Swiss Medical Informatics

Edition 2015/00

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SMI

Patientenidentifikation 2.0

Original article
Patrizia Zehnder, et. al.
Published on 10.09.2015
CS2\Cs2Journal\Domain\Model\Author:105633
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Introduction Improved medication safety and prevention of adverse drug events among hospital inpatients has many facets, such as improved ordering procedures by use of CPOE (Computerised Physician Order Entry) and CDSS (Clinical Decision Support System) functions. For this study we concentrated on the correct administration of drugs to the correct patient and performed a questionnaire study to evaluate the utilisation of patient bracelets in Swiss hospitals. Methods/Results An electronic questionnaire was distributed to 264 Swiss hospitals and answers were received from 73 institutions. Fifteen (22%) of the institutions used patient bracelets for identification, and another 10 (19%) planned to do so. Fourteen (93%) of the institutions using bracelets wrote name and birthdate on the bracelet, 11 (73%) a case identifier and 8 (53%) a patient identifier. Only six (40%) used a barcode on the patient bracelet and only one (7%) radiofrequency identification (RFID). We asked all institutions how they performed patient identification during any medical contact. Multiple answers were allowed. Sixty-eight (93.2%) of the 73 institutions used oral communication, 33 (45.2%) had additional nametags fixed to the bed, 17 (23.2%) also checked the bracelet and only 2 (2.7%) used a technical device (barcode scanner) to check identity. Among the 10 who planned to introduce patient bracelets, the rate for use of barcodes was identical (4; 40%), whereas an increased use of RFID was planned by 1 (10%). The remaining 5 (50%) will use only clear text information on the bracelets. Most institutions used patient bracelets for inpatients and most started filling out the bracelet when the patient entered the nursing station. The feedback from staff was predominantly positive, although doctors seemed to be the more sceptical. Conclusion Our results demonstrate a strong interest in the topic. When both performed and planned patient bracelet introductions are included, nearly half of Swiss hospitals will use this technology. But only one will rely on RFID and a negligent minority employ technical devices to prevent patient misidentification. Thus there is a remaining gap to bridge in order to achieve better medication safety by avoiding misidentification cases.
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Faton Shabanaj, et. al.
Published on 10.09.2015
Faton Shabanaj
+1

Background: During radiotherapy incorrect patient identification can have serious consequences. Our main goal was to develop an application that supports the radiotherapists during their workflow and to improve patient safety by the use of scanner terminals. Methods: The system development was evolutionary. Expert reviews and multiple interviews with target users were held. Results: A prototype to identify patients during their radiation therapy was made in collaboration with the Radiation Oncology Department of the University Hospital Basel. The result is a fully functional prototype that can be integrated into the existing system landscape. Conclusions: The system has been successfully implemented and evaluated positively by the customer. It could be tested in the future in a pilot study.

Daniel Borges Gonçalves, et. al.
Published on 10.09.2015
Daniel Borges Gonçalves
+4

We expect that the proposed framework and game development cycle will simplify interdisciplinary therapy game development by providing a unified platform for team members to contribute to and routinely bring state-of-the-art game technology to therapeutic games.

Bruno Alves, et. al.
Published on 10.09.2015
Bruno Alves
+4

A doctor’s job consists in making decisions in an environment of uncertainty. Certain tools and aids can help in this decision-making process, such as medical practice guidelines. When computerized, these save time and reduce error. The DiagnosticAid project aims to provide doctors with a computerized help tool for effective decision making based on medical practice guidelines developed for general medicine. Our in-depth knowledge of consulting processes has enabled us to develop a specialized tool as well as implement specially-designed test scenarios. In order to develop it, various new technologies had to be created, including a runtime environment for practice guidelines. To this end, we have developed a model, serialization, formula-based language, and runtime engine. This paper outlines in four sections the development of the different technologies.

Malic Maraachli
Published on 10.09.2015
Malic Maraachli

Authentication in companies is a recurring problem. This problem is even more crucial in the medical world where, on the one hand, we have medical confidentiality and, on the other hand, we need fast access to the patient’s records. As social media progressively infiltrate human activity, they could be a solution to this dual problem. We have developed a JAVA web application which, based on the authentication and the security inherent in these networks, allows users to authenticate themselves through media such as Facebook and Google or resorting to a key like the SuisseID. The Single Sign-On principle and the SAML standard are the drivers of the resulting authentication. Single Sign-On solves the problem of forgetting/losing multiple passwords, promoting fast and easy connection. Our application is able to authenticate a user by means of their username and password derived either from the main account of the application or from their attributes on an external account such as Facebook, previously coupled to their main account. The application can directly create an account on the basis of an external «social» account. The pairing between the social account and an account internal to our application enables the Single Sign-On mechanism which, in the medical world, will accelerate the access to patient records. Our application provides strong authentication as well as a Single Sign-On property. Its design is open to various new identity providers. An interesting future perspective.

Frederic Ehrler, et. al.
Published on 10.09.2015
Frederic Ehrler
+4

New devices redefining human/machine interactions are constantly entering the consumer market. After integrated mouse interactions and, later, tactile interactions, more changes are ongoing with the increasing popularity of devices allowing contactless interactions. This type of interaction device is particularly interesting in healthcare environments where physical contacts are prohibited. For instance, it can be used in the operating theatre to avoid contamination while surgeons manipulate medical images. Finding a new touchless interaction paradigm that allows manipulation of 3D images in space and time in a simple and efficient manner is not a simple task. We performed an explorative study to compare three different ways of interacting with the Leap Motion™, a device allowing interaction with a computer system through hand movements. Three interaction strategies have been implemented, one copying the traditional mouse interaction paradigm, one assigning a different hand gesture for each possible action and one using a single gesture but allowing switching between interaction modes. The qualitative results obtained during the debriefing and observation of three participants testing the systems revealed a clear preference for using a limited number of gestures. The next step in the process will be to link the device with a real medical imagery system and to use a medical scenario to confirm that these early findings are still valid in more realistic situations.

Thomas Hofer, et. al.
Published on 10.09.2015
Thomas Hofer
+2

Chronic diseases like those related to the cardiovascular system are among the most common causes of death worldwide, as are chronic obstructive diseases of the lung (COPD: chronic obstructive pulmonary disease). In most cases, the disease progression can be slowed down, yet there is no way to stop it. To this end, strict therapy compliance, along with the continuous monitoring of vital parameters, appears crucial. With the development of connected terminal devices and progress made in information technologies over the past years, continuous patient monitoring is now possible without requiring costly hospitalizations. In the best-case scenario, this translates into improved, or at least not deteriorated, quality of life for the patients, with only a minor impact on their daily life. The COMPASS1 (COntinuous multi-variate Monitoring of Patients Affected by chronic obstructive pulmonary diSeaSe) project seeks to develop a personal health system (PHS) that is capable of continuously monitoring vital parameters and compressing patient data, while ensuring interoperability and patient safety, in addition to providing prognostic information. This article presents a novel approach to combining interoperability with HL7 standards whilst simultaneously ensuring data compression via compressive sensing.

Patrick Beeler, et. al.
Published on 10.09.2015
Patrick Beeler
+2

We found that consideration of not only the drug, but also the route and the dose, had a substantial impact on the ability to predict inpatient diagnoses in real time. This has important implications: knowledge of the diagnoses early in the process may directly improve the quality of care; in addition, the present approach allows for automated pick lists displaying the most likely diagnoses, has the potential to minimise misunderstandings between healthcare professionals, to enable sophisticated CDS and to support efforts aiming to increase the completeness of problem lists.