Transcript presentation

E-ARMOR: An Online Tool to Evaluate
Polypharmacy in Elderly Persons
E-ARMOR Group
Jacob Brown – Domain Expert
Jordan Fish – Project Manager
Kajal Miyan – Facilitator
Yang Yang - Configuration Manager
PART I: OVERVIEW
Project Overview
• Motivation for project
– Many prescriptions by many Doctors
– No longer needed
– Wrong dose
• System Goals
– Evaluate prescribed medications
– Optimize prescribed medications
Overview of Features
• Given patient data…
– Compute
• Ideal Body Weight
• Creatinine Clearance
• Glomerular Filter Rate
– Assess drug impact
– Without storing data
• Limit system access
Domain Research
• Polypharmacy tools
– ARMOR
– Physician’s Desk Reference
– Mosby Drug Reference
• Formulae
– Cockcroft-Gault
– Devine formula
Risk Analysis
• Risks
– Data protection
– Result integrality
• How to mitigate risks?
– Secure Web Server
– HTTPS
– Don’t store patient data
PART II: MODEL-BASED VIEW OF
SYSTEM
Description of Use Case Diagram
• Generate Drug Report
– User enters data
• Vital Stats
• Prescriptions
• Basic Lab Panel
– System
• Computes stats of
interest
• Looks up drug data
• Reports results to user
Single Access Point
Description
of Class
Model
Proxy
Singleton
Interpreter
Behavior
Model:
Sequence
Diagrams
Exceptional
Normal
E-ARMOR State Diagram
DrugDataProxy State Diagram
Related Work
• START
– Set of rules used to determine omitted drugs in
elderly patients
• STOPP
– Set of rules used to identify inappropriate
drugs
• Both tools are non-electronic like the
ARMOR tool
Lessons Learned
• Design principles
o Client-Server
architecture
 Inherent for web application
 Central Control
o Singleton
proxy
 Easy to maintain the medication
information
 Provide access control and
uniform interfaces
Lessons Learned (cont.)
• In retrospect o Clean requirements document
o More efficient Customer
interaction for procuring
Domain Knowledge
o Time management
o Prototype can be a huge
temptation
Lessons Learned (cont.)
• Future work
o Communicate with EMRs
o Smart phone application
o Identify potentially
redundant medications
o Threshold values to
immediately notify danger
o Encrypted connection
PART III: DEMONSTRATION
Prototype: Login
• Provides Access controls
Prototype: Main Page
Prototype: Results
Video demonstration
• http://www.cse.msu.edu/~cse870/Input/SS2
010/E-ARMOR/video/demo_natural.mp4
• http://www.cse.msu.edu/~cse870/Input/SS2
010/E-ARMOR/video/demo_natural.html
Live Demonstration
• Workflow
– Login
– Enter data
– View/print results
– Logout
• http://www.cse.msu.edu/~cse870/Input/SS
2010/E-ARMOR/web/
References
•
Barry, P. J., et al. "START (screening tool to alert doctors to the right
treatment)—an evidence-based screening tool to detect prescribing
omissions in elderly patients." Age and Ageing (2007): 632-638.
•
Gallagher, Paul and Denis O'Mahony. "STOPP (Screening Tool of Older
Persons’ potentially inappropriate Prescriptions): application to acutely ill
elderly patients and comparison with Beers’ criteria." Age and Ageing (2008):
673-679.
•
Haque, Raza. "ARMOR: A Tool to Evaluate Polypharmacy in Elderly Persons."
Annals of Long-Term Care (2009): 2-6.