Transcript POC Engineering+Technology

Point of Care Engineering
and Technology — an overview
Blake W. Podaima1,2,3, Robert D. McLeod2,3
1. Virtuistix Inc., Winnipeg, Manitoba
2. TRLabs: Telecommunications Research Laboratory, Winnipeg, Manitoba
3. Department of Electrical and Computer Engineering, University of
Manitoba
Email: [email protected]; [email protected]
© B. W. Podaima, 2006
CMBEC-29
Dept. of Electrical and Computer
Engineering, University of Manitoba
CMBES 2006: June 1-3,
Vancouver, BC
Mission
• Heightened demand for improvements in Patient
Safety and Quality of Care at patient Point of Care
(POC).
• Errors and other adverse incidents are inevitable in
complex systems.
• The goal of Virtuistix is in mitigating medical errors
through the use of technology and protocols via
systems engineering.
• Specifically, Smart RFID Enabled Medical Devices.
CMBEC-29
Dept. of Electrical and Computer
Engineering, University of Manitoba
CMBES 2006: June 1-3,
Vancouver, BC
To Err is Human
• Approximately 36% of adverse drug events occur at
the patient POC while only 2% are intercepted.
• Technology can be used in conjunction with human
factors engineering to improve the accuracy and
efficiency of protocols and practice with the objective
of reducing errors.
• Systems engineering implies the use of tools such as
Failure Mode and Effects Analysis and Root Cause
Analysis (FMEA and RCA).
CMBEC-29
Dept. of Electrical and Computer
Engineering, University of Manitoba
CMBES 2006: June 1-3,
Vancouver, BC
Costs
• Estimated costs associated with adverse medical
events have been estimated to be in the billions.
–
–
–
–
–
Mortality + human suffering
Litigation
Extended stay
Complications
Adverse drug interactions
• Dissemination of Innovation: Costs of technology
adoption.
– Can we afford not to?
CMBEC-29
Dept. of Electrical and Computer
Engineering, University of Manitoba
CMBES 2006: June 1-3,
Vancouver, BC
Intervention
• Technologies play a major role in modernizing and
improving medical and health systems.
• Those being considered utilize information and
communication technology in mobile deployment:
– Hand held mobile devices (PDAs) with integrated RFID
readers; local wireless communication technologies, such as
802.11x; Wi-Fi Protected Access; ZigBee; Wireless USB;
Infrared; integrated sensor based devices; Barcodes, and
RFID tags.
• Back-end information systems are replacing much of
the paper storage and retrieval systems that still prevail
in health care today.
CMBEC-29
Dept. of Electrical and Computer
Engineering, University of Manitoba
CMBES 2006: June 1-3,
Vancouver, BC
Implementation
• The greatest benefit of an Electronic Records System,
is that relevant patient information can be readily
available to practitioners — whenever and wherever
needed. (PDAs, wireless, ERS)
• Sufficient security and standards will ensure reliable
and secure management of sensitive medical records.
(encryption, authentication, privacy)
• Security is a problem of perception — one that needs
to be addressed thoroughly and implemented properly
to be effective as Clinical Grade Networks are
developed and deployed. (properly implemented
protocols)
CMBEC-29
Dept. of Electrical and Computer
Engineering, University of Manitoba
CMBES 2006: June 1-3,
Vancouver, BC
RFID in Healthcare
• Conventional RFID technology in healthcare
– Primarily based upon identification.
– Built around inventory tracking and control.
– Extensions include pharmaceutical supply chain inventory and
tracking for medical reconciliation.
– Tied into a hospital management system, they have considerable
potential to reduce adverse drug events at the patient POC.
– This is accomplished through corroboration of the patient ID with
the drug prescribed by the physician
• “Smart” RFID Enabled Devices are new technologies
that have the potential to improve patient safety and
quality of care.
CMBEC-29
Dept. of Electrical and Computer
Engineering, University of Manitoba
CMBES 2006: June 1-3,
Vancouver, BC
Platform
Medical Compliance Platform — POC Interaction Components:
Preparation
Central Medical
Processing
Unit
Overseeing
Physician
Pharmacy
(RFID)
RFID Reader
Disposal +
Sterilization
Care Provider
Mobile PDA
RFID
Reader
Hospital
Information
System
RFID
Reader
Central Medical
Supply Unit
RFID Reader
Monitoring
Smart Medical Device
Medical
Content/
Apparatus
Patient
RFID +
Interface
(RFID)
(RFID)
CMBEC-29
Dept. of Electrical and Computer
Engineering, University of Manitoba
CMBES 2006: June 1-3,
Vancouver, BC
Smart RFID Devices
• What is Smart RFID Deployment?
• A Smart RFID enabled device and its system of
deployment include methods of identification and control
for medical compliance.
– Identification is accomplished with the aid of RFID.
– Control is enabled through a mechanism that can be
activated to prevent improper, erroneous, or unauthorized
access.
• Smart RFID enabled devices attempt to facilitate error-free
dispensing and administration (of medication and/or
medical supplies), and other clinical practices, to reduce or
prevent adverse medical events, near misses, or sentinel
events.
CMBEC-29
Dept. of Electrical and Computer
Engineering, University of Manitoba
CMBES 2006: June 1-3,
Vancouver, BC
RFID Basics
Basic RFID Near-Field Coupling and Telemetry:
Freq. Extraction /32 (423.75KHz)
Capacitor
Data (e.g. ID) 25Kbps
+
IC
De-mod
BP Filter
13.98 MHz
-
Coil
N-turns
Data (e.g. ID)
25Kbps
Modulates
(sub carrier)
Oscillating
Magnetic field Manchester Data, OOK/FSK
13.56 MHz Modulation
Capacitor
ac
Coil
M-turns Oscillating
Magnetic Field
The impedance seen by the
reader is modulated by the
load.
This is not particularly
easy to decode.
CMBEC-29
Dept. of Electrical and Computer
Engineering, University of Manitoba
CMBES 2006: June 1-3,
Vancouver, BC
Smart RFID Devices
• Incorporate an RFID enabled interface capable of
controlling access, (providing actuation, and sensor
information collection): smart medical containers,
smart pumps, smart clamps, smart valves, smart
syringes and pipettes, and smart bandages.
• The RFID tags on these devices can be either passive
or active, and the control and communication can be
derived from the interaction of an RFID reader and tag
in conjunction with the associated electronics and
overseeing medical information management system.
CMBEC-29
Dept. of Electrical and Computer
Engineering, University of Manitoba
CMBES 2006: June 1-3,
Vancouver, BC
Smart RFID Devices
Assorted Smart RFID Enabled Medical Devices:
– Smart Clamps (mechanical and electromechanical)
– Smart Valves (mechanical and electromechanical)
– Smart Syringes (mechanical and electromechanical)
CMBEC-29
Dept. of Electrical and Computer
Engineering, University of Manitoba
CMBES 2006: June 1-3,
Vancouver, BC
Smart Clamp
Smart Rotational Clamp (in-line or clam shell type — electromechanical instance):
Visual/Audio
Indicator
Motor
Drive Gear
Override
Key
Tubing
Internal Clock-wise
(Restriction)
Gear
RFID
Power Supply
Motor
Control
[Pinched Off]
CMBEC-29
RFID Enabled
Lock/Unlock
Mechanism and/or
Position Sensor
Dept. of Electrical and Computer
Engineering, University of Manitoba
CMBES 2006: June 1-3,
Vancouver, BC
Smart Clamp
Smart Roller-Actuator Clamp (electromechanical instance):
Lock/Unlock
Mechanism
and/or Position Sensor
RFID
Visual/Audio
Indicator
Linear
ActuatorMotor/Servo
Tubing
Unrestricted Flow
Cap
Power
Supply
Roller Pincer
Tubing
Restricted Flow
Top View
Override Keyhole (slot)
Override Key
Tubing
Linear
Actuator
CMBEC-29
Dept. of Electrical and Computer
Engineering, University of Manitoba
CMBES 2006: June 1-3,
Vancouver, BC
Smart Valve
Smart Stop-cock [3-port] Valve (electromechanical instance):
Port 1
Valve shown with
throughway open
Conduit
Electronics
RFID
Top
View
Port 1
Electromechanical
Cylinder Valve
[Rotary]
Override
Key
Port 3
Lock/Unlock
Mechanism
CMBEC-29
Port 3
Port 2 (into the
page) not shown
Port 2
Power
Supply
Dept. of Electrical and Computer
Engineering, University of Manitoba
CMBES 2006: June 1-3,
Vancouver, BC
Smart Valve
Smart Stop-cock [3-port, 4-way] Valve Flow Channels:
Conduit
Conduit
Flow
Flow
Conduit
Conduit
Flow
Note: Can stop
flow entirely by
offsetting the
Stop-cock to 45
degrees.
CMBEC-29
Flow
Dept. of Electrical and Computer
Engineering, University of Manitoba
CMBES 2006: June 1-3,
Vancouver, BC
Smart Valve
Smart Butterfly Valve (mechanical and electromechanical instance):
Butterfly Valve
Cut away View
Override Key
Optional
Lock/Unlock
Mechanism
Status Indicator
RFID
Electric Motor
Electronics and
Power Supply
Lock/Unlock
Mechanism
RFID
Status
Butterfly
Butterfly
Flow
Flow
Mechanical (Split View)
Butterfly Valve
Closed
CMBEC-29
Electromechanical (Split View)
Butterfly Valve
Partially Closed
Butterfly Valve
Open
Dept. of Electrical and Computer
Engineering, University of Manitoba
CMBES 2006: June 1-3,
Vancouver, BC
Smart Syringe
Smart Syringe (Fail-safe - Control Mechanism at Finger-Flange):
Finger Flange
Typical Syringe
Lock/Latch Mechanism (Grip/Release)
RFID
e.g. Keyed Stop
e.g. Friction Grip
Latch/Lock
Latch/Lock
Keyed
Plunger
Shaft
RFID
CMBEC-29
RFID
Dept. of Electrical and Computer
Engineering, University of Manitoba
CMBES 2006: June 1-3,
Vancouver, BC
Smart Syringe
Smart Syringe (Fail-safe or Operator Responsible - Rotation and Push-pull Latch
Mechanism):
Typical Syringe
Go/No-Go Indicator (Color Code)
Push/Pull or Rotate to unlock
RFID
e.g. Push to unlock
Plunger Shaft
Cross Section
e.g. Rotate to Unlock
(Lock/Latch)
Plunger
Shaft
RFID
CMBEC-29
Dept. of Electrical and Computer
Engineering, University of Manitoba
CMBES 2006: June 1-3,
Vancouver, BC
Smart Syringe
Smart Syringe (Possible Position [Resolver] Sensors):
Resistance Measurement
Shaft Encoded Wheel (Friction)
Reader
Optical Read/Write
Magnetic Strip
CMBEC-29
Encoded Grating
Dept. of Electrical and Computer
Engineering, University of Manitoba
CMBES 2006: June 1-3,
Vancouver, BC
Smart Syringe
Smart Syringe (Fail-safe - Intersticed control device):
Typical Syringe
RFID controlled valve
Typical Syringe
RFID
Standard Coupler
CMBEC-29
Dept. of Electrical and Computer
Engineering, University of Manitoba
CMBES 2006: June 1-3,
Vancouver, BC
Smart Syringe
Smart Syringe (Fail-safe - Motorized Control and Actuator Device):
Typical Syringe
RFID controlled Actuator
Motorized
Typical Syringe
Plunger
Motor
RFID
e.g.
Motor
Section Plunger Shaft
Linear Actuation
CMBEC-29
Dept. of Electrical and Computer
Engineering, University of Manitoba
CMBES 2006: June 1-3,
Vancouver, BC
Summary
• POC engineering and technology are brought to bear on the
medical community with the overall goal of improving patient
safety and quality of care.
• We ascertain the emerging field of RFID technology has the
potential to improve medical compliance via human factors
protocols and practice at the patient POC.
• Within a ubiquitous or pervasive health computing
environment, novel Smart RFID medical devices, in
conjunction with wireless PDAs, are proposed to integrate
identification, security, control, and actuation.
• Various POC embodiments along these lines are currently under
IP development and technology capture.
CMBEC-29
Dept. of Electrical and Computer
Engineering, University of Manitoba
CMBES 2006: June 1-3,
Vancouver, BC