scholarly journals A Composite and Wearable Sensor Kit for Location-Aware Healthcare Monitoring and Real-Time Trauma Scoring for Survival Prediction

2018 ◽  
Vol 1 (3) ◽  
pp. 35 ◽  
Author(s):  
Amit Walinjkar
Keyword(s):  
Signal Processing ◽  
Electronic Health Records ◽  
Real Time ◽  
Vital Signs ◽  
Physiological Parameters ◽  
Early Warning Score ◽  
Health Records ◽  
Electronic Health ◽  
Trauma Score ◽  
Trauma Scores

With the advances in the microfabrication of analogue front-end devices, and embedded and signal processing technology, it has now become possible to devise miniaturized health monitoring kits for non-invasive real time monitoring at any location. The current commonly available kits only measure singleton physiological parameters, and a composite analysis that covers all vital signs and trauma scores seems to be missing with these kits. The research aims at using vital signs and other physiological parameters to calculate trauma scores National Early Warning Score (NEWS), Revised Trauma Score (RTS), Trauma Score - Injury Severity Score (TRISS) and Prediction of survival (Ps), and to log the trauma event to electronic health records using standard coding schemes. The signal processing algorithms were implemented in MATLAB and could be ported to TI AM335x using MATLAB/Embedded Coder. Motion artefacts were removed using a level ‘5’ stationary wavelet transform and a ‘sym4’ wavelet, which yielded a signal-to-noise ratio of 27.83 dB. To demonstrate the operation of the device, an existing Physionet, MIMIC II Numerics dataset was used to calculate NEWS and RTS scores, and to generate the correlation and regression models for a clinical class of patients with respiratory failure and admitted to Intensive Care Unit (ICU). Parameters such as age, heart rate, Systolic Blood Pressure (SysBP), respiratory rate, and Oxygen Saturation (SpO2) as predictors to Ps, showed significant positive regressions of 93% at p < 0.001. The NEWS and RTS scores showed no significant correlation (r = 0.25, p < 0.001) amongst themselves; however, the NEWS and RTS together showed significant correlations with Ps (blunt) (r = 0.70, p < 0.001). RTS and Ps (blunt) scores showed some correlations (r = 0.63, p < 0.001), and the NEWS score showed significant correlation (r = 0.79, p < 0.001) with Ps (blunt) scores. Global Positioning System (GPS) system was built into the kit to locate the individual and to calculate the shortest path to the nearest healthcare center using the Quantum Geographical Information System (QGIS) Network Analysis tool. The physiological parameters from the sensors, along with the calculated trauma scores, were encoded according to a standard Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT) coding system, and the trauma information was logged to electronic health records using Fast Health Interoperability Resources (FHIR) servers. The FHIR servers provided interoperable web services to log the trauma event information in real time and to prepare for medical emergencies.

scholarly journals Real-time clinician text feeds from electronic health records

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
James T. H. Teo ◽  
Vlad Dinu ◽  
William Bernal ◽  
Phil Davidson ◽  
Vitaliy Oliynyk ◽  
...  
Keyword(s):  
Social Media ◽  
Electronic Health Records ◽  
Real Time ◽  
Capacity Planning ◽  
Low Cost ◽  
Disease Outbreaks ◽  
Record System ◽  
Health Records ◽  
Keywords And Phrases ◽  
Electronic Health

AbstractAnalyses of search engine and social media feeds have been attempted for infectious disease outbreaks, but have been found to be susceptible to artefactual distortions from health scares or keyword spamming in social media or the public internet. We describe an approach using real-time aggregation of keywords and phrases of freetext from real-time clinician-generated documentation in electronic health records to produce a customisable real-time viral pneumonia signal providing up to 4 days warning for secondary care capacity planning. This low-cost approach is open-source, is locally customisable, is not dependent on any specific electronic health record system and can provide an ensemble of signals if deployed at multiple organisational scales.

scholarly journals Secure Exchange of Medical Data Using a Novel Real-Time Biometric-Based Protection and Recognition Method

Electronics ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. 2013
Author(s):  
Shams Ud Din ◽  
Zahoor Jan ◽  
Muhammad Sajjad ◽  
Maqbool Hussain ◽  
Rahman Ali ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Real Time ◽  
Signal To Noise Ratio ◽  
Security And Privacy ◽  
The Internet ◽  
Healthcare Organizations ◽  
Health Records ◽  
Clinical Notes ◽  
Electronic Health ◽  
Value Decomposition

Security and privacy are essential requirements, and their fulfillment is considered one of the most challenging tasks for healthcare organizations to manage patient data using electronic health records. Electronic health records (clinical notes, images, and documents) become more vulnerable to breaching patients’ privacy when shared with an external organization in the current arena of the internet of medical things (IoMT). Various watermarking techniques were introduced in the medical field to secure patients’ data. Most of the existing techniques focus on an image or document’s imperceptibility without considering the watermark(logo). In this research, a novel technique of watermarking is introduced, which supersedes the shortcomings of existing approaches. It guarantees the imperceptibility of the image/document and takes care of watermark(biometric), which is further passed through a process of recognition for claiming ownership. It extracts suitable frequencies from the transform domain using specialized filters to increase the robustness level. The extracted frequencies are modified by adding the biomedical information while considering the strength factor according to the human visual system. The watermarked frequencies are further decomposed through a singular value decomposition technique to increase payload capacity up to (256 × 256). Experimental results over a variety of medical and official images demonstrate the average peak signal-to-noise ratio (PSNR 54.43), and the normal correlation (N.C.) value is 1. PSNR and N.C. of the watermark were calculated after attacks. The proposed technique is working in real-time for embedding, extraction, and recognition of biometrics over the internet, and its uses can be realized in various platforms of IoMT technologies.

scholarly journals Real-time clinician text feeds from electronic health records

2020 ◽  
Author(s):  
James Teo ◽  
Vlad Dinu ◽  
William Bernal ◽  
Phil Davidson ◽  
Vitaliy Oliynyk ◽  
...  
Keyword(s):  
Social Media ◽  
Electronic Health Records ◽  
Real Time ◽  
Capacity Planning ◽  
Low Cost ◽  
Free Text ◽  
Record System ◽  
Health Records ◽  
Keywords And Phrases ◽  
Electronic Health

AbstractAnalyses of search engine and social media feeds have been attempted for infectious disease outbreaks1, but have been found to be susceptible to artefactual distortions from health scares or keyword spamming in social media or the public internet 2–4. We describe an approach using real-time aggregation of keywords and phrases of free text from real-time clinician-generated documentation in electronic health records to produce a customisable real-time viral pneumonia signal providing up to 2 days warning for secondary care capacity planning. This low-cost approach is open-source, is locally customisable, is not dependent on any specific electronic health record system and can be deployed at multiple organisational scales.

Integration of Real-Time Electronic Health Records and Wireless Technology in a Mobile Stroke Unit

2019 ◽  
Vol 28 (9) ◽  
pp. 2530-2536 ◽  
Author(s):  
Brandi Schimpf ◽  
Kathy Deanda ◽  
David A. Severenuk ◽  
Tara M. Montgomery ◽  
Gregory D. Cooley ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Real Time ◽  
Stroke Unit ◽  
Wireless Technology ◽  
Health Records ◽  
Mobile Stroke Unit ◽  
Electronic Health

scholarly journals Electronic Health Records-Based Cardio-Oncology Registry for Care Gap Identification and Pragmatic Research: Development and Usability Study (Preprint)

2020 ◽  
Author(s):  
Alvin Chandra ◽  
Steven T Philips ◽  
Ambarish Pandey ◽  
Mujeeb Basit ◽  
Vaishnavi Kannan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Clinical Practice ◽  
Electronic Health Records ◽  
Real Time ◽  
Cancer Patients ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Health Records ◽  
Electronic Health ◽  
Cardiovascular Care

BACKGROUND Professional society guidelines are emerging for cardiovascular care in cancer patients. How effectively the cancer survivor population is screened and treated for cardiomyopathy in contemporary clinical practice remains unclear. As EHRs are now widely used in clinical practice, we tested the hypothesis whether an EHR-based cardio-oncology registry can address these questions. OBJECTIVE To develop an electronic health records (EHR)-based pragmatic cardio-oncology registry and, as proof of principle, to investigate care gaps in cardiovascular care of cancer patients. METHODS We generated programmatically a de-identified, real-time, EHR-based cardio-oncology registry from all patients in our institutional Cancer Population Registry (n=8275, 2011-2017). We investigated: 1) left ventricular ejection fraction (LVEF) assessment before and after treatment with potentially cardiotoxic agents, and 2) guideline-directed medical therapy (GDMT) for left ventricular dysfunction (LVD), defined as LVEF<50%, and symptomatic heart failure with reduced LVEF (HFrEF), defined as LVEF<50% and problem list documentation of systolic congestive heart failure or dilated cardiomyopathy. RESULTS Rapid development of an EHR-based cardio-oncology registry was feasible. Identification of tests and outcomes was similar by EHR-based cardio-oncology registry and manual chart abstraction (98% sensitivity and 92% specificity for LVD). LVEF was documented prior to initiation of cancer therapy in 20% of patients. Prevalence of post-chemotherapy LVD and HFrEF was relatively low (9% and 2.5%, respectively). Among patients with post-chemotherapy LVD or HFrEF, those referred to cardiology had significantly higher prescription of GDMT. CONCLUSIONS EHR data can efficiently populate a real-time, pragmatic cardio-oncology registry as a byproduct of clinical care for healthcare delivery investigation.

scholarly journals Caducidad de un documento escrito en handoff

2019 ◽  
Vol 11 (1) ◽  
pp. 4
Author(s):  
Estefanía Chamorro García ◽  
Inmaculada Hernández García ◽  
Ana Isabel Galve Marqués ◽  
Pilar Cabrerizo Torrente
Keyword(s):  
Electronic Health Records ◽  
Real Time ◽  
Medical Errors ◽  
Clinical Information ◽  
Health Records ◽  
Inaccurate Information ◽  
Surgical Services ◽  
Electronic Health ◽  
Impact Patient Care ◽  
Medical Teams

El “handoff” o “pase del paciente” se define como el intercambio de información clínica cuando un nuevo médico o equipo médico asume el manejo de un paciente, bien sea de forma oral o escrita. La transmisión de información (handoff) oral, es una fuente de errores de comunicación y debe mejorar para disminuir los errores y los eventos adversos. La naturaleza estática de los documentos escritos hace que rápidamente la información se desactualice aumentando el error. Los documentos de handoff electrónicos, integrados en la historia clínica se han asociado con mejoras. La impresión hace que la actualización de los datos a tiempo real sea prácticamente imposible, incrementando el riesgo de una información inexacta. El objetivo del estudio fue determinar el tiempo en el que los datos clínicos del documento escrito se vuelven imprecisos, caracterizar el tipo de imprecisiones e identificar diferencias entre los turnos de día y de noche, así como entre servicios médicos y quirúrgicos. La hipótesis afirmaba que al final del turno de noche, la mayoría de los documentos de handoff contenían al menos un error, con potencial de producir daño. Se usó el término de “vida media”. Documentando estas imprecisiones, los autores esperaron que existiera la posibilidad de actualizar los datos en la historia clínica electrónica a tiempo real, con el objetivo de mejorar la seguridad del paciente. ABSTRACT  Expiry of a handoff printed document The handoff is defined as the change of clinical information about patients for whom physicians are responsible for between doctors and medical teams, both printed and verbal. Medical errors related to poor communication remain unacceptably common. Verbal handoffs are known to be high-risk source of communication errors and it may be improved to reduce adverse events. The static nature of printed documents makes it likely that some of the information will quickly become inaccurate, increasing the potential for medical errors. Computerised handoff documents integrated with electronic health records have been associated with improvements. Printing makes real-time automatic updating impossible, and therefore, increases the potential for inaccurate information. The main goals of this study were to measure the average time to potential inaccuracy of a printed handoff, to determine the types of inaccuracy and to identify differences between day and night shifts, as well as surgical and non-surgical services. They hypothesized that by the end of an overnight call shift, most handoffs documents would contain at least one error, which had the potential to impact patient care. They used the term  “half-life”. By documenting the inaccuracies which can be expected on printed handoff documents, the authors hope to achieve a shift toward reliance on the electronic health records on screen real, real-time, with the ultimate desired result of improved patient safety.

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