Intensive Care Window Real time monitoring and analysis in the Intensive Care environment

11/10/09 [email protected] 1

Intensive Care WindowIntensive Care WindowReal time monitoring and analysis in the

Intensive Care environment

Nikolas Stylianides

Marios Dikaiakos

George Panayi

Theodoros Kyprianou


Introduction

• Intensive Care Units (ICUs) treat patients that are in a critical (life-threatening) physiological state.

• More than 4.000.000 people are admitted each year in ICUs in the U.S. alone – 500.000 of them do not survive. (The Leapfrog group,

2000)

– 12%


Motivation

• Human factor (on call ICU nurse) still is the invaluable tool in the ICU setting.

• Clinical systems commercially available utilize proprietary code and interface protocols.

• High cost to purchase, deploy and manage commercially systems.


Challenges

• A plethora of medical devices are used in the ICU to monitor the patients.

• The vast majority of medical device vendors utilize proprietary communication interfaces and languages to export information.

• Large volumes of produced data (physiological parameters, vital signs, medical images) that hospitals infrastructures cannot store for large periods of time.

• Personal and sensitive data.


Intensive Care UnitMonitor DeviceMonitor Device

VentilatorVentilator

Drug infusion–administrationDrug infusion–administrationpumps pumps

Portable DevicesPortable Devices

Laboratory Information Laboratory Information SystemsSystems

Numerous other medical Numerous other medical devices, diagnostic devices, diagnostic equipment, …equipment, …


Medical Record Information

Radiology

HospitalPharmacy

KnowledgeBases

PhysiologicalMonitors

MedicalDevices

PMRI

Laboratories

BedsideComputer

PatientRegistration/Admissions

Billing

ClinicalContent

Orders &Results

Payers

PharmacyBenefits Mgrs

RetailPharmacies

ProviderIEEE 1073ISO 11073

IEEE

IEEE 1073ISO 11073

HL7

HL7

DICOM &HL7

HL7 HL7

HL7

HL7

ASCX12N NCPDP Retail

ASC X12N

NCPDP RetailX12N

NCPDP script


ICW System


ICW bedside controller

• Automatic & semi automatic medical device configuration

• Standard compliant communication paths

• Hides proprietary protocol complexity


ICW major contributions

Real time monitoring and supervision

Data collection annotation

Local search capability

Playback functionality


ICW visual tools


Real life scenarios deployment

SCENARIO A: Multiple Organ Dysfunction SyndromeMultiple Organ Dysfunction Syndrome

SCENARIO B: Traumatic Brain InjuryTraumatic Brain Injury

Mean blood pressureBlood glucoseSaO2 - Oxygen Saturation

Cerebral perfusion pressureBlood glucoseSjO2 - Jugular Bulb Oxygen Saturation


Scenario Statistics

• Philips MP70– Arterial blood pressure

diastolic, Arterial mean blood pressure, Arterial blood pressure systolic, … (in total 14 parameters)

• Puritan Bennett Ventilator 840– Exhaled minute volume,

Exhaled tidal volume, .. (in total 18 parameters)

• ABL 800 Flex– Jugular bulb oxygen

saturation (SjO2), blood glucose

• 3 Months period• 10 Patients• 2 ICW bedside settings• 2 ICW system users• 72 hours average

session duration• 0,5 MB average

information stored per hour per patient


Near future work

• Full scale deployment for longer period of time.– This will rise new needs and feature requests

• Initiate an open source project.

• Enhance local search functionality.

• Introduce ICU scoring functionality (Acute Physiology and Chronic Health Evaluation , Simplified Acute Physiology Score, …).

• Extend the medical device driver library.


Thank you for your Attention

Questions ?

Intensive Care Window Real time monitoring and analysis in the Intensive Care environment

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