Dialysis Product & Interface
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Transcript of Dialysis Product & Interface
Kidney Dialysis MonitorResearch Report
Gina MetssaluPiret Uustal
Ruth-Helene MelioranskiMartin Pärn
Sven Sõrmus
supervised by:
Biomeditsiinitehnika instituut
spring 2014
in cooperation with:
Tehnomeedikum /Tallinna Tehnikaülikool
Introduction
The researchers' team of Technomedicum have worked out and patented a new optical method to monitor uremic toxins in the blood and through that raise the quality of the dialysis process.
The task for our semester project is to design
- the physical body for the new device (incl. the functions, case, semantics etc)
- the communication between dialysis device and users (patient, nurse, doctor).
Backround
Approximately 2.2 million end stage renal disease (ESRD) patients are treated worldwide, 1.5 of them are haemodialysis (HD) patients and the growth of new patients is approximately 7% a year (1). Without the treatment the patients would die rather quickly (after ca 3-4 days) due to complications caused by excessive body water and uremic toxins in the body. A large part of patients’ life quality decrease and HD expenditures are related to hospitalisations and interventions due to the side effects causing high morbidity and mortality (2). Therefore, to improve well-being of the patients and cost effectiveness, the society is interested that adequate renal replacement therapy with high quality and minimum complications is offered.
What is a dialysis?
· Dialysis is the artificial replacement for lost kidney function. · Eliminating waste (diffusion) and unwanted water (ultrafiltration) from the blood· Well functioning kidneys filter all the blood in your body with 30 min.· 2 leading causes of kidney disease are high blood pressure and diabetes.· It is possible to live with only one kidney.
The functions of the kidney
Excretory functions- remove waste products- remove excess fluid- regulate acid-base balance- regulate electrolyte levels Secretory functions
- regulate blood pressure (renin)- regulate red blood cell production (EPO)- regulate calcium uptake (active vitamin D)
Treatment Modalities
Hemodialysis
In hemodialysis, your blood flows through a machine that has a filter which cleans the blood. This machine is called a dialyzer or artificial kidney. Hemodialysis is usually done three times a week, several hours each session. It can be done at a dialysis center or at home. To get your blood into the dialyzer, two needles are inserted into your vein during each dialysis treatment.- hemofiltration- hemodiafiltration
http://clinicindelhi.com/hemodialysis/
Treatment Modalities
Peritoneal dialysis
How does peritoneal dialysis work?
A soft tube, called a catheter, is placed in your belly. This is done by minor surgery. This catheter makes it possible for you to easily connect to a special tubing which allows two to three quarts of a cleansing fluid to flow into your belly. The cleansing fluid is called dialysate. It takes about 10 minutes for the dialysate to fill a belly. When the filling is done, the catheter is capped so that it doesn't leak. The lining of a belly (called the peritoneal membrane) acts as a natural filter. It lets the wastes and extra fluid in blood pass through it into the cleansing fluid. At the same time, the lining of a belly holds back the important things a body needs, like red blood cells and nutrients. To do its job, the dialysate must stay in a belly for two hours or more, depending on body size and how much waste has to be removed. This time is called dwell time. After dwell time, cleansing fluid must be drained from body into an empty bag. In-and-out process must be repeated a number of times during the day, using fresh dialysate. PD can be done at home, at work, or while traveling.
Two options:
- Continuous cycling peritoneal dialysis or automated dialysis (CCPD)With CCPD, a machine called a cycler does the exchanges automatically while you sleep. You may also need to do one exchange during the day if your kidney function decreases further.- Continuous ambulatory peritoneal dialysis (CAPD) With CAPD, you do the exchanges yourself three to four times a day.
http://sainternshipufs.blogspot.com/2012/06/4-5-june-2012-universitas-hospital.html
Treatment modalities
Kidney transplant
A kidney transplant is an operation that places a healthy kidney in your body. The transplanted kidney takes over the work of the two kidneys that failed, so you no longer need dialysis.
If you have a transplant, you must take drugs for the rest of your life, to keep your body from rejecting the new kidney.
Transplanted kidney usually works well 8-10 years, after that it needs to be replaced.
Currently (2014) 99 000 people are in a waiting list of kidney donor in USA. Fewer than 17 000 receive one each year.Every day 14 people die waiting for a new kidney.
Alternatives
UCSF researchers today unveiled a prototype model of the first implantable artificial kidney, in a development that one day could eliminate the need for dialysis.
3D printed Kidney - by Surgeon Anthony Atala. An early-stage experiment that could someday solve the organ-donor problem: a 3D printer that uses living cells to output a transplantable kidney
Revital Cohen - Dialysis Sheep (2008)http://designculturelab.org/2011/08/06/dialysis-sheep-sacrificial-lambs-black-sheep-and-speculative-designs-publics/
http://blog.sculpteo.com/2011/08/10/3d-printing-for-regenerative-medicine/
http://www.ucsf.edu/news/2010/09/4450/ucsf-unveils-model-implantable-artificial-kidney-replace-dialysis
http://www.medindia.net/healthnews/kidney-transplantation-news.asp
Research Methodology
GIGAmapping
Online research
On-site observation at the hospital
Interview with a patient and patient journey
Mapping out different aspects of dialysis and the problems related to it. Analysing their interconnections. Finding new connections between the parts of the process. (addendum A)
To map out the nature and need of dialysis, to learn the dialysis process in detail and to identify the problems that dialysis patients are experiencing.
To understand the interaction between the patient and the hemodialysis machine. To monitor the workload of nurses.To monitor the activities of the patients during the dialysis process.
To recieve a feedback from the patient about the dialysis process.To map the level of his understanding of the process and the need for it. To understand patient’s daily schedule due to dialysis and his attitude towards it.
The poll
To get statistics. To map the level of patients understanding of the process. To measure the scope of the problem. To find out patients needs and expectations.
Overview of the research
Reality in hemodialysis
· 2,2 million ESRD patients worldwide (about 1,5 million HD patients)· 7 % annual growth rate· time consuming: 4-5 hrs, 3-4 times/week· Life expectancy if a person starts dialyse in the age over 75 years: 25 % - 1 year 60 % - 5 years· Life expectancy if a person starts dialyse in twenties: 20 or in some cases even 30 years· complex medical and dietary regimen· expensive- ca 50 billion USD annually· complications
Patient needs a dialysis process 3-4 times in a week and it takes 3-5 hours.
Blood urea concentration over a time of period(several dilaysis)
Mon WedWed FriFri
Bloo
d ur
ea c
once
ntra
tion
mm
ol/l
5
10
15
20
25
-20
30
0
Overview of the research
http://www2.nephrocare.com/global/en/products/5008.html
On-site observation at the hospital
- Majority of the patients are under the care of nurse* safer environment* fear of doing hemodialysis at home
- Younger and more fit patients interact with new machine themselves.
- During the dialysis the nurses are required to fill out patient records manually
- Newer hemodialysis machines have patient-friendly screens and operating principles and can be operated by the patients themselves.
Newest machines at the hospitals now. Patient friendlier. Self service.
Current machines at the hospotal.No patient-machine interaction takes place.
Older machines. Currently stocked aways and used only if really needed.
Addendum A
KIDNEY DIALYSISSTAKEHOLDERS
COMPETOTORS SELLING DIALYSIS
MACHINES
FAMILY EMPLOYER
SUPPLIERSHOSPITAL SYSTEM
PATIENT
Patient
SCHOOL WORK
QUALITY OF LIFEFEELINGS
VACATION
YOUNG WORKING PEOPLE
BABY CHILD TEENAGER STUDENT PARENT ELDERLY
2 leading causes of kidney desease are high blood pressure and diabetes.
It is possible to live with only one kidney.
Kidneys filter all the blood in your body with 30 min.
WHAT IS A DIALYSIS?Dialysis is the artificial replacement for lost kidney function. It is an artificial process of eliminating waste (diffusion) and unwanted water (ultrafiltration) from the blood. Kidneys do this naturally. If a kidney is failed or damaged and cannot carry out the function properly - a person may need dialysis.
fearuncertaintylack of motivationhelplessnessroutineno freedom being a burdenuselessnessno financesuncertain of futuredepressingwaitingallonewhat’s the pointtime lostwant to enjoy the last years of your life
HEMODIALYSIS AT THE HOSPITAL
3-4 x week 3-5 hours
stuck to the machinewasted timepainfulvein infection
For patients with other health problems and for elderly people
Hospital
MON TUE WED TH FRI SAT SUN MON
under medical careless infection“social club”get out of housemeet other people
HEMODIALYSIS AT HOME
PERITONEAL DIALYSIS
4 times in a day30 min
For patients with no other health problems
no needlesno painsuitable for kidsflexible scheduleless dietary restrictionsdoable at nighteasy to travel
risk of infection
3 x week3-4 hours
5-7 x week2 hours
6 x week6-8 hours
Every other night6-8 hours
8 % of all dialysises (in USA)
Due to longer/more frequent dialysis: feel betterless/no nausealess/no “washed out” feelingless/no headacheless/no crampingfexible schedulemore toxins removed
risk of infectionneed long trainingneed “care partner” (family member)need to hire a “care partner”
Home
IDEAPOTENTIALgrowing number of patients - 6 % in a yearcurrently on dialysis - 3 million people currently on hemodialysis - 1.3 million peoplew
Instant data of Dialysis qualitySAVE TIMESAVE MONEYshorter tiem of dialysisnew use of old machines (eg. in poor countries)
See the futureBe like others
Feel usefulFinancial independenceDo what you love
FreedomMotivationEnjoy the life
patient diaryeasy data handlingdata sharing Doctor-Nurse-Patient-Family member
Business - new device
UCSF researchers today unveiled a prototype model of the first implantable artificial kidney, in a development that one day could eliminate the need for dialysis.
3D printed Kidney - by Surgeon Anthony Atala. An early-stage experiment that could someday solve the organ-donor problem: a 3D printer that uses living cells to output a transplantable kidney
Revital Cohen - Dialysis Sheep (2008)
http://www.ucsf.edu/news/2010/09/4450/ucsf-unveils-model-implantable-artificial-kidney-replace-dialysis
http://blog.sculpteo.com/2011/08/10/3d-printing-for-regenerative-medicine/
http://designculturelab.org/2011/08/06/dialysis-sheep-sacrificial-lambs-black-sheep-and-speculative-designs-publics/
Alternatives
HEMODIALYSIS MACHINE
ADDED SCREEN
ADDED SENSOR
HOSPITAL
FAMILY
patient diaryat home
..............................
..................
Doctor Nurse
Data of dialys
is effecti
veness
in 2 days
Preparin
g the m
achine
Sterily
zing fl
ites
Start
pump and timer
Measure
blood press
ure in
every
30 minutes
Removing t
he tubes f
rom th
e patient in
3-5 hours
Patient r
ecove
ry 10-15 m
inutes
Possible afte
reffects
PROCESS
Measure
:kg
temperatu
re
blood press
ure w
hen standing a
nd sitti
ngMeasure
:kg
temperatu
re
blood press
ure w
hen standing a
nd sitti
ng
http://sainternshipufs.blogspot.com/2012/06/4-5-june-2012-universitas-hospital.html
FACTSbased on data of USA
1 out of 10 people (over 18 years old) have reduced kidney function
Currently (2014) 99 000 people are in a waiting list of kidney donor. Fiewer than 17 000 receive one each year.Every day 14 people die waiting for a new kidney.
Today’s dialysis machines are far from perfect. Their efficiency is only around 10% of that of a functioning kidney, and when used three times per week, they are incapable of controlling unhealthy fluctuations in the concentrations of metabolites such as urea in the blood.
90 000 people die of kidney desease (more than Breast and Prostate cancer combined)
Life expectancy if a person starts dialyse in the age over 75 years:25 % - 1 year60 % - 5 years
Life expectancy if a person starts dialyse in twenties: 20 or in some cases even 30 years.
SCHEDUAL
by Piret Uustal I Gina Metssalu I 2014supervised by Birger Sevaldson
HEMODIALYSIS
by Piret Uustal I Gina Metssalu I 2014supervised by Birger Sevaldson
KIDNEY DIALYSISSTAKEHOLDERS
COMPETOTORS SELLING DIALYSIS
MACHINES
FAMILY EMPLOYER
SUPPLIERSHOSPITAL SYSTEM
PATIENT
Patient
SCHOOL WORK
QUALITY OF LIFEFEELINGS
VACATION
YOUNG WORKING PEOPLE
BABY CHILD TEENAGER STUDENT PARENT ELDERLY
2 leading causes of kidney desease are high blood pressure and diabetes.
It is possible to live with only one kidney.
Kidneys filter all the blood in your body with 30 min.
WHAT IS A DIALYSIS?Dialysis is the artificial replacement for lost kidney function. It is an artificial process of eliminating waste (diffusion) and unwanted water (ultrafiltration) from the blood. Kidneys do this naturally. If a kidney is failed or damaged and cannot carry out the function properly - a person may need dialysis.
fearuncertaintylack of motivationhelplessnessroutineno freedom being a burdenuselessnessno financesuncertain of futuredepressingwaitingallonewhat’s the pointtime lostwant to enjoy the last years of your life
HEMODIALYSIS AT THE HOSPITAL
3-4 x week 3-5 hours
stuck to the machinewasted timepainfulvein infection
For patients with other health problems and for elderly people
Hospital
MON TUE WED TH FRI SAT SUN MON
under medical careless infection“social club”get out of housemeet other people
HEMODIALYSIS AT HOME
PERITONEAL DIALYSIS
4 times in a day30 min
For patients with no other health problems
no needlesno painsuitable for kidsflexible scheduleless dietary restrictionsdoable at nighteasy to travel
risk of infection
3 x week3-4 hours
5-7 x week2 hours
6 x week6-8 hours
Every other night6-8 hours
8 % of all dialysises (in USA)
Due to longer/more frequent dialysis: feel betterless/no nausealess/no “washed out” feelingless/no headacheless/no crampingfexible schedulemore toxins removed
risk of infectionneed long trainingneed “care partner” (family member)need to hire a “care partner”
Home
IDEAPOTENTIALgrowing number of patients - 6 % in a yearcurrently on dialysis - 3 million people currently on hemodialysis - 1.3 million peoplew
Instant data of Dialysis qualitySAVE TIMESAVE MONEYshorter tiem of dialysisnew use of old machines (eg. in poor countries)
See the futureBe like others
Feel usefulFinancial independenceDo what you love
FreedomMotivationEnjoy the life
patient diaryeasy data handlingdata sharing Doctor-Nurse-Patient-Family member
Business - new device
UCSF researchers today unveiled a prototype model of the first implantable artificial kidney, in a development that one day could eliminate the need for dialysis.
3D printed Kidney - by Surgeon Anthony Atala. An early-stage experiment that could someday solve the organ-donor problem: a 3D printer that uses living cells to output a transplantable kidney
Revital Cohen - Dialysis Sheep (2008)
http://www.ucsf.edu/news/2010/09/4450/ucsf-unveils-model-implantable-artificial-kidney-replace-dialysis
http://blog.sculpteo.com/2011/08/10/3d-printing-for-regenerative-medicine/
http://designculturelab.org/2011/08/06/dialysis-sheep-sacrificial-lambs-black-sheep-and-speculative-designs-publics/
Alternatives
HEMODIALYSIS MACHINE
ADDED SCREEN
ADDED SENSOR
HOSPITAL
FAMILY
patient diaryat home
..............................
..................
Doctor Nurse
Data of dialys
is effecti
veness
in 2 days
Preparin
g the m
achine
Sterily
zing fl
ites
Start
pump and timer
Measure
blood press
ure in
every
30 minutes
Removing t
he tubes f
rom th
e patient in
3-5 hours
Patient r
ecove
ry 10-15 m
inutes
Possible afte
reffects
PROCESS
Measure
:kg
temperatu
re
blood press
ure w
hen standing a
nd sitti
ngMeasure
:kg
temperatu
re
blood press
ure w
hen standing a
nd sitti
ng
http://sainternshipufs.blogspot.com/2012/06/4-5-june-2012-universitas-hospital.html
FACTSbased on data of USA
1 out of 10 people (over 18 years old) have reduced kidney function
Currently (2014) 99 000 people are in a waiting list of kidney donor. Fiewer than 17 000 receive one each year.Every day 14 people die waiting for a new kidney.
Today’s dialysis machines are far from perfect. Their efficiency is only around 10% of that of a functioning kidney, and when used three times per week, they are incapable of controlling unhealthy fluctuations in the concentrations of metabolites such as urea in the blood.
90 000 people die of kidney desease (more than Breast and Prostate cancer combined)
Life expectancy if a person starts dialyse in the age over 75 years:25 % - 1 year60 % - 5 years
Life expectancy if a person starts dialyse in twenties: 20 or in some cases even 30 years.
SCHEDUAL
by Piret Uustal I Gina Metssalu I 2014supervised by Birger Sevaldson
HEMODIALYSIS
Overview of the research
Interview with a patient / patient journeyMale I 81 years old I dialysis patient over 2 years
- had kidney failure after heart surgery when he was given wrong medicine (overdose of Potassium) which injured his kidney functions.
-kidney dialysis every Mon, Wed, Friday, from 8-12
- patient himself is responsible monitoring his heart rate during the dialysis. If its too low or high the patient moves the position of the bed to raise his legs.
- the patient is not aware of the effectiveness of the dialysis in the end of the process. He is not monitoring the display of the machine (even if there is screen it is not visible nor understandable for the patinet).
- if the display would be visible and understandable to the patient he would be interested and positively influenced to see the effectiveness of the dialysis process.
- the patient follows the remaining time of the dialysis process from the sepparate wall clock. He does not see the timer from the machine.
- he feels fairly good after the dialysis. He walkes home 15-20 minutes and needs to sleep 2 hours to feel completely well.
- the patient claimed that when he was sometimes placed under an older model of hemodialysis machine he did not feel comfortable and did not trust the effect of the dialysis as much
- the inability to use restroom during the dialysis process is sometimes a problem
Older hemodialysis machine
Overview of the research
Patients
Age
Working?
In order to get overview of patients habits and their awareness of hemodialyses process we conducted a research among the hemodialyses patients in estonia. There is about 200 regular HD patients and we got answers from 32. It makes ab 16 percent of all patients in Estonia.
Overview of the research
Patient awareness of the dialyses process
44 % of the patients are not aware what is happening with their blood during the dialyses process
64 % NOT aware what does the data displayed on the machine (such as Kt/v) means.
79% NOT aware how clean is their blood after the dialysis.
48% believe that knowing the results of the dialysis process effectiveness would influence them positively.
80% following their blood pressure during the process.
Overview of the research
Dialyses at home?
80% NOT willing to do dialysis at home
43% believes dialysis at home would affect their daily routine
Main reasons:
- no conditions- don’t dare- not sterile enough - live alone- fear of blood, needles and whole process
25% would be more encouraged to have dialysis at home if the doctor has overview of the process in real time.
Findings
Increase blood flow
Improvement in clearance
Positive effect on Kt/V
- The benefits of real-time measurement are obvious: if Kt/ V is only checked monthly or quarterly, it may be months before suboptimal dosing is discovered. By measuring online during every therapy, the new sensor is able to identify suboptimal dosing immediately, support timely adjustments in treatment parameters and also eliminate common process- related factors influencing the previous reference method (taking of blood samples).
In medicine, Kt/V is a number used to quantify hemodialysis and peritoneal dialysis treatment adequacy.
K - dialyzer clearance of urea t - dialysis time V - volume of distribution of urea, approximately equal to patient’s total body water
There are 4 ways of how the doctor, nurse or patient can influence the Kt/V during dialysis process thanks to the costant information of dialysis quality given by new sensor:
Hemodialysis machine and sensor
High concentartion of substances
Reduce blood flow Increase dialysate flow Longer dialysis time
Improvement in clearance
Positive effect on Kt/V
Improvement in clearance
Positive effect on Kt/V
Improvement in clearance
Positive effect on Kt/V
Findings
- The patient is interested in knowing and following the effectiveness of dialysis during the process.
- The patient would be positively motivated if he was able to monitor the effect of the process.
- Newer dialysis machine and a machine that is understandable to the patient raises trust towards the process and makes the patiet interact with the machine (more independence to the patient, less work to the hospital stuff)
Patient
-The ability to receive constant feedback of the patients dialysis quality eliminates the “guess work” of the nurses and doctors in setting the machine parameters before an during the dialysis process. The optimal dialysis process for each patient can be figured out faster and is based on reliable data.
- The machine could ease the workload of nurses by automatically saving the information of the dialysis process (work that is now done manually).
- In case the patient recives dialysis in a different clininc (e.g. while traveling) the data of the patients dialysis parameters will be available to the nurses and doctors in a new clinic as well.
Doctors / Nurses
Findings
Nursing file what now is filled by hand for each patient
Findings
Market
- Older models of hemodialysis machines that have new sensor can be used in a more effective way.
- Hemodialysis machines can be made avaialable to more patients. Older machines that would be otherwsie disregarded can be taken more clinics and to rural areas so the patient would not have to travel long distances to receive dialysis.
- Less developed countries with older dialysis machines can offer better dialysis quality to their patients and make it avaialble to more people.
- Lower costs than purchasing brand-new hemodialysis machines.
Regulations
- There are several laws and regulations in Estonia for producing, maintaining and handling medical devices (3), but as far as we talking about adding the new sensor only as a affix to outlet hose, then we are not influenced by them directly.
Existing solutions
The first integrated dialysis dose monitor in the world, utilising the UV-technology, is the Adimea system (Option Adimea, BBraun Avitum AG) (B. Braun Avitum AG 2010). The heart of the Adimea system is the optical sensor DiaSens, integrated into the HD machine, delivering values of real-time Kt/V or URR for the dialysis team during a treatment
Findings
Goal
Increase patient motivation to take better care of their
health through raising awareness of the dialysis
process.
Focus
The existing analysers are built in the whole kidney dialysis apparatus. The aim is to develop a standalone analyser which suits with dialysers produced by different companies. Today the procedure takes place in the hospital under the control of the medical personnel. The new system is connected with internet and should be able to work also in the other environments out of hospital and patient should be able to manage with it alone. The disadvantages of the existing methods for uremic toxins determination are utilization of disposables or chemicals, rather complicated and expensive measurement procedure. To overcome those difficulties, a monitoring system would be preferable. Recently a good correlation between ultraviolet (UV)-absorbance and several small removed waste solutes (urea, Cr, UA) has been found, indicating that UV-absorbance may enable monitoring of several uremic toxins linked to the malnutrition–inflammation complex syndrome and the risk factors of CVD. The obtained results demonstrate the possibility to follow a single hemodialysis session continuously and to monitor deviations in the dialysator performance by using UV-absorbance. The UV-method does not need blood samples, any disposables or chemicals, is fast, and allows continuous measurements of the standard dialysis adequacy parameters (e.g. Kt/V, URR).
http://www.bbraun-avitum.ro/cps/rde/xchg/av-avitum-ro-ro/hs.xsl/7370.html
http://www.cb.ttu.ee/ee/edu/DBB0070/Biooptics_HD_public.pdf
Focus
External sensor
· Real- time measurement system· Photometric sensor that continuously measures light absorption in spent dialysate· Estimating the reduction of substances concentration, which is linearly related to their concentration in blood· Capable of delivering Kt/V in most treatment models, including HDF, HD and single needle treatment
Advantages
· continous, on-line monitoring. Other methods- once in every 25 min. New sensor every 6 sec ( Kt/V)· no blood sampling· without any disposables or chemicals· evaluates delivery of prescribed treatment dose (Kt/V)· can estimate TRU, PCR, URR· possibility to measure other solutes besides urea· estimation until the target is achieved· no interference with dialysis machine’s operation
Values for patient
- simple, understandable,always visible screen
- blood result instantly shows if patient has been taking care of his health (eg. correct diet)
- practice in the hospital, simplicity of the process and awareness encourages to do dialysis at home
- aware what is happening
- cares more of his/her health
- independence
Values How?
Values
Values for nurse
- patient data stored in the device and easily accessible when needed
- most data saved automaticaly to the new screen during the process
-machine setup based on exact blood data. Alarm if goal not achived.
- easy data handling and storing
- save time
- easier setup of dialysis machine
Values How?
Values
Market
Values
Currently, there is about 600 000 old hemodialysis machines in the world. Many of these machines are in good condition, but miss certain functions limiting the treatment modalities a clinic can perform.Those functionality could be raised significally by adding them percise sensor and extra screen.
CHOOSE MACHINE
OLD MACHINE MANUAL PROCESS
MACHINE TESTING AND SETUPca 15 min
INSTALL FILTER, TUBES,
DIALYSATES
CONNECT PATEINET TO
MEASURE BLOOD PRESSURE
(connect with machine)
CONNECT PATIENT WITH
MACHINE
CHOOSE PROGRAM-Hemodialysis
-Hemodiafiltration (HDF)- Ultrafiltration
MACHINE ADJUSTS AUTOMATICALLY ACCORDING TO
PATIENT
ALL SETUP MADE INSTANTLY
CHANGES CAN BE MADE
SENSOR ALARM-change something
HOW DOES PATIENT
FEEL
START(MACHINE)
FOOD DIARY SYNC
NURSE CHANGES PARAMETERS ON
MACHINE:
- BLOOD FLOW
-DIALYSATE FLOW
- UF PROFILE +/-
NURSE ENTERS CHANGES TO THE
SCREEN:
- BLOOD FLOW
-DIALYSATE FLOW
- UF PROFILE +/-
DIALYSIS TIME ADJUSTS ON THE SCREEN GRAPH
SAvEPROCESS
PRINTDATA
WHICH DATA NEEDS
PRINTING?
In the case of independent patient - who fills out the paper sheet for nurses
now? Is patient able to do this?Is all that data always needed?
Can blood pressure be measured at the
same time in 2 places (in dialysis machine
and on NEW SCREEN)2 connections.
So blood pressure could be followed from the screen.
what happens if blood pressure will be shown only on
NEW SCREEN. What changes in Dialysis machine? Does it affect anything?Is bloodpressure
data usually saved to magnetic card also? Is
it needed for that?
FEEL + UNFASTEN THE
PATIENT
FEEL -
low blood pressureT
clogged fistula(MACHINE)
arter/vein pressure
blood sugar(MACHINE)
cramps(MACHINE)
headache(MACHINE)
DISPLAYED :-previous dialysis data
-usual setup parameters (kg, dialysis time)
-medicaments-previous blood test results from lab
- patient food DIARY
CHOOSE PROGRAM-Hemodialysis
-Hemodiafiltration (HDF)- Ultrafiltration
MAGNETIC CARD
NEW MACHINE
WEIGH THE PATIENT
CAN CHANGE SETUP PARAMETERS
-kg-dialysis time
.
.
.
1
2 3
4 5 6
7 8
9 10
11 12
13 14 15
Weights herself and remembers it
Prebooks always new machine
Sets up the machine parameters- with
magnetic card
Nurse preparesmachine
Connects herself- needles, sensors etc
Patient chooses pro-gram
Starts machine
Takes the new Screen
Start of new screen- automatically, after fluid starts flowing- TIME AND BLOOD
PRESSURE as a screen saver
Inserts parameters to the New Screen
BLOOD PRESSURE as a screensaver
Home menu-PATIENT SELECTION
PATIENT PARAMETERS
PRECISE GRAPH
SCREEN
progress is going on as predicted
Usual time is up, but screen shows onlly
75% of result
75% of GOAL
Becouse of upcom-ing meeting chooses
to finish anyway
Suggestions to the next time
Prebooks for the next time longer session Disconnects herself
Just comes every mondey, wendsday
and friday at 8 oclock
Waches his blood pressure
Nurse waches and marks down the
weight
Nurse preparesmachine
Nurse connects with machine
Nurse sets up the machine
Nurse choses program
NurseSTARTs
Machine
Calls nurse when not feeling good
Weights herself
Security code necessary?
Nurse gets info about PREvIOUS
SESSION PARAMETERS
Start of new screen- automatically, after fluid starts flowing- TIME AND BLOOD
PRESSUREin a patient page view
PRECISE GRAPH
SCREEN
lack of GOAL
Nursechanges parameters
AUTOMATICALLY SAvES ALL
WIRELESS CONNECTION?CAN IT START
AUTOMATICALLY AFTER FLUID
STARTS RUNNING?
GOALgets better
GOALis achieved
Nursedisconnects
nurse inserts weight
SAvEPROCESS
PRINTDATA
Nursetakes blood sample
nurse inserts BLOOD TEST RESULTS
PORTABLE SCREEN for INSERTING WEIGHT
INSTANTLY already in “weighting Cabinet”
JAAK, 62Pensioner. Doesn’t work, lives alone
in Mustamäe.
PIIA, 32Works as a project manager, studies
administrative management in TTU-s master program. Mother of two chil-
dren. Travels a lot
HOME MENU- PATIENT SELECTION-INSERTING WEIGHT
MACHINE NEEDS TO BE SET UP
BLOOD PRESSURE starts screening in a
patient page view
Nurse waches and marks down the
weight
inserts weight
Piias actings Jaaks actings Nurses actings NEW SCREEN Ns- Piias acting Ns- nurse acting Ns- Jaak acting
Concept in usePatient journey
CHOOSE MACHINE
OLD MACHINE MANUAL PROCESS
MACHINE TESTING AND SETUPca 15 min
INSTALL FILTER, TUBES,
DIALYSATES
CONNECT PATEINET TO
MEASURE BLOOD PRESSURE
(connect with machine)
CONNECT PATIENT WITH
MACHINE
CHOOSE PROGRAM-Hemodialysis
-Hemodiafiltration (HDF)- Ultrafiltration
MACHINE ADJUSTS AUTOMATICALLY ACCORDING TO
PATIENT
ALL SETUP MADE INSTANTLY
CHANGES CAN BE MADE
SENSOR ALARM-change something
HOW DOES PATIENT
FEEL
START(MACHINE)
FOOD DIARY SYNC
NURSE CHANGES PARAMETERS ON
MACHINE:
- BLOOD FLOW
-DIALYSATE FLOW
- UF PROFILE +/-
NURSE ENTERS CHANGES TO THE
SCREEN:
- BLOOD FLOW
-DIALYSATE FLOW
- UF PROFILE +/-
DIALYSIS TIME ADJUSTS ON THE SCREEN GRAPH
SAvEPROCESS
PRINTDATA
WHICH DATA NEEDS
PRINTING?
In the case of independent patient - who fills out the paper sheet for nurses
now? Is patient able to do this?Is all that data always needed?
Can blood pressure be measured at the
same time in 2 places (in dialysis machine
and on NEW SCREEN)2 connections.
So blood pressure could be followed from the screen.
what happens if blood pressure will be shown only on
NEW SCREEN. What changes in Dialysis machine? Does it affect anything?Is bloodpressure
data usually saved to magnetic card also? Is
it needed for that?
FEEL + UNFASTEN THE
PATIENT
FEEL -
low blood pressureT
clogged fistula(MACHINE)
arter/vein pressure
blood sugar(MACHINE)
cramps(MACHINE)
headache(MACHINE)
DISPLAYED :-previous dialysis data
-usual setup parameters (kg, dialysis time)
-medicaments-previous blood test results from lab
- patient food DIARY
CHOOSE PROGRAM-Hemodialysis
-Hemodiafiltration (HDF)- Ultrafiltration
MAGNETIC CARD
NEW MACHINE
WEIGH THE PATIENT
CAN CHANGE SETUP PARAMETERS
-kg-dialysis time
.
.
.
1
2 3
4 5 6
7 8
9 10
11 12
13 14 15
Weights herself and remembers it
Prebooks always new machine
Sets up the machine parameters- with
magnetic card
Nurse preparesmachine
Connects herself- needles, sensors etc
Patient chooses pro-gram
Starts machine
Takes the new Screen
Start of new screen- automatically, after fluid starts flowing- TIME AND BLOOD
PRESSURE as a screen saver
Inserts parameters to the New Screen
BLOOD PRESSURE as a screensaver
Home menu-PATIENT SELECTION
PATIENT PARAMETERS
PRECISE GRAPH
SCREEN
progress is going on as predicted
Usual time is up, but screen shows onlly
75% of result
75% of GOAL
Becouse of upcom-ing meeting chooses
to finish anyway
Suggestions to the next time
Prebooks for the next time longer session Disconnects herself
Just comes every mondey, wendsday
and friday at 8 oclock
Waches his blood pressure
Nurse waches and marks down the
weight
Nurse preparesmachine
Nurse connects with machine
Nurse sets up the machine
Nurse choses program
NurseSTARTs
Machine
Calls nurse when not feeling good
Weights herself
Security code necessary?
Nurse gets info about PREvIOUS
SESSION PARAMETERS
Start of new screen- automatically, after fluid starts flowing- TIME AND BLOOD
PRESSUREin a patient page view
PRECISE GRAPH
SCREEN
lack of GOAL
Nursechanges parameters
AUTOMATICALLY SAvES ALL
WIRELESS CONNECTION?CAN IT START
AUTOMATICALLY AFTER FLUID
STARTS RUNNING?
GOALgets better
GOALis achieved
Nursedisconnects
nurse inserts weight
SAvEPROCESS
PRINTDATA
Nursetakes blood sample
nurse inserts BLOOD TEST RESULTS
PORTABLE SCREEN for INSERTING WEIGHT
INSTANTLY already in “weighting Cabinet”
JAAK, 62Pensioner. Doesn’t work, lives alone
in Mustamäe.
PIIA, 32Works as a project manager, studies
administrative management in TTU-s master program. Mother of two chil-
dren. Travels a lot
HOME MENU- PATIENT SELECTION-INSERTING WEIGHT
MACHINE NEEDS TO BE SET UP
BLOOD PRESSURE starts screening in a
patient page view
Nurse waches and marks down the
weight
inserts weight
Piias actings Jaaks actings Nurses actings NEW SCREEN Ns- Piias acting Ns- nurse acting Ns- Jaak acting
Interface structure
Home menu
�Patient selection ô
orders to stock?
suggested parameters
patient 1
Blood pressure (+ time)
as a screensaver
suggested parameters
WeigHt
History
treatment plan
Blood tests Food diary
edit
patient info
program
-Hemodialysis-Hemodiafiltration ô- Ultrafiltration
time
4:00 ô
uF goal
History- date-trend graphs
patient inFo
- name-barcode-doctors name-height-age-...
start
treatment plan
-medicaments-....
Food diary
Blood tests
-predictable graph-goal %-time %-blood pressure-uf rate-art press-ven press-...
WeigHtbeforeôafter ô
Back
alarm
- Blood FloW ô-dial. FloW ô- uF proFile ô
FinisH
suggestionsWeigHtprint
The information measured by the sensor is instantly displayed on the screen. To map out the user interface and keeping in mind the goal for values we went through patients journeys and built the structure for user interface.
Display
Display
Information displayed on the screen is translated into graphics so everyone, even elderly patient can grasp visually what is happening with their blood at this very moment.The most vital information for the patient ( blood pressure, % of the process effectiveness and time remained) is displayed as a screen saver.
If it now, for example, happens that the patient has been eating nonproper food on a previous day, the result instantly shows on the screen. This will help him to understand and assess how his lifestile and diet can influence his health. And that, in turn, motivates him to take control over his health...and not leaving it to the doctors only.
Display
Also the nurses will benefit of the new solution. It will make easierfor them to set up the dialysis machine according to each patientsneeds. The setup data of the most effective process for this patient is already automatcally displayed and the nurse doesnt have to guess which process gives the most positive result to the patient.
Nurses time is saved by not having to fill out papers by hand for each patient. All the data about the process wat now is edited by hand could be saved automaticallyby the screen and if paper version is still needed, it can be simply printed out.
Sensor case
Process of ideas for sensor case