Ebola Tracker app

Developer Bryan Ratledge claims his Ebola Tracker app is the only up to date mapping application of the 2014 Ebola virus disease outbreak centred in West Africa. With this app, you track the Ebola outbreak just as you would track a hurricane, or the weather.

Application of Barcoding to Reduce Error of Patient Identification and to Increase Patient's Information Confidentiality of Test Tube Labelling in a Psychiatric Teaching Hospital

Learning from the experience of another medical center in Taiwan, Kaohsiung Municipal Kai-Suan Psychiatric Hospital has changed the nursing informatics system step by step in the past year and a half . We considered ethics in the original idea of implementing barcodes on the test tube labels to process the identification of the psychiatric patients. The main aims of this project are to maintain the confidential information and to transport the sample effectively. The primary nurses had been using different work sheets for this project to ensure the acceptance of the new barcode system. In the past two years the errors in the blood testing process were as high as 11,000 in 14,000 events per year, resulting in wastage of resources. The actions taken by the nurses and the new barcode system implementation can improve the clinical nursing care quality, safety of the patients, and efficiency, while decreasing the cost due to the human error.

Improving Quality and Safety through Positive Patient Identification

The World Health Organization recognizes that patient misidentification can contribute to medication, surgical and charting errors. Accreditation Canada has set national standards and the Joint Commission on Accreditation of Healthcare Organizations has listed patient identification as a national patient safety goal. A qualitative and observational evaluation of patient identification practices in the Pre-Admission Clinic, Admitting Department and the Perioperative Care Center uncovered confusion, with 90% (n = 55) of patient verification occurrences not matching current policies. These discrepancies identify an opportunity to reassess and standardize workflow, clarify what identification methods are acceptable and determine additional appropriate identification verification practices with ID bracelets and patient charts.

[Management directed at preventing misidentifications by introduction of the computed identification system and blood sampling by the transfusion unit; aim for good partnership between a transfusion unit and bedsides]

The initial step of blood transfusion therapy is blood type grouping. ABO-mismatch blood transfusion results in serious adverse effects. Several incidents in the process of blood sampling had been experienced in our hospital since 2006 to 2008. Therefore, we have introduced the computed identification system, and the transfusion unit has taken a part of blood sampling. Just after we introduced it in July 2010, only 7% of the doctors and the nurses used the system in blood sampling. Repeated training programs for doctors and nurses on blood sampling procedure improved the utilization to 95%. We realized the importance of our management in face of its introduction. We have to make continuous efforts on the safety of transfusion therapy, because new type of incidents can appear.

A hybrid localization technique for patient tracking

Nowadays numerous technologies are employed for tracking patients and assets in hospitals or nursing homes. Each of them has advantages and drawbacks. For example, WiFi localization has relatively good accuracy but cannot be used in case of power outage or in the areas with poor WiFi coverage. Magnetometer positioning or cellular network does not have such problems but they are not as accurate as localization with WiFi. This paper describes technique that simultaneously employs different localization technologies for enhancing stability and average accuracy of localization. The proposed algorithm is based on fingerprinting method paired with data fusion and prediction algorithms for estimating the object location. The core idea of the algorithm is technology fusion using error estimation methods. For testing accuracy and performance of the algorithm testing simulation environment has been implemented. Significant accuracy improvement was showed in practical scenarios.

Towards a global IT system for personalized medicine: the Medicine Safety Code initiative

The availability of pharmacogenomic data of individual patients can significantly improve physicians' prescribing behavior, lead to a reduced incidence of adverse drug events and an improvement of effectiveness of treatment. The Medicine Safety Code (MSC) initiative is an effort to improve the ability of clinicians and patients to share pharmacogenomic data and to use it at the point of care. The MSC is a standardized two-dimensional barcode that captures individual pharmacogenomic data. The system is backed by a web service that allows the decoding and interpretation of anonymous MSCs without requiring the installation of dedicated software. The system is based on a curated, ontology-based knowledge base representing pharmacogenomic definitions and clinical guidelines. The MSC system performed well in preliminary tests. To evaluate the system in realistic health care settings and to translate it into practical applications, the future participation of stakeholders in clinical institutions, medical researchers, pharmaceutical companies, genetic testing providers, health IT companies and health insurance organizations will be essential.

Framework for near-field-communication-based geo-localization and personalization for Android-based smartphones--application in hospital environments

Various applications using near field communication (NFC) have been developed for the medical sector. As a method of short-range wireless contact-driven data transfer, NFC is a useful tool in medicine. It can be used to transfer data such as blood pressure, control adherence to medication, or transmit in vivo data. The first proposed general framework uses NFC as a mechanism for indoor geo-localization in hospitals. NFC geo-localization is economical compared to classical concepts using indoor GPS or WLAN triangulation, and the granularity of location retrieval can be defined at a tag level. Using this framework, we facilitate the development of medical applications that require exact indoor geo-localization. Multi-user Android systems are addressed in the second framework. Using private NFC tags, users are able to carry on their personal settings for enabled applications. This eliminates the need for multiple user accounts on common Android devices, improves usability, and eases technical administration. Based on the prototypes presented here, we show a novel concept of using NFC-enabled Android devices in hospital environments.

The use of telemedicine in Italian Blood Banks: a nationwide survey

BACKGROUND

Telemedicine is defined as the use of electronic information and communication technologies to provide health care between distant people. Many activities in transfusion medicine could benefit from the application of telemedicine. To map the spread of the use of telemedicine in transfusion medicine in Italy, the Italian Society of Transfusion Medicine and Immunohaematology (SIMTI) performed a nationwide survey: the results are presented in this paper.

MATERIALS AND METHODS

A survey, dealing with different aspects of the use of telemedicine, was performed by sending a questionnaire to 280 Italian Blood Centres. The survey was designed to evaluate the diffusion of telemedicine and the features of the systems, with special attention to the systems' safety and legal adequacy. One section of the questionnaire was designed to identify the features of the systems considered essential by the respondents.

RESULTS

Out of 280 Blood Services contacted, 196 (70%) filled in at least one of the questions of the online questionnaire. Globally the use of some form of telemedicine was reported by 70% of the respondents. Telemedicine is used for remote validation of laboratory tests by 32% of the Centres that responded, for remote biological validation of blood units by 34% and for assignment of blood components by 29%. Less frequently, telemedicine is used to control electronic refrigerators, for electronic blood requests and for bed-side identification of patients.

DISCUSSION

The use of telemedicine is widespread in Italian Blood Services. There appears to be some heterogeneity between structures with regards to the evaluation of the systems' safety and their legal adequacy. No telemedicine system should be introduced into practice until it has proven to have the same standards of safety as the corresponding "on site" activity.

An improved algorithm to generate a Wi-Fi fingerprint database for indoor positioning

The major problem of Wi-Fi fingerprint-based positioning technology is the signal strength fingerprint database creation and maintenance. The significant temporal variation of received signal strength (RSS) is the main factor responsible for the positioning error. A probabilistic approach can be used, but the RSS distribution is required. The Gaussian distribution or an empirically-derived distribution (histogram) is typically used. However, these distributions are either not always correct or require a large amount of data for each reference point. Double peaks of the RSS distribution have been observed in experiments at some reference points. In this paper a new algorithm based on an improved double-peak Gaussian distribution is proposed. Kurtosis testing is used to decide if this new distribution, or the normal Gaussian distribution, should be applied. Test results show that the proposed algorithm can significantly improve the positioning accuracy, as well as reduce the workload of the off-line data training phase.

Capturing habitual, in-home gait parameter trends using an inexpensive depth camera

Results are presented for measuring the gait parameters of walking speed, stride time, and stride length of five older adults continuously, in their homes, over a four month period. The gait parameters were measured passively, using an inexpensive, environmentally mounted depth camera, the Microsoft Kinect. Research has indicated the importance of measuring a person's gait for a variety of purposes from fall risk assessment to early detection of health problems such as cognitive impairment. However, such assessments are often done infrequently and most current technologies are not suitable for continuous, long term use. For this work, a single Microsoft Kinect sensor was deployed in four apartments, containing a total of five residents. A methodology for generating trends in walking speed, stride time, and stride length based on data from identified walking sequences in the home is presented, along with trend estimates for the five participants who were monitored for this work.

[Measures to prevent patient identification errors in blood collection/physiological function testing utilizing a laboratory information system]

We constructed an integrated personal identification workflow chart using both bar code reading and an all in-one laboratory information system. The information system not only handles test data but also the information needed for patient guidance in the laboratory department. The reception terminals at the entrance, displays for patient guidance and patient identification tools at blood-sampling booths are all controlled by the information system. The number of patient identification errors was greatly reduced by the system. However, identification errors have not been abolished in the ultrasound department. After re-evaluation of the patient identification process in this department, we recognized that the major reason for the errors came from excessive identification workflow. Ordinarily, an ultrasound test requires patient identification 3 times, because 3 different systems are required during the entire test process, i.e. ultrasound modality system, laboratory information system and a system for producing reports. We are trying to connect the 3 different systems to develop a one-time identification workflow, but it is not a simple task and has not been completed yet. Utilization of the laboratory information system is effective, but is not yet perfect for patient identification. The most fundamental procedure for patient identification is to ask a person's name even today. Everyday checks in the ordinary workflow and everyone's participation in safety-management activity are important for the prevention of patient identification errors.

[Specimen misidentification in pathology laboratory: trends and measures]

Specimen misidentification in pathology laboratories may have serious consequences. Reports on the frequency of errors in pathology laboratories in Japan are rare. We reviewed near-miss and incident reports over 7 years in our laboratory, extracted those associated with misidentification, analyzed annual changes in numbers and content, and discussed the problems faced and measures taken to prevent misidentification. Of 113,447 pathological cases, 88 (0.078%) reports were associated with misidentification. Of these 88 misidentification cases, 19% occurred before and during accessioning, 16% during dissecting and sectioning, 30% during embedding, 13% during tissue cutting and slide mounting, 19% during slide submitting, and 3% during diagnosis. Two cases (2.3%) of misidentification were detected after diagnosis; however, misidentification did not appear to cause adverse effects in any patient. The frequency of events is similar to that reported in the literature; specimen misidentification was noted in 0.1-0.2% of cases in a modern pathology laboratory. Two-thirds of misidentification events occurred associated with gross specimens, similar to findings in other studies. With the introduction of new technologies that minimize the possibility of human errors (e.g., barcode reading, digital imaging of every specimen, and installation of a glass slide printer), education on medical safety, and the use of multiple safety nets (e.g., diagnosis cancelling and slide checking), errors have decreased, but have not been eliminated completely. Recording errors and reporting them to the hospital and social community, and maintaining a sustainable quality improvement system is very important to reduce errors in pathology.

Automated patient identity recognition by analysis of chest radiograph features

RATIONALE AND OBJECTIVES

The aim of this study was to develop a computerized scheme for automated identity recognition based on chest radiograph features.

MATERIALS AND METHODS

The proposed method was evaluated on a database consisting of 1000 pairs of posteroanterior chest radiographs. The method was based on six features: length of the lung field, size of the heart, area of the body, and widths of the upper, middle, and lower thoracic cage. The values for the six features were determined from a chest image, and absolute differences in feature values between the two images (feature errors) were used as indices of image similarity. The performance of the proposed method was evaluated by receiver operating characteristic (ROC) analysis. The discriminant performance was evaluated as the area Az under the ROC curve.

RESULTS

The discriminant performance Az of the feature errors for lung field length, heart size, body area, upper cage width, middle cage width, and lower cage width were 0.794 ± 0.005, 0.737 ± 0.007, 0.820 ± 0.008, 0.860 ± 0.005, 0.894 ± 0.006, and 0.873 ± 0.006, respectively. The combination of the six feature errors obtained an Az value of 0.963 ± 0.002.

CONCLUSION

The results indicate that combining the six features yields a high discriminant performance in recognizing patient identity. The method has potential usefulness for automated identity recognition to ensure that chest radiographs are associated with the correct patient.

A navigation system for the visually impaired an intelligent white cane

In this paper, we describe about a developed navigation system that supports the independent walking of the visually impaired in the indoor space. Our developed instrument consists of a navigation system and a map information system. These systems are installed on a white cane. Our navigation system can follow a colored navigation line that is set on the floor. In this system, a color sensor installed on the tip of a white cane, this sensor senses a color of navigation line and the system informs the visually impaired that he/she is walking along the navigation line by vibration. This color recognition system is controlled by a one-chip microprocessor. RFID tags and a receiver for these tags are used in the map information system. RFID tags are set on the colored navigation line. An antenna for RFID tags and a tag receiver are also installed on a white cane. The receiver receives the area information as a tag-number and notifies map information to the user by mp3 formatted pre-recorded voice. And now, we developed the direction identification technique. Using this technique, we can detect a user's walking direction. A triaxiality acceleration sensor is used in this system. Three normal subjects who were blindfolded with an eye mask were tested with our developed navigation system. All of them were able to walk along the navigation line perfectly. We think that the performance of the system is good. Therefore, our system will be extremely valuable in supporting the activities of the visually impaired.

Conformity between protocol eligibility criteria for electronic patient identification: a comparison of clinical trials

Clinical trial eligibility criteria define the target patient population for research studies. We assessed the eligibility criteria from 40 different protocols for Type II Diabetes Mellitus and depression (20 protocols each), to determine the extent to which protocol eligibility criteria were similar at three levels (test, test-value, and test-value-time clause). This was done to determine criteria that could be standardized to aid in identification of eligible patients from electronic health records. It was found that Type II Diabetes Mellitus had 36.9% similar and depression protocols had 53.1% similar at the test-value-clause level. This study demonstrates the need for more standardization of study protocol criteria as well as the associated query definitions to be run against the electronic healthcare data. Standardizing criteria based on the similar eligibility criteria between protocols will aid in patient recruitment by being able to reuse criteria and minimizing the time and money it takes to recruit patients.

Architecture and implementation for a system enabling smartphones to access smart card based healthcare records

The healthcare researchers', academics' and practitioners' interest concerning the development of Healthcare Information Systems has been on a steady rise for the last decades. Fueling this steady rise has been the healthcare professional need of quality information, in every healthcare provision incident, whenever and wherever this incident may take place. In order to address this need a truly mobile health care system is required, one that will be able to provide a healthcare provider with accurate patient-related information regardless of the time and place that healthcare is provided. In order to fulfill this role the present study proposes the architecture for a Healthcare Smartcard system, which provides authenticated healthcare professionals with remote mobile access to a Patient's Healthcare Record, through their Smartphone. Furthermore the research proceeds to develop a working prototype system.

An automated information system for families of patients in the operation room based on EMR data

When children undergo surgery, the parents waiting for them outside the room feel extreme anxiety. SNUH was a full EMR hospital. But nurses had to manually operate an electronic display board which provided information regarding the progresses of the operations. The parents had to be located in front of the board. It was a unilateral and passive system. Therefore, we were about to improve the system to provide efficient information satisfying both parents and nurses. This service, which connected to the EMR system to provide real time location of patients undergoing operations, provide information through an electronic display board outside the operating room and SMS messages. We could reduce uneasiness of patients' families, increase satisfactions, and further, not only contribute to establishing the improved service of SNUH but also lessening unnecessary duties of nurses.

Proposal of the patient location tracking and query (PLQ) of IHE integration profile for the better patient tracking

The Patient Location Tracking Query (PLQ) is the IHE integration profile in order to find the location of patient only in a hospital, not for cross-referencing between multiple hospitals. In Japan, it is common for elderly patients to consult multiple departments in one hospital visit. To find the location of patients quickly is very important for productivity and use of resources in a hospital. We analyzed the workflow of patients and defined three actors and two transactions for PLQ integration profile. In order to collect the location of patients, multiple systems must provide the location into central management system. We proposed PLQ for the better patient care in hospitals. We believe that by using this PLQ profile hospital staffs are able to utilize the resource more efficiently.

Radio Frequency Identification (RFID) in healthcare: a literature review

Creating and maintaining a safe and high-quality health care environment is of great importance for global community. New technologies and their applications can help us achieve this goal. Radio-Frequency Identification (RIFD) technology is considered one of those technologies and even today there are some interesting deployments in the health industry. As a result, this work aims to present the basic idea behind RFID solutions, problems that can be addressed with the adoption of RFID and the benefits of relative applications.

A mobile-health application to detect wandering patterns of elderly people in home environment

Wandering is a common and risky behavior in people with dementia (PWD). In this paper, we present a mobile healthcare application to detect wandering patterns in indoor settings. The application harnesses consumer electronics devices including WiFi access points and mobile phones and has been tested successfully in a home environment. Experimental results show that the mobile-health application is able to detect wandering patterns including lapping, pacing and random in real-time. Once wandering is detected, an alert message is sent using SMS (Short Message Service) to attending caregivers or physicians for further examination and timely interventions.