Diatelic - An Intelligent TeleSurveillance System for

Peritoneal DialysisLaurent Romary

Minit Gupta

Loria Labs, Nancy

Context

A Tele Medicine System Need for flexibility Use of XML Perspectives

Quelle télémédecine?

Différentes perspectivesTélé-opérationTransmission d ’informations : médecin-médecinTélémédecine « publique » :

_ Rapprochement patient-médecin_ Matériel peu coûteux _ Utilisation simplifiée

Difficultés rencontrées en DP

suivi épisodique du malade (mensuelle etc.) fiche journalière de suivipas d’exploitation de ces fiches en continu isolement du malade

risques pathologiques importants=> hospitalisations fréquentes

Objectifs de Diatélic

moyenssuivi médical en temps réelprévention des accidents

finalité réduction de la morbiditéamélioration du confortéconomies de santé

Follow Up Organisation

patient Doctors

Expert System

• alertes• suivi des malades• envoi et •réception de messages

• fiches journalières• envoi et • réception de messages base de données

RTC RTC/Internet

Expérimentation en cours

Validation technologiquede Juillet 1998 à Mai 1999 après autorisation de la

CNIL

Évaluation clinique depuis juin 1999expérimentation randomisée auprès de 30 patients:

_ 15 patients équipés de Diatélic_ 15 patients formant le groupe témoin

Diatelic: Extension

Extension to other pathologies like diabetes, heart diseases, …

Interfacing with Data Acquisition Machines. Customization for each Patient. Dynamic Generation of the Interface.

Why UIML?

XML based - homogenous view Easy updation Dynamic generation - daily monitoring Swing renderer Ability to invoke methods at runtime -

Potential Devices/Flexibility

New Follow up OrganizationDiabetes

Doctors

Expert System

• Alerts• Patient’s follow up• Messages

• Daily datas• Messages

Data base& MedComp

RTC

RTC/Internet

Application

Peritoneal Dialysis

Heart Disease

The XML Based Architecture

Medical Component

Represents a single monitoring parameter, an entity, and defines its meta data.

It contains both medical and environmental information about the patient.

The « peers  » describes the method for the retrieval of the medical data.

Blood Pressure is an example entity

<medComp id="00215062000112"><name>Blood Pressure</name><state>sitting</state>...<value id="00215062000112sys" datatype="integer">

<descrip type="medical" class="clinical">systolic</descrip><bound type="max">23</bound>

</value>...

</medComp><peers>

...<retrieve idref="00215062000112sys" type="bsnQuery">

<method><name>bsnQuery</name><param datatype="char" name="BP"/><param datatype="char" name="Systolic"/><return datatype="integer"/>

</method></retrieve>...

</peers>

Dynamic Generation of the Interface

It is a three phase processPhase I: parsing the medComps file and initialising the

local data structures

Phase II: parsing the pre-written templates and filling in missing information

Phase III: the templates are combined to form a valid UIML file and the Swing renderer

invoked on it

<template name=”HelpTemplate”> <structure> 

<part class="JFrame" name="BPHelpFrame"><style>...</style><part class="JPanel" name="BPHelpMainPanel">

<style>...</style><part class="JTextArea“ name="BPHelpTextArea">

<style>...<property name="text">this is the new BP Help. Entry type is

mixed.Make of Machine is GAMBO. The scale for measuring used is mm of Hg.. Type: systemParam. Type: medical Class: clinical For value with id= 00215062000112dias the lower bound is 5. Type: medical Class: clinical</property>

</style></part>

... </structure>  <behavior>

<rule> <condition> <event class="actionPerformed" part-name="BPHelpCloseButton" /> </condition> <action> <property name="visible" part-name="BPHelpFrame"> false</property> </action> </rule></behavior></template>

Conclusion

Diatelic interface enhanced flexible, customizable separation of user interface and logic

Non standard templates - definition and parsing One to one mapping of the elements Marking the missing information

The communication with the Data Acquisition Machine

Remarks

Parsing the data enteredType definition and type checkingSimple mathematical relations like <,>,<>

Programming language control structures if-then-else, do-while

Editing parts of the interface at run time Representation of graphics oriented

interfaces and time based parameters.