The document describes a distributed system called SQUD (System Quality Use of Drugs) that was created to help with accurate drug dosage calculations. SQUD allows pharmacy administrators to generate drug protocols and clinicians to access calculators from mobile devices and computers. It has a web-based architecture that stores protocols on a server and has been deployed on a test website. Future work aims to expand drug problems addressed, improve security and integration with health systems, and collect usage data on expensive drugs.
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A Distrubuted System For Accurate Use Of Drugs - Bhaskar Rudroju
1. A Distributed System for
Accurate Use of Drugs
โข Bhaskar Rudroju
โข Dr. Michael Schukat
โข Peter Kidd
16th Annual Conference and Scientific Symposium
Healthcare Informatics Society of Ireland
Date 17 -11-11, Dublin
2. Outline
โข Introduction
โข Research background
โข Capabilities of ICT
โข SQUD Design & Architecture
โข Progress
โข Future work
โข Conclusion
16th Annual Conference and Scientific Symposium
Healthcare Informatics Society of Ireland
Date 17 -11-11, Dublin
3. Introduction
โข The recent advances in Information and communication
technologies (ICT) are acting as catalyst for significant
development in the sector of health care.
โข Internet enabled healthcare applications
โข Electronic Healthcare Records
โข Telemedicine
โข Inter-organisational collaborations
โข Data management
โข High performance computing
โข Consumer health informatics
โข m-Health
โข Internet based services (e-Pharmacy, e-Care)
โข Security
16th Annual Conference and Scientific Symposium
Healthcare Informatics Society of Ireland
Date 17 -11-11, Dublin
4. Research Background
โข Problems facing in hospitals
โข Hospital Wide Medication Management (HMM)
โข Personalised Medication Management (PMM)
โข Hospital Wide Medication Management
โข Use of important and costly drugs, e.g. Immunoglobinun
โข Lack of resources e.g. computers, Internet connection, server
problems.
โข Personalised Medication Management
โข Individualised patient care
โข Right drug, right dose, every time
16th Annual Conference and Scientific Symposium
Healthcare Informatics Society of Ireland
Date 17 -11-11, Dublin
5. Research Background (Cont..)
โข Medication errors
โข Giving the wrong drug
โข Giving the wrong dose
โข Skipping the dose
โข Giving the drug by wrong route
โข Giving the drug at wrong rate
โข Giving the drug at wrong time.
16th Annual Conference and Scientific Symposium
Healthcare Informatics Society of Ireland
Date 17 -11-11, Dublin
6. Importance for Drug Dosage
Levels
โข Over dose.
โข Under dose.
โข Low therapeutic index
drugs.
โข Finding out optimal level.
16th Annual Conference and Scientific Symposium
Healthcare Informatics Society of Ireland
Date 17 -11-11, Dublin
7. Complexity involved in
Calculating Dosage Levels
โข Complex
โข The calculation of dosage levels are complex, for e.g. Finding the
creatinine clearance the formula is
((140-age)*ideal body weight)/serum creatinine.
((140+age*ideal body weight))/serum creatinine.
โข Multi-step
โข Calculate IBW, adjusted body weight, CrCl, dosage regimen.
โข Error prone
โข Even a single misplace of decimal point can lead to a major error.
โข Multiple Times a day
โข E.g. antibiotics
16th Annual Conference and Scientific Symposium
Healthcare Informatics Society of Ireland
Date 17 -11-11, Dublin
8. Capabilities of ICT
โข The information & communication technologies ICT
capabilities can be classified into 6 categories.
16th Annual Conference and Scientific Symposium
Healthcare Informatics Society of Ireland
Date 17 -11-11, Dublin
9. Applying ICT to Drug Dosage
Problems
Person Process System
Wrong
Dose
Performance Communication
ICT
Capabilities
Standardisation Smart Phones
16th Annual Conference and Scientific Symposium
Healthcare Informatics Society of Ireland
Date 17 -11-11, Dublin
10. SQUD
โข SQUD stands for System Quality Use of Drugs
โข Formed by
โข IT Department of National University of Ireland, Galway and
โข Pharmacy Department of Galway University Hospital.
โข Aim/Objectives
โข Research on Quality use of drugs in hospital environment.
โข Initiated with developing applications for calculating the drug
dosage levels for renal impairment medication.
โข These calculators must accessible from patientโs bedside and from
hospital PCโs.
โข Capable of sending instant messages to pharmacy staff.
โข Transparent validation.
โข Reliable.
16th Annual Conference and Scientific Symposium
Healthcare Informatics Society of Ireland
Date 17 -11-11, Dublin
11. System Design of SQUD
1. Design drug dosage calculator for clinicians
2. Design framework for pharmacy administrator to generate
drug dosage regimens
3. Implement the calculator on multiple platforms like PDAโs,
mobile phones and on computers
16th Annual Conference and Scientific Symposium
Healthcare Informatics Society of Ireland
Date 17 -11-11, Dublin
12. System Architecture
16th Annual Conference and Scientific Symposium
Healthcare Informatics Society of Ireland
Date 17 -11-11, Dublin
13. System Architecture (Cont..)
1. The pharmacy administrator can login into the application
anywhere via Internet and can create, validate, update and
delete the drug protocols.
2. The created drug protocols will be saved in the webserver.
3. Clinicians can login into the application anywhere via the
Internet and can access the calculator or view the patient or
download the installation file for the mobile phones.
16th Annual Conference and Scientific Symposium
Healthcare Informatics Society of Ireland
Date 17 -11-11, Dublin
14. System Architecture (Cont..)
4. The downloaded installation files can be installed on the
clinician mobile phones and access the application.
5. Clinicians can access the application on the smart phones by
downloading the application on their devices.
6. Smart phones which are enabled with Wi-Fi or GPRS can login
into the application via Internet.
16th Annual Conference and Scientific Symposium
Healthcare Informatics Society of Ireland
Date 17 -11-11, Dublin
15. Progress
โข The web application is deployed in an Ireland server, the
application can be accessed by the url: www.squd.eu
โข Clinicians are registering into the application and accessing it.
โข The framework can be accessed/used by
โข Java enabled mobile phones.
โข Smart phones with internet connection
โข Stationary hospital PCs
16th Annual Conference and Scientific Symposium
Healthcare Informatics Society of Ireland
Date 17 -11-11, Dublin
17. www.squd.eu Clinician page
16th Annual Conference and Scientific Symposium
Healthcare Informatics Society of Ireland
Date 17 -11-11, Dublin
18. Mobile Version
16th Annual Conference and Scientific Symposium
Healthcare Informatics Society of Ireland
Date 17 -11-11, Dublin
19. Future Work
โข Broaden / extending the technology
โข to assist other dosing related problems such as those found
in new-born babies, cancer patients, ICU patients, etc.
โข โdrug-regime editorโ
โข Security / authenticity
โข Deployment on other mobile device types (e.g. Android etc.)
โข Improved system integration (HIS connectivity, adaptive
workflow integration)
โข Start looking into HMM aspects
โข to collect usage data on high priority (expensive) drugs like
intravenous immunoglobulin.
16th Annual Conference and Scientific Symposium
Healthcare Informatics Society of Ireland
Date 17 -11-11, Dublin
20. Conclusion
โข The research has shown that there is an increasing need for
robust medication management systems for clinical use.
โข The present prototype provides this functionality over a
wide range of user platforms, while providing a reliable
mechanism to generate, verify and distribute dosage
calculations.
16th Annual Conference and Scientific Symposium
Healthcare Informatics Society of Ireland
Date 17 -11-11, Dublin
21. Questions?
Thank you for your attention
16th Annual Conference and Scientific Symposium
Healthcare Informatics Society of Ireland
Date 17 -11-11, Dublin
Editor's Notes
1 minute
1 minute, overview only (donโt refer to all applications)!
2 minutes, important; talk about HMM and PMM!
1 minute, overview only, as slide has a clear message