Hi everyone,
I'm working on a personal learning project: building an open-source telemetry gateway for MIC@Home / hospital step-down scenarios, mainly to understand how real-world medical systems are designed.
I'm trying to implement essential features while keeping the solution simple and low-cost, learning concepts one by one (IEC 62304 basics, data immutability, device authentication, etc.).
Key things I've implemented so far:
- Real-time vital signs (HR, SpO2, Temp, RR)
- 5-minute rolling suppression window to reduce alarm fatigue
- HMAC-SHA256 hash-chained audit trail for data integrity
- Postgres RLS for ward-level data isolation
I'm particularly interested in:
How hospitals currently handle audit log immutability and tampering detection in real systems?
Best practices (or common pitfalls) for managing **alarm fatigue** in remote monitoring / Hospital-at-Home setups.
Any suggestions on making such a system more compatible with existing clinical workflows and devices?