media:Patient Connect Report.pdf - Health Systems Institute

CS 8803 ICU of Future
PATIENT CONNECT
Care without Distances
Asmita Karandikar (902586253)
Pradnyesh Gore (902608224)
Mandar Samant (902629532)

CS 8803 ICU Room of the Future
Patient Connect
Table Of Contents
1. Introduction………………………………………………………..2
2. Related Work……………………………………………………...3
3. Description of solution…………………………………………….4
4. Design……………………………………………………………..5
5. Implementation……………………………………………………6
6. Challenges and Opportunities...………………………………….11
7. Executive Summary……………………………………………...12
8. References………………………………………………………..13
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CS 8803 ICU Room of the Future
Patient Connect
Introduction:
The project idea came to us from our visit to the Scottish Rite children’s hospital and the
Piedmont hospital in Atlanta. After watching the ICU rooms in the hospital, it struck to us that
there were many patients who were alone in their rooms either because their family members
could not be physically present besides them all the time or because of space constraints of the
room.
Also, we read about ICU rooms and hospitals in general and it came to our attention that cameras
were being used at some places for monitoring the patients and/or for security purposes.
We decided to put such cameras to use in a very different way!
The problem domain we are addressing is patient family communication, particularly the lacks of
communication between patient and family members when family members cannot be alongside
the patient.
Family members cannot remain along patient bedside 24 Hours and this is often a case of
concern and anxiety for them because they wish to connect with their loved ones
Why do we think this problem is important? Because emotional connection between the patient
and the family members is often thought as one of the means for speedy recovery.
Every hospital has limited visiting hours to meet the patients in ICU; also there is not enough
space and furniture for family members in ICU room, which is most common reason for conflicts
between hospital staff and family members.
Family members may be out of town or may be traveling and are not in a position to see the
patient.
In some hospitals children are in ICU rooms’ right from birth for more than a year, in such cases
parents often wish to see their children even they cannot be present in the hospital
There may be case where patient is not conscious enough to start the communication with family
members e.g. patients in coma and family members may want to communicate or see patient.
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CS 8803 ICU Room of the Future
Patient Connect
Related Work:
1. Electronic ICU Monitoring Improves Patient Care, Charlotte Huff
“The analogy we use is that we are the air traffic control for ICU patients”
In the past, cameras have been traditionally used for patient monitoring which has proved
effective. However, none of the hospitals have been using cameras for family- patient
communication.
2. Effects of behavioral family management on family communication, The British Journal
of Psychiatry (2000)
“Family interventions have proved to be highly effective in preventing relapse.”
As the paper suggests, family interventions and family interactions play a major role in
the patient’s speedy recovery. Our project is centered around this and many such similar
findings.
3. Enhancing Provider-Patient-Family Communication: Theoretical, Ethical, Clinical and
Socio-cultural Considerations by Dana Gionta, PhD
“In recent years, there has been increasing awareness regarding the importance of clear
and effective communication between patients, families, and medical staff in the context
of illness and medical ethics.”
“Increasing evidence demonstrates that the family is not only affected by a loved one's
illness, but that it often plays a central role in a family member's health care, and more
specifically, in their health communication encounters with doctors and other health
providers.”
4. Some of the NICUs (Neonatal ICUs) have been using cameras that enable mothers in the
hospital wards/parents to view their child. We extend this idea to all the ICUs by
installing web cameras in all the rooms and providing interfaces to the patient and the
family members for effective communication.
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CS 8803 ICU Room of the Future
Patient Connect
Description of Solution
To establish the communication between patient and family members we are proposing simple
method of communication.
We have considered following scenarios:
Scenario 1: Patient wants to initiate communication with family members
In this scenario, patient is fully conscious and wants to see and communicate with his family
members
We have provided simple user interface to establish communication, which requires minimal
efforts.
Simple device is attached to patient’s bed using which patient can enable or disable
communication, adjust the volume, switch on/ off the camera whenever he wants.
Scenario 2: Family members initiate the communication
In this scenario, patient may not be conscious enough to start the communication with family
members.
Family members can start the communication without patient being actively involved or
accepting the communication commencement.
Family members are provided with secured interface to view the patient and start the
communication.
Family members can do this using laptops, iPADs, smart phones irrespective of their location
even if they are not physically alongside the patient.
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CS 8803 ICU Room of the Future
Patient Connect
Design:
The architecture diagram is as shown in the above figure. Web cameras are installed in every
patient’s ICU room, which is controlled by a central server managed by hospital. Family
members can access the camera using laptop, ipad or smart phone using unique URL. Patients/
Doctor/ Nurses can activate/deactivate camera in case of emergencies.
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CS 8803 ICU Room of the Future
Patient Connect
Implementation:
As shown in architecture diagram, we propose to install web camera in every patient’s room.
There is central server managed by hospital, which controls secured access to the camera and
saves the information about patient.
Family members:
Family members just have to use simple URL e.g. 128.61.125.61:8080 and patient credentials to
initiate the communication as shown in figures below.
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CS 8803 ICU Room of the Future
Patient Connect
Features:
1. Patient does not need to be actively involved in communication establishment.
2. Family members can view the patient using their ipads, laptops smart phones irrespective
of their location, so they can use the feature even if they are travelling.
3. Family members need secured password to establish communication which ensures
privacy of the patient.
Patients:
Patients are provided with simple device along bedside with simple user interface using
which patient can start/stop communication; adjust volume, on/off camera. As shown in
figure below
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CS 8803 ICU Room of the Future
Patient Connect
Nurse/Hospital Staff:
At times of emergencies like surgeries, diaper changing etc nurses, doctors or the patients
themselves may want to stop the communication between the patient and family members.
Doctors can deactivate camera in case of emergency by pressing STOP button.
Nurses can remotely control cameras from nurse station in case of emergency. She can
activate/deactivate the cameras in ICU room as shown in figure below.
When nurse/doctors deactivate the camera, family members get notification
We make sure that this does not cause further anxiety among patients by displaying a “Web
camera not available” screen at the family member’s end rather than just disconnecting the
camera from the family member’s end.
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CS 8803 ICU Room of the Future
Patient Connect
Privacy:
In cases like these, the question of privacy arises. There may be times when the patient may
not want to reveal all the information such as his condition, the disease he is suffering from
etc.
He is entitled to keep his information private and not disclose this to anyone.
In such cases, we respect his right to withhold this information and keep this information
private by not displaying it in the patient information in the family interface that we provide.
We tie up the right to view/not view the private information with the login credentials.
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CS 8803 ICU Room of the Future
Patient Connect
Depending upon the login credentials, the family members/friends are either shown or not
shown this information
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CS 8803 ICU Room of the Future
Patient Connect
Challenges and Opportunities
• We propose to further work with the nurse control system. We initially said that a nurse
control interface would be provided to take care of emergency situations. However, there
may be times when a nurse is not always present at the nurse station. In such situations,
we propose to introduce timers in the nurse control system which will automatically shut
down the cameras after a stipulated time in case the nurse is not around to do that herself.
• We have made the patient interface as simplistic as possible. We further propose to make
the interface even less complex by introducing touch gestures and integrating voice
commands with the system. The interface will be installed close to the patient’s bedside
and can be activated by mere voice commands and/or touch gestures with minimalistic
efforts on the patient end.
• The installation of web cameras in the patient room needs to be a done in a systematic
way. We need to determine an optimum way for camera placement and location so as to
have minimum interference with the existing hospital systems, routines and protocols.
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CS 8803 ICU Room of the Future
Patient Connect
Executive Summary:
The executive summary of our project is as follows:
We address the issue of the family-patient communication particularly the lack of
communication when the family members cannot be present at the bedside of the patient.
We also address the issue of the family members not being able to see the patient when the
patient himself is not conscious enough to start the communication channel.
We believe this is an important issue because emotional connection between the patient and his
loved ones is considered to be an important means for patient recovery and hence we address the
issue here.
We do this by providing a secure access to the web cameras installed in the patient’s ICU Room
via a web portal.
Since it is essentially a web portal that connects to the web cameras, the family members are able
to access it via their laptops, ipads and even smart phones and hence can be connected with their
loved ones even while traveling.
An interface is also provided to the patient at times when he is himself able to start the
communication and/or wishes to disable the communication.
We have kept this interface as simple as possible involving the least of the efforts from the
patient’s end.
We have also provided an override system interface for the nurses/hospital staff, which overrides
and disables any active communication in case of an emergency or a similar situation.
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CS 8803 ICU Room of the Future
Patient Connect
References:
• Effects of behavioral family management on family communication and patient outcomes
in schizophrenia (GRETCHEN L. HAAS, NINA R. SCHOOLER, JANINE D. FLORY)
• Family-Centered Bedside Rounds: A New Approach to Patient Care and Teaching
(Muething SE, Kotagal UR, Schoettker PJ, Gonzalez del Rey J and DeWitt TG)
• Communication with Patient’s Family , Friends Or Others involved in Patient’s care
(US department of Health and Human Services)
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