Roberto Miniati

Patients tracking and identifying inside hospital: A multilayer method to plan an RFId solution

This paper shows a method to get a patient tracking RFId solution, basing on a multilayer planning architecture. This approach is thought to guarantee that the found technical solution is as much as possible coherent to the very initial idea. Project aims, functional requirements and technical constraints are defined in order to arrive to an active RFId solution to track and identify patients inside a hospital. The article also deals with economical issues and physical design aspects. In this work its also defined a three phases process for patient tracking, that could serve as a guideline for different technical solutions to the same problem.

Heart Failure analysis Dashboard for patient's remote monitoring combining multiple artificial intelligence technologies

In this paper we describe an Heart Failure analysis Dashboard that, combined with a handy device for the automatic acquisition of a set of patients clinical parameters, allows to support telemonitoring functions. The Dashboards intelligent core is a Computer Decision Support System designed to assist the clinical decision of non-specialist caring personnel, and it is based on three functional parts: Diagnosis, Prognosis, and Follow-up management. Four Artificial Intelligence-based techniques are compared for providing diagnosis function: a Neural Network, a Support Vector Machine, a Classification Tree and a Fuzzy Expert System whose rules are produced by a Genetic Algorithm. State of the art algorithms are used to support a score-based prognosis function. The patients Follow-up is used to refine the diagnosis.

Health technology management: A database analysis as support of technology managers in hospitals

Technology management in healthcare must continually respond and adapt itself to new improvements in medical equipment. Multidisciplinary approaches which consider the interaction of different technologies, their use and user skills, are necessary in order to improve safety and quality. An easy and sustainable methodology is vital to Clinical Engineering (CE) services in healthcare organizations in order to define criteria regarding technology acquisition and replacement. This article underlines the critical aspects of technology management in hospitals by providing appropriate indicators for benchmarking CE services exclusively referring to the maintenance database from the CE department at the Careggi Hospital in Florence, Italy.

Random forest for automatic assessment of heart failure severity in a telemonitoring scenario

In this study, we describe an automatic classifier of patients with Heart Failure designed for a telemonitoring scenario, improving the results obtained in our previous works. Our previous studies showed that the technique that better processes the heart failure typical telemonitoring-parameters is the Classification Tree. We therefore decided to analyze the data with its direct evolution that is the Random Forest algorithm. The results show an improvement both in accuracy and in limiting critical errors.

Electromagnetic Interferences (EMI) from Active RFId on Critical Care Equipment

RFId is quickly becoming a pervasive technology inside hospitals. EMI on electrical medical equipment is a concern. Patient safety has to be assured by assessing the electromagnetic compatibility (EMC) between Radio Frequency Identification (RFId) equipment and electrical medical devices. This study tests the effects of an active RFId system, used to track patients, on a critical care electrical medical equipment. 16 devices in five different categories have been tested in a children’s Intensive Care Unit (ICU) and no performance modifications were observed.

An RFId Smart Container to Perform Drugs Administration Reducing Adverse Drug Events

In this work is proposed an RFId drugs container to perform a correct link between patients and their medications. The system is designed to reduce the risk of Adverse Drug Events (ADEs) in the drugs administration process. Mechanical and electronic design details are discussed. The system is based on ISO 15693 standard in order to be compatible with most of the wristbands on the market.

A Custom Decision-Support Information System for Structural and Technological Analysis in Healthcare

This paper presents a custom informative system called SACS, a software that drives Autocad to manage and analyze digital plans of hospital buildings coded on specific layers. The software maps Departments, Operative Units, Destinations of Use, healthcare technologies and environmental comforts grouping info by single rooms and homogeneous areas, giving quantitative and qualitative results. System outputs can be used by top-management as a decision-support aid to assess parameters to improve the hospital’s structure and organization.

Development of sustainable models for technology evaluation in hospital

BACKGROUND This paper reports the development of standard techniques for technology evaluation in hospital carried out at the Florence Teaching Hospital Careggi (AOUC), where, as a complex system, the technological evaluation is a strategic and essential element for the maintenance of high-quality clinical activity and maximization of available resources. OBJECTIVE The aim of this paper has been the development of a system of economically sustainable models for the implementation of HTA and HS analyses in the hospital environment as well as presenting, in addition to a valid scientific resilience, the methodological and temporary flexibility to satisfy needs of hospital decision-makers. METHODS The evaluation models call for 3 main phases: an initial analysis of the in-hospital request, a collection of data, and finally a draft of a specific, easily usable set of reports. RESULTS Three standardized and tested models of evaluation were developed, which, in relation to the objective of the request and schedule of the assignment, provide for the production of a speedy report (1-week), an intermediate report (1-month), or a extensive report typical of classical studies of hospital based HTA (1-year). It is then related to the evaluation model of the IORT (Intra-Operative Radiation Therapy) technology. DISCUSSIONS AND CONCLUSION The developed models have permitted the construction, using personnel and laboratories within the hospital, of an evaluation system reliable and responsive to the HOSPITALs temporary needs based on the HS and HTA analyses in the hospital environment. Regarding the applicable case of IORT, this has shown how in-hospital requests have been satisfied in the preset time: although it establishes expected improvements on the social effect and weight of the illness and reveals a high territorial strategic relevance, the introduction of IORT in the hospital presents some criticalities on the impact on the healthcare organization and the necessity of specific training of medical technologist personnel.

HTA decision support system for sustainable business continuity management in hospitals. The case of surgical activity at the University Hospital in Florence

BACKGROUND A fundamental element of the social and safety function of a health structure is the need to guarantee continuity of clinical activity through the continuity of technology. OBJECTIVE This paper aims to design a Decision Support System (DSS) for medical technology evaluations based on the use of Key Performance Indicators (KPI) in order to provide a multi-disciplinary valuation of a technology in a health structure. METHODS The methodology used in planning the DSS followed the following key steps: the definition of relevant KPIs, the development of a database to calculate the KPIs, the calculation of the defined KPIs and the resulting study report. Finally, the clinical and economic validation of the system was conducted though a case study of Business Continuity applied in the operating department of the Florence University Hospital AOU Careggi in Italy. RESULTS A web-based support system was designed for HTA in health structures. The case study enabled Business Continuity Management (BCM) to be implemented in a hospital department in relation to aspects of a single technology and the specific clinical process. Finally, an economic analysis of the procedure was carried out. CONCLUSIONS The system is useful for decision makers in that it precisely defines which equipment to include in the BCM procedure, using a scale analysis of the specific clinical process in which the equipment is used. In addition, the economic analysis shows how the cost of the procedure is completely covered by the indirect costs which would result from the expenses incurred from a broken device, hence showing the complete auto-sustainability of the methodology.

SEMIO: an expert system for monitoring critical hospital infrastructures

The expert system for tracking critical hospital infrastructures is able to simulate the effects cascade induced in a system of infrastructure when there are interdependencies between the different plants. This article outlines a method to obtain the connection between the facilities of a hospital - based on Input-Output Inoperability Model - and a web based software for the application of the method to the hospital, simulating a possible scenario of concurrent faults.