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1
Doctor’s Office Information System
May06-22 team: Adam Oberhaus
Kevin Schmidt
Srdjan Pudar
Saalini Sekar
Faculty advisor: Dr. Clive Woods
Client: Senior Design2/16/2006
May06-22 Doctor’s Office Information System 2
Agenda
Introduction Project Activities Resources & Schedules Closing Material
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Definitions
EMR: Electronic medical record IVR: Interactive voice response RFID: Radio frequency identification SQL: Structured query language GUI: Graphical user interface
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Problem Statement
Medical patients often miss or forget crucial information during/after doctor visits.
This information should be presented to the patients in another manner or presented again so the patients are more likely to remember the most important information.
Any solution must be easy to use for most medical patients and should not require computer literacy.
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Solution Approach
Innovative solutions that a wide base of patients can utilize
Research current doctor-patient communication procedures
Focus on one clinic Focus further narrowed to prescription information Provide way for patients to review information outside of
doctor’s office Create easy to use kiosks where patients can print out
desired information Research feasibility and design requirements for
automated phone system
May06-22 Doctor’s Office Information System 6
Operating Environment
KioskPharmacy/drug storesControlled temperature 60˚-80˚ FHigh traffic area
Phone SystemControlled central locationControlled temperature 50˚-70˚ FPhysically accessible only to administrators
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Intended Users and Uses
Kiosk Used to review pertinent prescription information
outside of doctor’s office by nearly any patient (elderly, young adults) who picks up prescriptions from a pharmacy/drug store
Automated phone system Used to review pertinent prescription information from
home or any phone by any patient able to use a phone (non-hearing impaired).
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Assumptions
Prescription procedures will be definable and available in some manner
Access to medical software used by clinic Access to specifications which allow
interfacing the end product systems with an EMR system
Design completed by second semester EMR database will have SQL interface
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Limitations
No access to actual records Prescription bottles must remain compact Cost must be minimal for patients Quick and easy to use for patients and
doctors Access to information must be readily
available
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End Product and Deliverables
Proof of concept of stand alone kiosk using RFID tags to view prescription information
Detailed requirements and specifications for successful automated phone system with IVR
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Present Accomplishments
Familiarized with current doctor-patient communication procedures at McFarland Clinic in Ames
Familiarized with current medical information system at McFarland
Obtained RFID evaluation kit Started testing RFID reader and software
capabilities
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MilestonesTask Due % Complete
Project Plan 23-Sept-05 100
Design Report 11-Nov-05 100
Design Review 12-Dec-05 100
Poster 28-Feb-06 65
Software Development 10-Mar-06 25
Software Testing 24-Mar-06 --
Final Report 31-Mar-06 --
IRP Presentation 25-Apr-06 --
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Research Activities
Current medical information practices Electronic medical records (EMR) Barcode/RFID Comparison Automated phone systems
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Current medical information practices Interviewed Director of Medical Records
Services at McFarland Clinic in Ames, IA Paper version of entire record stored Parts of medical records stored/created electronically
(i.e. radiology, doctor’s notes) Currently researching electronic medical record
software Hoping to propose a particular solution soon Use of printed materials (i.e. brochures)
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Electronic medical records
Government support and push for electronic medical record systems within 10 years
EMR makes information sharing easier and faster than paper records
Some allow for customized print-outs EMR system could allow remote access to
records with proper authentication
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Technologies Chosen
Low-frequency RFID
Automated IVR phone system
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RFID vs. Barcode
RFID Barcodes
Does not require line of sight
Read distance limited to a few feet for some tags
Scan accuracy near 100%; not prone to peeling/tearing/etc
Easier to locate for reading (just needs to be in range of the reader)
Barcodes are line of sight technology. Scanners have to “see” the barcode to read it.
Bar code stickers may peel or tear off, making a barcode unusable
Scan accuracy near 100% for undamaged barcodes
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Automated phone systems
Researched systems offered by various companies Price ranges ($5,000+) Features (Max users, voice/keypad interaction,
customizability) Decided system would be too expensive for
senior design to purchase Requirements for implementing such a system
will be created instead
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Overall system block diagram
PhoneUser
Automated PhoneSystem
Database read interface
RFID information
PatientDatabase
Medicine InformationDatabase
User
Pharmacist
EMR Database Environment
Database Read /write
interface
Database read interface
Pharmacy RFID Reader
Pharmacy RFID Encoder
RFIDtag
RFIDtag
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Interactive voice response system
Provides a phone-based interface to the EMR database
SQL interface Ties into the same database as the RFID
solution Patient information is retrieved via key presses
or spoken word Would be purchased and then customized by
implementing team
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Interactive voice response system
Advantages Ease of use by patient Access from any phone Easy to maintain
Disadvantages Cost – roughly $10k for a basic system Authentication More difficult to use by the hearing impaired
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IVR system block diagram
Patient ID
Patient PIN Patient’s phone
Server
PatientDatabase
Medicine InformationDatabase
EMR Database Environment
Database read interface
Phone line
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RFID / touch-screen system
Reads authentication information from an RFID tag Accesses a central EMR database Presents the information to the patient via a touch-screen
interface Clinics and pharmacies equipped with these systems Terminal allows patients to print information
Images courtesy of (respectively):http://news.softpedia.com/news/RFID-between-spying-and-utility-868.shtmlhttp://www.barcoding.com/rfid/choosing_rfid_reader.shtml
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RFID / touch-screen system
Advantages: Low cost to patients Relatively simple to use Access mechanism (prescription bottle) unlikely to be lost Not time-intensive for doctors Provides anonymity to answer medical questions
Disadvantages: Pharmacy would have to purchase system Information from tag can be read only at pharmacy Some users may have trouble with the computer interface
May06-22 Doctor’s Office Information System 25
RFID tag data breakdown
Six data fields First three contain information used to access the EMR database Last three contain additional patient information to validate and
connect with EMR database All six fields encoded to maintain patient privacy This is an idealized tag breakdown which requires cost prohibitive
technology for a proof-of-concept
text
Hospital ID Patient IDSN of the pill
bottle
Patient name and address
Pill usage information
EMR database connection data
RFID tag
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RFID tag data breakdown
Similar to bank checking system: Hospital ID : Bank ID Patient ID : User account number Bottle number : Check number
Used solely to get records from the EMR database Records contain important information for the patient With proper standardization, patients could access their
records nationwide
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RFID system block diagramRFID
information
PatientDatabase
Medicine InformationDatabase
User
Pharmacist
EMR Database Environment
Database Read /write
interface
Database read interface
Pharmacy RFID Reader
Pharmacy RFID Encoder
RFIDtag
RFIDtag
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RFID evaluation kit
Donated by Texas Instruments to senior design Consists of:
RFID Reader S2000 with RS232 interface Several RFID tags RO, RW Evaluation software and manual Antenna Cables, power supply
Images courtesy of Texas Instrumentshttp://www.ti.com/rfid/docs/products/products.shtml
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Patient Access
Team-developed software that implements RFID/touch screen system
Utilizes RFID evaluation kit Windows GUI application
Simple interface Coded in .NET 2005
Straightforward GUI design Easy communication with reader board
Accessible for elderly and ill patients Color themes Large font
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Patient Access - Screenshot
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Difficulties
Problem statement was difficult to define properly Possible solution space was dependent on clarifying the
problem statement Some solutions already being researched by other
institutions and are outside the scope of the project Some solutions already considered by McFarland Clinic Solutions limited by time and background constraints Necessary resources beyond the scope of the project
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Total Personal EffortPersonal Effort (Hours)
162
148157
142
Kevin Srdjan Saalini Adam
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Financial RequirementsItem Without
LaborWith
Labor
Materials:
Poster $60 $60
RFID Kit $0 (Donated)
$0 (Donated)
Subtotal $60 $60
Labor at $10.00 per hour:
Kevin Schmidt $1,620
Saalini Sekar $1,570
Srdjan Pudar $1,480
Adam Oberhaus $1,420
Subtotal $5,990
Total $60 $6,050
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Project Schedule (Original vs. Revised)
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Closing Material
Commercialization Recommendations Risks and Risk Management Summary
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Commercialization
Need to find best solution for security issues Convince pharmacies/drug stores of need for
kiosks Gather details on EMR systems used by many
clinics Create possibility for checking from many
remote locations across the country/across the world
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Recommendations for Future Work
KioskContinue to define standard tag data fields for
use across the country with multiple hospitals/clinics
Implement encoding of RFID tags Interface with actual EMR database
Phone SystemFind best way to integrate with EMR
May06-22 Doctor’s Office Information System 38
Risks and Risk Management Loss of a team member
Solution: Tasks would be spread out appropriately between remaining members. Inadequate budget
Solution: Team members may contribute personal funds or seek outside funding. Insufficient knowledge/background
Solution: Between four team members, work can be distributed efficiently so each member has work they are comfortable doing. Much of the first semester was also dedicated to research to fill the knowledge gap.
Loss of RFID reader Solution: Team will concentrate on detailed design specifications for end products
instead of developing proof-of-concept code. Usable RFID tags contain less data than required
Solution: Include less information on tags than initially proposed (eg hospital code and patient ID only).
Can’t interface with EMR Solution: Create an emulated database to show a proof-of-concept design until
software can be interfaced with an actual EMR database.
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Closing Summary
Problem Summary Patients often miss or forget crucial medical information during/after
visits to the doctor’s office This problem is being considered already by local clinics, but the same
is not being done with prescription information Approach Used
Focus on a local hospital/clinic (McFarland Clinic) Design two end products, which together would serve a broad range of
users/patients RFID/Touch-screen Kiosk and Automated Phone System chosen
Solution Summary Products will be created that will provide patients with the information
they need, on demand, with minimal technical background or time required.
May06-22 Doctor’s Office Information System 40
Questions/comments?