Integrated Approach to Monitoring Integrated Approach to Monitoring Paediatric Cases at HomePaediatric Cases at Home

Malcolm Clarke - BrunelAlex Jones – Gt Ormond StRussell Jones - Chorleywood

Case Study – Single Heart VesselCase Study – Single Heart Vessel

• Congenital abnormality of single heart vessel• Rare problem• Balance pulmonary and systemic blood flow• Prone to infection• Rapid deterioration• Small number specialist centres• Large distance to travel for review and management• Occupy valuable bed• Separation of family• Greater survival rate and longevity

Case Study – Single Heart VesselCase Study – Single Heart Vessel

• Desire to release from hospital but need safe environment at home• Frequent checks

– Nurse calls– Time consuming– Lack of objective information for management– Can be delay in recognising deterioration– Not pro-active

ApproachApproach

• Single platform– Extensible – add sensors for changing conditions and issues– Platform “grows” with child – change the sensor with age

• Inexpensive– Based on ubiquitous platform not bespoke– Deploy on wide scale – large number of conditions not specialist– Advantage of scale for cost and experience of use

• Simple to use– Not all families familiar with technology– Don’t add to complications of the family– Do not burden busy family– Optional aspects that “add value”

Telecare

Semantic interoperability

Functional interoperability

Telehealth Home controls

Protocol interoperability

Physical co-existence

Inter-related standardsInter-related standards

ApproachApproach

• Base on standards - IEEE 11073 • Apply guidelines – e.g. Continua Alliance• Support interoperability beyond immediate environment (in home,

out of the home, in the healthcare enterprise)

Continua ArchitectureContinua Architecture

7

NFC

HealthReportingNetwork

(HRN)Interface

Personal Device(PAN/LAN/TAN)

Weight Scale

Pulse Oximeter

Independent Living Activity

Cardio / Strength

Adherence Monitor

Glucose Meter

Pulse /Blood Pressure

Thermometer

Peak Flow

ApplicationHostingDevice

DeviceConnectivity

WideArea

Network(WAN)

Interface

WANDevice

HRN Device

EHR

PHR

NHIN

CCD

PCD 01

WaterGas

TemperatureFall

Low Energy

Integrated platformIntegrated platform

Simple home Simple home useuse

Home sensorsHome sensors

Clinician viewClinician view

Family viewFamily view

System investigatedSystem investigated

• SECA Model 336– Inexpensive base model– Internal connection for modules– Can be supplied with wireless USB and SECA proprietary protocol– Modified to take IEEE 11073 module using -10415 Standard Weighing

Scale• Nonin SpO2 Module and paediatric probe (not compatible with adult)

– IEEE 11073-10404• (Also investigate TaiDoc TD8201 Hand Held with paediatric probe)

ProgressProgress

• Proof of concept meetings with staff• Internal validation of sensors

What benefitsWhat benefits

1. Extensible range of devices

2. Single system for all patients3. Protect investment

– devices compatible and re-usable– lower cost

4. Modularise the system (common interfaces)a) Niche sensorsb) Specialist providers of system componentsc) Extend range of devices availabled) Improved system functionalitye) Competition from different device manufacturersf) Lower cost

5. Increased scalea) Can be used on patients with more prevalent diseasesb) System cost spread over more usersc) Lower cost

Innovative applicationsInnovative applications

1. Cardiac patients2. Many types of patients3. Extension to other centres

4. Instant install (by the patient)- Early discharge

- Reduce cost

5. System grows with need- Can support mother and child

- E.g. Pre-eclampsia (device can be mapped to patient)

Innovative applicationsInnovative applications

Malcolm Clarke

Department of Computer Science

Brunel University

malcolm.clarke@brunel.ac.uk

Thank YouThank You