G.R. Zaramba eICU Electronic Intensive Care Unit
Human Disease Diagnoses and Treatment Advancing Health Treatment through Technology G.R. Zaramba
Problem <ul><li>Need for military intensive  </li></ul><ul><li>care services around the world </li></ul><ul><li>Increased ...
Solution <ul><li>Electronic Intensive Care Units “eICU” </li></ul><ul><li>How do they work? </li></ul><ul><li>What are the...
How Does eICU Work? <ul><li>Physicians in military medical facilities in the US can examine, diagnose, and monitor patient...
What are the Benefits? <ul><li>Through  telemetry and ‘virtual exam’ of  the  patient, ICU specialists can make  real time...
What are the  Challenges? <ul><li>High cost  of technology </li></ul><ul><li>Cooperation between onsite physicians and eIC...
What are Some of  the Successes? <ul><li>Reduced mortality and morbidity </li></ul><ul><li>Shortened stays  in ICU </li></...
MC4 <ul><li>Electronic Medical Records </li></ul><ul><li>Medical Communications for Combat Casualty Care. </li></ul><ul><l...
MC4 References <ul><li>https://www.mc4.army.mil/index.asp </li></ul><ul><li>AHLTA-Mobile   AHLTA-T   Enables medical profe...
VA Update <ul><li>Obama Announces Vets e-Records System </li></ul><ul><li>April 09, 2009 </li></ul><ul><li>Military.com| <...
eICU <ul><li>Questions </li></ul>
References <ul><li>Tele-treatment: Monitoring from Afar; Liz Kowalczky,  </li></ul><ul><li>The Boston Globe, November 19, ...
References <ul><li>Tele-treatment: Monitoring from Afar; Liz Kowalczky,  </li></ul><ul><li>The Boston Globe, November 19, ...
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Zaramba The E Icu Telemedicine 2009 Hci 37

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Brief summary of current developments in telemedicine.

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  • One of the tools military medical personnel use from the EMT to ICU to other parts of the hospital is the Medical Combat Casualty Care System. MC4, a computer system, is used in Iraq, Afghanistan and stateside. Medical Communications for Combat Casualty Care (MC4) integrates, fields and supports a comprehensive medical information system, enabling lifelong electronic medical records, streamlined medical logistics and enhanced situational awareness for Army tactical forces. &amp;quot;It&apos;s a wonderful tool that we can utilize to document patient care and be able to utilize that system to send the information to other folks. They can actually sit in remote areas so they can re-transfer a patient to the next level of care. They have the ability to go in and see what we&apos;ve been doing at our level and get a background history on that patient so it is an invaluable asset for us to be able to track and maintain patients and provide quality medical care,&amp;quot; said House.
  • HARDWARE MC4’s fielding of ruggedized hardware - including handhelds, laptops, servers and printers - guarantees deployable medical forces receive durable technologies that long withstand harsh battlefield conditions. Depending on the size of the unit and the mission, MC4 fields a variety of  hardware configurations . HANDHELDS The current MC4 handheld computers are the HP iPAQ 4700 and the Motorola MC70. Each device is a point-of-care hand-held assistant, enabling military providers to record, store, retrieve and transfer the essential elements of patient encounters by synchronizing the handheld with an MC4 laptop. LAPTOPS MC4’s ruggedized laptop is a Panasonic “ Toughbook ” CF 51 notebook computer. Notable accessories include a mobile surge protector, handheld barcode scanner, multimedia drive cleaning kit, compact flash to PC card adapter and a ruggedized transit case. DEPLOYABLE SERVERS MC4 deploys a variety of servers to best meet the size and location of the health care facility. In some instances, the Panasonic Toughbook is used as a server, accessed by several other Toughbooks as clients In larger facilities such as Combat Support Hospitals, MC4 deploys the HP DL380 ProLiant G4 server. Notable accessories include Online Power Factor Corrected UPS (Uninterrupted Power Supply), ProCurve Switch, CISCO 2600 router, Fluke cable meter and ruggedized storage rack. PRINTERS The Intermec 3400E Label Printer is used in medical settings that require pharmaceutical labels. Notable accessories include a seven-star voltage converter and a ruggedized label printer transit case. MC4 deploys the HP LaserJet 1320n and Lexmark Optra T634N printers in the server hardware configurations
  • http://www.va.gov/performance/docs/VA_Snapshot_FY2008.pdf UNITED STATES DEPARTMENT OF VETERANS AFFAIRS Budget, Performance, and Financial Snapshot Fiscal Year 2008 Total Assets $56.9 B Total Liabilities $1.5.0 B
  • Zaramba The E Icu Telemedicine 2009 Hci 37

    1. 1. G.R. Zaramba eICU Electronic Intensive Care Unit
    2. 2. Human Disease Diagnoses and Treatment Advancing Health Treatment through Technology G.R. Zaramba
    3. 3. Problem <ul><li>Need for military intensive </li></ul><ul><li>care services around the world </li></ul><ul><li>Increased numbers of critical care patients in military facilities </li></ul><ul><li>Limited number of Intensive Care Specialists in the active military </li></ul>
    4. 4. Solution <ul><li>Electronic Intensive Care Units “eICU” </li></ul><ul><li>How do they work? </li></ul><ul><li>What are the benefits? </li></ul><ul><li>What are the challenges? </li></ul><ul><li>What are the successes? </li></ul>
    5. 5. How Does eICU Work? <ul><li>Physicians in military medical facilities in the US can examine, diagnose, and monitor patients in ICU’s across the globe. </li></ul><ul><li>Through the use of high resolution cameras, stateside physicians can consult with local physicians at the patient’s bedside. </li></ul><ul><li>Specialists can review the patient’s chart, lab work, and other data. </li></ul>
    6. 6. What are the Benefits? <ul><li>Through telemetry and ‘virtual exam’ of the patient, ICU specialists can make real time decisions in consultation with the attending physician. </li></ul><ul><li>The patient’s chances of recovery are greatly improved. </li></ul><ul><li>By bringing the specialist to the patient, there is a reduction in air evacuations and associated cost savings.$$$$$ </li></ul>
    7. 7. What are the Challenges? <ul><li>High cost of technology </li></ul><ul><li>Cooperation between onsite physicians and eICU specialists </li></ul><ul><li>“ Big Brother” concerns, particularly among young physicians with limited experience </li></ul><ul><li>Staff turnover at remote sites </li></ul><ul><li>Military “Red Tape” </li></ul><ul><li>Limits access to patients in ICU </li></ul>
    8. 8. What are Some of the Successes? <ul><li>Reduced mortality and morbidity </li></ul><ul><li>Shortened stays in ICU </li></ul><ul><li>Reduced cost of air evacuations </li></ul><ul><li>Support and training to onsite physician staff </li></ul><ul><li>Enhanced inter-service cooperation </li></ul><ul><li>Potential new horizons : eICU on ships at sea and battlefield hospitals </li></ul>
    9. 9. MC4 <ul><li>Electronic Medical Records </li></ul><ul><li>Medical Communications for Combat Casualty Care. </li></ul><ul><li>MC4 is several information-collection devices, software, databases, and servers for use on battlefields and in field hospitals. </li></ul><ul><li>5 M Documents, 25K devices, 29K trained medical personnel </li></ul>
    10. 10. MC4 References <ul><li>https://www.mc4.army.mil/index.asp </li></ul><ul><li>AHLTA-Mobile   AHLTA-T   Enables medical professionals to record, store and transfer medical records to the DoD’s clinical data repository (CDR) by synchronizing the device with an MC4 laptop </li></ul><ul><li>Displays medical history, physical exam and disposition in structured data terms – ICD-9, </li></ul><ul><li>disease non-battle injury (DNBI) and MEDCIN </li></ul><ul><li>Human body diagrams and forms enable users to capture data using a stylus </li></ul><ul><li>DCAM  ( Defense Medical Logistics Standard System Customer Assistant Module) </li></ul><ul><li>ePDHA  (Electronic Post Deployment Health Assessment )  </li></ul><ul><li>JMeWS  (Joint Medical Workstation )  </li></ul><ul><li>MEDIC  (Medical Environmental Disease Intelligence & Countermeasures )  </li></ul><ul><li>Micromedex   </li></ul><ul><li>TC2  ( Theater Medical Information Program Composite Health Care System Caché)  </li></ul><ul><li>TMDS  (Theater Medical Data Store) </li></ul>
    11. 11. VA Update <ul><li>Obama Announces Vets e-Records System </li></ul><ul><li>April 09, 2009 </li></ul><ul><li>Military.com| </li></ul><ul><li>by Bryant Jordan </li></ul><ul><li>President Barack Obama today announced plans to provide service members with an electronic health records </li></ul><ul><li>Defense Secretary Robert Gates and Secretary of Veterans Affairs Eric Shinseki, a former Army chief of staff . Also in attendance was Tammy Duckworth, an Army UH-60 Black Hawk helicopter pilot who lost both her legs when her helicopter was shot down in Iraq. Duckworth has been nominated to be assistant secretary of public and intergovernmental affairs at the VA. </li></ul><ul><li>Obama said his 2010 budget includes $25 billion more for the Department of Veterans Affairs over the next five years. The money will also include funding for other new or expanding programs, among these efforts to treat veterans with mental health issues and those who suffer from brain injuries -- one of the signature injuries of the wars in Iraq and Afghanistan. </li></ul><ul><li>&quot;This budget approves services for cognitive injuries ,&quot; he said, noting that many veterans &quot;with these injuries have never been evaluated&quot; by a doctor. </li></ul><ul><li>Obama also cited the needs of thousands of veterans who suffer from post-traumatic stress disorder, the rising increase of suicides among veterans, and the problem of some 154,000 veterans who are homeless (not homelessness). </li></ul><ul><li>In all, he said, some 500,000 veterans who previously have been denied health care will get it, including through the use of mobile clinics that will reach veterans in rural areas. </li></ul>
    12. 12. eICU <ul><li>Questions </li></ul>
    13. 13. References <ul><li>Tele-treatment: Monitoring from Afar; Liz Kowalczky, </li></ul><ul><li>The Boston Globe, November 19, 2007. </li></ul><ul><li>Tripler’s Scenic View Includes Glimpse of Military Medicine’s Future; Kevin Downey, Tripler Army Medical Center Public Affairs; February 25, 2008. </li></ul><ul><li>www.saintlukeshealthsystem.org/slhs/services/common/ eicu /welcome.htm , 2006. </li></ul><ul><li>http://www.hawaiitelehealth.net/documents/Telehealth%20Project%20Summaries/eICU.pdf , 2008. </li></ul><ul><li>https://www.mc4.army.mil/mc4newsletter/2008_9/index.asp </li></ul><ul><li>http://medicaldesign.com/electrical-components/managing_medical_data_0808/index.html </li></ul>
    14. 14. References <ul><li>Tele-treatment: Monitoring from Afar; Liz Kowalczky, </li></ul><ul><li>The Boston Globe, November 19, 2007. </li></ul><ul><li>Tripler’s Scenic View Includes Glimpse of Military Medicine’s Future; Kevin Downey, Tripler Army Medical Center Public Affairs; February 25, 2008. </li></ul><ul><li>www.saintlukeshealthsystem.org/slhs/services/common/ eicu /welcome.htm , 2006. </li></ul><ul><li>http://www.hawaiitelehealth.net/documents/Telehealth%20Project%20Summaries/eICU.pdf , 2008. </li></ul><ul><li>https://www.mc4.army.mil/mc4newsletter/2008_9/index.asp </li></ul><ul><li>http://medicaldesign.com/electrical-components/managing_medical_data_0808/index.html </li></ul>

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