Hi Bear, I am coming back to our discussion about clinical data-access devices. Here, I put together some arguments from your recent e-mails and try to give my opinions. I find this discussion too important to leave. The hardware, we are discussing now, will be the hardware Care2x will/is to be designed for....
> Personally i do not like PDAs - They take too much time to interact > with. My personal preference would be a wearable computer with voice > command capability and complete access to the MIS..... .... > .....be a device that recognizes where the nurse is and asks to validate > that the nurse wants to turn their attention to the patient in that > room. > I think small, wearable computers could be built for a fraction of > current products. power - if hot swappable, may not be as hard as it > may seem. Do you happen to know such a device ? Is it already existing ? What do you mean by "hot swappable power" ? > I also suspect that the wireless lans are not as formidable > an obstacle as might seem - many hospitals already have internet access > in each workstation anway and a wireless router may be adequate within > each unit. So, than I ask you to ask a technician about reliabilty of WLAN. In general: qulaity of copnnection is rather unpredictable. I know about installations, where they had to install 5(!) or more WLAN-access points in a bureau area of not more than 100 square meters to assure for connection from every workplace. > retro-engineering this may not be that difficult in most hospitals. > after all they already have a variety of tubing, plumbing, cabling > going all over the place... Yes, but cabling is manual work, old-fashioned craftmanship. It needs careful planing and high-quality delivery . Thats why everyone likes WLAN so much... > My own particular objective would be that the amount of time nurses > spend documenting their activity should be reduced by 90 - 95% Isn't that an illusion ? A reduction of documentation time by may be 10-20%, wouldn't that be more realistic ? To my opinion, first thing to eliminate would be double/triple/+++ entering of redundant data, like patient name, birthday, etc.. and the automatic creation of patient specific documentation forms, where only the relevant data are to be entered. > to have their needs anticipated by the system and an absolute minimum > of wasted keystrokes. again - voice activated commands would be a lot > easier to handle than a device that takes two hands (or one hand and a > surface) to use... Totally agree, what efficiency is concerned. But I have my doubts about voice driven data entry what privacy is concerned. (Everyone could hear, what is entered into the system). I also doubt about technical feasibility today. Think about 2-4 nurses dictating their data simultanuosly in the same place, eventually with additional people talking in the background. I believe, that is overkill for every modern dictation system. I would rather propose paper based documentation by using OMR-forms (optical mark recognition), which would be inserted in a nearby scanner-device for automatic data acquisition. OMR systems correctly used are reliable >99%. > Generally agree. The only reservation is that locating interfaces at a > patient's bed introduces problems - the device is not available to the > nurse continuously - this means that the nurse has to be at a patient's > bedside or at the nursing station to interact with the system. It would be rather easy to have more data entry stations, may one for the patient room in general, one every 10 meters on the floor, etc.. to create quasi-continuity in availability. > means that the nurse would have to log-in and logout every time they > went to see another patient - this is definitely a problem from my > viewpoint. This could be overcome with some sort of scannable device > like a wrist ID randomly assigned when coming on duty but the need to > scan it and logout is still cumbersome... I would trust most on smart-card technology. Nurse is logged in by entering her/his card, is logged out by removing card.. Is that already too cumbersome.? > i hear you on the disaster issue - of course in disasters all hell > breaks loose and it almost doesn't matter what life was like before - > everything is awry - the system is designed for efficiency and utility As far as I know hospitals from my personal experience as M.D. there is a disaster near by every day..Additional use of a multitude of mobile devices (be it PDA are wearable) would potentiate the possibilty of "little disasters", thinking only about additional logistics as mentioned earlier. > most of the time - not all the time. definitely agree on batteries - > but the more utility the sytem provides the more power it will > demand... So, that is why I adhere to stationary solutions. You can easily attach cameras, microphones, mobile medical diagnostic devices without "hoping" for enough power.. More than that: Stationary bed side device is self-financing, it is the only solution, I am aware of, which will pay back in rael cash all investments made in IT-infrastructure in hospitals. Citing myself, explaining the business model: > > Investment in this technologies could be -to some extend- refinanced > > by selling digital content to patients (movies, MP3) and > > telecommunication services (VoIP, Internet, e-mail) etc, simply by charging them some > > amount per day...In Germany hospitals it is normal, that you pay for > > TV-rent, Phone etc..If you charge 5 Euros a day, you "earn" 1500 Euros a year (if > > bed is booked 300 days/year). > In general, and not specific to your thoughts, the most important > considerations ought to be (IMHO) how to reduce the tedium and wasted > time for nurses who must repeatedly interact with these systems dozens > if not hundreds of times each shift. 110% agree !!!! Not to forget the necessities of other personal besides nurses, first of all the doctors. Their work -at least here in Germany- consists to more than 50% of paper work, means documentation, reporting, letter writing.. Alex ------------------------------------------------------- This SF.Net email sponsored by Black Hat Briefings & Training. Attend Black Hat Briefings & Training, Las Vegas July 24-29 - digital self defense, top technical experts, no vendor pitches, unmatched networking opportunities. Visit www.blackhat.com _______________________________________________ Care2002-developers mailing list [EMAIL PROTECTED] https://lists.sourceforge.net/lists/listinfo/care2002-developers
