here to take a trip to the doctor's office for the same check up? Base on this comparison, which one will safe more $$$ in the long run?
--
Mazilo always prays for FREEBIES!
US Phone: +1-678-601-0907
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stevech0

join:2006-09-17
San Diego, CA
reply to N9MD

said by N9MD:

said by notambiguous:

... pacemaker ... compatibility issues with VoIP?
A pacemaker check is not an acute life or death situation. It is simply designed to confirm that the battery is still charged and that the continuous or demand pacing function is operating properly.
Serious issue - I disagree with this and caution the original poster. Pacemaker checks involve not only a battery condition check, but readjusting the sensing thresholds, and normally, disabling pacing momentarily to check the patient's inherent rhythms and synchronisms. No doubt the pacemaker can timeout and recover from lost communications or other difficulties, but why take the risk?

VoIP does NOT convey analog data like FAX, modems and even DTMF tones (touch tones, in-band) well due to the digitizing and compression processes in VoIP CODECs which were intended to exploit the nature of human speech.

Not worth it, I say.

cbrain

join:2000-05-21
Silver Spring, MD
reply to notambiguous

Doesn't anyone make an IP monitor with ethernet connection? I would think enough people have broadband connections to make such equipment a viable option.


pandora
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Outland
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It'd seem a Bluetooth connection to an ethernet dongle would be a better solution. Though I guess it takes years to get anything approved.

To the OP, please don't endanger the life of anyone, keep your POTS line. I love my VOIP, but in your situation, I'd use POTS.
--
"People demand freedom of speech as a compensation for the freedom of thought which they seldom use."



usa2k
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reply to N9MD

said by N9MD:

Incidentally, for those who are wondering, Colonoscopy does not work well over a VoIP connection (CoIP)!
Always there with a good Re-BUTT-al

On a serious note ... VoIP is unreliable for modem communications, but people still try. Some succeed with FAX and Pay-Per-View and ...

UDP packets do not have any handshaking and when lost here and there, your voice sounds fine. Try and send a digital signal, and it gets more easily degraded.

Too bad its not a networked check, plugging into your router.
--
Jim, VoIP since 12/2002, VOIPo 2/7/2007

FAH-Tool ... Whales ... VOIPo Forum ... VOIPo Review

hoolahoous

join:2004-08-25
Red Valley, AZ
reply to cbrain

said by cbrain:

Doesn't anyone make an IP monitor with ethernet connection? I would think enough people have broadband connections to make such equipment a viable option.
yes I agree.. why are these supposedly 'cutting edge' technology still relying on modem connection when a much faster/better/always on broadband is available. same goes for home monitoring equipment


N9MD
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said by hoolahoous:

... why are these supposedly 'cutting edge' technology still relying on modem connection when a much faster/better/always on broadband is available. same goes for home monitoring equipment
Probably because the majority of "paced people" are elderly and totally unfamiliar with broadband technology ... although this will change as the younger technically knowledgeable age group eventually enters their "elderly" years. I personally am on the cusp!


N9MD
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reply to stevech0

said by stevech0:

said by N9MD:

said by notambiguous:

... pacemaker ... compatibility issues with VoIP?
A pacemaker check is not an acute life or death situation. It is simply designed to confirm that the battery is still charged and that the continuous or demand pacing function is operating properly.
Serious issue - I disagree with this and caution the original poster. Pacemaker checks involve not only a battery condition check, but readjusting the sensing thresholds, and normally, disabling pacing momentarily to check the patient's inherent rhythms and synchronisms.
Not to get into a debate, Steve, but most telephonic pacemaker checking devices (modems) currently in use do not allow the in depth testing that can be done during an actual hospital/clinic/office visit. These "phone checks" simply yield a remote EKG tracing that shows the cardiac rhythm and confirm that the pacemaker is operating at its correct setting. And these modems are not product-specific since they can be used with any brand of pacemaker.

The standard pacemaker either is "always on" or is "on demand" (when the heart rate drops too low or has long pauses, essentially dropped beats). The phone check for this device involves placing cuffs on one's wrist and a magnet over the chest-implanted device, with leads going to the acoustic modem. So this is simply a remote EKG setup. No "controlling" signals are involved.

I believe you are referring to a device that both Medtronics and St. Jude Medical had developed back in 2004 that involves plugging a non-acoustic home-monitoring device into the phone jack ... this device actually receives and transmits signals to and from a somewhat more complex implanted cardioverter / defibrillator device which can indeed put the apparatus thru its paces ... and the patient can, on his/her own, initiate the call to the cardiology folks, allowing the results of the resulting data to be transmitted to the "checker-upper" people.
»www.medtronic.com/rhythms/downlo···ENp7.pdf
»sip-trunking.tmcnet.com/news/200···2807.htm

Since the simple pacemaker is by far the most common device in circulation ... and remote monitoring simply means a remote EKG ... I stand by my statement "A pacemaker check is not an acute life or death situation." If the phone connection is disrupted, one can always call back (preferrably on a PSTN line).

I've spoken with two Cardiology colleagues with years of pacemaker experience. Neither of them is aware of any of their patients who have asked about using VoIP ... but I'm sure somewhere out there, cardiologists have encountered this situation.

I guess the final answer will be determined once a bunch of techies with pacemakers start trying out VoIP-connected pacemaker checkups. So, at this point, I can't say "absolutely yes" or "absolutely no". But "life or death"? ... I think not.

stevech0

join:2006-09-17
San Diego, CA

Let me simplify
A biannual pacemaker check in the Dr's office (always?) includes checking and resetting the thresholds. Just checking EKG and battery condition is not what a normal visit entails.



N9MD
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said by stevech0:

Let me simplify
A biannual pacemaker check in the Dr's office (always?) includes checking and resetting the thresholds. Just checking EKG and battery condition is not what a normal visit entails.
I totally and unequivocally agree in the Dr's office. I was responding more to the OP's curiosity about PM checks via VoIP connection. I don't want to beat it to death ... but I just felt that there's no real risk in trying other than the possibility the remote checkup will be unsuccessful, requiring PSTN re-try or a visit to the doctor's office.

Keep in mind that with a telephone checkup, one avoids the co-pay.