A Distrubuted System For Accurate Use Of Drugs - Bhaskar Rudroju
- 1. A Distributed System for Accurate Use of Drugs • Bhaskar Rudroju • Dr. Michael Schukat • Peter Kidd 16th Annual Conference and Scientific Symposium Healthcare Informatics Society of Ireland Date 17 -11-11, Dublin
- 2. Outline • Introduction • Research background • Capabilities of ICT • SQUD Design & Architecture • Progress • Future work • Conclusion 16th Annual Conference and Scientific Symposium Healthcare Informatics Society of Ireland Date 17 -11-11, Dublin
- 3. Introduction • The recent advances in Information and communication technologies (ICT) are acting as catalyst for significant development in the sector of health care. • Internet enabled healthcare applications • Electronic Healthcare Records • Telemedicine • Inter-organisational collaborations • Data management • High performance computing • Consumer health informatics • m-Health • Internet based services (e-Pharmacy, e-Care) • Security 16th Annual Conference and Scientific Symposium Healthcare Informatics Society of Ireland Date 17 -11-11, Dublin
- 4. Research Background • Problems facing in hospitals • Hospital Wide Medication Management (HMM) • Personalised Medication Management (PMM) • Hospital Wide Medication Management • Use of important and costly drugs, e.g. Immunoglobinun • Lack of resources e.g. computers, Internet connection, server problems. • Personalised Medication Management • Individualised patient care • Right drug, right dose, every time 16th Annual Conference and Scientific Symposium Healthcare Informatics Society of Ireland Date 17 -11-11, Dublin
- 5. Research Background (Cont..) • Medication errors • Giving the wrong drug • Giving the wrong dose • Skipping the dose • Giving the drug by wrong route • Giving the drug at wrong rate • Giving the drug at wrong time. 16th Annual Conference and Scientific Symposium Healthcare Informatics Society of Ireland Date 17 -11-11, Dublin
- 6. Importance for Drug Dosage Levels • Over dose. • Under dose. • Low therapeutic index drugs. • Finding out optimal level. 16th Annual Conference and Scientific Symposium Healthcare Informatics Society of Ireland Date 17 -11-11, Dublin
- 7. Complexity involved in Calculating Dosage Levels • Complex • The calculation of dosage levels are complex, for e.g. Finding the creatinine clearance the formula is ((140-age)*ideal body weight)/serum creatinine. ((140+age*ideal body weight))/serum creatinine. • Multi-step • Calculate IBW, adjusted body weight, CrCl, dosage regimen. • Error prone • Even a single misplace of decimal point can lead to a major error. • Multiple Times a day • E.g. antibiotics 16th Annual Conference and Scientific Symposium Healthcare Informatics Society of Ireland Date 17 -11-11, Dublin
- 8. Capabilities of ICT • The information & communication technologies ICT capabilities can be classified into 6 categories. 16th Annual Conference and Scientific Symposium Healthcare Informatics Society of Ireland Date 17 -11-11, Dublin
- 9. Applying ICT to Drug Dosage Problems Person Process System Wrong Dose Performance Communication ICT Capabilities Standardisation Smart Phones 16th Annual Conference and Scientific Symposium Healthcare Informatics Society of Ireland Date 17 -11-11, Dublin
- 10. SQUD • SQUD stands for System Quality Use of Drugs • Formed by • IT Department of National University of Ireland, Galway and • Pharmacy Department of Galway University Hospital. • Aim/Objectives • Research on Quality use of drugs in hospital environment. • Initiated with developing applications for calculating the drug dosage levels for renal impairment medication. • These calculators must accessible from patient’s bedside and from hospital PC’s. • Capable of sending instant messages to pharmacy staff. • Transparent validation. • Reliable. 16th Annual Conference and Scientific Symposium Healthcare Informatics Society of Ireland Date 17 -11-11, Dublin
- 11. System Design of SQUD 1. Design drug dosage calculator for clinicians 2. Design framework for pharmacy administrator to generate drug dosage regimens 3. Implement the calculator on multiple platforms like PDA’s, mobile phones and on computers 16th Annual Conference and Scientific Symposium Healthcare Informatics Society of Ireland Date 17 -11-11, Dublin
- 12. System Architecture 16th Annual Conference and Scientific Symposium Healthcare Informatics Society of Ireland Date 17 -11-11, Dublin
- 13. System Architecture (Cont..) 1. The pharmacy administrator can login into the application anywhere via Internet and can create, validate, update and delete the drug protocols. 2. The created drug protocols will be saved in the webserver. 3. Clinicians can login into the application anywhere via the Internet and can access the calculator or view the patient or download the installation file for the mobile phones. 16th Annual Conference and Scientific Symposium Healthcare Informatics Society of Ireland Date 17 -11-11, Dublin
- 14. System Architecture (Cont..) 4. The downloaded installation files can be installed on the clinician mobile phones and access the application. 5. Clinicians can access the application on the smart phones by downloading the application on their devices. 6. Smart phones which are enabled with Wi-Fi or GPRS can login into the application via Internet. 16th Annual Conference and Scientific Symposium Healthcare Informatics Society of Ireland Date 17 -11-11, Dublin
- 15. Progress • The web application is deployed in an Ireland server, the application can be accessed by the url: www.squd.eu • Clinicians are registering into the application and accessing it. • The framework can be accessed/used by • Java enabled mobile phones. • Smart phones with internet connection • Stationary hospital PCs 16th Annual Conference and Scientific Symposium Healthcare Informatics Society of Ireland Date 17 -11-11, Dublin
- 17. www.squd.eu Clinician page 16th Annual Conference and Scientific Symposium Healthcare Informatics Society of Ireland Date 17 -11-11, Dublin
- 18. Mobile Version 16th Annual Conference and Scientific Symposium Healthcare Informatics Society of Ireland Date 17 -11-11, Dublin
- 19. Future Work • Broaden / extending the technology • to assist other dosing related problems such as those found in new-born babies, cancer patients, ICU patients, etc. • “drug-regime editor” • Security / authenticity • Deployment on other mobile device types (e.g. Android etc.) • Improved system integration (HIS connectivity, adaptive workflow integration) • Start looking into HMM aspects • to collect usage data on high priority (expensive) drugs like intravenous immunoglobulin. 16th Annual Conference and Scientific Symposium Healthcare Informatics Society of Ireland Date 17 -11-11, Dublin
- 20. Conclusion • The research has shown that there is an increasing need for robust medication management systems for clinical use. • The present prototype provides this functionality over a wide range of user platforms, while providing a reliable mechanism to generate, verify and distribute dosage calculations. 16th Annual Conference and Scientific Symposium Healthcare Informatics Society of Ireland Date 17 -11-11, Dublin
- 21. Questions? Thank you for your attention 16th Annual Conference and Scientific Symposium Healthcare Informatics Society of Ireland Date 17 -11-11, Dublin
Editor's Notes
- #3: 1 minute
- #4: 1 minute, overview only (don’t refer to all applications)!
- #5: 2 minutes, important; talk about HMM and PMM!
- #6: 1 minute, overview only, as slide has a clear message
- #7: Not sure about relevance of this slide
- #8: 1 minute, refer back to slide 5, overview only
- #9: What’s the message here?
- #10: What’s the message here?
- #11: 1-2 minutes, see my comment box above
- #12: 1 minute
- #13: 2-4 minutes, incorporate next 2 slides
- #14: Provide these details with previous slide
- #15: ditto
- #16: 1-2 minutes
- #17: 3 minutes
- #18: 2 minutes, provide conclusion with your own words