Safe Implementation of Embedded Software for a Portable Device Supporting Drug Administration

Poor adherence to medical regimen causes approximately 33% to 69% of medication-related hospitalizations and accounts for $100 billion in annual health care costs. In this paper we address the problem of unintentional non adherence, when patient fails to take a medication due to forgetfulness or carelessness. We present the safe approach to software implementation of a portable reminder device with enabled personalization of medical regimen. The presented prototype is designed for imatinib administration, a drug used to treat Chronic Myeloid Leukemia (CML). However, thanks to the component-based structure of the software, the method can be applied to other cases by replacing implementation of certain components

Technology Target Studies: Technology Solutions to Make Patient Care Safer and More Efficient

Presents findings on technologies that could enhance care delivery, including patient records and medication processes; features and functionality nurses require, including tracking, interoperability, and hand-held capability; and best practices

Closed loop medication administration using mobile nursing information system

Through this long journey of PhD study including a research on ‘Closed Loop Medication Administration Using Mobile Nursing Information System’ and the thesis writing, I obtained a lot of knowledge and experience about research method and writing. I really very appreciate the help of all my supervisors

M-health review: joining up healthcare in a wireless world

In recent years, there has been a huge increase in the use of information and communication technologies (ICT) to deliver health and social care. This trend is bound to continue as providers (whether public or private) strive to deliver better care to more people under conditions of severe budgetary constraint

A rapidly moving target: Conformance with e-health standards for mobile computing

The rapid adoption and evolution of mobile applications in health is posing significant challenges in terms of standards development, standards adoption, patient safety, and patient privacy. This is a complex continuum to navigate. There are many competing demands from the standards development process, to the use by clinicians and patients. In between there are compliance and conformance measures to be defined to ensure patient safety, effective use with integration into clinical workflow, and the protection of data and patient privacy involved in data collection and exchange. The result is a composite and intricate mixture of stakeholders, legislation, and policy together with national and individual perspectives. The challenges for standards development are numerous and include the cross over from traditional medical devices and mobile devices with apps, as well as harmonisation for consistent semantic terminology, and the diverse range of standards required in mobile health solutions. These issues affect the ability of conformance and compliance to be undertaken. Additionally, the need for interoperability in development of safe and secure mHealth software whilst being mindful of the implications for patient safety is vital. Conformance and compliance to established international standards is the first and, at present, the only step in meeting the mobile health challenges

A rapidly moving target: Conformance with e-health standards for mobile computing

The rapid adoption and evolution of mobile applications in health is posing significant challenges in terms of standards development, standards adoption, patient safety, and patient privacy. This is a complex continuum to navigate. There are many competing demands from the standards development process, to the use by clinicians and patients. In between there are compliance and conformance measures to be defined to ensure patient safety, effective use with integration into clinical workflow, and the protection of data and patient privacy involved in data collection and exchange. The result is a composite and intricate mixture of stakeholders, legislation, and policy together with national and individual perspectives. The challenges for standards development are numerous and include the cross over from traditional medical devices and mobile devices with apps, as well as harmonisation for consistent semantic terminology, and the diverse range of standards required in mobile health solutions. These issues affect the ability of conformance and compliance to be undertaken. Additionally, the need for interoperability in development of safe and secure mHealth software whilst being mindful of the implications for patient safety is vital. Conformance and compliance to established international standards is the first and, at present, the only step in meeting the mobile health challenges

Perioperative comparison of the agreement between a portable fingertip pulse oximeter vs. a conventional bedside pulse oximeter in adult patients (COMFORT trial)

Background: Low-cost, portable fingertip pulse oximeters are widely available to health professionals and the public. They are often not tested to ISO standards, or only undergo accuracy studies in healthy volunteers under ideal laboratory conditions. This study aims to pragmatically evaluate the agreement between one such device and a conventional bedside pulse oximeter in a clinical setting, in patients with varied comorbidities and skin pigmentations. Methods: A single-centre equipment comparison study was conducted. Simultaneous measurements were obtained in 220 patients with both a Contec CMS50D Fingertip Pulse Oximeter and a Nihon Kohden Life Scope MU-631 RK conventional bedside monitor. Peripheral oxygen saturations (SpO₂) and pulse rates were documented, and patient skin tone was recorded using the Fitzpatrick scale. Data was assessed using a Bland-Altman analysis with bias, precision and limits of agreement (LOA) calculated with 95% confidence intervals. A priori acceptability for LOA was determined to be 3%, in keeping with international standards. Results: Mean difference (therefore bias) between the conventional and fingertip oximeters for all data was -0,55% (95% CI -0,73 to -0,36%). Upper and lower limits of agreement (95% CI) were 2,16 (1,84 to 2,47) and -3,25 (-3,56 to -2,94) %. Regression analysis demonstrated worsening agreement with decreasing SpO₂. When samples were separated into “normal” (SpO₂ ≥ 93%) and “hypoxaemic” (SpO₂ < 93%) groups, the normal range displayed acceptable agreement between the two oximeters (bias -0,20 with LOA 2,20 to -2,27%), while the hypoxaemic group fell outside the study’s a priori limits. Heart rate measurements had mean difference (LOA) of -0,43 (-5,61 to 4,76) beats per minute. The study was not powered to detect difference among the skin tones, but demonstrated no trend for this parameter to alter the SpO₂ measurements. Conclusions: During normoxia, portable fingertip pulse oximeters are reliable indicators of SpO₂ and pulse rates in patients with various comorbidities in a pragmatic clinical context. However, they display worsening agreement with conventional pulse oximeters during hypoxaemia. Skin tones do not appear to adversely affect measurements