MedEngr
08-26-2008, 22:42
Hello,
I found this site a few days ago and immediately became excited and have been reading posts for three days. I want to do a quick introduction of myself before I ask my question. I am an engineer by education and a Certified Clinical Engineer. For those who don't know what that is I am a Biomedical and Mechanical Engineer who has specialized in designing, understanding, implementing and manging clinical technology in the clinical enviroment. I am very interested in how technology impacts the system (for better or worse). The system is everything from the enviroment, the clinicians, the patient, medical devices, supplies. A little over a year ago I founded a medical device company focusing on developing technologies which provide process management, closed loop control, safety interlocks, and device/equipment integration. Our initial product is focusing in the ICU (product launch next July), but we are beginning to research other enviroments including trauma and battlefield medicine.
I have been reading and analyzing the case studies posted on here in every moment of free time I've had over the past few days. The question I have for the post is where in your day to day activities could integrated technology improve your efficiency, patient safety?
By asking for examples of connectivity that could a) solve current clinical problems, b) improve safety or efficiency, or c) enable innovative clinical systems of the future, is the initial step in developing systems which meet the end users needs and decreasing the amount of steps required to complete the task. Assume that there are no technical, economic, legal, or regulatory obstacles to deploying a comprehensive system.
An example of a scenario is:
Current State: A 32-year-old woman had a laparoscopic cholecystectomy performed under general anesthesia. At the surgeon’s request, a plane film x-ray was shot during a cholangiogram. The anesthesiologist stopped the ventilator for the film. The x-ray technician was unable to remove the film because of its position beneath the table. The anesthesiologist attempted to help her, but found it difficult because the gears on the table had jammed. Finally, the x-ray was removed, and the surgical procedure recommenced. At some point, the anesthesiologist glanced at the EKG and noticed severe bradycardia. He realized he had never restarted the ventilator. This patient ultimately expired. (Lofsky, 2004)
Proposed State: The portable X-Ray is connected to the anesthesia machine ventilator as part of the setup and positioning. The technician is prompted to shoot the image at either inspiration or expiration per order. Once the technician is ready they X-ray machine is activated, the ventilator is then pause at either inspiration or expiration. The pause time is determined by the necessary exposure time and then the ventilation is resumed at the pre-image respiration rate.
So after this really long post my question is
What clinical challenges exist today that could be solved by utilizing integration, device to device control, automated documentation, closed loop control, etc? I am very interested in situations in the field, and trauma situations, but anywhere in the hospital enviroment works.
With all scenarios posted I will make sure the person who posts or the entire list receives feedback.
Thanks in Advance,
Tracy
I found this site a few days ago and immediately became excited and have been reading posts for three days. I want to do a quick introduction of myself before I ask my question. I am an engineer by education and a Certified Clinical Engineer. For those who don't know what that is I am a Biomedical and Mechanical Engineer who has specialized in designing, understanding, implementing and manging clinical technology in the clinical enviroment. I am very interested in how technology impacts the system (for better or worse). The system is everything from the enviroment, the clinicians, the patient, medical devices, supplies. A little over a year ago I founded a medical device company focusing on developing technologies which provide process management, closed loop control, safety interlocks, and device/equipment integration. Our initial product is focusing in the ICU (product launch next July), but we are beginning to research other enviroments including trauma and battlefield medicine.
I have been reading and analyzing the case studies posted on here in every moment of free time I've had over the past few days. The question I have for the post is where in your day to day activities could integrated technology improve your efficiency, patient safety?
By asking for examples of connectivity that could a) solve current clinical problems, b) improve safety or efficiency, or c) enable innovative clinical systems of the future, is the initial step in developing systems which meet the end users needs and decreasing the amount of steps required to complete the task. Assume that there are no technical, economic, legal, or regulatory obstacles to deploying a comprehensive system.
An example of a scenario is:
Current State: A 32-year-old woman had a laparoscopic cholecystectomy performed under general anesthesia. At the surgeon’s request, a plane film x-ray was shot during a cholangiogram. The anesthesiologist stopped the ventilator for the film. The x-ray technician was unable to remove the film because of its position beneath the table. The anesthesiologist attempted to help her, but found it difficult because the gears on the table had jammed. Finally, the x-ray was removed, and the surgical procedure recommenced. At some point, the anesthesiologist glanced at the EKG and noticed severe bradycardia. He realized he had never restarted the ventilator. This patient ultimately expired. (Lofsky, 2004)
Proposed State: The portable X-Ray is connected to the anesthesia machine ventilator as part of the setup and positioning. The technician is prompted to shoot the image at either inspiration or expiration per order. Once the technician is ready they X-ray machine is activated, the ventilator is then pause at either inspiration or expiration. The pause time is determined by the necessary exposure time and then the ventilation is resumed at the pre-image respiration rate.
So after this really long post my question is
What clinical challenges exist today that could be solved by utilizing integration, device to device control, automated documentation, closed loop control, etc? I am very interested in situations in the field, and trauma situations, but anywhere in the hospital enviroment works.
With all scenarios posted I will make sure the person who posts or the entire list receives feedback.
Thanks in Advance,
Tracy