Eric Rosow

Virtual instrumentation and real-time executive dashboards. Solutions for health care systems.

Successful organizations have the ability to measure and act on key indicators and events in real time. By leveraging the power of virtual instrumentation and open architecture standards, multidimensional executive dashboards can empower health care organizations to make better and faster data-driven decisions. This article will highlight how user-defined virtual instruments and dashboards can connect to hospital information systems (e.g., admissions/discharge/transfer systems, patient monitoring networks) and use statistical process control to “visualize” information and make timely, data-driven decisions. The case studies described will illustrate enterprisewide solutions for: bed management and census control, operational management, data mining and business intelligence applications, and clinical applications (physiological data acquisition and wound measurement and analysis).

JEDI An Executive Dashboard and Decision Support System for Lean Global Military Medical Resource and Logistics Management

Each individual U.S. Air Force, Army, and Navy Surgeon General has integrated oversight of global medical supplies and resources using the Joint Medical Asset Repository (JMAR). A Business Intelligence system called the JMAR Executive Dashboard Initiative (JEDI) was developed over a three-year period to add real-time interactive data-mining tools and executive dashboards. Medical resources can now be efficiently reallocated to military, veteran, family, or civilian purposes and inventories can be maintained at lean levels with peaks managed by interactive dashboards that reduce workload and errors

Development of a wound assessment system for quantitative chronic wound monitoring

Wound care technology is rapidly advancing, yet the treatment of wounds remains as much art as science. Much of the data currently collected on healing wounds is qualitative-varying by assessor and not easily tracked over time. The purpose of this research project is to evaluate several methods for quantitative wound assessment-wound volume, wound area, and wound coloration. By comparing various assessment parameters for the same patient population, conclusions can be drawn on which information is most useful to the clinical community and which information can be collected in a reasonable amount of time in the busy environment of the health care clinic.

Validation of a vibrotactile stimulation system to treat apnea of prematurity

Apnea is a cessation of respiration. A system that uses vibrotactile stimulation to treat apnea in neonates was modified. Traditional (hand) stimulation, where the nurse stimulates the baby by hand contact, is compared to vibrotactile stimulation (VTS). Modifications and methods of conducting the clinical study are described.

The design, development and application of a virtual instrument system to assess vibrotactile stimulation to interrupt neonatal apnea

Premature infants are susceptible to apnea. Presently physical stimulation, administered to interrupt apneic episodes, is accomplished by hand contact, which is often delayed and presents infection risks. This study developed a software system to collect and analyze data to study the efficacy and safety of mechanical vibrotactile stimulation (VTS) as a means of interrupting an apneic episode. This software system was utilized to compare VTS (n=12) and hand stimulation (n=12). VTS and traditional hand stimulation were found to be equally effective in terminating apnea (9/12 (75%) vs. 10/12 (80%)). Mean time to resumption of breathing from onset of stimulation was similar (VTS 3.1/spl plusmn/2.6 seconds vs. hand 3.7/spl plusmn/4.1 seconds, p=0.67), as was total apnea duration (VTS 28.1/spl plusmn/12.1 seconds vs. hand 28.5/spl plusmn/5.2 seconds, p=0.93). The duration of VTS was half as long as hand stimulation (VTS 2.9/spl plusmn/1.7 seconds vs. hand 6.8/spl plusmn/5.4 seconds, p=0.05). No adverse effects of VTS were noted Overall, VTS was similar to hand stimulation in its ability to end apneic spells. Since the duration of VTS was half that of hand stimulation VTS seems more efficient in interrupting apnea.

Strategic Graphic Dashboards for improved technology management decisions

This paper discusses the ongoing application of Strategic Digital Dashboard (SGD) technologies to a growing number of important medical applications. The growing number of medical data warehouses and repositories in military and civilian healthcare applications have proved challenging for useful application due to the sheer size and complexity of the knowledge-base (HighTechMaui 2002, Stratton and Dick 2002). Advances in graphical software development tools like Lab View and others has allowed development of soft-configurable display systems that simplify human interpretation in several ways. SGD development in the JMAR project will be another step in the evolution of complex medical information systems that can improve military and civilian medical supply logistics.

Clinical Engineering Department Strategic Graphical Dashboard to Enhance Maintenance Planning and Asset Management

The Clinical Engineering (a.k.a. biomedical engineering) Department has heretofore lagged in adoption of some of the leading-edge information system tools used in other industries. This present application is part of a DOD-funded SBIR grant to improve the overall management of medical technology, and describes the capabilities that strategic graphical dashboards (SGDs) can afford. This SGD is built on top of an Oracle database, and uses custom-written graphic objects like gauges, fuel tanks, and geographic information system (GIS) maps to improve and accelerate decision making

Design, implementation and validation of a graphical user interface for analysis of patient monitor event logs

With the emergence of networks and sophisticated programming languages, it has become possible over the years to accumulate and translate large amounts of data in a short time period. And as biomedical engineering departments gain more active roles in the hospital, the opportunity to use such data to improve the effectiveness and safety of patient care increases. The patient monitoring network at Hartford Hospital lends itself to data elements such as patient alarms and indicators that can be used to track a patients medical record or history. These error logs are created on GE Clinical Information Center (CIC) computers, but such logs remain there without being analyzed until there is a need to investigate suspected device malfunctions or operator errors. These data log files were previously accessed through a manual process using DOS commands to export the data from the CIC to a floppy disk for further manual analysis. Thus, with the large amounts of patient data, there is a need to create an application that allows engineers and clinicians to make better, faster data-driven decisions. The proposed developments to existing utilities provide an excellent opportunity to utilize biomedical engineering principles and skills in the clinical environment.

Integration of heterogeneous medical supplies and computerized medical maintenance management (CMMS) databases and decision support systems

This paper discusses an ongoing medical informatics and business process reengineering research project. The Joint Medical Asset Repository (JMAR) is a relational database system created to integrate very diverse medical supply and medical maintenance management information from the US military services existing heterogeneous database systems. JMAR allows strategic and tactical decision making without the cost, complexity, risk and delay of forcing military service to convert to a standard platform.

A non-invasive cardiopulmonary measurement system

This paper describes a non-invasive method for the accurate determination of cardiac output and oxygen consumption, by using a rebreathing technique. Other pulmonary function testing parameters, such as lung capacities are also evaluated in the system.