AMEDS - PMHS - part two


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AMEDS - PMHS - part two

  1. 1. AMEDS - PMHS<br />Innovation<br />for<br />Cure and Care<br />
  2. 2. AMEDS - PMHS<br />AMEDS - PMHS<br />Part two<br />
  3. 3. AMEDS - PMHS<br />In the first part a largeupcomingproblem in todayshealthcare was outlined. It is very important to view the first part beforethissecond part.<br />In thissecond part the innovationsorinventions AMEDS and PMHS willbepresented as a technicalsolutionfor the problemdiscussed in the first part.<br />
  4. 4. AMEDS - PMHS<br />In the first part of these presentationsitbecameclearthat, in order to beable to help frail, elderlypatients to taketheirmedication, a special technical system design is needed.<br />As thissytem is not a realitynow we have to inventor design it.<br />There is a differencebetweeninvention and innovation.<br />
  5. 5. AMEDS - PMHS<br />SystiMed defines four key concepts concerning innovation and invention: <br />Inventional process: a systematic and logical thinking process to create an invention.<br />Invention: a creative, new conceptual design with great beneficial potential. <br />Innovative process: a process which leads to the usage of an invention.<br />Innovation: a combination of an invention and an innovative process.<br />
  6. 6. AMEDS - PMHS<br />In case you want to know more about the different stages of innovation and invention,<br />The systemsAMEDS (AutomatedMedication Dispenser System) and PMHS (Personal Mobile Health management System) are invented and beingfurtherdevelopedby SystiMed. Patents for these systems are pending. <br />Beforegiving a detailedtechnicaldescription of the systems we have to know more about the situation in which these systemscanbeapplied.<br />
  7. 7. AMEDS - PMHS<br />The patient, the pharmacist and the prescribing MD are the peoplewho are primarilyinvolvedwith a patienttakingmedication, eachwith a specificrole:<br />Otherpeople and organizations are alsoinvolved and influencethisprimaryhealthcareprocess, but more indirect. <br />Patient<br />M D<br />Pharmacist<br />The primaryhealthcareprocesswithmedication<br />
  8. 8. AMEDS - PMHS<br />In the first part of thispresentation we have definedfourclearattributesfor the design foranappropriatetechnical system:<br />Multi-userfriendly<br />Optimalergonomic design<br />Safe<br />Reliable<br />All these attributes are important and it is important to notethat in case one of these attributes is not met, the design is of muchlessvalue, and can even considered to beuseless. <br />
  9. 9. AMEDS - PMHS<br />The basicidea of AMEDS and PMHS is the following:<br />The most tedious and difficult part in takingmedication is dispensing the medication. <br />To achieve a suitable design foradherence support forelderlyfrail, polypharmic and multimorbidpatients, the dispensing of medication, is fullyautomatedand directlyavailableat the site of the patient. <br />Untillnowdispensing of medication has been doneautomatedorby hand at the pharmacydepartment, orby hand at the location of the patient.<br />
  10. 10. AMEDS - PMHS<br />As we willseethisnewbasicidea, fullyautomated of medicationdispensing at the site of the patient, willmakeitpossible to design effectivesystemsforelderly, frailpatientswith polypharmacy and multimorbidity.<br />To achieve the design forsuchsystems we have to applytechnologiesderrivedfromseveraltechnical disciplines in the systems:<br /> Computer sciences, electronics, robotics, telecommunication, electromechanics, ergonomics and sensor technology.<br />
  11. 11. AMEDS - PMHS<br />AMEDS consists of hardware and software.<br />The hardware consists of network servers and socalled ‘dispenser units’.<br />Special medication cartridges canbeattached to the dispenser units.<br />Bymeans of the software the dispenser units and servers canbecontroled.<br />Digital data canbestoredon the server and in the memory of the dispenser unit. <br />Communicationbetween dispenser units and servers canbewired and/orwireless. <br />
  12. 12. AMEDS - PMHS<br />The AMEDS dispenser unit is a lightweighted, mobile device and consists of:<br /><ul><li>A frame
  13. 13. A computer
  14. 14. An power supply unit
  15. 15. A lockablecompartment
  16. 16. Electromotors
  17. 17. A pillcollecting system
  18. 18. A lockablechallice
  19. 19. A weightingscalefor the chalice
  20. 20. Sensors</li></li></ul><li>AMEDS - PMHS<br />The computer is fullyfunctional and has all connections, like USB, monitor, mouse, keyboard, etc. <br />The power supply unit canbeattached to the network and consists of a tranformator and an accumulator.<br />Sensors are strategicallyplaced in the dispenser unit forcontrol and safety.<br />In the lockablecompartmentmedication cartridges canbeattached to the dispenser unit. The medication cartridges containpills in special medication strips. <br />The dispenser units are able to selectivelyexpell the pillsfrom the strips to the pillcollecting system. <br />
  21. 21. AMEDS - PMHS<br />Diagram of the inner of a dispenser unit and attachedcartridge<br />
  22. 22. AMEDS - PMHS<br />Explanation of the diagram:<br />A: Electromotor<br />B+C: Rods<br />D: Gearmechanism<br />E: Bumper<br />F: Strip collectingmechanism<br />G: Medication strip<br />H: Strip lockingmechanism<br />I: Pill stamp<br />J: Strip guidingmechanism<br />K: Strip cuttingmechanism<br />L: Outlet to strip discharge container <br />M: Outlet to pillgathering system<br />
  23. 23. AMEDS - PMHS<br />Diagram of the inner of a dispenser unit and attachedcartridge<br />
  24. 24. AMEDS - PMHS<br />Furtherexplanation of diagram:<br />Sensors:<br />1+2: Electronic slip contact sensor (expell)<br />3+4: Cartridgeidentification sensor<br />5: Pillmovement sensor<br />Medication strip segment (lower right):<br /><ul><li>The pills are situated in the middle of the strip and canbeexpelledby the pill stamp.
  25. 25. With the holes at bothsends of the segments the strip segment canbecaughtby the catchingmechanism of the dispenser unit to renderforwardmovement of the strip.</li></li></ul><li>AMEDS - PMHS<br />The width of a medicationcartridge is appr. 2-2.5 cm.<br />A maximum of 20 cartridges canbeattached to one dispenser unit, whichmakes the maximum totalwidth of a dispenser unit ca. 40-50 cm.<br />Eachcartridge has a maximuncapacity of of 200 pills in onepill strip.<br />All medicines on a localmarket are beinggiven a unique code representing the generic name and strength of the medicine.<br />
  26. 26. AMEDS - PMHS<br />Bymeans of the uniquemedicine codes and adjustments to the cartridges all medicines on a localmarketcanbedispensedwith the AMEDS dispenser units.<br />As soon a cartridge is attached to the dispenser unit a sensor identifies the cartridgewith the specificmedicine code.<br />Thisway the informationabout the sort of medicine and strength of the medicine is automaticallybroughtinto the system.<br />The sensor technique to identify the cartridges is RFID, or barcode based. <br />
  27. 27. AMEDS - PMHS<br />In the diagramstwootheressential sensors <br />are notdisplayed:<br /><ul><li>Patient ID sensor</li></ul> A chip based ID sensor is placedon the dispenser unit to makesure the correct patient is takingmedicinefrom the corresponding dispenser unit.<br /><ul><li>Chaliceweightingscale</li></ul> The chaliceweighingscaleweighs the chalicebefore and after the medicationexpell to makesure the right amount of pills are expelledfrom the cartridges.<br />
  28. 28. AMEDS - PMHS<br />Safety is an important aspect of AMEDS. <br />Everydispensingprocess at a givendosageormedication time is accompaniedby a sensor basedsafetyalgorithm.<br />In case one step of the algorithm is notadequately met a preprogrammed dispenser behaviour is rendered.<br />Thispreprogrammed dispenser behaviourcanbepredefinedflexibly in accordance to the situation of the patient and healthcareworkersinvolved and the specific step in the algorithm.<br />Onlyif all steps of the algorithm are passed the chalice is made accesiblefor the patient. <br />
  29. 29. AMEDS - PMHS<br />AMEDS-PMHS safetyalgorithm<br />Medication ID<br /> Pre Programmed Dispenser Behaviour<br />Patient ID<br />Expell<br />Movement<br />Chalice release<br />Weight<br />
  30. 30. AMEDS - PMHS<br />The medicationchalice has a special ergonomic design. <br />The basicidea of thisergonomic design is very important, becauseitwillmakehandling of the chaliceforpatientswithphysicalshortcomingspossible.<br />Examples of these shortcomings are:<br />Shaking of the hands (tremors) due to forexampleParkinson’sdiseaseor multiple sclerosis.<br />Muscleweakness (paralysis) orclumsyness (apraxia) due to a stroke.<br />Visionimpairment<br />Reumatic disease<br />
  31. 31. AMEDS - PMHS<br />Ergonomicattributes of a medicationchalicewhichmakehandling easy forpatientswithphysicalshortcomings:<br />Lightweighted, transparentmaterial.<br />Big handlewith easy grip.<br />Easy accesible and even easy to findby touch forpeoplewithvisionimpairment.<br />Closedfor the most part when taken in the hand of the patient, sothatwhen the chalicefalls, or is shaken, the pillsdon’t drop out of the chalice.<br />Easy washable.<br />Tiltedbottom.<br />
  32. 32. AMEDS - PMHS<br />Drawing of the ergonomic AMEDS medication<br />chalice, side view<br />Withthis design pillscanonlyleave the chalice<br />whenthey are beingcalmlypoored out by the <br />patient. <br />Ergonomicchalice design<br />
  33. 33. AMEDS - PMHS<br />Monitoring of medicationadherencein AMEDS is achievedbysensing the handling of the chaliceby the patient:<br />Taking the chalice out of the dispenser unit is beingregistered, as is putting in. <br />Thisinformation is availablefor the patient and/orsupportinghealthcareworkers.<br />This is a form of indirect monitoring of medicationadherence and is considered to besufficientforitspurpose.<br />
  34. 34. AMEDS - PMHS<br />Offeringpatientinformation is crucialfor support of the medicationdispensingprocess. Bymeans of the internal computer thiscanbedone in anoptimalpatientfriendlyway.<br />For example: <br />For patientswithvisionimpairmentthiswillberealizedbymeans of: spoken text, a wearablebuzz-pager and sound alert signals.<br />For deafpeoplethiswillberealizedby: a wearablebuzz-pager, graphic display signals and light alert signals.<br />
  35. 35. AMEDS - PMHS<br />AMEDS is veryuser-friendlyfor the pharmacist:<br />With the medicationcartridge system the number of handlingsfrom the side of the pharmacist are reduced to a minimum.<br />Handlingsthatstill have to beperformedby hand (attaching the cartridges to the dispenser units) are easy and alwayscheckedby the system.<br />Bymeans of AMEDS the pharmacist is able to have a significant, activerole in the reduction of medicationadherence (concordance model).<br />
  36. 36. AMEDS - PMHS<br />AMEDS is veryuser-friendlyfor the prescribingmedical doctor:<br />Prescription of medicationcanbedonefromany site a doctor is located. Even remoteprescriptions are easilypossible.<br />The software design, and especially the user interface, makesprescription of medicationfast and accurate; this is even possible by means of a simple mobile phone.<br />Everypossibletime-dosagescheme is technicallyfeasable.<br />AMEDS offers easy and fastfeatures fordosageadjustments, discontinuation of medication and start up of newmedication. <br />
  37. 37. AMEDS - PMHS<br />AMEDS offers all the attributesneeded to support elderlypatientswith polypharmacy and multimorbidity:<br />Multi-userfriendly<br />Optimalergonomic design<br />Safe<br />Reliable<br />
  38. 38. AMEDS - PMHS<br />PMHS orPersonal Mobile Health Management Systems is the extendedversion of AMEDS.<br />PMHS uses a more advanced computer setup and special adapters.<br />PMHS dispenser units cancommunicatewithotherequipmentessentialfor the healthcareprocessbymeans of the adapters.<br />Communication is “twoway” and includestechniqueslike USB and Blue Tooth. <br />
  39. 39. AMEDS - PMHS<br />Examples of the extendedfunctionality of PMHS: <br />Advanced medication prescription support for medical doctors.<br />Dispensing and/or monitoring intake of non oral medication, like inhalation medication or injection fluids. <br />Telediagnostics and telemonitoring: weight, blood pressure, INR, heart rhythm, blood sugar, electrolytes, FEV1 value, etc. <br />Enhanced teleconferencing with desktop sharing. <br />Advanced patient information applications supporting the medication dispensing process.<br />
  40. 40. AMEDS - PMHS<br />AlthoughAMEDS and PMHS are very<br />sophisticated and powerfullsystems to <br />support the intake of medication, and also to <br />enhanceotheressentialfunctions in the <br />healthcareprocess, it is important to keep in <br />mindthat these systems are just tools to <br />support the actions of the peopleinvolved.<br />
  41. 41. AMEDS - PMHS<br />Thank you for taking the time to read <br />this presentation. We look forward to <br />meet you at<br />