An Intelligent Diabetic Patient Tracking System Based on Machine Learning for E-Health Applications.

BACKGROUND: Continuous surveillance helps people with diabetes live better lives. A wide range of technologies, including the Internet of Things (IoT), modern communications, and artificial intelligence (AI), can assist in lowering the expense of health services. Due to numerous communication systems, it is now possible to provide customized and distant healthcare. MAIN PROBLEM: Healthcare data grows daily, making storage and processing challenging. We provide intelligent healthcare structures for smart e-health apps to solve the aforesaid problem. The 5G network must offer advanced healthcare services to meet important requirements like large bandwidth and excellent energy efficacy. METHODOLOGY: This research suggested an intelligent system for diabetic patient tracking based on machine learning (ML). The architectural components comprised smartphones, sensors, and smart devices, to gather body dimensions. Then, the preprocessed data is normalized using the normalization procedure. To extract features, we use linear discriminant analysis (LDA). To establish a diagnosis, the intelligent system conducted data classification utilizing the suggested advanced-spatial-vector-based Random Forest (ASV-RF) in conjunction with particle swarm optimization (PSO). RESULTS: Compared to other techniques, the simulation's outcomes demonstrate that the suggested approach offers greater accuracy.

Implementing a Patient Tracking System in a Large EMS System.

Objective: Accurate tracking of patients poses a significant challenge to prehospital and hospital emergency medical providers in planned and unplanned events. Previous reports on patient tracking systems are limited primarily to descriptive reports of post incident reviews or simulated exercises. Our objective is to report our experience with implementing a patient barcode tracking system during various planned events within a large urban EMS system.Methods: In 2018, representatives from the Chicago Department of Public Health, Chicago Fire Department EMS, private EMS agencies, and 27 hospitals in the Chicago EMS System were trained on the use of a web-based patient tracking system using barcoded triage tags and wristbands to monitor triage category and hospital destination during an event. The tracking system was used on two planned operational days and three pre-planned mass gathering events. The primary outcome was the percent of patients initially scanned by EMS that were scanned by the hospital. Descriptive statistics were collected. Barriers to patient tracking system use were identified.Results: Each event was reviewed for the number of patients assigned a barcode identifier and scanned by EMS that were then scanned by the hospital. In the first planned operational day, 57% (359/622) of patients initially scanned by EMS were scanned by the hospital. In the second planned operational day, 88% (355/402) of EMS scanned patients were scanned by the hospital and 37% (133/355) were assigned a final disposition. At three city mass gathering events, there were 79% (50/63), 95% (190/199), and 82% (46/56) of EMS scanned patients also scanned by hospitals. Logistical and technological challenges were documented.Conclusions: Use of a web-based system with barcode identifiers successfully tracked patients from prehospital to hospital during planned operational days and mass gathering events. Percent of scanned patients increased after the first operational day and remained consistent in subsequent events. Limitations to the patient tracking system included logistical and technological barriers. Similar patient tracking systems may be implemented to assist with event management in other EMS systems.

Using patient flow analysis with real-time patient tracking to optimize radiation oncology consultation visits.

PURPOSE: Clinical efficiency is a key component of the value-based care model and a driver of patient satisfaction. The purpose of this study was to identify and address inefficiencies at a high-volume radiation oncology clinic. METHODS AND MATERIALS: Patient flow analysis (PFA) was used to create process maps and optimize the workflow of consultation visits in a gastrointestinal radiation oncology clinic at a large academic cancer center. Metrics such as cycle times, waiting times, and rooming times were assessed by using a real-time patient status function in the electronic medical record for 556 consults and compared between before vs after implementation of the PFA recommendations. RESULTS: The initial PFA revealed four inefficiencies: (1) protracted rooming time, (2) inefficient communications, (3) duplicated tasks, and (4) ambiguous clinical roles. We analyzed 485 consult-visits before the PFA and 71 after the PFA. The PFA recommendations led to reductions in overall median cycle time by 21% (91 min vs 72 min, p < 0.001), in cumulative waiting times by 64% (45 min vs 16 min; p < 0.001), which included waiting room time (14 min vs 5 min; p < 0.001) and wait for physician (20 min vs. 6 min; p < 0.001). Slightly less than one-quarter (22%) of consult visits before the PFA lasted > 2 h vs. 0% after implementation of the recommendations (p < 0.001). Similarly, the proportion of visits requiring < 1 h was 16% before PFA vs 34% afterward (p < 0.001). CONCLUSIONS: PFA can be used to identify clinical inefficiencies and optimize workflows in radiation oncology consultation clinics, and implementing their findings can significantly improve cycle times and waiting times. Potential downstream effects of these interventions include improved patient experience, decreased staff burnout, financial savings, and opportunities for expanding clinical capacity.

Holographic patient tracking after bed movement for augmented reality neuronavigation using a head-mounted display.

BACKGROUND: Holographic neuronavigation has several potential advantages compared to conventional neuronavigation systems. We present the first report of a holographic neuronavigation system with patient-to-image registration and patient tracking with a reference array using an augmented reality head-mounted display (AR-HMD). METHODS: Three patients undergoing an intracranial neurosurgical procedure were included in this pilot study. The relevant anatomy was first segmented in 3D and then uploaded as holographic scene in our custom neuronavigation software. Registration was performed using point-based matching using anatomical landmarks. We measured the fiducial registration error (FRE) as the outcome measure for registration accuracy. A custom-made reference array with QR codes was integrated in the neurosurgical setup and used for patient tracking after bed movement. RESULTS: Six registrations were performed with a mean FRE of 8.5 mm. Patient tracking was achieved with no visual difference between the registration before and after movement. CONCLUSIONS: This first report shows a proof of principle of intraoperative patient tracking using a standalone holographic neuronavigation system. The navigation accuracy should be further optimized to be clinically applicable. However, it is likely that this technology will be incorporated in future neurosurgical workflows because the system improves spatial anatomical understanding for the surgeon.

Understanding Social Behaviour in a Health-Care Facility from Localization Data: A Case Study.

The most frequent form of dementia is Alzheimer's Disease (AD), a severe progressive neurological pathology in which the main cognitive functions of an individual are compromised. Recent studies have found that loneliness and living in isolation are likely to cause an acceleration in the cognitive decline associated with AD. Therefore, understanding social behaviours of AD patients is crucial to promote sociability, thus delaying cognitive decline, preserving independence, and providing a good quality of life. In this work, we analyze the localization data of AD patients living in assisted care homes to gather insights about the social dynamics among them. We use localization data collected by a system based on iBeacon technology comprising two components: a network of antennas scattered throughout the facility and a Bluetooth bracelet worn by the patients. We redefine the Relational Index to capture wandering and casual encounters, these being common phenomena among AD patients, and use the notions of Relational and Popularity Indexes to model, visualize and understand the social behaviour of AD patients. We leverage the data analyses to build predictive tools and applications to enhance social activities scheduling and sociability monitoring and promotion, with the ultimate aim of providing patients with a better quality of life. Predictions and visualizations act as a support for caregivers in activity planning to maximize treatment effects and, hence, slow down the progression of Alzheimer's disease. We present the Community Behaviour Prediction Table (CBPT), a tool to visualize the estimated values of sociability among patients and popularity of places within a facility. Finally, we show the potential of the system by analyzing the Coronavirus Disease 2019 (COVID-19) lockdown time-frame between February and June 2020 in a specific facility. Through the use of the indexes, we evaluate the effects of the pandemic on the behaviour of the residents, observing no particular impact on sociability even though social distancing was put in place.

Phylogenetic analysis of the first four SARS-CoV-2 cases in Chile.

The current pandemic caused by the new coronavirus is a worldwide public health concern. To aboard this emergency, and like never before, scientific groups around the world have been working in a fast and coordinated way to get the maximum of information about this virus when it has been almost 3 months since the first cases were detected in Wuhan province in China. The complete genome sequences of around 450 isolates are available, and studies about similarities and differences among them and with the close related viruses that caused similar epidemics in this century. In this work, we studied the complete genome of the first four cases of the new coronavirus disease in Chile, from patients who traveled to Europe and Southeast Asia. Our findings reveal at least two different viral variants entries to Chilean territory, coming from Europe and Asia. We also sub-classified the isolates into variants according to punctual mutations in the genome. Our work contributes to global information about transmission dynamics and the importance to take control measures to stop the spread of the infection.

Needs for aids and equipment for the management of epilepsy in an Australian cohort.

AIM: This paper investigated the bases of needs for a range of epilepsy aids and equipment and expressed concerns about the use of such devices. METHOD: There was a 29.6% response rate (n = 393 of 1328) to Wave 4 of the Australian Epilepsy Longitudinal Study (AELS). The focus of Wave 4 was on the expressed needs and affordability of aids and equipment for people with epilepsy (PWE) and quality of life (QoL). Quantitative analysis was used to examine the association between self-reported need for aids and equipment, sociodemographic information, and QoL. Open-ended responses were subject to qualitative analysis. RESULTS: Approximately one-fifth of the sample felt that they needed specific aids, including emergency ID bracelets, seizure alarms, and seizure monitors. Those respondents who felt that they needed aids had more frequent seizures, had been recently injured by a seizure, and were less prosperous. The QoL of those in need of equipment was lower than that of those who felt that they did not need it. Qualitative analysis revealed a need for more information about the aids available, issues associated with affordability, and some concern about the utility of these aids for those who lived alone. DISCUSSION: Much research to date has focussed on the development and validation of devices for PWE and standards for testing. Fewer studies deal with the needs and experiences of PWE with regard to the use of such equipment. The development of these devices needs to ensure patient comfort and acceptability. In addition, there is a need to canvas the views of family, caregivers, and primary care providers on the usability of epilepsy aids and equipment. CONCLUSION: Further person-centered research is needed in assessing the need for and usability of aids and equipment for the management of epilepsy.

Grand Duchy of Luxembourg: a case study of a national master patient index in production since five years.

BACKGROUND: Unequivocal identification of patients is a precondition for a safe medical journey through different information systems (ISs) and software applications that are communicating and exchanging interoperable data. A master patient index (MPI) can facilitate this task. Being a repository of patient identity traits, a MPI allows an accurate surveillance of the patients' "medical identities". Up to 2014, the Grand Duchy of Luxembourg did not possess a MPI. Here, we describe our experience in the establishment of a national MPI for the Grand Duchy of Luxembourg. METHODS: The different steps that were used to establish the MPI system are described. Firstly, through the identification of the suitable application and, secondly, through the implementation of the MPI to the eHealth national platform and its connection to the national health care system. In parallel to the first two phases, the identity management policies were defined and implemented. RESULTS: Since 2014, when the MPI was integrated to the eHealth platform, we observed a continuous increase of identity profiles. At the latest update (31 December 2018), 2.418.336 identity profiles have been counted, including almost the totality of Luxembourgish residents (95.2%) as well as all the cross-border workers that are affiliated to the Luxembourgish social security system. An analysis of the identification domains connected to the platform highlighted a yearly increase in the usage rate of the identities by external applications (currently representing 70%). The evaluation of the quality of information contained in each identity profile showed low rejection rates (0.2%), indicating a high quality and a good level of completeness in regards to the required identity traits. CONCLUSIONS: This paper presents the current state of patient identity management in Luxembourg and discusses how this synergistically supports the functioning of the national electronic health record (EHR) known as DSP (from the French Dossier de Soins Partagé) and the Luxemburgish health care system. The here described national MPI has refined the identification of patients, leading to an improvement of their safety during their medical journey. Nevertheless, the application regularly undergoes updates to better meet the current requirements of the Luxembourgish health system.

Follow-up after failed newborn hearing screening: Parental and primary care provider awareness.

PURPOSE: The current loss to follow-up rate after failed newborn hearing screening (NBHS) is 34.4%. Previous studies have found that lack of parental and primary care provider (PCP) awareness of NBHS results are significant contributors to loss to follow-up. The objective of this study was to identify factors associated with parental and PCP awareness of NBHS results. MATERIALS AND METHODS: Retrospective cohort study. A survey asking about demographics and knowledge of NBHS testing and results was offered to parents in the waiting room of an urban pediatric primary care office. Included were biological parents ≥18 years of age of children ≤10 years of age born in Pennsylvania. Each child's chart was reviewed for PCP documentation of NBHS results. The odds of knowing NBHS results were evaluated using logistic regression. RESULTS: The survey was completed by 304 parents. 74.0% were aware of their child's NBHS results. Child age ≥1 year old (OR: 0.49, 95%CI[0.29, 0.82], P = 0.007) and Hispanic ethnicity (OR: 0.38, 95%CI[0.16, 0.89], P = 0.03) were associated with decreased odds of a parent knowing NBHS results. In addition, fewer fathers knew the results of their child's NBHS compared with mothers (OR: 0.33, 95%CI[0.18, 0.62], P < 0.001). However, parental awareness was not associated with birthing facility or insurance type. 222 charts were reviewed for NBHS documentation, revealing PCP awareness in 95.5% of cases and no associations with any of the factors examined. CONCLUSIONS: Factors associated with parents not knowing NBHS results included being the parent of an older child, Hispanic, or the father.

Medical alert card: a valuable tool in the management of Hirschsprung's-associated enterocolitis from parental perspective.

PURPOSE: Awareness of Hirschsprung's-associated enterocolitis (HAEC) among patient's families and medical staff can lead to prompt recognition of symptoms and earlier implementation of management. We designed an HAEC medical alert card to raise awareness of HAEC among medical staff and carers of children with Hirschsprung's disease (HD). Our aim was to investigate parental opinion on the utility of this tool. METHODS: All patients diagnosed with HD in two institutions over a period of 14 years received an HAEC alert card and were invited to answer a 1-year follow-up structured questionnaire. RESULTS: A total of 123 patients received an HAEC card. The response rate for the follow-up questionnaire was 62% (n = 76). The majority 96% (n = 73) of the responders considered the card useful. A total of 89% (n = 68) of patients or parents stated that they carry the card with them, while 39% (n = 30) of them have used it on 57 occasions. The majority (83%; n = 25) of these declared that, when presented, the card increased awareness among medical staff and on 53% (n = 16) occasions prompted contact with the tertiary centre. CONCLUSION: The HAEC medical card was found useful by most parents of HD patients. This tool increased awareness of HAEC and improved communication between peripheral hospitals and tertiary paediatric institutions. Therefore, we feel the HAEC alert card may be used in institutions with high HD addressability.

[Patient tracking with beacon technology : Pilot project in a radiological practice]. / Patiententracking mit Beacon-Technologie : Pilotprojekt in einer radiologischen Praxis.

Waiting times are still assumed to be unavoidable in medicine. However, waiting time is an essential factor of patient satisfaction. Because patient expectations are increasing, medical institutions should address the issue. Above all, this requires transparency about the current processes in the facilities. Conventional information systems often do not offer sufficient solutions to ensure this in real time combined with helpful visualization. In a pilot project in a radiological practice, the use of a patient tracking system based on beacon technology was tested. The aim was to track the actual location of the patients in the practice, to determine the patient status (e.g. patient waiting) and to display the entire processes on a smart dashboard. The successful pilot project has shown that the technology meets all requirements, that patients accept the system and that staff are familiar with the new processes after some time. For the first time, patient flows, including waiting times, were displayed clearly and in real time on a dashboard. This made it possible to control processes and waiting times that had previously never been recorded in a structured manner and were usually only recognized in the event of complaints. From a technical point of view, the system is arbitrarily scalable, whereby the connection to different information systems will be a challenge. If this succeeds, however, the possibilities are manifold. The created transparency makes it possible to reduce waiting times and to actively inform patients about waiting times and thus contribute to increasing patient satisfaction.

Assessment of RAdiopaque Patient IDentification Stickers (RAPIDS) for patient-scan correlation in a mass casualty incident.

PURPOSE: To qualitatively assess the legibility of radiopaque patient identification stickers and their effect on image quality. These stickers are intended for use as a part of a patient registration and identification pack utilized in a mass casualty incident (MCI), to prevent errors in correlating patients with their diagnostic imaging and reports. METHODS: Four different prototype designs of stickers with radiopaque identification numbers which are legible on radiographs and CT were created. These were affixed to head and thorax phantoms and scanned using standard imaging protocols. Images were reviewed qualitatively for legibility and the presence of image degradation due to the radiopaque sticker materials using Likert scales by four radiologists and four emergency physicians. RESULTS: All four prototypes were confidently legible on forehead, shoulder and sternum on CT on topogram and reconstructed images. Sticker positioning over the temple resulted in unreliable legibility on topogram. All prototypes were confidently legible on shoulder and sternum on CT and radiographs. Significant image degradation was reported on radiographs with sticker position over the sternum. The preferred anatomic position was the forehead. CONCLUSION: In a mass casualty incident, radiopaque patient identification stickers affixed to injured patients may help to ensure confidence in the correlation between patients and their imaging. Tested prototypes were found to be easily legible without substantial degradation of image quality. Preferred anatomical position and construction material was established. Consideration should be given to addition of such radiographic identity aides to MCI patient registration packs.

MRLIHT: Mobile RFID-based Localization for Indoor Human Tracking.

Radio Frequency Identification (RFID) technology has been widely used in indoor location tracking, especially serving human beings, due to its advantage of low cost, non-contact communication, resistance to hostile environments and so forth. Over the years, many indoor location tracking methods have been proposed. However, tracking mobile RFID readers in real-time has been a daunting task, especially for achieving high localization accuracy. In this paper, we propose a new Mobile RFID (M-RFID)-based Localization approach for Indoor Human Tracking, named MRLIHT. Based on the M-RFID model where RFID readers are equipped on the moving objects (human beings) and RFID tags are fixed deployed in the monitoring area, MRLIHT implements the real-time indoor location tracking effectively and economically. First, based on the readings of multiple tags detected by an RFID reader simultaneously, MRLIHT generates the response regions of tags to the reader. Next, MRLIHT determines the potential location region of the reader where two algorithms are devised. Finally, MRLIHT estimates the location of the reader by dividing the potential location region of the reader into finer-grained grids. The experimental results demonstrate that the proposed MRLIHT performs well in both accuracy and scalability.

An Anti-Collision Scheme for RFID for Patient Tracking Using Linear Interpolation Estimation.

Radio Frequency Identification (RFID) tags are widely used in the healthcare industry for patient tracking. A mainstream RFID implementation is based on a series of readers installed in a fixed location within a hospital or a nursing home and tags are embedded in the clothing worn by patients. Caregivers can readily obtain near real-time location information of individual patients from the tag locations. For implementation in washable clothing tags are often passive such that tag collision is a common problem within co-operation mechanism between tags. Tag anti-collision scheme is there an important consideration that affects the identification effectiveness. To address this issue, this paper proposes a dynamic frame slotted Aloha algorithm based on linear interpolation based estimation that adaptively adjusts the frame length. Simulation results show that the proposed algorithm yields an estimation error below 1.5% achieved in less than 10 iterations, it provides reduction in identification time while reduces the tags leakage probability in a clinical environment where patient tracking is automatically managed.

Development and Implementation of a Cloud-Based Meningitis Surveillance and Specimen Tracking System in Burkina Faso, 2018.

Nationwide case-based meningitis surveillance was established in Burkina Faso following the introduction of meningococcal serogroup A conjugate vaccine in 2010. However, timely tracking and arrival of cerebrospinal fluid specimens for confirmation at national reference laboratories remained suboptimal. To better understand this gap and identify bottlenecks, the Burkina Faso Ministry of Health, along with key partners, developed and implemented a cloud-based System for Tracking Epidemiological Data and Laboratory Specimens (STELAB), allowing for timely nationwide data reporting and specimen tracking using barcodes. STELAB was adapted to Burkina Faso's infrastructure to ensure suitability, functionality, flexibility, and sustainability. We describe the design, development, and implementation of STELAB. In addition, we discuss strategies used to promote sustainability, lessons learned during the first year of implementation, and future directions. STELAB's novel design and country-driven approach has the potential to achieve sustainable real-time data reporting and specimen tracking for the first time in sub-Saharan Africa.

Interpreting Radiographs with Concurrently Obtained Patient Photographs.

A technology for automatically obtaining patient photographs along with portable radiographs was implemented clinically at a large academic hospital. This article highlights several cases in which image-related clinical context, provided by the patient photographs, provided quality control information regarding patient identification, laterality, or position and assisted the radiologist with the interpretation. The information in the photographs can easily minimize unnecessary calls to the patient's nursing staff for clarifications and can lead to new methods of physically assessing patients. Published under a CC BY 4.0 license.

Allergic contact dermatitis caused by 1,6-hexanediol diacrylate in a hospital wristband.

BACKGROUND: 1,6-Hexanediol diacrylate (1,6-HDDA) is a multifunctional acrylate and a potent sensitizer. OBJECTIVES: To report a case of allergic contact dermatitis caused by 1,6-HDDA in a hospital wristband. METHODS: A male patient presented with eczema on his wrist where he had worn a hospital wristband. Patch testing was performed with our extended European baseline series, additional series, and pieces of the hospital wristband. Thin-layer chromatography (TLC) was performed with extracts from the wristband and gas chromatography-mass spectrometry was used for chemical analysis. RESULTS: Positive reactions were found to pieces of the wristband, including adhesive rim (+++), inside (+++), and outside (++); to multiple allergens in the (meth)acrylates series; and to extracts of the wristband in acetone and ethanol. Chemical analysis of the ethanol extract showed presence of lauryl acrylate and 1,6-HDDA. Patch testing with TLC strips and subsequent chemical analysis showed that the substance causing the strongest reaction was 1,6-HDDA, to which the patient had a confirmed positive patch test reaction. CONCLUSION: 1,6-HDDA was identified as the culprit allergen responsible for allergic contact dermatitis caused by the hospital wristband.

Ear biometrics for patient identification in global health: a field study to test the effectiveness of an image stabilization device in improving identification accuracy.

BACKGROUND: In many low and middle-income countries (LMICs), difficulties in patient identification are a major obstacle to the delivery of longitudinal care. In absence of unique identifiers, biometrics have emerged as an attractive solution to the identification problem. We developed an mHealth App for subject identification using pattern recognition around ear morphology (Project SEARCH (Scanning EARS for Child Health). Early field work with the SEARCH App revealed that image stabilization would be required for optimum performance. METHODS: To improve image capture, we designed and tested a device (the 'Donut'), which standardizes distance, angle, rotation and lighting. We then ran an experimental trial with 194 participants to measure the impact of the Donut on identification rates. Images of the participant's left ear were taken both with and without use of the Donut, then processed by the SEARCH algorithm, measuring the top one and top ten most likely matches. RESULTS: With the Donut, the top one identification rate and top ten identification rates were 99.5 and 99.5%, respectively, vs. 38.4 and 24.1%, respectively, without the Donut (P < 0.0001 for each comparison). In sensitivity analyses, crop technique during pre-processing of images had a powerful impact on identification rates, but this too was facilitated through the Donut. CONCLUSIONS: By standardizing lighting, angle and spatial location of the ear, the Donut achieved near perfect identification rates on a cohort of 194 participants, proving the feasibility and effectiveness of using the ear as a biometric identifier. TRIAL REGISTRATION: This study did not include a medical intervention or assess a medical outcome, and therefore did not meet the definition of a human subjects research study as defined by FDAAA. We did not register our study under clinicaltrials.gov .

Verification of a Portable Motion Tracking System for Remote Management of Physical Rehabilitation of the Knee.

Rehabilitation following knee injury or surgery is critical for recovery of function and independence. However, patient non-adherence remains a significant barrier to success. Remote rehabilitation using mobile health (mHealth) technologies have potential for improving adherence to and execution of home exercise. We developed a remote rehabilitation management system combining two wireless inertial measurement units (IMUs) with an interactive mobile application and a web-based clinician portal (interACTION). However, in order to translate interACTION into the clinical setting, it was first necessary to verify the efficacy of measuring knee motion during rehabilitation exercises for physical therapy and determine if visual feedback significantly improves the participant's ability to perform the exercises correctly. Therefore, the aim of this study was to verify the accuracy of the IMU-based knee angle measurement system during three common physical therapy exercises, quantify the effect of visual feedback on exercise performance, and understand the qualitative experience of the user interface through survey data. A convenience sample of ten healthy control participants were recruited for an IRB-approved protocol. Using the interACTION application in a controlled laboratory environment, participants performed ten repetitions of three knee rehabilitation exercises: heel slides, short arc quadriceps contractions, and sit-to-stand. The heel slide exercise was completed without feedback from the mobile application, then all exercises were performed with visual feedback. Exercises were recorded simultaneously by the IMU motion tracking sensors and a video-based motion tracking system. Validation showed moderate to good agreement between the two systems for all exercises and accuracy was within three degrees. Based on custom usability survey results, interACTION was well received. Overall, this study demonstrated the potential of interACTION to measure range of motion during rehabilitation exercises for physical therapy and visual feedback significantly improved the participant's ability to perform the exercises correctly.

Based Medical Systems for Patient's Authentication: Towards a New Verification Secure Framework Using CIA Standard.

In medical systems for patient's authentication, keeping biometric data secure is a general problem. Many studies have presented various ways of protecting biometric data especially finger vein biometric data. Thus, It is needs to find better ways of securing this data by applying the three principles of information security aforementioned, and creating a robust verification system with high levels of reliability, privacy and security. Moreover, it is very difficult to replace biometric information and any leakage of biometrics information leads to earnest risks for example replay attacks using the robbed biometric data. In this paper presented criticism and analysis to all attempts as revealed in the literature review and discussion the proposes a novel verification secure framework based confidentiality, integrity and availability (CIA) standard in triplex blockchain-particle swarm optimization (PSO)-advanced encryption standard (AES) techniques for medical systems patient's authentication. Three stages are performed on discussion. Firstly, proposes a new hybrid model pattern in order to increase the randomization based on radio frequency identification (RFID) and finger vein biometrics. To achieve this, proposed a new merge algorithm to combine the RFID features and finger vein features in one hybrid and random pattern. Secondly, how the propose verification secure framework are followed the CIA standard for telemedicine authentication by combination of AES encryption technique, blockchain and PSO in steganography technique based on proposed pattern model. Finally, discussed the validation and evaluation of the proposed verification secure framework.