Slashdot Mirror
Taking Care of Mobile Patients
Roland Piquepaille writes "After a patient has been hospitalized for a surgical intervention, he usually wants to return to his normal life. But doctors would like to monitor him to be sure that the operation was successful. How can they manage this without being too intrusive? In "Health Care Monitoring of Mobile Patients," Italian researchers offer a three-layer networking solution. First, a body area sensor network would continuously record your cardiac activity or your body temperature. A second level would involve a home sensor network, including for example a PC wirelessly receiving this information. Finally, this home network would be able to alert an hospital network if needed. Right now, this whole idea is at the proof-of-concept level, but it really looks promising."
Exactly what we don't need, more high tech flim-flammery for diseases that should have been prevented. More money for antismoking, better diet, better exercise, better public health, not this kind of nonsense
But the problem is that we'll probably be using this sort of stuff on the baby boomers that have already done plenty of damage to their bodies by now. We are going to need this sort of technology because when all the boomers start getting sick, we're not going to have enough room in the hospitals to keep 'em all.
Being aware of Apollo stuff and some successive stuff this is just a natural progression. The really good thing here would be to get the patient out of the hospital and away from all of those nasty germs growing in that germ factory called a hospital. Your health gets in greater danger the closer you get to a hospital. They are really dangerous. Just to clarify I am an RN and I do know what I am talking about.
Hospitals have a risk of infection that is horrid. The problem is population density. In a 100 bed hospital your chances of catching something there in 3 days is about 10% or less. If the hospital has 500 beds it is about 50% Don't even think of those 2000 or so bed hospitals! What is worse your risk is of really nasty (Germ Warfare types etc) bugs getting to you like MRSA and Hemolytic Strep etc.
The best thing we could do for public health in the USA is to reduce the size of our hospitals dramatically. Following right behind that we should for the exact same reasons cut down on the size of our schools and especially get rid of or reduce daycares!
Now that I have stepped on all of the politically correct toes.. Mods get a life if you disagree.
Never Politically Correct ~ I prefer the facts If you don't like what I say, get a life, or comment yourself.
Expecting a patient that wants to "return to normal life" is never going to leave the house is unrealistic. Why create a home network layer for this kind of application when you can use something like Bluetooth and a GSM/GPRS cell phone to relay the information instead. This way the patient can go anywhere as long as they keep their cell phone with them and the hospital can still receive updates on the patients health. They may have to shield some of the sensetive equipment from the cell transmitter however, but that's something that they should already have looked into. The Bluetooth/GPRS combo is incredibly underrated. I bought a $30 usb bluetooth dongle for my laptop and now I have wireless internet access everywhere. Albeit not that fast but sufficient for an ssh session, or in this case, sending vital signs every couple minutes.
- Cary
--Fairfax Underground: Where Fairfax County comes out to play
But beware the cult of data, particularly as it relates to medicine.
There is a human tendency to focus on the numbers; the objective things that we can quantify and measure. Unfortunately, numbers in medicine are fuzzy... they MUST be interpreted within the context of individual patient normals, and existing illness.
Here's a great example from my own experience (Disclaimer: I am a physician who works in Emergency Services). Home blood-pressure monitoring devices are widespread now, such that many patients maintain these devices in their own homes. I sometimes see a half-dozen patients a day who present because they got a "high" number on their blood pressure machine. These people are asymptomatic, have no signs of end-organ damage, but are concerned enough about the number to come to the ER. I usually explain the phenomenon of cerebral BP autoregulation to them, and tell them that they're actually in greater danger if I aggressively lower their high blood pressure than if we gradually lower it with some medication changes. They often leave, still anxious despite the reassurance... they're worried about that number... that concrete, objective, hard piece of data to which we're all taught to lend so much weight.
This is the problem with absolute numbers... they have to be interpreted by a clinician in the context of the individual patient. Gathering the numbers is easy... it's interpreting them that's the difficult and rate-limiting step. Every student is taugh early in training to "treat the patient, not the number." It's a cliche, but it contains a kernel of hard truth; one must recognize the importance of individualized treatment and interpretation.
This system seems like it gathers lots of data... I just wonder what they're going to do to interpret it.
Even if a man chops off your hand with a sword, you still have two nice, sharp bones to stick in his eyes.
ISPs are gonna love this. Suddenly your net connection is as critical as a phone connection. People will die when the net connection goes down. Suddenly telco 99.999% uptime looks small.
Even when the ISP doesn't care about you, their lawyers care because your heirs will have an easy suit if they can prove the network was down for even 30 seconds at about the time you died.
Geeks everywhere will rejoice if this happens after "fast enough" netconnections are rolled out. Suddenly the bandwidth we want will be legally 24x7, and an effective static ip address because 30 seconds is less than how long it can take to reconnect after a dhcp lease changes.
Even if they only go to a convalescent care center, the faster they get out of the hospital and into a place that is more like a home envoronment, the better for all concerned. Hospitals are no place to try to rest and recover from anything (and I speak as an ex-Med Tech).
Being able to monitor blood pressure, temp and pulse, perhaps with a "store and send" technology, would be a big step, because the firsat sign of a complicating infection is usually shown when one or more of the three goes off the patient's usual pattern.
I can just imagine it now...
Sensor modules are located in the appropriate places - cardiac, temperature, blood oxygen level - all connected by bluetooth to the hub of your Body Sensor Suite - your cell phone. The phone stores 2 hours worth of telemetry at the maximum collection rate. It runs the input data through gates, constantly checking for pre-loaded alert triggers. If it detects a problem it can react with a variety of responses, from warning you in a kindly caretaker voice (maybe recorded messages from your 3 daughters) to take it easy, activating a medpak release, automatically connecting with your doctors office, up to sending a mayday on the 911 channel with automatic integration to the nearest EMT unit. The EMTs and your doctor receive real time sensor feeds as well as a GPS upload from your phone. Your doctor can remote activate medpaks, adjust your pacemaker, or use your phones camera to check pupil dilation. The EMTs have your complete medical history as well as treatment instructions from your doctor before they reach the scene. Your phone handshakes with the infotags embedded in the EMT's drug deliver system - verifying doses and checking for allergies.
If you don't have any problems every two hours your phone links with your PC at home. Data is downloaded. Your complete records are available to your doctor (or his Virtual Physicians Assistant) via internet. He can monitor trends and modify the alert trips and actions. These new settings are uploaded to your phone during regular updates. Lifestyle information linking time, place, and physical condition are available for diagnostic evaluation. Your phone calls you and says "you are entering the first phase of an allergic reaction, what are you touching?" Sensors are available for environmental contaminants, radiation, air quality, even electromagnetic and sonic energy. Your phone won't let you drive drunk or fall asleep at the wheel. There's a hack available that masks cannabis detection. There's a lot of hacks available - recreational, performance enhancing, popular supplements. To refill your medpaks you just insert them into the AutoScript at your favorite store - yes - hacks are available. Of course if your phone indicates you have been deviating from your doctor prescribed regimen your co-pays go up. And there is that nasty rumor about the NSA...
And of course.....it runs linex.
The other thing to remember is that people vary.
For example - I always have a bitch of a time donating blood, because I usually run a little hot - 99.2 F. That's my normal temperature - and too many health professionals forget that the original studies that determined body temp were done in Celcius, and were accurate to a degree ( have you ever wondered why 98.6 F = 37.0 C? Because the measurement was done in Celcius first, then converted).
You have to have the background data - what is normal for the patient - in order to really judge what is going on.
This is ALSO why it is SO important to NOT go doctor-shopping - the new doc won't have the accumulated data on you.
Another example - my 94 year old great-aunt has "high" blood pressure - and every doc she sees feels it is his sworn duty to lower it. Of course, when they get her BP where they want it, she is unsteady on her feet, will get dizzy standing up (postural hypotension), and will lose what little mental acuity she has (Alzheimers is a bitch!). These docs seem to forget that it is not unnatural for a 94 year old to have a higher pressure than a 30 year old!
www.eFax.com are spammers
All of us hospitalists and hospital-based docs deal with drug-resistant nosocomial infections... but I've never heard the numbers you're espousing. They're interesting if true... I'd appreciate a reference.
In my area MRSA is rampant out in the community... people walk in the door with MRSA abscesses and skin infections all the time... many of them are young people with no sick relatives who have never spent a day in a health-care facility.
Even if a man chops off your hand with a sword, you still have two nice, sharp bones to stick in his eyes.