This document summarizes research on kidney dialysis monitors. The researchers developed an optical method to monitor uremic toxins in blood to improve dialysis quality. Their project involves designing the device body/interface and communication between the dialysis machine and users. The background section describes dialysis and its importance, noting its time-consuming nature and high costs. Research methods included online research, mapping dialysis aspects/problems, observing a hospital dialysis process, and interviewing a patient. Key findings were that many patients are unaware of dialysis effectiveness and monitoring their results could positively influence them. The potential for a device with an improved interface and monitoring was identified.
1. Kidney Dialysis Monitor
Research Report
Gina Metssalu
Piret Uustal
supervised by:
Ruth-Helene Melioranski
Martin Pärn
Sven Sõrmus
in cooperation with:
Tehnomeedikum /
Tallinna Tehnikaülikool
Biomeditsiinitehnika instituut
spring 2014
2. Introduction
The researchers' team of Technomedicum have worked out and
patented a new optical method to monitor uremic toxins in the
blood and through that raise the quality of the dialysis process.
The task for our semester project is to design
- the physical body for the new device (incl. the functions, case,
semantics etc)
- the communication between dialysis device and users (patient,
nurse, doctor).
3. Backround
Approximately 2.2 million end stage renal disease (ESRD) patients are treated worldwide, 1.5
of them are haemodialysis (HD) patients and the growth of new patients is approximately 7%
a year (1). Without the treatment the patients would die rather quickly (after ca 3-4 days) due
to complications caused by excessive body water and uremic toxins in the body. A large part of
patients’ life quality decrease and HD expenditures are related to hospitalisations and interventions
due to the side effects causing high morbidity and mortality (2). Therefore, to improve well-being
of the patients and cost effectiveness, the society is interested that adequate renal replacement
therapy with high quality and minimum complications is offered.
What is a dialysis?
· Dialysis is the artificial replacement for lost kidney function.
· Eliminating waste (diffusion) and unwanted water (ultrafiltration) from
the blood
· Well functioning kidneys filter all the blood in your body with 30 min.
· 2 leading causes of kidney disease are high blood pressure and
diabetes.
· It is possible to live with only one kidney.
The functions of the kidney
Excretory functions
- remove waste products
- remove excess fluid
- regulate acid-base balance
- regulate electrolyte levels
Secretory functions
- regulate blood pressure (renin)
- regulate red blood cell production (EPO)
- regulate calcium uptake (active vitamin D)
4. Treatment Modalities
Hemodialysis
In hemodialysis, your blood flows through a machine that has a filter
which cleans the blood. This machine is called a dialyzer or artificial kidney.
Hemodialysis is usually done three times a week, several hours each session. It
can be done at a dialysis center or at home. To get your blood into the dialyzer,
two needles are inserted into your vein during each dialysis treatment.
- hemofiltration
- hemodiafiltration
http://clinicindelhi.com/hemodialysis/
5. Treatment Modalities
Peritoneal dialysis
How does peritoneal dialysis work?
A soft tube, called a catheter, is placed in your belly. This is done by minor surgery. This
catheter makes it possible for you to easily connect to a special tubing which allows
two to three quarts of a cleansing fluid to flow into your belly. The cleansing fluid is
called dialysate. It takes about 10 minutes for the dialysate to fill a belly. When the filling
is done, the catheter is capped so that it doesn't leak. The lining of a belly (called the
peritoneal membrane) acts as a natural filter. It lets the wastes and extra fluid in blood
pass through it into the cleansing fluid. At the same time, the lining of a belly holds
back the important things a body needs, like red blood cells and nutrients. To do its job,
the dialysate must stay in a belly for two hours or more, depending on body size and
how much waste has to be removed. This time is called dwell time. After dwell time,
cleansing fluid must be drained from body into an empty bag. In-and-out process must
be repeated a number of times during the day, using fresh dialysate. PD can be done at
home, at work, or while traveling.
Two options:
- Continuous cycling peritoneal dialysis or automated dialysis (CCPD)
With CCPD, a machine called a cycler does the exchanges automatically while you sleep.
You may also need to do one exchange during the day if your kidney function decreases
further.
- Continuous ambulatory peritoneal dialysis (CAPD) With CAPD, you do the exchanges
yourself three to four times a day.
http://sainternshipufs.blogspot.com/2012/06/4-5-june-2012-universitas-hospital.html
6. Treatment modalities
Kidney transplant
A kidney transplant is an operation that places a healthy kidney in your
body. The transplanted kidney takes over the work of the two kidneys
that failed, so you no longer need dialysis.
If you have a transplant, you must take drugs for the rest of your life, to
keep your body from rejecting the new kidney.
Transplanted kidney usually works well 8-10 years, after that it needs to
be replaced.
Currently (2014) 99 000 people are in a waiting list of kidney donor in
USA. Fewer than 17 000 receive one each year.
Every day 14 people die waiting for a new kidney.
Alternatives
UCSF researchers today unveiled a prototype model of the
first implantable artificial kidney, in a development that one
day could eliminate the need for dialysis.
3D printed Kidney - by Surgeon Anthony Atala. An
early-stage experiment that could someday solve the
organ-donor problem: a 3D printer that uses living cells
to output a transplantable kidney
Revital Cohen - Dialysis Sheep (2008)
http://www.ucsf.edu/news/2010/09/4450/ucsf-unveils-model-implantable-
artificial-kidney-replace-dialysis
http://blog.sculpteo.com/2011/08/10/3d-printing-for-regenerative-medicine/
http://designculturelab.org/2011/08/06/dialysis-sheep-sacrificial-lambs-black-
sheep-and-speculative-designs-publics/
http://www.medindia.net/
healthnews/kidney-transplantation-news.
asp
7. Research Methodology
Online research
To map out the nature and need of dialysis, to learn the dialysis
process in detail and to identify the problems that dialysis patients are
experiencing.
GIGAmapping
Mapping out different aspects of dialysis and the problems related to it.
Analysing their interconnections. Finding new connections between the
parts of the process. (addendum A)
On-site observation at the hospital
To understand the interaction between the patient and the hemodialysis
machine.
To monitor the workload of nurses.
To monitor the activities of the patients during the dialysis process.
Interview with a patient and patient journey
To recieve a feedback from the patient about the dialysis process.
To map the level of his understanding of the process and the need for it.
To understand patient’s daily schedule due to dialysis and his attitude
towards it.
The poll
To get statistics. To map the level of patients understanding of the
process. To measure the scope of the problem. To find out patients
needs and expectations.
8. Overview of the research
Reality in hemodialysis
· 2,2 million ESRD patients worldwide (about 1,5 million HD
patients)
· 7 % annual growth rate
· time consuming: 4-5 hrs, 3-4 times/week
· Life expectancy if a person starts dialyse in the age over 75
years: 25 % - 1 year 60 % - 5 years
· Life expectancy if a person starts dialyse in twenties: 20 or in
some cases even 30 years
· complex medical and dietary regimen
· expensive- ca 50 billion USD annually
· complications
Patient needs a
dialysis process
3-4 times in a week
and it takes 3-5
hours.
Blood urea concentration over a time of period
(several dilaysis)
Wed Fri Mon Wed Fri
Blood urea concentration mmol/l
25
20
15
10
5
-20
30
0
9. Overview of the research
http://www2.nephrocare.com/global/en/
products/5008.html
On-site observation at the hospital
- Majority of the patients are under the care of nurse
* safer environment
* fear of doing hemodialysis at home
- Newer hemodialysis machines have patient-friendly screens and
operating principles and can be operated by the patients themselves.
- Younger and more fit patients interact with new machine themselves.
- During the dialysis the nurses are required to fill out patient records
manually
Newest machines at the
hospitals now. Patient friendlier.
Self service.
Current machines at the hospotal.
No patient-machine interaction takes
place.
Older machines. Currently stocked
aways and used only if really needed.
10. KIDNEY DIALYSIS
WHAT IS A DIALYSIS?
Dialysis is the artificial replacement for lost kidney function.
It is an artificial process of eliminating waste (diffusion) and unwanted
water (ultrafiltration) from the blood. Kidneys do this naturally. If a kidney
is failed or damaged and cannot carry out the function properly - a person
may need dialysis.
Kidneys filter all the blood in your body with 30 min.
90 000 people die of kidney desease (more than Breast and Prostate cancer
combined)
Hospital
Addendum A
STAKEHOLDERS
FAMILY EMPLOYER
PATIENT
HOSPITAL SUPPLIERS
SYSTEM
COMPETOTORS
SELLING DIALYSIS
MACHINES
Patient
2 leading causes of kidney desease are high blood pressure and diabetes.
It is possible to live with only one kidney.
BABY CHILD TEENAGER STUDENT HEMODIALYSIS AT THE HOSPITAL
3-4 x week
3-5 hours
stuck to the machine
wasted time
painful
vein infection
For patients with other health problems and for elderly people
MON TUE WED TH FRI SAT SUN MON
under medical care
less infection
“social club”
get out of house
meet other people
HEMODIALYSIS AT HOME
PERITONEAL DIALYSIS
For patients with no needles
no pain
suitable for kids
flexible schedule
less dietary restrictions
doable at night
easy to travel
4 times in a day
30 min
risk of infection
3 x week
3-4 hours
5-7 x week
2 hours
8 Home
Doctor Nurse
Data of dialysis effectiveness in 2 days
Preparing the machine
Sterilyzing flites
Start pump and timer
Measure blood pressure in every 30 minutes
Removing the tubes from the patient in 3-5 hours
Patient recovery 10-15 minutes
Possible aftereffects
PROCESS
Measure:
kg
temperature
blood pressure when standing and sitting
Measure:
kg
temperature
blood pressure when standing and sitting
FACTS
based on data of USA
1 out of 10 people (over 18 years old) have reduced kidney function
Currently (2014) 99 000 people are in a waiting list of kidney donor.
Fiewer than 17 000 receive one each year.
Every day 14 people die waiting for a new kidney.
Today’s dialysis machines are far from perfect. Their efficiency is only
around 10% of that of a functioning kidney, and when used three times
per week, they are incapable of controlling unhealthy fluctuations in the
concentrations of metabolites such as urea in the blood.
Life expectancy if a person starts dialyse in the age over 75 years:
25 % - 1 year
60 % - 5 years
Life expectancy if a person starts dialyse in twenties:
20 or in some cases even 30 years.
SCHEDUAL
HEMODIALYSIS
11. FEELINGS QUALITY OF LIFE
SCHOOL WORK
VACATION
http://designculturelab.org/2011/08/06/dialysis-sheep-sacrificial-lambs-black-
Business - new device
sheep-and-speculative-designs-publics/
by Piret Uustal I Gina Metssalu I 2014
supervised by Birger Sevaldson
STUDENT PARENT ELDERLY
YOUNG
WORKING
PEOPLE
fear
uncertainty
lack of motivation
helplessness
routine
no freedom
being a burden
uselessness
no finances
uncertain of future
depressing
waiting
allone
what’s the point
time lost
want to enjoy the last years of your life
8 % of all dialysises (in USA)
with no other health problems
infection
6 x week
6-8 hours
Every other night
6-8 hours
Due to longer/more frequent dialysis:
feel better
less/no nausea
less/no “washed out” feeling
less/no headache
less/no cramping
fexible schedule
more toxins removed
risk of infection
need long training
need “care partner” (family member)
need to hire a “care partner”
POTENTIAL IDEA
growing number of patients - 6 % in a year
currently on dialysis - 3 million people
currently on hemodialysis - 1.3 million peoplew
Instant data of Dialysis quality
SAVE TIME
SAVE MONEY
shorter tiem of dialysis
new use of old machines (eg. in poor countries)
See the future
Be like others
Feel useful
Financial independence
Do what you love
Freedom
Motivation
Enjoy the life
patient diary
easy data handling
data sharing Doctor-Nurse-Patient-Family member
UCSF researchers today unveiled a prototype model of the first
implantable artificial kidney, in a development that one day could
eliminate the need for dialysis.
3D printed Kidney - by Surgeon Anthony Atala. An early-stage
experiment that could someday solve the organ-donor problem: a 3D
printer that uses living cells to output a transplantable kidney
Revital Cohen - Dialysis Sheep (2008)
http://www.ucsf.edu/news/2010/09/4450/ucsf-unveils-model-implantable-artificial-kidney-replace-dialysis
http://blog.sculpteo.com/2011/08/10/3d-printing-for-regenerative-medicine/
Alternatives
HEMODIALYSIS
MACHINE
ADDED SCREEN
ADDED SENSOR
HOSPITAL
FAMILY
patient diary
at home
..............
................
..................
http://sainternshipufs.blogspot.com/2012/06/4-5-june-2012-universitas-hospital.html
by Piret Uustal I Gina Metssalu I 2014
supervised by Birger Sevaldson
12. Overview of the research
Interview with a patient / patient journey
Male I 81 years old I dialysis patient over 2 years
- had kidney failure after heart surgery when he was given wrong medicine (overdose
of Potassium) which injured his kidney functions.
-kidney dialysis every Mon, Wed, Friday, from 8-12
- patient himself is responsible monitoring his heart rate during the dialysis. If its too
low or high the patient moves the position of the bed to raise his legs.
- the patient is not aware of the effectiveness of the dialysis in the end of the process.
He is not monitoring the display of the machine (even if there is screen it is not visible
nor understandable for the patinet).
- if the display would be visible and understandable to the patient he would be
interested and positively influenced to see the effectiveness of the dialysis process.
- the patient follows the remaining time of the dialysis process from the sepparate
wall clock. He does not see the timer from the machine.
- he feels fairly good after the dialysis. He walkes home 15-20 minutes and needs to
sleep 2 hours to feel completely well.
- the patient claimed that when he was sometimes placed under an older model of
hemodialysis machine he did not feel comfortable and did not trust the effect of the
dialysis as much
- the inability to use restroom during the dialysis process is sometimes a problem
Older hemodialysis machine
13. Overview of the research
Patients
In order to get overview of patients habits and their awareness of hemodialyses process
we conducted a research among the hemodialyses patients in estonia. There is about 200
regular HD patients and we got answers from 32. It makes ab 16 percent of all patients in
Estonia.
Age
Working?
14. Overview of the research
Patient awareness of the dialyses process
44 % of the patients are not aware
what is happening with their blood
during the dialyses process
64 % NOT aware what does the data
displayed on the machine (such as
Kt/v) means.
79% NOT aware how clean is their
blood after the dialysis.
48% believe that knowing the results
of the dialysis process effectiveness
would influence them positively.
80% following their blood pressure
during the process.
15. Overview of the research
Dialyses at home?
80% NOT willing to do dialysis at
home
43% believes dialysis at home would
affect their daily routine
Main reasons:
- no conditions
- don’t dare
- not sterile enough - live alone
- fear of blood, needles and whole
process
25% would be more encouraged to
have dialysis at home if the doctor
has overview of the process in real
time.
16. Findings
Hemodialysis machine and sensor
- The benefits of real-time measurement are obvious: if Kt/ V is only checked monthly or quarterly, it
may be months before suboptimal dosing is discovered. By measuring online during every therapy,
the new sensor is able to identify suboptimal dosing immediately, support timely adjustments in
treatment parameters and also eliminate common process- related factors influencing the previous
reference method (taking of blood samples).
In medicine, Kt/V is a number used to quantify hemodialysis and peritoneal dialysis treatment adequacy.
K - dialyzer clearance of urea
t - dialysis time
V - volume of distribution of urea, approximately equal to patient’s total body water
Increase blood flow
Improvement in clearance
Positive effect on Kt/V
There are 4 ways of how the doctor, nurse or patient can influence
the Kt/V during dialysis process thanks to the costant information of
dialysis quality given by new sensor:
17. High concentartion of substances
Reduce blood flow Increase dialysate flow Longer dialysis time
Improvement in clearance
Positive effect on Kt/V
Improvement in clearance
Positive effect on Kt/V
Improvement in clearance
Positive effect on Kt/V
18. Findings
Patient
- The patient is interested in knowing and following the effectiveness of dialysis during the process.
- The patient would be positively motivated if he was able to monitor the effect of the process.
- Newer dialysis machine and a machine that is understandable to the patient raises trust towards the
process and makes the patiet interact with the machine (more independence to the patient, less work
to the hospital stuff)
19. Findings
Doctors / Nurses
-The ability to receive constant feedback of the patients dialysis quality eliminates the “guess work” of
the nurses and doctors in setting the machine parameters before an during the dialysis process.
The optimal dialysis process for each patient can be figured out faster and is based on reliable data.
- The machine could ease the workload of nurses by automatically saving the information of the
dialysis process (work that is now done manually).
- In case the patient recives dialysis in a different clininc (e.g. while traveling) the data of the patients
dialysis parameters will be available to the nurses and doctors in a new clinic as well.
Nursing file what now is
filled by hand for each
patient
20. Findings
Market
- Older models of hemodialysis machines that have new sensor can be used in a more effective way.
- Hemodialysis machines can be made avaialable to more patients. Older machines that would be
otherwsie disregarded can be taken more clinics and to rural areas so the patient would not have to
travel long distances to receive dialysis.
- Less developed countries with older dialysis machines can offer better dialysis quality to their
patients and make it avaialble to more people.
- Lower costs than purchasing brand-new hemodialysis machines.
Regulations
- There are several laws and regulations in Estonia for producing, maintaining and handling medical
devices (3), but as far as we talking about adding the new sensor only as a affix to outlet hose, then we
are not influenced by them directly.
21. Findings
Existing solutions
The first integrated dialysis dose monitor in the world, utilising the UV-technology, is the Adimea system
(Option Adimea, BBraun Avitum AG) (B. Braun Avitum AG 2010). The heart of the Adimea system is the
optical sensor DiaSens, integrated into the HD machine, delivering values of real-time Kt/V or URR for
the dialysis team during a treatment
22. Goal
Increase patient motivation
to take better care of their
health through raising
awareness of the dialysis
process.
23. Focus
The existing analysers are built in the whole kidney dialysis apparatus. The aim is to develop a
standalone analyser which suits with dialysers produced by different companies.
Today the procedure takes place in the hospital under the control of the medical personnel. The
new system is connected with internet and should be able to work also in the other environments
out of hospital and patient should be able to manage with it alone.
The disadvantages of the existing methods for uremic toxins determination are utilization
of disposables or chemicals, rather complicated and expensive measurement procedure. To
overcome those difficulties, a monitoring system would be preferable. Recently a good correlation
between ultraviolet (UV)-absorbance and several small removed waste solutes (urea, Cr, UA) has
been found, indicating that UV-absorbance may enable monitoring of several uremic toxins linked
to the malnutrition–inflammation complex syndrome and the risk factors of CVD. The obtained
results demonstrate the possibility to follow a single hemodialysis session continuously and
to monitor deviations in the dialysator performance by using UV-absorbance. The UV-method
does not need blood samples, any disposables or chemicals, is fast, and allows continuous
measurements of the standard dialysis adequacy parameters (e.g. Kt/V, URR).
http://www.bbraun-avitum.ro/cps/rde/xchg/av-avitum-
ro-ro/hs.xsl/7370.html
http://www.cb.ttu.ee/ee/edu/DBB0070/Biooptics_HD_
public.pdf
24. Focus
External sensor
· Real- time measurement system
· Photometric sensor that continuously measures light absorption in spent dialysate
· Estimating the reduction of substances concentration, which is linearly related to their concentration
in blood
· Capable of delivering Kt/V in most treatment models, including HDF, HD and single needle treatment
Advantages
· continous, on-line monitoring. Other methods- once in every 25 min. New sensor every 6
sec ( Kt/V)
· no blood sampling
· without any disposables or chemicals
· evaluates delivery of prescribed treatment dose (Kt/V)
· can estimate TRU, PCR, URR
· possibility to measure other solutes besides urea
· estimation until the target is achieved
· no interference with dialysis machine’s operation
25. Values
Values for patient
Values How?
- simple,
understandable,always visible
screen
- blood result instantly shows if
patient has been taking care of
his health (eg. correct diet)
- practice in the hospital,
simplicity of the process and
awareness encourages to do
dialysis at home
- aware what is happening
- cares more of his/her health
- independence
26. Values for nurse
Values How?
- patient data stored in the
device and easily accessible
when needed
- most data saved automaticaly
to the new screen during the
process
-machine setup based on exact
blood data. Alarm if goal not
achived.
- easy data handling and storing
- save time
- easier setup of dialysis machine
Values
27. Values
Market
Currently, there is about 600 000 old hemodialysis machines in the
world. Many of these machines are in good condition, but miss certain functions
limiting the treatment modalities a clinic can perform.
Those functionality could be raised significally by adding them
percise sensor and extra screen.
28. Concept in use
Patient journey
CHOOSE MACHINE
Nurse waches and
marks down the
weight
OLD MACHINE MANUAL PROCESS
MACHINE TESTING
AND SETUP
ca 15 min
INSTALL
FILTER, TUBES,
DIALYSATES
CONNECT
PATIENT WITH
MACHINE
CONNECT
PATEINET TO
MEASURE BLOOD
PRESSURE
(connect with
machine)
CHOOSE PROGRAM
-Hemodialysis
-Hemodiafiltration (HDF)
- Ultrafiltration
BLOOD PRESSURE
starts screening in a
patient page view
MACHINE ADJUSTS
AUTOMATICALLY
ACCORDING TO
PATIENT
ALL SETUP MADE
INSTANTLY
CHANGES CAN BE
MADE
START
(MACHINE)
Can blood pressure
be measured at the
same time in 2 places
(in dialysis machine
and on NEW SCREEN)
2 connections.
So blood pressure
could be followed
from the screen.
what happens if
blood pressure will
be shown only on
NEW SCREEN. What
changes in Dialysis
machine? Does it
affect anything?
Is bloodpressure
data usually saved to
magnetic card also? Is
it needed for that?
MAGNETIC CARD
WEIGH THE
PATIENT
NEW MACHINE
1
2 3
4 5 6
7 8
Prebooks always new
Weights herself and
remembers it
machine
Sets up the machine
parameters- with
magnetic card
Nurse prepares
machine
Connects herself-needles,
sensors etc
Patient chooses pro-gram
Starts machine
Start of new screen-automatically,
after
fluid starts flowing-
TIME AND BLOOD
PRESSURE as a
screen saver
BLOOD PRESSURE
as a screensaver
Just comes every
mondey, wendsday
and friday at 8 oclock
Nurse prepares
machine
Nurse connects with
machine
Nurse sets up the
machine
Nurse choses
program
Nurse
STARTs
Machine
Security code necessary?
Nurse gets info
about PREvIOUS
SESSION
PARAMETERS
Start of new screen-automatically,
after
fluid starts flowing-
TIME AND BLOOD
PRESSUREin a
patient page view
CAN IT START AUTOMATICALLY
AFTER FLUID
STARTS RUNNING?
PORTABLE SCREEN for
INSERTING WEIGHT
INSTANTLY already in
“weighting Cabinet”
JAAK, 62
Pensioner. Doesn’t work, lives alone
in Mustamäe.
PIIA, 32
Works as a project manager, studies
administrative management in TTU-s
master program. Mother of two chil-dren.
Travels a lot
HOME MENU-PATIENT
SELECTION-INSERTING
WEIGHT
MACHINE NEEDS TO
BE SET UP
Piias actings Jaaks actings Nurses actings NEW SCREEN Ns- Piias acting Ns- nurse acting Ns- Jaak acting
29. SENSOR ALARM
-change something
HOW DOES
PATIENT
FEEL
75% of GOAL
FOOD DIARY
SYNC
NURSE ENTERS
CHANGES TO THE
SCREEN:
- BLOOD FLOW
-DIALYSATE FLOW
- UF PROFILE +/-
NURSE CHANGES
PARAMETERS ON
MACHINE:
- BLOOD FLOW
-DIALYSATE FLOW
- UF PROFILE +/-
DIALYSIS TIME
ADJUSTS ON THE
SCREEN GRAPH
SAvE
PROCESS
PRINT
DATA
WHICH
DATA
NEEDS
PRINTING?
CAN CHANGE SETUP
PARAMETERS
-kg
-dialysis time
...
In the case of independent patient -
who fills out the paper sheet for nurses
now? Is patient able to do this?
Is all that data always needed?
FEEL
+ UNFASTEN THE
PATIENT
FEEL
-
low blood
pressureT
clogged fistula
(MACHINE)
arter/vein
pressure
blood sugar
(MACHINE)
cramps
(MACHINE)
headache
(MACHINE)
DISPLAYED :
-previous dialysis data
-usual setup parameters (kg, dialysis
time)
-medicaments
-previous blood test results from lab
- patient food DIARY
CHOOSE PROGRAM
-Hemodialysis
-Hemodiafiltration (HDF)
- Ultrafiltration
9 10
11 12
13 14 15
Takes the new Screen
Inserts parameters
to the New Screen
Home menu-
PATIENT SELECTION
PATIENT
PARAMETERS
PRECISE GRAPH
SCREEN
progress is going on
as predicted
Usual time is up, but
screen shows onlly
75% of result
Becouse of upcom-ing
meeting chooses
to finish anyway
Suggestions to the
next time
Prebooks for the next
time longer session Disconnects herself
Waches his blood
pressure
Calls nurse when not
feeling good
Weights herself
PRECISE GRAPH
SCREEN
lack of GOAL
Nurse
changes parameters
AUTOMATICALLY
SAvES ALL
WIRELESS
CONNECTION?
GOAL
gets better
GOAL
is achieved
Nurse
disconnects
nurse inserts weight
SAvE
PROCESS
PRINT
DATA
Nurse
takes blood sample
nurse inserts BLOOD
TEST RESULTS
Nurse waches and
marks down the
weight
inserts weight
30. Interface structure
Home menu
Patient selection ô
orders to stock?
suggested parameters
patient 1
Blood pressure
(+ time)
as a screensaver
suggested
parameters
WeigHt
beforeô
after ô
WeigHt
History
edit
patient info
treatment
plan
Blood tests Food diary
program
-Hemodialysis
-Hemodiafiltration ô-
Ultrafiltration
uF
goal
time
4:00 ô
patient
inFo
- name
-barcode
-doctors name
-height
-age
-...
History
- date
-trend graphs
start
treatment
plan
-medicaments
-....
Food
diary
Blood tests
-predictable graph
-goal %
-time %
-blood pressure
-uf rate
-art press
-ven press
-...
Back
alarm
- Blood FloW ô
-dial. FloW ô
- uF proFile ô
FinisH
suggestions
WeigHt
print
The information measured by the sensor is instantly displayed on the screen.
To map out the user interface and keeping in mind the goal for values we went
through patients journeys and built the structure for user interface.
32. Display
Information displayed on the screen is translated into graphics so everyone, even
elderly patient can grasp visually what is happening with their blood at this very
moment.
The most vital information for the patient ( blood pressure, % of the process
effectiveness and time remained) is displayed as a screen saver.
If it now, for example, happens that the patient has been eating nonproper food on a
previous day, the result instantly shows on the screen. This will help him to understand
and assess how his lifestile and diet can influence his health. And that, in turn, motivates
him to take control over his health...and not leaving it to the doctors only.
33. Display
Also the nurses will benefit of the new solution. It will make easier
for them to set up the dialysis machine according to each patients
needs. The setup data of the most effective process for this patient is already
automatcally displayed and the nurse doesnt have to guess which process gives the
most positive result to the patient.
Nurses time is saved by not having to fill out papers by hand for each patient. All the
data about the process wat now is edited by hand could be saved automaticallyby the
screen and if paper version is still needed, it can be simply printed out.