1 Doctor’s Office Information System May06-22 team: Adam Oberhaus Kevin Schmidt Srdjan Pudar...

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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


Definitions

EMR: Electronic medical record IVR: Interactive voice response RFID: Radio frequency identification SQL: Structured query language GUI: Graphical user interface


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.


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


Operating Environment

KioskPharmacy/drug storesControlled temperature 60˚-80˚ FHigh traffic area

Phone SystemControlled central locationControlled temperature 50˚-70˚ FPhysically accessible only to administrators


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).


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


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


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


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


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 --


Research Activities

Current medical information practices Electronic medical records (EMR) Barcode/RFID Comparison Automated phone systems


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)


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


Technologies Chosen

Low-frequency RFID

Automated IVR phone system


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


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


Overall system block diagram

PhoneUser

Automated PhoneSystem

Database read interface

RFID information

PatientDatabase

Medicine InformationDatabase

User

Pharmacist

EMR Database Environment

Database Read /write

interface


Pharmacy RFID Reader

Pharmacy RFID Encoder

RFIDtag

RFIDtag


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


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


IVR system block diagram

Patient ID

Patient PIN Patient’s phone

Server

PatientDatabase




Phone line


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


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


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


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


RFID system block diagramRFID

information

PatientDatabase


User

Pharmacist


Database Read /write

interface


Pharmacy RFID Reader

Pharmacy RFID Encoder

RFIDtag

RFIDtag


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


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


Patient Access - Screenshot


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


Total Personal EffortPersonal Effort (Hours)

162

148157

142

Kevin Srdjan Saalini Adam


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


Project Schedule (Original vs. Revised)


Closing Material

Commercialization Recommendations Risks and Risk Management Summary


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


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


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.


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.


Questions/comments?

1 Doctor’s Office Information System May06-22 team: Adam Oberhaus Kevin Schmidt Srdjan Pudar...

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