MHealth secures hygiene in hospitals.

Experts say nearly 2 million hospital-acquired infections occur each year, resulting in about 5,000 deaths and more than 90,000 illnesses in the US. Research shows that simple hand washing by medical staff could cut the number of infections in half. But what if your rushing to the next patient? There is now a wireless, credit-card-sized sensor that can detect whether health care workers have properly washed their hands upon entering a patient’s room.

The Virginia Commonwealth University Medical Center was chosen as a study site because of its higher-than-average rate of hand hygiene compliance, nearly twice the national average. The sensor is worn like a name badge and is programmed to detect the presence of ethyl alcohol, the most common ingredient in hand cleansing solutions used in hospitals.
When a health care worker enters a patient’s room, a small, wall-mounted sensor sends a signal to the badge to check for the presence of alcohol. The worker places their hands near the badge to obtain a reading. Lights on the badge glow red if no alcohol is present, indicating the need to wash hands. A green light indicates alcohol is present.

“Health care workers don’t deliberately avoid washing their hands; they get distracted or are so busy moving from one thing to the next they don’t remember to do it,” said Mike Edmond, M.D., chief hospital epidemiologist. “Until now, the only way we’ve been able to track hand washing habits is through direct observation. This new system continuously monitors and records data and serves as a constant reminder.”

The hand hygiene program is part of an aggressive environmental and patient safety campaign at the VCU Medical Center called Safety First, Every Day. The goal of the campaign is to make the medical center the safest health care institution in the country with no events of preventable harm to patients, employees and visitors. The device was developed by BioVigil, LLC.

Ten features that make a tablet PC a unique device.

And here they are:

1. Write on the screen and draw figures and diagrams when taking notes. Use different color pens, circle things and draw arrows to indicate relationships and to mock up flow diagrams.
2. The interface is more personable and less intrusive. Comfortably hold the tablet and look at the person in the face.
   
3. Use it when standing, so it provides tremendous flexibility taking notes at the bedside.
4. Get a full keyboard when needed or swivel the screen.
5. While in a meeting, you can easily get away with a tablet.
6. You can be more efficient and faster navigating an electronic health record (EHR) that’s optimized for pen-based computing.
   
7. Using handwriting recognition forces to improve and maintain a certain quality of handwriting clarity.
   
8. Showin g patients diagrams, pictures, etc. to others.
   
9. It’s so natural to use the pen to scroll and “flip” through pages like a book while reading.
   
10. It invaluable on a plane and the person in front of you reclines and diminishes your workspace.

What the mHealth fight is all about.

Medical applications for the iPhone are far over 300 apps. Does this mean a knockout for competitors? A pack of medical applications was just released for Android.

Although our phones are far from tricorders at this point (but getting closer), Android has a bit more of a versatile position. A powerful smartphone OS and a passable netbook or tablet one. It seems like it may be a really good fit for embedded systems. With a modern, touchable, and inexpensive OS like Android, there could be a huge increase in standardization and interoperability.

Obviously it wouldn’t just be doctors carrying around G1s and stuff. But picture a hospital where the embedded and use-limited devices integral to its functioning are all running Android in some form or another. It acquits itself equally well to a tablet as to a wall monitor as to a handset. A few tweaks would make it eminently networkable. Of course, this is all pie in the sky, and one could say the same for any number of alternate OSes. Still, it’s food for thought.

As for the medical applications; they are expensive! But they’re established, professional apps that also work on Blackberries and such.

Wireless Sensor Networks see everything.

With tags we enter the field of Wireless Sensor Networks. Can we detect everything happening around us? And can we communicate this findings wirelessly? Yes, we can sense everything and show the results when ever or where ever you like.

The Smart Dust project is aimed at putting a complete sensing/communication platform inside a cubic millimeter, including power supply, analog and digital electronics, etc. Thousands or millions of these dust motes will all communicate simultaneously. Applications are all over the map. Instrumented hospital rooms so that your doctor knows if you’re the right patient or not. Instrumented bodies so that we can all participate in 3D virtual ballet. Instrumented atmosphere so we can predict weather. This project is running on the University of California, Berkeley.

In future doctors will be coaches.

The collection of healthdata is built whithin our lifestyles. Real-time monitoring and feedback from specialists. Will being a doctor become an artform? The enclosed perpective is realistic enough to build your vision and futuristic enough to see the changes coming.

Healthcheck at the groceries.

Going to the supermarket for a medical check-up. How about an appointment? In the supermarket next to the vegitables?  Massachusetts General Hospital is working on a computerized kiosk.

The medical kiosk, dubbed the Health Care 360, is meant to reduce the time and cost of health screenings or routine doctor visits. Especially for patients with chronic health conditions. This device supports both real-time (synchronous) and non-real-time (asynchronous) visits between a patient and a physician. The kiosk contains two-way video and audio links and can monitor blood pressure, heart rate, SpO2, peak-flow, weight and blood coagulation times. It has the format of a tabletop computer with a number of peripherals such as a blood-pressure cuff, a scale, a pulse oximeter and a peak-flow meter to determine whether someone’s airways are constricted, as well as a blood-testing device to measure cholesterol and glucose levels.

“Customers could step up, key in their password-protected information, answer questions related to their personal health history, and then get their checkup” said Ronald Dixon, director of the Virtual Practice Project at Boston-based hospital. “We’re trying to catch people who typically don’t get screened, since a lot of the population doesn’t go to the doctor unless they’re sick. But everyone goes to the drugstore or grocery store once in a while.”

The Health 360 is not unique. HealthAnywhere and Computerized Screening Inc. (CSI) already make medical testing kiosks with a long trackrecord. These devices are more looking like a photo booth. Medical data are sent through a network connection to a medical backoffice. A physician monitors the data. Your medicalprovider sends a message back to you the way you want it, either through e-mail, texting or by phone, about what to do with the results. It could determine whether current medications are doing their job, whether a particular strategy is working or changes need to be made, and whether a more in-depth exam is necessary.

In June, the U.K. National Health Service will do a test deployment of Health Care 360 to screen people for vascular disease. Commercialization of the kiosk is planned for 2010.

Twitter and YouTube surgery

Last week we could all participate in a robot-assisted surgery by dr. Craig Rogers and his team at the Henry Ford Hospital in Detroit. How and specialy why? Are operations a new kind of mass-media life-event? It’s to serious to speculate about that. The patient was a 56-year-old-male with a large left kidney mass that biopsy has proven as kidney cancer.

Using Twitter, doctors uploaded short messages from a laptop in the darkened operating room. At least 385 Twitter users followed the Twitter feed as surgeons gave a play-by-play rundown of the surgery. The operations was accompanied by YouTube video snippets. The doctors answered questions from users about the surgery in real time.

By posting live updates, hospital officials said they hope to give patients, medical students and doctors better exposure to the hospital’s new surgical procedures and technology. The users could follow the surgeon’s journey into the body, around vital organs and finally to the cancerous tumor on the kidney using miniaturized instruments attached to the end of the robotic arms.

“It’s interactive,” said Dr. Rajesh Laungani, chief resident of urology. He was Twittering the updates while  Dr. Rogers, sat nearby guiding the tentacle-like arms of the robot from a remote console. “With the way medicine is going, patients are looking for more information about procedures going on,” Laungani said. “This way lets them know our world, what we go through in the OR and what kind of new technology we’re using.”

With this tweet the Henry Ford hospital also hopes to promote the use of surgical robots. The large multi-armed machines, that assist doctors with making tiny incisions in the body, are said to be more precise and come with fewer complications than traditional forms of surgery.

Don’t try this at home 😉

Changes for WLAN with 802.11n in the hospital.

I signaled the problem of the need for more bandwidth in my previous blog post about Wi-Fi. This growing need for bandwidth, you can capture by access points to 802.11n. A new mobile trend emerged as very promising in the recently published study by Gardner.

802.11n Still isn’t accepted as a standard, but is already widely used in WLAN equipment. Especially access points based on this technology are in focus of byers. That’s no supprise. A combination of two times the speed, twice the distance and less than half the price of typical wireless LAN equipment, makes 802.11a rapidly popular.

The standard Fast Ethernet port is over its top. The 100 Mb is not actually required and the costs for maintenance and upgrades are high. The technology is based on MIMO (Multiple-Input Multiple-Output). It uses multiple antennas to send and receive data. The development is supported by parties like Cisco, Intel. Atheros, Broadcom and Marvell.

How should we see the 802.11n technology within our hospitals?

The improvement in range and the slightly wider scope are interesting. If the WLAN infrastructure supports 802.11n, all Wi-Fi equipment, even those without 802.11n radio’s, will ensure a better and more reliable connection. To create a greater speed the users of the network infrastructure should be fitted with MIMO smart antenna technology. This will take time. The extra bandwidth is interesting for a small number of users such as video, portable x-ray and ultrasound equipment. To equip many medical devices with a minimum of 3 antennas, broadly spread and the necessary energy use …………

Two white papers and background material (one and two).

Steralise your mobile.

Last month, Fujitsu launched a new tablet PC called the ESPRIMO Ma. It’s been specially developed for health professionals. Due to its compactness, it may well be used on the point of care in the hospital.

The reason to highlight it  in my blog is because of some special qualities. For example the housing. It’s completely sealed so it can be steralized. In addition, he is passively cooled. That means no fan inside. So he can even be used in the operating room.

The ESPRIMO Ma is lightweight (1.3 kg) and supported 3G/UMTS and Wi-Fi wireless LAN. The device is based on the Intel Mobile Clinical Assistant platform. He has an integrated barcode scanner, RFID reader and an autofocus camera. With the smart card functionality only authorised use can be regulated. In short, a useful device.

Here is a white paper on the Intel Mobile Clinical Assistant. And this link shows that Philips supports the development.

De ziekenhuis interne WiFi-uitdaging (2).

Meer medische apparaten gebruik laten maken van het interne Wi-Fi netwerk kan een leuke uitdaging zijn. Let wel op de verborgen kosten! De Wi-Fi radio zelf vormt het struikelblok niet. Het aan te sluiten apparaat zal meer geheugen en kracht van de processor nodig hebben. Er zal een TCP/IP-software stack op moeten om verbinding te maken.

De verborgen kosten ontstaan doordat het apparaat een veilige en betrouwbare verbinding moet kunnen onderhouden. Ook tijdens het vervoer door het ziekenhuis, waar het in stand houden van de Wi-Fi verbinding nog wel eens een uitdaging vormt. De Wi-Fi device driver vormt de kritieke schakel.

Er zijn veel drivers beschikbaar voor zowel Microsoft als Linux. Kijken we naar het operating system van medische apparaten, dan wordt de spoeling een stuk dunner. Het zelf schrijven van een driver is een kostbare en tijdrovende zaak. Als er een driver meegeleverd wordt, kiezen veel leveranciers voor Windows Embedded CE of een geïntegreerd operating system. CE is echter te groot voor medische apparatuur, die op eigen kracht moet draaien.

Een aantrekkelijk alternatief vormt het .NET Micro Framework van Microsoft. Het vraagt maar 300 KB geheugen en levert daarvoor een volledige ontwikkel- en aansturingsomgeving. De module kan zowel boven op een onderliggend operating system draaien als op een zelfstandig apparaat.

Volgens de opgaven van Microsoft heeft een typisch .Net Micro Framework apparaat een 32-bit processor zonder externe geheugenmanagementunit en 64 K random-access memory (RAM). Onder de apparaten, die momenteel worden ontwikkeld, vinden we ondermeer medische apparaten voor consumenten.

Het .NET Micro Framework is ontwikkeld om de mogelijkheden van de .NET omgeving een plek te geven in het alledaagse leven. Een volledig geïntegreerde Visual Studio interface maakt het voor apparaatontwikkelaars mogelijk om met het .NET-gereedschap op de desktop, systemen te ontwikkelen. Deze kunnen vervolgens worden overgezet op reguliere apparaten. Met versie 3.0 kunnen apparaten gebruik maken van meerdere faciliteiten die een veilige verbinding mogelijk maken. Midden 2009 zullen deze mogelijkheden ook WiFi omvatten, meer specifiek 802.11 a/b/g.