A Distrubuted System For Accurate Use Of Drugs - Bhaskar Rudroju

A Distributed System for Accurate Use of

Drugs

• Bhaskar Rudroju• Dr. Michael Schukat• Peter Kidd

16th Annual Conference and Scientific Symposium

Healthcare Informatics Society of IrelandDate 17 -11-11, Dublin

Outline

• Introduction• Research background• Capabilities of ICT• SQUD Design & Architecture• Progress• Future work• Conclusion



Introduction

• The recent advances in Information and communication technologies (ICT) are acting as catalyst for significant development in the sector of health care.

• Internet enabled healthcare applications• Electronic Healthcare Records• Telemedicine• Inter-organisational collaborations• Data management • High performance computing• Consumer health informatics• m-Health• Internet based services (e-Pharmacy, e-Care)• Security



Research Background

• Problems facing in hospitals• Hospital Wide Medication Management (HMM)• Personalised Medication Management (PMM)

• Hospital Wide Medication Management• Use of important and costly drugs, e.g. Immunoglobinun• Lack of resources e.g. computers, Internet connection,

server problems.

• Personalised Medication Management• Individualised patient care• Right drug, right dose, every time



Research Background (Cont..)

• Medication errors• Giving the wrong drug• Giving the wrong dose• Skipping the dose• Giving the drug by wrong route• Giving the drug at wrong rate• Giving the drug at wrong time.



Importance for Drug Dosage Levels

• Over dose.• Under dose.• Low therapeutic index drugs.• Finding out optimal level.



Complexity involved in Calculating Dosage Levels

• Complex• The calculation of dosage levels are complex, for e.g.

Finding the creatinine clearance the formula is ((140-age)*ideal body

weight)/serum creatinine. ((140+age*ideal body weight))/serum creatinine.

• Multi-step• Calculate IBW, adjusted body weight, CrCl, dosage

regimen. • Error prone

• Even a single misplace of decimal point can lead to a major error.

• Multiple Times a day• E.g. antibiotics 16th Annual Conference and Scientific Symposium


Capabilities of ICT

• The information & communication technologies ICT capabilities can be classified into 6 categories.



Applying ICT to Drug Dosage Problems

Person Process System

Wrong Dose

ICT Capabilities

Smart Phones

Communication

Standardisation

Performance



SQUD

• SQUD stands for System Quality Use of Drugs• Formed by

• IT Department of National University of Ireland, Galway and • Pharmacy Department of Galway University Hospital.

• Aim/Objectives • Research on Quality use of drugs in hospital

environment.• Initiated with developing applications for calculating the

drug dosage levels for renal impairment medication.• These calculators must accessible from patient’s bedside

and from hospital PC’s.• Capable of sending instant messages to pharmacy staff.• Transparent validation.• Reliable. 16th Annual Conference and Scientific Symposium


mschukat

You mix generic goals with implementation-specific aspects (e.g. instant messages).Stick to generic aspects, e.g.workflow integrationdevice independence etc.

System Design of SQUD

1. Design drug dosage calculator for clinicians

2. Design framework for pharmacy administrator to generate drug dosage regimens

3. Implement the calculator on multiple platforms like PDA’s, mobile phones and on computers



mschukat

Change title, this is one project of SQD

System Architecture



System Architecture (Cont..)

1. The pharmacy administrator can login into the application anywhere via Internet and can create, validate, update and delete the drug protocols.

2. The created drug protocols will be saved in the webserver.

3. Clinicians can login into the application anywhere via the Internet and can access the calculator or view the patient or download the installation file for the mobile phones.



System Architecture (Cont..)

4. The downloaded installation files can be installed on the clinician mobile phones and access the application.

5. Clinicians can access the application on the smart phones by downloading the application on their devices.

6. Smart phones which are enabled with Wi-Fi or GPRS can login into the application via Internet.



Progress

• The web application is deployed in an Ireland server, the application can be accessed by the url: www.squd.eu

• Clinicians are registering into the application and accessing it.

• The framework can be accessed/used by• Java enabled mobile phones.• Smart phones with internet connection• Stationary hospital PCs



www.squd.eu Admin page

http://www.squd.eu/

www.squd.eu Clinician page



http://www.squd.eu/

Mobile Version



Future Work

• Broaden / extending the technology • to assist other dosing related problems such as those

found in new-born babies, cancer patients, ICU patients, etc.• “drug-regime editor”

• Security / authenticity• Deployment on other mobile device types (e.g.

Android etc.)• Improved system integration (HIS connectivity,

adaptive workflow integration)

• Start looking into HMM aspects• to collect usage data on high priority (expensive)

drugs like intravenous immunoglobulin. 16th Annual Conference and Scientific Symposium


Conclusion

• The research has shown that there is an increasing need for robust medication management systems for clinical use.

• The present prototype provides this functionality over a wide range of user platforms, while providing a reliable mechanism to generate, verify and distribute dosage calculations.



Questions?

Thank you for your attention



A Distrubuted System For Accurate Use Of Drugs - Bhaskar Rudroju

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