Friday, June 5, 2009
Dr. John Halamka's blog
I just thought I would post a link to Dr. Halamka's blog here. He's the CIO of CareGroup and Chair of the Healthcare Information Standards Panel who's been namedropped a few times this week. I've subscribed to it since he spoke at the intensives last summer. In addition to healthcare and technology he also posts about being a vegan and locavore, reducing his carbon footprint, etc. A very interesting read!
Wednesday, June 3, 2009
Open Source Mobile Technology Software Reinventing Health Care In Developing Countries
- Sarah Foster -
Episurveyor is an opensource software application specifically developed for mobile data collection in developing countries, specifically for public health purposes. The software is available for download for free from its website and can easily be installed onto mobile devices. The mobile availability and open source features are extremely important to its functionality because of the widespread use of cellular phones and weak economic conditions of many developing nations.
More information is available at: http://www.medicalnewstoday.com/articles/147941.php
http://www.episurveyor.org/view/login.jsp
Use Case for Episurveyor
Primary Actor and Goal:
NGO health worker in remote location wants to monitor/record patient health in an accurate and timely manner.
Secondary users:
NGO management wants to monitor area-wide health conditions.
Patient wants to manage personal health.
Funders/WHO want to have tangible and reliable data to substantiate funding.
Supporting Actors:
Mobile device provides platform.
Cell phone company provides internet connectivity in remote locations.
Server/data management system stores and collects data.
Success Scenario:
1. Health worker records patient information. (Patient may also contribute to data collection.)
2. Information is stored and can be used by doctor for future visits/consultations.
3. Other stakeholders use data to signal potential health epidemics, etc.
Variations
Connectivity issues – where will data be stored when the device can’t connect? Battery power/needs for solar in very remote areas. While the software is free, will the NGO have the IT support to effectively use the application?
Standards: It has been adopted as the official data collection standard by the World Health Organization.
Episurveyor is an opensource software application specifically developed for mobile data collection in developing countries, specifically for public health purposes. The software is available for download for free from its website and can easily be installed onto mobile devices. The mobile availability and open source features are extremely important to its functionality because of the widespread use of cellular phones and weak economic conditions of many developing nations.
More information is available at: http://www.medicalnewstoday.com/articles/147941.php
http://www.episurveyor.org/view/login.jsp
Use Case for Episurveyor
Primary Actor and Goal:
NGO health worker in remote location wants to monitor/record patient health in an accurate and timely manner.
Secondary users:
NGO management wants to monitor area-wide health conditions.
Patient wants to manage personal health.
Funders/WHO want to have tangible and reliable data to substantiate funding.
Supporting Actors:
Mobile device provides platform.
Cell phone company provides internet connectivity in remote locations.
Server/data management system stores and collects data.
Success Scenario:
1. Health worker records patient information. (Patient may also contribute to data collection.)
2. Information is stored and can be used by doctor for future visits/consultations.
3. Other stakeholders use data to signal potential health epidemics, etc.
Variations
Connectivity issues – where will data be stored when the device can’t connect? Battery power/needs for solar in very remote areas. While the software is free, will the NGO have the IT support to effectively use the application?
Standards: It has been adopted as the official data collection standard by the World Health Organization.
Medscape Physician Connect
I’ve been looking into Medscape Physician Connect, a site that has rapidly grown into the largest social network of physicians. This page offers a good summary of available features: http://www.medscape.com/connect
Description: Medscape Physician Connect is a community of physicians that facilities the exchange of ideas on both clinical and non-clinical topics. Through a rating system and open discussion, physicians can get feedback from other physicians on their research and fresh perspectives on cases.
Use Case: Physicians are the primary actor. Their goal is to get information on a particular clinical topic. They use the site by creating an account and having their medical credentials verified. Then the physician can create posts to get feedback from other users, watch threads on topics they are interested in, and share their insights on the topics of other physicians.
Information Sharing Standards: Standards are crucial for the success of Medscape Physician Connect. Those posting on this site are not anonymous like the typical web forum. All physicians have had their identity and credentials verified by Medscape. This crucial standard addresses the adverse selection problem inherent with other wiki-based information sharing websites where anonymous users often post false information.
Description: Medscape Physician Connect is a community of physicians that facilities the exchange of ideas on both clinical and non-clinical topics. Through a rating system and open discussion, physicians can get feedback from other physicians on their research and fresh perspectives on cases.
Use Case: Physicians are the primary actor. Their goal is to get information on a particular clinical topic. They use the site by creating an account and having their medical credentials verified. Then the physician can create posts to get feedback from other users, watch threads on topics they are interested in, and share their insights on the topics of other physicians.
Information Sharing Standards: Standards are crucial for the success of Medscape Physician Connect. Those posting on this site are not anonymous like the typical web forum. All physicians have had their identity and credentials verified by Medscape. This crucial standard addresses the adverse selection problem inherent with other wiki-based information sharing websites where anonymous users often post false information.
Doctor in Your Pocket
Link: http://www.livemint.com/2009/02/19103745/Mobile-phones-aim-to-be-a-82.html (Overview of technology)
Description: The mobile phone carriers in Spain are looking to use mobile phones for yet another medical application. Getting medical information to the indigent population comprising of 51 programs in 26 countries. They believe that since these people already have mobile access, getting them medical information should be the next natural progression of hand-held technology. The largest adopters thus far are India, South Africa and Uganda.
“Bringing this type of innovation to market should substantially reduce the strain on the public health systems if implemented correctly” – Daniel Carucci
Primary Actor: Persons who have limited access to public healthcare, yet own and operate a cellular phone in developing countries.
Goal: To provide necessary medical information and advice to persons who normally would not be able to seek, or afford, medical care because of their economic status or social situation.
Use Case: The actor would login to their medical providers website where they would have access to general medical information as well as a link to a doctor or nurse who will answer their medical questions through a web / texting interface. The actor can use this information to substantially improve their healthcare situation, especially in the preventative healthcare arena.
Standards: There are no standards yet identified for this type of technology because it is so new. They are actively trying to develop a standard for disseminating this type of information to this target population.
Merge Healthcare launches Merge Mobile app for the iPhone
http://www.zimbio.com/Radiology/articles/61/Merge+Healthcare+launches+Merge+Mobile+app
"Merge Healthcare announced mobile technology that enables patients and healthcare professionals to view digital medical images such as CT, MRI, X-ray and other images on an Apple iPhone™ or iPod touch. A demonstration of Merge Mobile™ for the iPhone™ is available free of charge from the iPhone App Store.
Merge Mobile is breakthrough technology intended to help health organizations and clinicians improve quality of care, reduce costs and improve responsiveness to patients. Today, radiologists and physicians have access to patient medical images from computers connected to their practice management or PAC (picture archiving and communications) systems. Applications* built upon Merge Mobile technology will enable radiologists to view emergency cases directly from their iPhone or iPod touch, consult with colleagues and, when necessary, forward critical findings directly and securely to a patient’s referring physician. "
USE CASE: Doctor retreiving medical records including X-ray, CT-scan and MRI images on modile devices
Primary Actor: Doctor
Goal: To instantly retreive health information in an emergency situation.
Other Stakeholders and Interests: (1) Patient - life depends on the effectiveness of the application, (2) Attendant in Ambulance who is asking for consultation from doctor - required expert advice from a qualified person.
Supporting Actors: (1) PAC (Pictures and Archiving Communication) system. (2) Mobile/Cellular Network. (3) Mobile devices
Success Scenario:
1. Attendant retreives medical data of patient using Merge Mobile.
2. If required, Attendant requests a medical consult from a Doctor, and sends images using merge Mobile
Variations:
- Inability to connect to wireless newtork
- Access to medical record denied.
Innovative iPhone™ Medical Application Granted FDA Clearance
http://www.earthtimes.org/articles/show/innovative-iphonetrade-medical-application-granted-fda-clearance,776024.shtml
Description of Technology
"AirStrip OB allows obstetricians to use their iPhones to remotely access virtual real-time and historical waveform data for both the mother and baby, including heart tracings and contraction patterns, as well as nursing notes and exam status. The data is sent directly from hospitals’ labor and delivery units and can be accessed on the iPhone anytime, anywhere the doctor gets a cell-phone connection."
Use Case
Primary Actor - Obstetricians who are out of the office
Goal - to monitor and evaluate the health of the mother and unborn baby
Procedure - The Doctor downloads the iPhone App to their iPhone and can monitor real time information about the contraction cycles, hearth rate of mother and baby, as well as access other relevant medical information without actually being with the patient. this allows the Doctor to be more accessible and guide hospital staff to take the correct steps in preventing a mishap.
Sucess Scenario: A sucessful connection would incorporate a real time connection to the patient and be able to moniotr the health of the patient from a remote location as if the doctor was next to the patient.
Standards
Standards for the application were not listed in the article.
Description of Technology
"AirStrip OB allows obstetricians to use their iPhones to remotely access virtual real-time and historical waveform data for both the mother and baby, including heart tracings and contraction patterns, as well as nursing notes and exam status. The data is sent directly from hospitals’ labor and delivery units and can be accessed on the iPhone anytime, anywhere the doctor gets a cell-phone connection."
Use Case
Primary Actor - Obstetricians who are out of the office
Goal - to monitor and evaluate the health of the mother and unborn baby
Procedure - The Doctor downloads the iPhone App to their iPhone and can monitor real time information about the contraction cycles, hearth rate of mother and baby, as well as access other relevant medical information without actually being with the patient. this allows the Doctor to be more accessible and guide hospital staff to take the correct steps in preventing a mishap.
Sucess Scenario: A sucessful connection would incorporate a real time connection to the patient and be able to moniotr the health of the patient from a remote location as if the doctor was next to the patient.
Standards
Standards for the application were not listed in the article.
Kenkou = Healthy
Website
http://www.wellbuiltsoftware.com/products/kenkou/kenkou.html
Description of Technology
The Kenkou iPhone App allows end users to track vital health measurements and to alert others to those changes. It's an opportunity for patients to provide closer to real-time health statistics to health care providers, family members or other stakeholders. The Kenkou (Japanese for "healthy") App allows users to input health statistics like blood sugar and blood pressure while also tracking health habits like exercise or food consumption. That information can then be emailed to whomever the user decides. This can be used to track those with serious health problems, or by those looking to keep a running "health diary" of their life.
Use Case
Primary Actor - Patient suffering from Diabetes due to Obesity.
Goal - To track Patient's over all health habits to track effectiveness of diet and exercise on blood sugar levels.
Procedure - The Patient downloads the Kenkou iPhone App to their iPhone (which ~everyone~ should own) and begins entering key statistics daily. This information is gathered and tracked by the App and then sent to a list of stakeholders determined by the Patient. That information is then sent, in table and graphic form, to those stakeholders. A proper combination of diet and exercise can be found to help create individualized lifestyle plans for unique Patients.
Standards
Standards for Kenkou are not listed on the Well Built Software website, but were developed using the iPhone SDK for iPhone OS 2.2.1.
Toughbook H1 Mobile Clinical Assistant
Product Description
http://www.gottabemobile.com/2008/11/04/panasonic-announces-the-toughbook-h1-mobile-clinical-assistant/
YouTube Tutorial
http://www.youtube.com/watch?v=ufDDOi19anQ&hl=en&fs=1
The Panasonic Toughbook H1 Mobile Clinical Assistant is a mobile lightweight computer used by nurses and doctors to electronically monitor and update patients’ health records. The technology connects wirelessly to a hospital’s server. It is light weight and also has a camera built into it. The operating system is based on Windows.
USE CASE :
Use Case : Nurse updating a patient’s electronic medical record through mobile technology
Primary Actor and Goal: Nurse wants to accurately update a patient’s record
Other Stakeholders and Interests:
Patient : Wants proper care
Doctor(s) : Wants accurate data in order to make correct / best decisions
Supporting Actors (external systems):
Hospital’s Server – where data is stored
Ethernet / Switches / Local Area Network – Connects device to hospital’s servers
Success Scenario:
1. Nurse measures patients vitals (temperature, blood pressure and pulse)
2. Nurse logs into the Toughbook
3. Nurse enters data on the patient’s vitals
Variations:
- Connectivity issues, what if nurse cannot log onto the server?
- What if nurse logs data for wrong patient
Although the product description and YouTube video do not specifically address standards, the operating system is Windows based, potentially suggesting that the mobile technology will be fully compatible with the computers used in hospitals.
http://www.gottabemobile.com/2008/11/04/panasonic-announces-the-toughbook-h1-mobile-clinical-assistant/
YouTube Tutorial
http://www.youtube.com/watch?v=ufDDOi19anQ&hl=en&fs=1
The Panasonic Toughbook H1 Mobile Clinical Assistant is a mobile lightweight computer used by nurses and doctors to electronically monitor and update patients’ health records. The technology connects wirelessly to a hospital’s server. It is light weight and also has a camera built into it. The operating system is based on Windows.
USE CASE :
Use Case : Nurse updating a patient’s electronic medical record through mobile technology
Primary Actor and Goal: Nurse wants to accurately update a patient’s record
Other Stakeholders and Interests:
Patient : Wants proper care
Doctor(s) : Wants accurate data in order to make correct / best decisions
Supporting Actors (external systems):
Hospital’s Server – where data is stored
Ethernet / Switches / Local Area Network – Connects device to hospital’s servers
Success Scenario:
1. Nurse measures patients vitals (temperature, blood pressure and pulse)
2. Nurse logs into the Toughbook
3. Nurse enters data on the patient’s vitals
Variations:
- Connectivity issues, what if nurse cannot log onto the server?
- What if nurse logs data for wrong patient
Although the product description and YouTube video do not specifically address standards, the operating system is Windows based, potentially suggesting that the mobile technology will be fully compatible with the computers used in hospitals.
Lose It! iPhone App to Help Track Weight Loss
http://www.theiphoneappreview.com/01/lose-it-iphone-weight-loss/
Description: Lose It! is an iPhone application that allows you to track your caloric intake and expenditure anywhere. You create a customized profile which contains your weight, age, and height and it helps to regulate your weight because it creates a daily caloric budget based on your fitness. The user simply enters the foods they eat throughout the day into the device and also any exercise data, Lose It! then goes to work keeping track of this information, making calorie counting much easier.
Use Case: Lose It! will be used by iPhone users, the primary actors, who want to lose weight. These users download this application from the Apple AppStore and then simply enter their target weight for the week and Lose It! goes to work. Lose It! creates a daily caloric budget based on this target weight and users need to strive to reach this goal. Throughout the day users enter the foods that they are eating into the system, they can either look up certain foods or create a custom entry, along with entries about exercise. This ability to look the caloric content of certain foods and the number of calories burned through certain types of exercises allows users to easily monitor their daily caloric intake in real time and makes the tedious process of calorie counting a simple procedure using an iPhone application.
Currently there does not seem to be any sort of information sharing standards but this application is based on caloric intake, a standard in healthcare, and this information could easily be added to online user health profiles because of the connectivity of the Apple iPhone.
Speech Recognition Product: Dragon Medical
Laura Plattner
http://www.healthcareitnews.com/news/product-spotlight-speech-recognition
http://www.nuance.com/naturallySpeaking/products/medical.asp
Description:
Speech recognition software enables physicians to create and update EMR more efficiently than traditional manual inputting, and more accurately by eliminating human reporting error (handwriting, etc.). Rather, these voice recognition software tools enable physicians to make medical decisions in their natural diction and have it recorded properly. These tools allow for easier documentation and increase patient safety and the overall standard of care.
Use Case:
The primary actors are the physicians who use these software in order to more accurately and efficiently update information and have general access to reports and report sharing through the ease of voice recognition.
Other interests include the patients who will benefit from faster and more accurate updating of EMR and subsequent turnover of diagnosis, etc., as well as hospitals and other patient-care facilities that will see faster and improved EMR.
Standards:
These speech recognition technologies must focus on industry standard medical language and coding practices, as well as versatility across operating systems.
http://www.healthcareitnews.com/news/product-spotlight-speech-recognition
http://www.nuance.com/naturallySpeaking/products/medical.asp
Description:
Speech recognition software enables physicians to create and update EMR more efficiently than traditional manual inputting, and more accurately by eliminating human reporting error (handwriting, etc.). Rather, these voice recognition software tools enable physicians to make medical decisions in their natural diction and have it recorded properly. These tools allow for easier documentation and increase patient safety and the overall standard of care.
Use Case:
The primary actors are the physicians who use these software in order to more accurately and efficiently update information and have general access to reports and report sharing through the ease of voice recognition.
Other interests include the patients who will benefit from faster and more accurate updating of EMR and subsequent turnover of diagnosis, etc., as well as hospitals and other patient-care facilities that will see faster and improved EMR.
Standards:
These speech recognition technologies must focus on industry standard medical language and coding practices, as well as versatility across operating systems.
Tuesday, June 2, 2009
ADAMS: Database Management System to coordinate anti-doping
About Anti-Doping Administration & Management System: http://www.wada-ama.org/en/dynamic.ch2?pageCategory.id=265
Q&A : Anti-Doping Administration & Management System (ADAMS): http://www.wada-ama.org/rtecontent/document/QA_ADAMS_en.pdf
Step by step tutorial for athletes: http://www.100percentme.co.uk/adams_tutorial/index.html
Description: The Anti-Doping Administration & Management System (ADAMS) was established to help in coordinating anti-doping activities and implementation of Anti-Doping Code. It is a web-based database management system that simplifies the daily activities of all stakeholders and athletes involved in the anti-doping system. It requires accurate filing of an athlete whereabouts on a 3 month basis or triggers further investigation in case of no submission by the athlete or his designated representative. It performs four primary functions to enforce anti-doping objective:
Athlete Whereabouts: The web-based functionality allows athletes to enter their information on their own or designate a representative such as their anti-doping organization (ADO) for the same.
Information Clearing House: The clearing house is where all data is stored, in particular lab results, Therapeutic Use Exemption authorizations and anti-doping rules violations. It permits the sharing of information among the relevant organizations (guarantees transparency).
Doping Control Platform: Stakeholders can use ADAMS to plan, coordinate, and order tests, as well as manage test results. Coordination of doping control programs in the ADAMS system helps to avoid duplication in doping controls.
Therapeutic Use Exemption(TUE) Management: If the medication an athlete is required to take to treat an illness happens to fall under the Prohibited List, a Therapeutic Use Exemption or TUE may give that athlete the authorization to take the needed medicine. ADAMS allows for online management of TUE requests.
Use Case: There are two types of actors with their own set of goals:
Actor: Athletes, Goal: Athletes enter information about their whereabouts. By accurate filing of whereabouts information such as competition location, training location et al. on a 3 month basis , athletes avoid investigation. An athlete after submitting the info, gets his detailed quarterly calendar. By usage of TUE Management an athlete gets the permission to use a medicine that is under the prohibited list.
Actor: Anti-doping organizations, Goal: Access to information in clearing house, Enforce anti-doping code, Avoid duplication in doping programs by usage of Doping Control Platform. It provides transparency in performing anti doping practice.
Standards: With standardized mechanisms such as Information Clearing House and Doping Control Platform different organizations share, plan, coordinate and manage test results. It has been introduced to and implemented by numerous anti-doping organizations and anti-doping laboratories.
Debasis Patra
Q&A : Anti-Doping Administration & Management System (ADAMS): http://www.wada-ama.org/rtecontent/document/QA_ADAMS_en.pdf
Step by step tutorial for athletes: http://www.100percentme.co.uk/adams_tutorial/index.html
Description: The Anti-Doping Administration & Management System (ADAMS) was established to help in coordinating anti-doping activities and implementation of Anti-Doping Code. It is a web-based database management system that simplifies the daily activities of all stakeholders and athletes involved in the anti-doping system. It requires accurate filing of an athlete whereabouts on a 3 month basis or triggers further investigation in case of no submission by the athlete or his designated representative. It performs four primary functions to enforce anti-doping objective:
Athlete Whereabouts: The web-based functionality allows athletes to enter their information on their own or designate a representative such as their anti-doping organization (ADO) for the same.
Information Clearing House: The clearing house is where all data is stored, in particular lab results, Therapeutic Use Exemption authorizations and anti-doping rules violations. It permits the sharing of information among the relevant organizations (guarantees transparency).
Doping Control Platform: Stakeholders can use ADAMS to plan, coordinate, and order tests, as well as manage test results. Coordination of doping control programs in the ADAMS system helps to avoid duplication in doping controls.
Therapeutic Use Exemption(TUE) Management: If the medication an athlete is required to take to treat an illness happens to fall under the Prohibited List, a Therapeutic Use Exemption or TUE may give that athlete the authorization to take the needed medicine. ADAMS allows for online management of TUE requests.
Use Case: There are two types of actors with their own set of goals:
Actor: Athletes, Goal: Athletes enter information about their whereabouts. By accurate filing of whereabouts information such as competition location, training location et al. on a 3 month basis , athletes avoid investigation. An athlete after submitting the info, gets his detailed quarterly calendar. By usage of TUE Management an athlete gets the permission to use a medicine that is under the prohibited list.
Actor: Anti-doping organizations, Goal: Access to information in clearing house, Enforce anti-doping code, Avoid duplication in doping programs by usage of Doping Control Platform. It provides transparency in performing anti doping practice.
Standards: With standardized mechanisms such as Information Clearing House and Doping Control Platform different organizations share, plan, coordinate and manage test results. It has been introduced to and implemented by numerous anti-doping organizations and anti-doping laboratories.
Debasis Patra
Astronaut Health-Monitoring Technology with Earth Applications
Posted by Eric Stevens
http://www.nsbri.org/NewsPublicOut/Release.epl?r=119
This article describes a new "Star Trek-like" technology called Venus designed as a noninvasive way to monitor blood and tissue chemistry in astronauts. The device shines near-infrared light into the skin and analyzes the reflected light to determine tissue oxygen, pH, and metabolic rate. It was designed for spacewalking astronauts who need to know how quickly they are using up the oxygen in their suits. However, the article also mentions several use cases for people on Earth, such as emergency medical technicians treating patients in ambulances and sending the data directly to the hospital, doctors monitoring pediatric or intensive care patients, and athletes or physical therapy patients using it to determine the most beneficial training programs.
Another possible use case:
Mountain climber knows when it's time to rest or turn back.
A team of mountain climbers are scaling a challenging mountain such as Everest. The team leader wants to make sure everyone survives the trip. The climbers all wear the Venus device. If one of them experiences a dangerous drop in tissue oxygen, the device alerts him and his companions. They make sure he either takes a rest or turns back, based on pre-established safety rules.
The device is a prototype and the article does not explicitly identify standards. But these devices will need to employ standards if they are to encode this health information and transmit it over a network.
http://www.nsbri.org/NewsPublicOut/Release.epl?r=119
This article describes a new "Star Trek-like" technology called Venus designed as a noninvasive way to monitor blood and tissue chemistry in astronauts. The device shines near-infrared light into the skin and analyzes the reflected light to determine tissue oxygen, pH, and metabolic rate. It was designed for spacewalking astronauts who need to know how quickly they are using up the oxygen in their suits. However, the article also mentions several use cases for people on Earth, such as emergency medical technicians treating patients in ambulances and sending the data directly to the hospital, doctors monitoring pediatric or intensive care patients, and athletes or physical therapy patients using it to determine the most beneficial training programs.
Another possible use case:
Mountain climber knows when it's time to rest or turn back.
A team of mountain climbers are scaling a challenging mountain such as Everest. The team leader wants to make sure everyone survives the trip. The climbers all wear the Venus device. If one of them experiences a dangerous drop in tissue oxygen, the device alerts him and his companions. They make sure he either takes a rest or turns back, based on pre-established safety rules.
The device is a prototype and the article does not explicitly identify standards. But these devices will need to employ standards if they are to encode this health information and transmit it over a network.
Pyxis® MedStation® system
http://www.cardinal.com/us/en/providers/products/pyxis/products/medStation3500/index.asp
http://www.cardinal.com/us/en/providers/products/pyxis/brochure/MedStation%20Datasheet%203500.pdf
http://www2.kumc.edu/pharmacy/Policies/Operations/Pyxis%20MedStation%20Policy.pdf
What it is: a medication dispensing system that works with a hospital’s EMR system and barcodes to ensure that medications are dispensed to the right patients on schedule and in the proper dosages.
A nurse can check the Pyxis machine and see when the next patients in a department are to be administered and to whom. The nurse can open a patient’s Pyxis profile and compare it to their EMR (which is on the same console). Using a mobile unit, nurses confirm that they have the right patient before administering any drugs and then scan their own ID as an electronic signature.
Why it’s useful: The Pyxis MedStation is mobile. A nurse is able to bring everything to the patient and confirm what is to be administered before giving anything to a patient. Having the computer in the same unit as the medication, everything is in one place, reducing the risk of pulling the wrong medication. Additionally, nurses have to scan their own ID to confirm who gave patients their medication.
Standards: The machine needs access to a reliable internet connection so patient information is available in real time and nurses have the most up to date information regarding a patient’s information. Additionally, doctors need to be able to confirm that their patients have been given their medication on schedule.
http://www.cardinal.com/us/en/providers/products/pyxis/brochure/MedStation%20Datasheet%203500.pdf
http://www2.kumc.edu/pharmacy/Policies/Operations/Pyxis%20MedStation%20Policy.pdf
What it is: a medication dispensing system that works with a hospital’s EMR system and barcodes to ensure that medications are dispensed to the right patients on schedule and in the proper dosages.
A nurse can check the Pyxis machine and see when the next patients in a department are to be administered and to whom. The nurse can open a patient’s Pyxis profile and compare it to their EMR (which is on the same console). Using a mobile unit, nurses confirm that they have the right patient before administering any drugs and then scan their own ID as an electronic signature.
Why it’s useful: The Pyxis MedStation is mobile. A nurse is able to bring everything to the patient and confirm what is to be administered before giving anything to a patient. Having the computer in the same unit as the medication, everything is in one place, reducing the risk of pulling the wrong medication. Additionally, nurses have to scan their own ID to confirm who gave patients their medication.
Standards: The machine needs access to a reliable internet connection so patient information is available in real time and nurses have the most up to date information regarding a patient’s information. Additionally, doctors need to be able to confirm that their patients have been given their medication on schedule.
IPhone application for judging blood pressure and glucose
IPhone application for judging blood pressure and glucose
http://adage.com/digital/article?article_id=136991
Brief description:
The article is about a potential iPhone application that would check a user’s blood pressure and glucose with the help of a medical device, glucometer. LifeScan, a Jonhson & Johnson company that makes diabetes products, introduced a prototype for this application that would allow diabetics to interface their glucometers (which track blood-sugar levels) with the iPhone. The glucometer would measure a consumer's sugar, and the iPhone app would interpret and chart the results, calculate sugar intake during meals, and allow the user to better adjust his or her diabetes medications and diet accordingly. Additionally, the results could also be sent to a physician who would analyze them further if needed.
Use case for this technology: Judging the blood pressure and forwarding the reading to a physician:
The use case could be that the user makes use of the glucometer device to record the sugar level in his blood. The user then connects the device to his iPhone which reads the data and helps interpret the results in terms of calculating sugar intake and allowing user to better adjust his eating habits as suited for his health. The data could also be transferred to a physician who might do further sophisticated calculations with it.
Role of standards:
The article mentions no role of standards in this application. However, it is apparent that the standardized methods of measuring sugar levels are used for communicating the information.
~Shailesh Otari
http://adage.com/digital/article?article_id=136991
Brief description:
The article is about a potential iPhone application that would check a user’s blood pressure and glucose with the help of a medical device, glucometer. LifeScan, a Jonhson & Johnson company that makes diabetes products, introduced a prototype for this application that would allow diabetics to interface their glucometers (which track blood-sugar levels) with the iPhone. The glucometer would measure a consumer's sugar, and the iPhone app would interpret and chart the results, calculate sugar intake during meals, and allow the user to better adjust his or her diabetes medications and diet accordingly. Additionally, the results could also be sent to a physician who would analyze them further if needed.
Use case for this technology: Judging the blood pressure and forwarding the reading to a physician:
The use case could be that the user makes use of the glucometer device to record the sugar level in his blood. The user then connects the device to his iPhone which reads the data and helps interpret the results in terms of calculating sugar intake and allowing user to better adjust his eating habits as suited for his health. The data could also be transferred to a physician who might do further sophisticated calculations with it.
Role of standards:
The article mentions no role of standards in this application. However, it is apparent that the standardized methods of measuring sugar levels are used for communicating the information.
~Shailesh Otari
FrontlineSMS:Medic
Katherine Alex
Website: http://medic.frontlinesms.com/
Article in The Guardian featuring FrontlineSMS:Medic: http://www.guardian.co.uk/technology/2009/mar/27/mobile-phones-sms
Brief Description of the Technology: Noting that community health workers in the developing world face significant challenges in communicating medical information in remote areas, the founders of FrontlineSMS:Medic created a system involving "a free, open-source software program that enables large-scale, two-way text messaging using only a laptop, a GSM modem, and cell phones." They run something of a hub-and-spoke model, in which there's a central clinic with a laptop running their software, and mobile phone-toting community health workers interfacing with patients out in the rural villages. Their solution is particularly valuable in that their target market communities, despite facing chronic diseases requiring "complex treatment regimens and ongoing monitoring," face impediments to access and are served by relatively few medics.
Use Case for this Technology:
Primary Actor: Community health worker
Goal: To ascertain whether a patient is experiencing side effects on account of taking his prescribed medication
Procedure: A patient in a remote village comes to his community health worker, complaining of nausea and rash. The community health worker uses his mobile phone to send a text message to the computer at the central clinic containing the name of the medication her patient has recently taken, and a request to learn the side effects associated with that medication. Software on the system in the central clinic rapidly responds to the community health worker's message, sending a text message containing information on the side effects which could be expected from the drug. If the community health worker is satisfied with this query, she relays this information to her patient and will pursue further treatment options as necessary; otherwise, she will call the central clinic to request further, customized information from the medic on staff.
Role Played by Standards in this Technology: FrontlineSMS:Medic uses GSM mobile phone standards, allowing for international roaming. One might also consider it to use open standards generally, in that its software is distributed free of charge and uses code that is open source.
Website: http://medic.frontlinesms.com/
Article in The Guardian featuring FrontlineSMS:Medic: http://www.guardian.co.uk/technology/2009/mar/27/mobile-phones-sms
Brief Description of the Technology: Noting that community health workers in the developing world face significant challenges in communicating medical information in remote areas, the founders of FrontlineSMS:Medic created a system involving "a free, open-source software program that enables large-scale, two-way text messaging using only a laptop, a GSM modem, and cell phones." They run something of a hub-and-spoke model, in which there's a central clinic with a laptop running their software, and mobile phone-toting community health workers interfacing with patients out in the rural villages. Their solution is particularly valuable in that their target market communities, despite facing chronic diseases requiring "complex treatment regimens and ongoing monitoring," face impediments to access and are served by relatively few medics.
Use Case for this Technology:
Primary Actor: Community health worker
Goal: To ascertain whether a patient is experiencing side effects on account of taking his prescribed medication
Procedure: A patient in a remote village comes to his community health worker, complaining of nausea and rash. The community health worker uses his mobile phone to send a text message to the computer at the central clinic containing the name of the medication her patient has recently taken, and a request to learn the side effects associated with that medication. Software on the system in the central clinic rapidly responds to the community health worker's message, sending a text message containing information on the side effects which could be expected from the drug. If the community health worker is satisfied with this query, she relays this information to her patient and will pursue further treatment options as necessary; otherwise, she will call the central clinic to request further, customized information from the medic on staff.
Role Played by Standards in this Technology: FrontlineSMS:Medic uses GSM mobile phone standards, allowing for international roaming. One might also consider it to use open standards generally, in that its software is distributed free of charge and uses code that is open source.
Osirix: Imaging Software for DICOM Images
About the Technology
Osirix is imaging software that lets users (doctors, attorneys, others) view DICOM images. These images include those produced by MRI, CT, PET, and other scans. The technology is superior to traditional methods of viewing these images because they allow users to view the information in 2D, 3D, 4D, and 5D. (5D, for example, is “3D series with temporal and functional dimensions”). The software accesses these images on PACS servers (Picture Archiving and Communication System). Images for all patients are stored on these servers and can be viewed by approved users (both inside and outside a given LAN) with software such as Osirix.
Osirix runs on a Mac, and in the last year, the company also released an iPhone application.
Use Case
Primary User: A Doctor (Radiologist)
Goal: Use images to make the most accurate diagnosis and recommend the best treatment; to simplify the process of diagnosis
A Doctor has ordered a series of X-RAYs for her patient. Afterwards, the Radiologist starts up the Osirix program and enters the patient’s name into a search query. All images associated with the patient come up with meta information, including type and date of X-RAY. To evaluate the patient’s condition, the Doctor or Radiologist can combine the images to form multi-dimensional views of the area scanned (as opposed to printing the images - which may number in the hundreds - as film and hanging the images against a light box which offers only a 1-dimensional view). The doctor could then easily request a colleague or outside expert to review the images. The colleague or expert would follow the same steps to access the image server.
Standards
Osirix uses the DICOM standard for images. The program is also able to make images accessible over the HTTP XML-RPC SOAP server of Osirix.
Resources
http://osirix-viewer.com/AboutOsiriX.html
http://osirix-viewer.com/Users.html
http://www.apple.com/downloads/macosx/imaging_3d/osirix.html
http://en.wikipedia.org/wiki/Picture_archiving_and_communication_system
athenahealth
Company: Athenahealth Software system: athenaCollector
Website:
http://athenahealth.com
Description:
athenahealth is a leading provider of Internet-based services for physician practices. athenaCollector is their proprietary web-based physican billing and practice management system that aims at helping their clients ( i.e. physicians) achieve faster reimbursement from payers ( i.e. insurance companies), reduce error reates, increase collections and lower operating costs. The heart of the software is a proprietary database of payer rules, containing over 40 million payer rules permutations, which can be continually updated with new rules continually due to the web-based nature of the software. This rules engine enables athenaHealth officials to effectively and efficiently file claims on behalf of their clients.
Use Cases:
The primary actors in the system are the physicans and the athenaHealth officials. The goal of the physican, the primary actor is to submit his claims to the athenaHealth officials. The physican logs in to the web based athenaCollector software, fills in the claims details and submits his claims. The goal of the athenaHealth officials is to retrieve the claims submitted by the physicans and process the same. The athenaHealth officials retrieve the claims by logging in to the system, and submit the retrieved claim to the rules engine subsystem. the rules engine subsytem processes the claim and provides the most effective way to process the claim as an output after checking for discrepancies and erroneous entries.
Standards:
The use of standards were not explicitly mentioned in the overview page, but secondary readings did suggest that the software uses HL7 standards for communicating healthcare information.
Website:
http://athenahealth.com
Description:
athenahealth is a leading provider of Internet-based services for physician practices. athenaCollector is their proprietary web-based physican billing and practice management system that aims at helping their clients ( i.e. physicians) achieve faster reimbursement from payers ( i.e. insurance companies), reduce error reates, increase collections and lower operating costs. The heart of the software is a proprietary database of payer rules, containing over 40 million payer rules permutations, which can be continually updated with new rules continually due to the web-based nature of the software. This rules engine enables athenaHealth officials to effectively and efficiently file claims on behalf of their clients.
Use Cases:
The primary actors in the system are the physicans and the athenaHealth officials. The goal of the physican, the primary actor is to submit his claims to the athenaHealth officials. The physican logs in to the web based athenaCollector software, fills in the claims details and submits his claims. The goal of the athenaHealth officials is to retrieve the claims submitted by the physicans and process the same. The athenaHealth officials retrieve the claims by logging in to the system, and submit the retrieved claim to the rules engine subsystem. the rules engine subsytem processes the claim and provides the most effective way to process the claim as an output after checking for discrepancies and erroneous entries.
Standards:
The use of standards were not explicitly mentioned in the overview page, but secondary readings did suggest that the software uses HL7 standards for communicating healthcare information.
WhiteNoise - The iPhone app for relaxation, sleep
Link: http://www.tmsoft.com/iphone-whitenoise.html
Description: This iPhone application allows a user to select from 40 ambient sounds using a graphical interface. At first the interface was quite simplistic but has been updated over time to include backgrounds that match the sounds. Controls include volume, pitch, alarm and a catalog. Volume and alarm are self-explanatory. Pitch allows a user to change sounds to sound slower or faster, such as the rate of crashing waves. The catalog option is available for the user to group his or her favorite sounds together.
Use case: The primary actors would be those in search of relaxation, distraction or sleep. They would open the application and select from the 40 ambient sounds by scrolling through the sounds or referring to the user catalog. Users would then adjust the sound to their liking and listen through the iPhone's speakers, or by plugging headphones or other external speakers into the iPhone. Some users have claimed they have used the application to help their infants sleep.
Standards: According to the iPhone Dev Center, developers use Xcode, "Apple’s first-class integrated development environment (IDE)," according to the "iPhone Development Guide" (available at http://developer.apple.com/iphone).
Description: This iPhone application allows a user to select from 40 ambient sounds using a graphical interface. At first the interface was quite simplistic but has been updated over time to include backgrounds that match the sounds. Controls include volume, pitch, alarm and a catalog. Volume and alarm are self-explanatory. Pitch allows a user to change sounds to sound slower or faster, such as the rate of crashing waves. The catalog option is available for the user to group his or her favorite sounds together.
Use case: The primary actors would be those in search of relaxation, distraction or sleep. They would open the application and select from the 40 ambient sounds by scrolling through the sounds or referring to the user catalog. Users would then adjust the sound to their liking and listen through the iPhone's speakers, or by plugging headphones or other external speakers into the iPhone. Some users have claimed they have used the application to help their infants sleep.
Standards: According to the iPhone Dev Center, developers use Xcode, "Apple’s first-class integrated development environment (IDE)," according to the "iPhone Development Guide" (available at http://developer.apple.com/iphone).
HEALTHPAL – MOBILE WIRELESS HEALTH MONITORING
Link: http://public.medapps.net/Pages/HealthPAL.aspx and http://mobihealthnews.com/2166/medapps-connects-to-microsoft-healthvault/
Description: HealthPAL is a low cost, simple, portable device, about the size of the cell phone that automatically collects data from compatible, off-the-shelf medical monitors using smart cable or wirelessly via Bluetooth. The data is then transmitted to various health portals. HealthPAL can currently be used with the Glucose meter. For the normal daily operations the patient does not have to push any buttons or navigate any screens on the HealthPAL. It was originally devised to send data to the MedApps Healthcare portal but has now been upgraded to transfer data to Microsoft’s HealthVault and some other similar systems. The important challenge for HealthPAL is to see weather patients will be willing to carry an additional device with them as almost everyone carries a mobile phone.
Use-Case: Transfer medical data to the Medical record systems like Microsoft’s HealthVault
The patient (actor) takes the relevant reading (for example: his blood glucose level) on this normal regular device as he has been doing. HealthPAL collects and transmits the data automatically in the background and forwards the data to Healthcare portals.
Standards: For transferring data, HealthPAL uses embedded wireless technology like M2M Cellular, CDMA, GSM, Bluetooth and GPS. This device does not use any specific information sharing standards other than the normal data transfer standards mentioned above.
Certification Commission for Healthcare Information Technology (CCHIT)
Adele Burnes
Website: http://www.cchit.org/
Article about CCHIT: http://www.healthcareitnews.com/news/cchit-work-new-timelines-new-programs
Description: CCHIT is an organization that is publishing and certifying EHR standards. This organization is implementing standards apparently in accordance with the American Recover and Reinvestment Act (ARRA). It is among the many standards but sounds somewhat official. They certify a variety of EHR applications and products.
Use Case: Software Certification
A company creates a software program that will target small medical offices in their implementation of Electronic Health Records, however in order to gain credibility they need a certification. They come to the CCHIT because they are a widely recognized standards body that is implementing ARRA policies. They work with CCHIT to gain certification, and CCHIT evaluates their system ensuring that it follows the EHR standards. Once it passes, the software can advertise and display the CCHIT certification to gain the needed credibility among customers.
This organization is focused completely on setting standards to increase interoperability among products and applications.
Website: http://www.cchit.org/
Article about CCHIT: http://www.healthcareitnews.com/news/cchit-work-new-timelines-new-programs
Description: CCHIT is an organization that is publishing and certifying EHR standards. This organization is implementing standards apparently in accordance with the American Recover and Reinvestment Act (ARRA). It is among the many standards but sounds somewhat official. They certify a variety of EHR applications and products.
Use Case: Software Certification
A company creates a software program that will target small medical offices in their implementation of Electronic Health Records, however in order to gain credibility they need a certification. They come to the CCHIT because they are a widely recognized standards body that is implementing ARRA policies. They work with CCHIT to gain certification, and CCHIT evaluates their system ensuring that it follows the EHR standards. Once it passes, the software can advertise and display the CCHIT certification to gain the needed credibility among customers.
This organization is focused completely on setting standards to increase interoperability among products and applications.
AirStrip’s iPhone application for obstetrics
http://www.airstriptech.com/Portals/_default/Skins/AirstripSkin/home.aspx
AirStrip OB allows obstetricians to use their iPhones to remotely access virtual real-time and historical waveform data for both the mother and baby, including heart tracings and contraction patterns, as well as nursing notes and exam status. The data is sent directly from hospitals’ labor and delivery units and can be accessed on the iPhone anytime and anywhere the doctor gets a cell-phone connection. The hospital purchases the AirStrip system, which works in tandem with the hospital’s existing patient monitoring system, and doctors can then install the AirStrip OB application on their iPhone.
Use Case Check fetus' vitals from home while on call.
The doctor, the primary actor, opens the iPhone app and checks the vitals of both mother and fetus from home while he/she is on call. This allows him/her to be aware of progress without being present or calling in to talk with staff on hand.
Standards No standards are mentioned in this application, however, since this is meant to work with the hospitals existing monitoring systems some standards would need to be accepted from those systems.
AirStrip OB allows obstetricians to use their iPhones to remotely access virtual real-time and historical waveform data for both the mother and baby, including heart tracings and contraction patterns, as well as nursing notes and exam status. The data is sent directly from hospitals’ labor and delivery units and can be accessed on the iPhone anytime and anywhere the doctor gets a cell-phone connection. The hospital purchases the AirStrip system, which works in tandem with the hospital’s existing patient monitoring system, and doctors can then install the AirStrip OB application on their iPhone.
Use Case Check fetus' vitals from home while on call.
The doctor, the primary actor, opens the iPhone app and checks the vitals of both mother and fetus from home while he/she is on call. This allows him/her to be aware of progress without being present or calling in to talk with staff on hand.
Standards No standards are mentioned in this application, however, since this is meant to work with the hospitals existing monitoring systems some standards would need to be accepted from those systems.
Capzule - iPhone application for pyhsicians to work real-time remotely
http://dropfolder.blogspot.com/2009/01/new-iphone-web-application-lets-doctors.html
http://www.iclarified.com/entry/index.php?enid=2490
http://www.capzule.com/iphone.html
What is it – iPhone application for physicians to work remotely
Webahn has launched an iPhone web application for its online EMR service Capzule.com. Physicians can now connect with their office via their iPhone. They can use their mobile device to review patient files, view messages, check schedules, review charts and write prescriptions.
Why is it useful
This new application provides physicians with greater flexibility in caring for their patients. They can review patient files on their mobile device, and provide quicker response times when away from the office.
"Capzule has improved our physicians' quality of life greatly, as we can now access charts anytime from home, hospital and even on an iPhone. It has also increased the overall efficiency of our practice from handling phone messages, to charting, to care giving. " - Iqbal Boxwala, MD
Capzule is HIPAA compliant, and maintains the highest standards in computer & internet security including server protection through continuous monitoring, firewalls, antivirus protection and 128 bit SSL encryption.
A Use Case
Primary actor for this application is the “Physician”. Their goal is to access patient related data real time and in an easily readable format and take actions based on that data while offsite. A physician opens the Capzule application on his iPhone, checks the patient vital stats real time. Based on these data, he can prescribe a medicine for that patient, and schedule him for his next check-up. All this is done through iPhone in a very user-friendly way.
Standards
You need a reliable internet connection with at least broadband strength and probably a backup connection. Latest version of your favorite browser, with javascript and cookies enabled.
Oracle's Healthcare Transaction Base (HTB)
David Spevick
http://www.oracle.com/industries/healthcare/htb.html
The goal of this technology is to improve the quality of patient care by giving physicians the proper tool to run their practice - everything from running the administration of the clinic, the clinic's finances and patient information. The primary actor in this scenario could be either the physician or the patient because this technology allows physicians to create a comprehensive profile for every patient that is stored electronically, and this information can follow the patient where ever s/he may go. This technology supports sharing, but it is not standardized. It most likely works best if the information is shared between two Oracle clients.
http://www.oracle.com/industries/healthcare/htb.html
The goal of this technology is to improve the quality of patient care by giving physicians the proper tool to run their practice - everything from running the administration of the clinic, the clinic's finances and patient information. The primary actor in this scenario could be either the physician or the patient because this technology allows physicians to create a comprehensive profile for every patient that is stored electronically, and this information can follow the patient where ever s/he may go. This technology supports sharing, but it is not standardized. It most likely works best if the information is shared between two Oracle clients.
23andMe - Sharing Your Genome Online
Paul Kim
https://www.23andme.com/
This Silicon Valley startup seeks to have people submit DNA samples online, which would then generate a report that uncovers possible risks for genetic diseases. On one hand, this is simply an interesting piece of personal information that can be bought for $399; however, their is a broader goal here. They are taking the idea of crowdsourcing and applying it to sensitive information, hoping that it will lead to breakthroughs in the discovery of cures for diseases.
Use Case: Finding a Cure
Sergey Brin is a high-profile example of someone who is actually putting this service to use, but the actor could be anyone who is interested in learning more about their genetic composition, particularly as it relates to their predisposition for disease. In Brin's case, he is disclosing his genetic information with the hope that it will lead to new ideas for a cure to Parkinson's disease, to which he is susceptible.
Standards
23andMe is big on the use of standards, not just in database management, but also in the clinical testing portion of their service (https://www.23andme.com/more/science/)
https://www.23andme.com/
This Silicon Valley startup seeks to have people submit DNA samples online, which would then generate a report that uncovers possible risks for genetic diseases. On one hand, this is simply an interesting piece of personal information that can be bought for $399; however, their is a broader goal here. They are taking the idea of crowdsourcing and applying it to sensitive information, hoping that it will lead to breakthroughs in the discovery of cures for diseases.
Use Case: Finding a Cure
Sergey Brin is a high-profile example of someone who is actually putting this service to use, but the actor could be anyone who is interested in learning more about their genetic composition, particularly as it relates to their predisposition for disease. In Brin's case, he is disclosing his genetic information with the hope that it will lead to new ideas for a cure to Parkinson's disease, to which he is susceptible.
Standards
23andMe is big on the use of standards, not just in database management, but also in the clinical testing portion of their service (https://www.23andme.com/more/science/)
Tunstall Wireless Telehealth Monitor
Jeremy Burlingame
Link: Healthcare IT News
Tunstall just received FDA approval for "an interactive telehealth device with in-built GSM/GPRS mobile phone technology that collects vital signs wirelessly from a range of external devices such as weight scales and blood pressure cuffs." With this new technology the hospital or doctor's office of the future can be wireless and stream data from different devices and even upload that data to a platform such as an electronic medical record such as Google Health. Additionally, with this technology, nurses can more easily track a patient's vitals and a physician can review patterns in this data as more of it will be recorded.
Use Case: Allow patient's medical information from various wireless devices in a doctor's office or hospital to be uploaded to the network.
With this system in place, a nurse would no longer need to record the results of the weight scale or blood pressure monitor, reducing not only the need for the nurse to record this information but also to enter that data to the client's chart. This also prevents human error from entering into crucial medical records. Using this system, digital medical charts become even easier to create and maintain because basic information such as the readings of these devices are uploaded electronically.
Standards: The information gathered from the wireless enabled devices will, "automatically transmit the data to a clinical backend software application based on an open architecture interface."
Link: Healthcare IT News
Tunstall just received FDA approval for "an interactive telehealth device with in-built GSM/GPRS mobile phone technology that collects vital signs wirelessly from a range of external devices such as weight scales and blood pressure cuffs." With this new technology the hospital or doctor's office of the future can be wireless and stream data from different devices and even upload that data to a platform such as an electronic medical record such as Google Health. Additionally, with this technology, nurses can more easily track a patient's vitals and a physician can review patterns in this data as more of it will be recorded.
Use Case: Allow patient's medical information from various wireless devices in a doctor's office or hospital to be uploaded to the network.
With this system in place, a nurse would no longer need to record the results of the weight scale or blood pressure monitor, reducing not only the need for the nurse to record this information but also to enter that data to the client's chart. This also prevents human error from entering into crucial medical records. Using this system, digital medical charts become even easier to create and maintain because basic information such as the readings of these devices are uploaded electronically.
Standards: The information gathered from the wireless enabled devices will, "automatically transmit the data to a clinical backend software application based on an open architecture interface."
USB Personal Healthcare Device Class Specification
Jesse Brooks
LINK: http://www.xbitlabs.com/news/other/display/20070403121551.html
Medical devices like home blood pressure monitors and blood sugar monitors are very common, but the majority of these devices simply display your stats. The medical device industry has created a personal healthcare device class specification, based on USB (universal serial bus), which sets a standard for connectivity for future medical devices. Not only is this USB standard going to allow patients to connect their devices to their computers and cell phones, but also it handles healthcare messages and data in a different way than traditional USB interface devices. This standardization will force medical device companies to use USB for connectivity, which will make connecting medical devices to your computer and cell phones more common. As more people have their medical data on Internet connected devices, the possibility for information sharing with physicians and medical researchers is endless.
STANDARDS: This USB personal healthcare device class is establishing a standard for connectivity of medical devices and how these devices should handle special healthcare messages/data.
iPill – now swallow nanotechnology!
-Arvind Rawat
http://www.research.philips.com/newscenter/backgrounders/081111-ipill.html
How about a pill equipped with microprocessor, power supply, medicine reservoir and pump, and a radio so that it can accurately determine its position in the digestive tract (yes, you actually swallow this!) to deliver drugs precisely where they're needed, reducing dosage strength and side effects. The good news for technophobes is that it is still not commercially available.
Use Case: Deliver Medicine
Primary Actor: Patient
The patient swallows the electronic pill and it enters her digestive tract. Continuous Ph measurements help to determine the location of the pill in the gut and information is transmitted through radio frequency transceiver. When the target Ph level is reached, localized drug delivery is performed with help of iPill’s internal pump and microprocessor control.
Patient Care is brought to the Bedside TV
Cady Roberts - Homework #1
Description: Patient Care (IPC), a technology solution powered by Optimum Lightpath's fiber optic network, uses hospital bedside televisions to provide an interactive experience for patients and doctors. Patients can learn about their condition, connect with family and interact with caregivers using the television. With active participation from the patients and their families, it ultimately improves patient knowledge and safety, clinical care outcomes, staff responsiveness, bed turnover rates and workflow efficiencies for hospital staff. It works through on-demand access to a patient education video library and medications database, hospital stay and visitor information, movies and games, non-clinical service request menus, meal ordering, surveys and real-time feedback features, Internet and email access, music and more.
Use Case: Patient – Receive specialized hospital care to improve stay and decrease recover y time.
Automated prompts appear on the television monitor to invite each patient to learn more about his/her care, condition and safety. Hospitals are able to customize a patient's hospital experience based on particular data inputs or automatic triggers such as diagnostic or procedure codes.
Standards: No application-specific standards are explicitly mentioned, other than the technology is provided by a fiber optic network by Optimum.
Phreesia-The Patient Check In Company
Company: Phreesia- www.Phreesia.com
Description: Phreesia aims to provide a portable electronic means for patient registration. The Phressia Pad allows patients to quickly register themselves when coming in for a doctor’s visit (replacing a clip board). Clinics/Hospitals can also customize the registration process for their particular organizational or departmental needs. In addition, Phreesia has also introduced a risk assessment tool that observes symptoms indicated by patients at check-in and compares them to a national data base to raise flags for doctors prior to seeing a patient. Their revenue model is based on advertisements from major pharmaceutical companies during the registration process that are customized to each user’s specific conditions, age, or gender.
Brief Use Case:
Patient Check-In (primary actor is the patient): Patient arrives at doctor’s office. Nurse/Registrar provides patient with Phressia Pad. Patient swipes their health insurance card. Patient answers standard information questions. Patient answers customized health questions to be used in risk assessment. Patient returns Phreesia Pad to registration desk and is placed in queue to be seen by doctor.
Technology Standards: Phreesia is working to be compatible with EHR software platforms at clinic sites on an as needed basis but is not promoting any singular standard themselves. They are however promoting themselves as the standard in patient registration.
Description: Phreesia aims to provide a portable electronic means for patient registration. The Phressia Pad allows patients to quickly register themselves when coming in for a doctor’s visit (replacing a clip board). Clinics/Hospitals can also customize the registration process for their particular organizational or departmental needs. In addition, Phreesia has also introduced a risk assessment tool that observes symptoms indicated by patients at check-in and compares them to a national data base to raise flags for doctors prior to seeing a patient. Their revenue model is based on advertisements from major pharmaceutical companies during the registration process that are customized to each user’s specific conditions, age, or gender.
Brief Use Case:
Patient Check-In (primary actor is the patient): Patient arrives at doctor’s office. Nurse/Registrar provides patient with Phressia Pad. Patient swipes their health insurance card. Patient answers standard information questions. Patient answers customized health questions to be used in risk assessment. Patient returns Phreesia Pad to registration desk and is placed in queue to be seen by doctor.
Technology Standards: Phreesia is working to be compatible with EHR software platforms at clinic sites on an as needed basis but is not promoting any singular standard themselves. They are however promoting themselves as the standard in patient registration.
IS705 Homework 1 - Healthcare Use Case
Title: Global Medical Imagery Access by Harris Healthcare Solutions.
Link to the article:
http://www.govcomm.harris.com/news/view_pressrelease.asp?act=lookup&pr_id=2667
Brief Description:
Harris Healthcare Solutions has developed a service that will enable medical professionals to remotely locate, view and manipulate very large digital images of their patients online. The solution ensures that the images remain integrated with other patient records. The key component of the solution is the ability to transmit extremely large files to the remote locations such as rural areas using Harris tactical radios with broadband Ethernet capabilities. In my opinion, this is an extremely useful feature in countries that lack communication infrastructure in rural areas.
Brief Use Case:
Remote Access of Patient Images:
The primary actor in this use case is the doctor. A patient in the rural areas needs expert medical advice from a doctor in a large city hospital. The city doctor uses the system to view the medical images of the patient and advises the local doctors that are actually treating the patient. The patient can move from one hospital to another and can seek advice from multiple doctors using the same medical images stored in the system. The goal of the solution is to provide interoperability amongst different healthcare systems and to provide better medical assistance to remote locations.
Standards:
There is no mention of the standards being used by the company for this solution.
Link to the article:
http://www.govcomm.harris.com/news/view_pressrelease.asp?act=lookup&pr_id=2667
Brief Description:
Harris Healthcare Solutions has developed a service that will enable medical professionals to remotely locate, view and manipulate very large digital images of their patients online. The solution ensures that the images remain integrated with other patient records. The key component of the solution is the ability to transmit extremely large files to the remote locations such as rural areas using Harris tactical radios with broadband Ethernet capabilities. In my opinion, this is an extremely useful feature in countries that lack communication infrastructure in rural areas.
Brief Use Case:
Remote Access of Patient Images:
The primary actor in this use case is the doctor. A patient in the rural areas needs expert medical advice from a doctor in a large city hospital. The city doctor uses the system to view the medical images of the patient and advises the local doctors that are actually treating the patient. The patient can move from one hospital to another and can seek advice from multiple doctors using the same medical images stored in the system. The goal of the solution is to provide interoperability amongst different healthcare systems and to provide better medical assistance to remote locations.
Standards:
There is no mention of the standards being used by the company for this solution.
Healthcare for bottom of the pyramid
http://www.youtube.com/watch?v=yB47wx-b6sY
http://medgadget.com/archives/2009/03/portable_ecg_system_with_sms_keyboard.html
A lot of time and effort is spent in improving Healthcare IT systems using internet or mobile based technologies. However that only serves a small fraction of the global population. There is a huge potential to use technology to improve healthcare for people at the bottom of the pyramid. These people are surviving with less than a $1 per day and so a Google Health or an iPhone app doesn't matter to them.
GE Healthcare has come up with the MAC 800, which is a unique ECG, specifically designed to help physicians, to better predict and diagnose patients at risk of heart diseases. It is highly portable and easy to use. It helps to provide low cost medical care to people in rural areas.
As connectivity within a physician’s work environment is key to coordinated care and improved diagnoses. MAC 800 helps to make that vision a reality through its multiple communication options that fit the needs of most practices, including LAN, modem, SD card and serial port to store and send ECG data from any location.
Also, MAC 800 offers the option of a PDF or XML output for universally recognized storing and data sharing. MAC 800 also connects seamlessly to a variety of vendors’ EMR solutions via a software called Cardiosoft. MAC 800 was developed looking at what is needed to deliver affordable heathcare in India and then building a viable business proposition which incorporates the latest technologies. Though priced at the higher end, GE Healthcare says it should be able to deliver ECG reports at less than a dollar.
http://medgadget.com/archives/2009/03/portable_ecg_system_with_sms_keyboard.html
A lot of time and effort is spent in improving Healthcare IT systems using internet or mobile based technologies. However that only serves a small fraction of the global population. There is a huge potential to use technology to improve healthcare for people at the bottom of the pyramid. These people are surviving with less than a $1 per day and so a Google Health or an iPhone app doesn't matter to them.
GE Healthcare has come up with the MAC 800, which is a unique ECG, specifically designed to help physicians, to better predict and diagnose patients at risk of heart diseases. It is highly portable and easy to use. It helps to provide low cost medical care to people in rural areas.
As connectivity within a physician’s work environment is key to coordinated care and improved diagnoses. MAC 800 helps to make that vision a reality through its multiple communication options that fit the needs of most practices, including LAN, modem, SD card and serial port to store and send ECG data from any location.
Also, MAC 800 offers the option of a PDF or XML output for universally recognized storing and data sharing. MAC 800 also connects seamlessly to a variety of vendors’ EMR solutions via a software called Cardiosoft. MAC 800 was developed looking at what is needed to deliver affordable heathcare in India and then building a viable business proposition which incorporates the latest technologies. Though priced at the higher end, GE Healthcare says it should be able to deliver ECG reports at less than a dollar.
Lose It! Weight Loss iPhone Application
Links
Review: http://www.theiphoneappreview.com/01/lose-it-iphone-weight-loss/
Link to Application in iTunes Store: itunes.apple.com/WebObjects/MZStore.woa/wa/viewSoftware?id=297368629&mt=8
Description
Lose it is a weight loss application for iPhone. This application allows users to establish a daily calorie budget and track progress by entering daily caloric intake and exercise. This application is incredibly easy to use, and includes calorie content for many popular restaurant foods.
Use Case
Primary actor: Anyone with an iPhone looking for a way to track weight loss progress.
After a user has downloaded the application they will then enter their goal weight and how many pounds they hope to lose per week. Lose It! then creates a daily calorie budget. After eating a meal, the user then can look up the caloric intake using the database, or create a custom food entry. The goal of this application is to take the guess work out of weight loss, allowing people to know exactly how many calories they have eaten and burned. It goes beyond a simple tracking system by allowing users to look up caloric content and how many calories are burned by hundreds of different excercises.
There is no mention of standards for this application and ss far as I can tell, there is no way to share the information from this application. This is exactly the sort of information that would be very useful to upload to Google Health for sharing with your physician.
Review: http://www.theiphoneappreview.com/01/lose-it-iphone-weight-loss/
Link to Application in iTunes Store: itunes.apple.com/WebObjects/MZStore.woa/wa/viewSoftware?id=297368629&mt=8
Description
Lose it is a weight loss application for iPhone. This application allows users to establish a daily calorie budget and track progress by entering daily caloric intake and exercise. This application is incredibly easy to use, and includes calorie content for many popular restaurant foods.
Use Case
Primary actor: Anyone with an iPhone looking for a way to track weight loss progress.
After a user has downloaded the application they will then enter their goal weight and how many pounds they hope to lose per week. Lose It! then creates a daily calorie budget. After eating a meal, the user then can look up the caloric intake using the database, or create a custom food entry. The goal of this application is to take the guess work out of weight loss, allowing people to know exactly how many calories they have eaten and burned. It goes beyond a simple tracking system by allowing users to look up caloric content and how many calories are burned by hundreds of different excercises.
There is no mention of standards for this application and ss far as I can tell, there is no way to share the information from this application. This is exactly the sort of information that would be very useful to upload to Google Health for sharing with your physician.
BR Med-Link connects Ambulances and ERs
http://www.govtech.com/dc/articles/627345
The city of Baton Rouge has equipped some of their EMS Ambulances with data and video links to local hospitals (called BR Med-Connect), enabling ER physicians to give treatment and diagnosis instructions to the paramedics before the patient ever reaches the hospital. While this system will not be used with every patient, for severe cases, this could greatly increase the ability for the patient to receive the proper treatment as soon as possible, especially before reaching the hospital. The data link takes advantage of the city’s wireless mesh network to transmit and receive data.
Use Case: A patient is reported to and picked up by Baton Rouge paramedics. Those who participate in the treatment of the patient (initially the EMTs, and then the ER doctors) want to give the best level of care possible. The high severity of the injury justifies the need to use the BR Med-Connect system. Doctors from the destination hospital’s ER view the patient, receive preliminary information from the paramedics while either on scene or en route to the hospital, and provide treatment instructions for the patient. The hospital can prepare for the patient’s arrival, receiving real time data and video of the patient, and altering and amending the treatment until the time the patient arrives at the hospital’s ER. The patient is transferred from the paramedics to the ER, and treatment continues without interruption.
Data standards for transmission of the patient’s vital signs, voice, and video from the ambulance are all network standard UDP, from my assumption that the stream is more important than an individual packet. From a medical side, the treatment course desired by the doctor can occur immediately, giving the patient a better chance for a speedier diagnosis and possibly a faster recovery. While the standards for EMT treatment are triage, this allows for more detailed treatment, like that which would be received if a doctor was performing a ride along in the ambulance.
The city of Baton Rouge has equipped some of their EMS Ambulances with data and video links to local hospitals (called BR Med-Connect), enabling ER physicians to give treatment and diagnosis instructions to the paramedics before the patient ever reaches the hospital. While this system will not be used with every patient, for severe cases, this could greatly increase the ability for the patient to receive the proper treatment as soon as possible, especially before reaching the hospital. The data link takes advantage of the city’s wireless mesh network to transmit and receive data.
Use Case: A patient is reported to and picked up by Baton Rouge paramedics. Those who participate in the treatment of the patient (initially the EMTs, and then the ER doctors) want to give the best level of care possible. The high severity of the injury justifies the need to use the BR Med-Connect system. Doctors from the destination hospital’s ER view the patient, receive preliminary information from the paramedics while either on scene or en route to the hospital, and provide treatment instructions for the patient. The hospital can prepare for the patient’s arrival, receiving real time data and video of the patient, and altering and amending the treatment until the time the patient arrives at the hospital’s ER. The patient is transferred from the paramedics to the ER, and treatment continues without interruption.
Data standards for transmission of the patient’s vital signs, voice, and video from the ambulance are all network standard UDP, from my assumption that the stream is more important than an individual packet. From a medical side, the treatment course desired by the doctor can occur immediately, giving the patient a better chance for a speedier diagnosis and possibly a faster recovery. While the standards for EMT treatment are triage, this allows for more detailed treatment, like that which would be received if a doctor was performing a ride along in the ambulance.
Mobile Consumer Directed Healthcare Software Application For iPhone and iPod
Sachin Dewagan IS705- HW#1
Technology:
Mobile Consumer Directed Healthcare (CDH) Software Application for the iPhone
http://iphone.tmcnet.com/topics/iphone/articles/56059-canopy-releases-mobile-consumer-directed-healthcare-software-application.htm
Description:
Makes CDH significantly more accessible to consumers with Health Savings Accounts (HSAs), Health Reimbursement Accounts (HRA) and Flexible Spending Accounts (FSAs). Mobile CDH allows consumers to search for medical procedures using keywords to determine if the consumer is eligible can be reimbursed using tax advantage CDH spending accounts.
Use Case: Allows patients to search for eligibility and costs of medical procedures.
Gives real-time access to patients (Primary Actor) who want to know information on medical procedure eligibility and customary cost in a local market. This application provides transparency for the consumers on their medical bills. It will give consumers negotiating power with their procedures prior to signing billing agreements at the provider’s office.
Standards:
The only listed standard is that this product is an iphone application. (Apple’s application standards)
Technology:
Mobile Consumer Directed Healthcare (CDH) Software Application for the iPhone
http://iphone.tmcnet.com/topics/iphone/articles/56059-canopy-releases-mobile-consumer-directed-healthcare-software-application.htm
Description:
Makes CDH significantly more accessible to consumers with Health Savings Accounts (HSAs), Health Reimbursement Accounts (HRA) and Flexible Spending Accounts (FSAs). Mobile CDH allows consumers to search for medical procedures using keywords to determine if the consumer is eligible can be reimbursed using tax advantage CDH spending accounts.
Use Case: Allows patients to search for eligibility and costs of medical procedures.
Gives real-time access to patients (Primary Actor) who want to know information on medical procedure eligibility and customary cost in a local market. This application provides transparency for the consumers on their medical bills. It will give consumers negotiating power with their procedures prior to signing billing agreements at the provider’s office.
Standards:
The only listed standard is that this product is an iphone application. (Apple’s application standards)
"medmobile" - Device to monitor blood pressure levels
Ramya Sugumar
Description: medmobile is a specially designed blood pressure measuring device connected via Bluetooth to a preconfigured mobile phone. A patient could measure his/her blood pressure using this device and these measurements will be transmitted via the mobile phone to a central data archive. Here, the measurements are analyzed automatically by prewritten algorithms and screened for abnormalities. If the blood pressure is abnormal the patient’s physician or clinic is notified automatically.
Use Case: Analyze blood pressure levels and notify physician if levels are abnormal
Primary Actor and Goal: Patient needs to keep a check on his/her blood pressure level and notify physician if the blood pressure is abnormal.
Other Stakeholders and Interests: Physicians and clinicians. Wants to be notified immediately if patient’s blood pressure level is abnormal in order to provide immediate medical care that is required.
Success Scenario: Patient measures blood pressure level using medmobile. The measurements are transmitted by the preconfigured mobile to the central data center. The measurements are analyzed by automated computer software and expert systems. No action if blood pressure levels are normal. Physician is notified if blood pressure level is abnormal.
Standards: I assume that the system uses the existing standards for bluetooth and cellular communication. There is no mention of what standards are used for notifying physicians nor there is any mention about the standards used for storing the data in the central data center.
Kenkou – Health Application for iPhone and iPod touch
Karla Hernandez
http://www.wellbuiltsoftware.com/products/kenkou/kenkou.html
Description: Kenkou (health in Japanese) lets users keep track of some important personal health and fitness data. The user can enter her blood sugar levels, blood pressure, cholesterol, and weight—and date-stamp each entry, enabling her to track trends over time. The program also lets users track how many minutes they exercised, record what foods they ate, and note other relevant details. Additionally, all the entries can be emailed.
Use case
Goal: end user that wants to keep track of vital health statistics.
It’s almost summer time, and our end user (primary actor) has been working hard trying to get rid of few extra pounds. For the past ten months, he’s been going regularly to the gym, and has also been paying attention to his food. He just finished today’s workout and it’s now having dinner. He accesses his Kenkou application on his iPhone and enter, with date and time, what he did at the gym and what he’s about to eat. He also wants to change his exercising routine, so he filters the fitness entries by date in order to access the details of his workouts in the past two months.
Standards: compatible with iPhone (OS 2.1 or later) and iPod touch
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