Imagine being at a hospital a few decades back. There is an emergency at the door step. Doctors and nurses are stepping in to attend the situation. There would be attenders running around assisting the doctors. Counsellors would try to calm down people associated with the affected patient. Constant real time monitoring of the status was something that was manually done by experts. Randomness and confusion prevailed.
Enter today, the word “real time” monitoring is very much possible thanks to technology. It’s the evolutionary advantage that gives us the edge to achieve more with the invisible fabric of connectivity that envelops us called the “Internet”. If we thought internet was an information bank, its brainchild Internet of things is another form of it sweeping off information from things and helping us learn what we are and we could do with data. Let’s take a look at this product, which blends real time monitoring of medical data with predictive analytics, resulting in a system that sounds like the “IIoT Predictive Maintenance” equivalent for the human body.
Need for an online saviour
India has seven doctors for every ten thousand people and data from Indian Medical Association shows the country needs more than fifty thousand critical care specialist. These shortages mean that small facilities in India’s fifty five billion private hospital market is ill equipped to provide critical care even as numbers seeking private healthcare has spiked over the years. This implies that smart concepts need to be introduced to save the situation and fill the void.
“The problem of non-availability of quality care for critical patients in rural areas prompted us to design ICU Connect and NICU connect solutions initially. During the process of our innovation we collaborated with a leading neonatal equipment manufacturing company in the world to start building solutions for ICU, NICU and neonatal care centres,” says Rajendra Kurady.
There is no doubt that the cloud technology will be on the frontier of healthcare predictions, making itself equally available to everyone. In order to get this straight to the common people, smarter systems must be designed in a cost effective manner. Analytics in healthcare is on the frontier of providing a way of predicting life threatening diseases. Millions of India’s poor patients wait for days to gain admission to public hospitals which is a fact. It is thus imaginable that the potential of connected health care solutions where people need not wait for their turns are immense.
Innovation is about reinventing the invented
Innovation is a merger of ideas and thoughts to existing technology and making it way better than it is. Monitoring of health vitals in real time may be at its infancy today but it is about to go light years ahead as we speak. The innovation we are talking about here revolves around the uberistaion of medical device data.
The product connects the vital stats of humans that require intensive care to healthcare providers via servers, enabling monitoring of the patient in real time. Unlike traditional systems that merely focus on data acquisition, monitoring and reporting, this product is able to use predictive analytics to identify an issue proactively. It uses algorithms built into the device to give preventive alerts before patient goes into crisis. Moreover, the device has a small electronics board with an HL7 conversion kit to ease the documentation process.
“We have one among the highest mortality rates for any country in the world. About 70% of infant deaths and more than half of under-five child deaths occur in the neonatal period i.e. in the first four weeks of life. Manual data capturing errors in Intensive care units (ICU) and neonatal care units (NICU) is not sufficient enough to enable accurate diagnosis and treatment due to the rapid changes in the condition of critical patients. These leads to deaths in critical care units or in NICUs. Similarly, deaths do happen to adult patients in critical care units too,” says RajendraKuradi Co-founder and Managing Director, RTWO Healthcare Solutions.
At the heart of this innovation are crisis prediction algorithms. They are being built based on variation of some of the key vital health parameters like heart rate, Temperature, Respiratory Rate and Oxygen Saturation to predict the diseases like sepsis, RDS and Asphyxia for neonates or adults. These parameters are captured from multipurpose bed side devices like baby warmers, ventilator etc. For example when hypothermia and hyperthermia strikes in patient, the is a greater risk of getting a sepsis as the patient panics while his heart rate elevates. The trending indicators that monitor these heart rate variations indicate the progress while the system takes the aid of algorithms and smartly switch itself to the next level of monitoring and observes additional parameters like Oxygen Saturations in the body. Unlike traditional systems, these trends are based on clinical protocols designed by expert neonatologists which are out for comparison by the prediction engine.
The solution also aims to solve the key pain points by potentially predicting life threatening infections based on the variation in the vital parameters. Remote consultation specialists now have access to multitude of information and complete profile of the patient while making it convenient to diagnose and delivering right care at the right time.
With Internet of things, constrains of distance, time, better predictability and manual intervention disappear. This online saviour or connected ICU’s we are talking about leverages cloud, intelligent algorithms, prediction engines and medical monitoring devices present near the patient to gather vital data while replacing a designated person providing personalised care.
Connecting these care units
Breaking the barriers of non-connectivity,ICU connect and NICU connect system leverages the power of real-time monitoring of vital health parameters leveraging Wi-Fi, Local area network (LAN) and mobile network.
The real time or historical vital stats could be viewed at nursing station, physician’s office, central monitoring station or from any distance through smart phone application. Additionally, the system can be used to program customised alerts with respective health parameters and conditions that flag up in case of deviations from set benchmark levels.Real time notifications are sent to the concerned Neonatologists and Intensivist anywhere in the world that could prevent neonates or very sick people going into crisis mode.
The ICU connect platform is built on open source technologies to control the cost of the solutions. This cloud based solution needs minimal infrastructure at minimum cost of deployment. The ICU Connect and NICU Connect Solutions comes with three main subsystems that include both hardware and software components
- Aggregator Connectivity Hub: This hardware hub will have multi ports which will connect to multiple devices. Data streams into the cloud or external with the help ofWi-Fi or LAN. The connectivity hub will also have data buffering capabilities to store required minimum data before sending it to the cloud.
- ICU and NICU Connect Server: Data aggregation from different device from is implemented in this stage. Data listening mechanism, device driver implementation, HL7 conversion and data publishing mechanism are the processes that help accumulate and process data. Algorithms for trending critical diseases are the key components of the application.
ICU and NICU Connect Client Application:The system components at this stage include real-time data broadcaster and message subscriber. Web-socket protocols are implemented for an effective browsers based readings on computer, tablet or a smartphone. At the client end, the reporting systems include plotting and charting mechanism to assist with trends and patterns which again needs expert eyes for evaluation.
Similarities and differences
Most of the competitor applications are integrated application for electronic medical record (EMR) or hospital information system (HIS) systems that requires expensive IT infrastructure making it a costly affair for its beneficiaries. ”The only solution was to use open source softwares and indigenous connectivity engines with inbuilt internal HL7 conversion engines,” says RajendraKurady.
The HL7 message helps manage medical records by transmitting new or updated documents, or by transmitting important status information and/or updates for the record. Real-time Monitoring through analytics, prediction engines combined with HL7 conversions could be viewed and analysed using any smart device. Customised alerts could be set to capture the attention of the expert or doctor and can be set by the expert himself. Crisis prediction became achievable by leveraging data from every component available on the bedside of patient such as patient monitor, ventilator, warmers and even syringe pumps. This implied that vital information could be extracted from these systems as well.
Healthy offering and Future of Critical Healthcare
As vital health data starts pouring in from the machines through wireless or wired mediums to the aggregator device, the analytics platform powered by prediction algorithm kick in to create trends and real time charts for reporting.
The statics and readings could be logged in anywhere from a stationary or a moving infrastructure which is an add-on. This approves the fact that NICU and ICU connect can be installed and connected anywhere in a cost effective manner, full-filling a healthy offering for a critically ill patient from any walk of life.
“In essence we are offering Uberization of medical device data, connecting Doctor to their critical Patient’s data via Universal critical care realtime remote monitoring system with customizable alerts and predictive algorithms, enabling Healthcare delivery beyond boundaries”, Says Dr Prasanna Ganapa, Co Founder and Head of Strategy.
Data-enabled Cloud-based health care is our future
In a never concluding note, cloud based health care is truly catching up and essentially will leverage all the computing power that there is using Internet of Things. The ICU connect platform is on a constant upgradation with respect to clinical features, aggregator models and healthcare Analytics.
SHANOSH KUMAR T A, Technology Journalist | Bengaluru, EFYGROUP