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Background Hospital real-time location systems (RTLS) are increasing efficiency and reducing operational costs, but room access tags are necessary. Objectve We developed three iPhone 5 applications for an RTLS and communications using Bluetooth low energy (BLE). Methods The applications were: Peripheral device tags, Central beacons, and a Monitor. A Peripheral communicated with a Central using BLE. The Central communicated with a Monitor using sockets on TCP/IP (Transmission Control Protocol/Internet Protocol) via a WLAN (wireless local area network). To determine a BLE threshold level for the received signal strength indicator (RSSI), relationships between signal strength and distance were measured in our laboratory and on the terrace. Results The BLE RSSI threshold was set at -70 dB, about 10 m. While an individual with a Peripheral moved around in a concrete building, the Peripheral was captured in a few 10-sec units at about 10 m from a Central. The Central and Monitor showed and saved the approach events, location, and Peripheral's nickname sequentially in real time. Remote Centrals also interactively communicate with Peripherals by intermediating through Monitors that found the nickname in the event database. Conclusions Trial applications using BLE on iPhones worked well for patient tracking, and messaging in indoor environments.

Background: Auscultation is one of the basic techniques for the diagnosis of heart disease. However, the interpretation of heart sounds and murmurs is a highly subjective and difficult skill. Objectives: To assist the auscultation skill at the bedside, a handy phonocardiogram was developed using a smartphone (Samsung Galaxy J, Android OS 4.4.2) and an external microphone attached to a stethoscope. Methods and Results: The Android app used Java classes, “AudioRecord,” “AudioTrack,” and “View,” that recorded sounds, replayed sounds, and plotted sound waves, respectively. Sound waves were visualized in real-time, simultaneously replayed on the smartphone, and saved to WAV files. To confirm the availability of the app, 26 kinds of heart sounds and murmurs sounded on a human patient simulator were recorded using three different methods: a bell-type stethoscope, a diaphragm-type stethoscope, and a direct external microphone without a stethoscope. The recorded waveforms were subjectively confirmed and were found to be similar to the reference waveforms. Conclusions: The real-time visualization of the sound waves on the smartphone may help novices to readily recognize and learn to distinguish the various heart sounds and murmurs in real-time.

The benefits of Hospital real-time location systems (RTLSs) have been characterized as increasing efficiency and reducing operational costs. We developed iPhone applications for an indoor RTLS with Bluetooth low energy (BLE) and evaluated the system in our laboratory rooms instead of on actual hospital wards. The applications were installed in peripherals as tags on iPhone5s, centrals as access points (5th-generation iPod touch pads or iPhone5s) placed in rooms in a concrete building, and a monitor as a server on an iPhone5. The centrals and monitor were connected on a wireless LAN. Each peripheral communicates with a central by BLE, and the centrals communicate with the monitor by sockets on TCP/IP. While individuals with iPhone5s moved around in the building, the “access events” were captured in a few ten- second units at about 10 m from a central. The monitor showed the access events with the peripheral identifier and location, and interactively returned messages to the peripheral. A RTLS was simply created with only iPhone applications using Bluetooth low energy without RFID tags. This system may effectively be used as an indoor RTLS, patient tracking, and calling system.

K. Mizuno1, Y. Shiba 2, H. Sato 2, N. Kamide 2, Y. Suzuki 2, N. Arisaka 3, H. Tsuruta 2, A. Takeuchi 4, M. Fukuda5, N. Ikeda 6 1 Kitasato University East Hospital, Department of Rehabilitation, Sagamihara, Japan; 2 Kitasato University School of Allied Health Sciences, Sagamihara, Japan; 3 Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan; 4 Kitasato University School of Medicine, Sagamihara, Japan; 5 Kitasato University East Hospital, Sagamihara, Japan; 6 Kitasato University, Sagamihara, Japan