Transcript Research - Vanderbilt University

Point-of-Care Bedside Bar Code Verification System
Alex
2
Stramel ,
Talbot
1,2
Hansum ,
Nicholas
1
Ryan , Jason
Whaylen², Vanessa
1,2
Luckman
Advisors: Paul King, Ph.D.1, Patrick Harris 3
1
Department of Biomedical Engineering, Vanderbilt University, Nashville, TN
2 Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, TN
3 PharmaSys Hospital Solutions, Cary, NC
Design Goals
Hardware and Software Design
System Design
Problem Statement
Hardware Data Flow
Graphical User Interface
In recent years, preventing medical errors has been a major initiative of the Food
and Drug Administration (FDA). According to a study conducted by the Institute of
Medicine, medical errors affect an estimated 1.5 million people annually, costing $1.5
billion and killing several thousands in the United States alone. A Preventable Adverse
Drug Event (PADE) is a common medical error that occurs during medication
administration. The FDA has strongly recommended a bar code system to
reduce this error using NDC (National Drug Code) bar codes on unit doses of
medicine. We worked with PharmaSys Hospital Solutions to develop a product
to address this need.
Host
Computer
PDA: mobile device
capable of barcode
scanning at the
point-of-care
Wireless Router:
creates WLAN for
communication
between PDA and
host computer
Wireless
Router
Existing Products and Cost
Competitors: Omnicell, CareFusion, Baxter Healthcare, McKesson, Cerner
Bridge Medical, Intellidot Corporation
Cost Example:
- St. Clair Hospital (Pittsburgh, PA), using Veriscan
- 15646 annual hospital admissions
- 0.63 PADEs in 100 admissions; 98.57 PADEs per year
- Average $6400 per prevention
Savings: $630,000/year
Potential Market Growth
Market Considerations:
- 2.4 million registered nurses in 7,000 hospitals in the United States
- Largest Annual Growth Rate (5.12%) in medium hospitals which have 50-250
beds
- Market goal: To find one potential customer at a medium hospital to
implement system
Our System Advantage:
We offer a user-friendly interface and have an organizational flow that will
decrease the amount of time that a nurse spends filling out forms and enhances
patient safety. In addition, the FDA mandate for drug validation will ensure the
need for these sorts of systems in hospitals.
Drug
Database
Staff
Database
Handheld
PDA
Barcode
Printer
Product Description (eMEDS)
We created a system called eMEDS that works by scanning the nurse’s bar code
on his/her identification badge, the bar code on the wrist band of the patient, and the
bar code of the medication. If there is a conflict, the system will visually alert the
nurse and drug administration will not be allowed. If all three scans check out, the
system will save the following information:
Example:
-Date/Time
- Size and # of Units
- Nurse’s Name
- Dose # of Total
Objectives:
“Please administer drug” “Mismatch: No drug administration”
- Reflect the needs and constraints of the current hospital environment and
consider pharmacists, nurses, and hospital IT professionals when making
design decisions
- Include software, hardware and other digitized apparatus to develop and
execute the bar code system
- Adapt to a number of hospital settings and interface with an
organization’s existing software and IT architecture
- Be HIPAA compliant and consider network security issues
- Easily adapted and intuitive for end-users
SQL
Server
Patient
Database
Host Computer:
acts as database server
as well as barcode
printing station
Barcode Printer:
creates labels with
barcodes and other
needed information
Handheld PDA
Handheld PDA Choice:
Symbol MC50
PDA Requirements:
- Alphanumeric Keypad
- Barcode Scanning
Capabilities
- Windows OS
- WLAN Capabilities
- Multicolor Display
- Speakers
PDA Considerations:
- Size of Display
- Weight and Size
- Processor and Memory
- Environmental Sealing
- Durability/Drop Specs
- Battery Life
- Cost
Symbol MC50 Specifications:
- Dimensions: 5.35 x 2.95 x .94 in.
-Weight: 6.77 oz
-Touch Panel Display: 4 x 3 in., TFT-LCD
- QWERTY 37 button keypad
- 1D Linear CMOS Scanner
- CPU: Intel®XScale 520 Mhz processor
- Memory: 64MB RAM/ 64MB ROM
- Operating System: Windows Mobile 2003
- WLAN: IEEE 802.11b
- Battery: Rechargeable Lithium Ion 3.7V
- Includes: Speakers, Microphone, SDIO Slot
- Approximately $1200
Host Computer, Router, and Barcode Label Printer
Barcode Printer Choice:
Intermec EasyCoder PC4
Barcode Printer
Requirements:
Produces quality
barcode labels
Host Computer Requirements:
- Windows based for synchronization with PDA
- Adequate memory to hold prototype databases
Host Computer Choice: HP Laptop
Our team has succeeded in the creation of a system that deters medication
administration errors at the patient bedside. With our fully functional prototype,
the next logical step is to pilot eMEDS in a small or medium-sized hospital.
Hospitals are not the only option, however. Pharmacies, nursing homes, and
small clinics would also benefit from our system. On an even simpler level,
school systems might be interested in eMEDS for ensuring student safety when
medications are administered by school nurses.
Software and Databases
Software Description:
- PDA program developed with Visual Studio and Visual Studio Emulator
- Written in C# to be compatible with Windows CE .NET operating system of the PDA
- Alternate version written in C++ using GUI layout software QT for use with windows
based PCs
Software Process Flow:
Personnel
Database
PDA
Patient
Query
Patient
Database
PDA
Drugl
Query
Drug
Database
Record of
Administration
PDA
Data
Buffer
- Incorporate patient photographs into the patient record
- Color changes to the program’s background when medication errors are
detected
- Automatic updates to the eMAR (electronic medication administration record)
- Compatibility with RFID technology
- Notification of drug administration method (i.e. pill, IV bag, syringe)
- Compatibility with multiple types of servers (Oracle, DB/2, etc.) and databases
(MS Access, SAP DB, etc.)
Conclusions and Future Direction
Wireless Router Requirements:
Capable of creating WLAN for PDA
Wireless Router Choice: Linksys Router
PDA
Personnel
Query
Possible Software Modifications
PharmaSys Hospital Solutions plans on piloting our prototype system and
expanding the functionality for hospital use. With an estimated savings of
$630,000 per year and a market growth of 5.12%, piloting eMEDS in a
medium-sized hospital yields the greatest return. Future business plans include
hiring employees with software engineering and marketing experience to take
over the product and continue working on new developments for the pilot.
These plans are currently in work and will continue into the summer and next
year. Overall, our prototype of eMEDS has created a solid foundation for future
design and development considerations.
Administration
Approval or
Rejection
Acknowledgements
We would not have succeeded without the patience, consideration and assistance of the following individuals:
Record of
Rejection
Databases:
- Currently using Microsoft SQL server to hold drug, patient, and staff databases
- PDA application must use SQL server because of limitations of C#, however PC
version can integrate with multiple types of servers
•
•
•
•
•
Charles Lankford, CEO, PharmaSys
Patrick Harris, eMEDS Product Manager, PharmaSys Hospital Solutions
Paul King, Ph.D., Vanderbilt University School of Engineering
Mark Roberts, Computer Science, Vanderbilt University
David Cochran, Manager Health Systems Network, Vanderbilt University