Abstract
Most existing, expert monitoring systems do not provide the real time continuous analysis of the monitored physiological data that is necessary to detect transient or combined vital sign indicators nor do they provide long term storage of the data for retrospective analyses. In this paper we examine the feasibility of implementing a long term data storage system which has the ability to incorporate real-time data analytics, the system design, report the main technical issues encountered, the solutions implemented and the statistics of the data recorded. McLaren Electronic Systems expertise used to continually monitor and analyse the data from F1 racing cars in real time was utilised to implement a similar real-time data recording platform system adapted with real time analytics to suit the requirements of the intensive care environment. We encountered many technical (hardware and software) implementation challenges. However there were many advantages of the system once it was operational. They include: (1) The ability to store the data for long periods of time enabling access to historical physiological data. (2) The ability to alter the time axis to contract or expand periods of interest. (3) The ability to store and review ECG morphology retrospectively. (4) Detailed post event (cardiac/respiratory arrest or other clinically significant deteriorations in patients) data can be reviewed clinically as opposed to trend data providing valuable clinical insight. Informed mortality and morbidity reviews can be conducted. (5) Storage of waveform data capture to use for algorithm development for adaptive early warning systems. Recording data from bed-side monitors in intensive care/wards is feasible. It is possible to set up real time data recording and long term storage systems. These systems in future can be improved with additional patient specific metrics which predict the status of a patient thus paving the way for real time predictive monitoring.
Highlights
De Georgia et al in their review of monitoring and data acquisition systems for patient care state that though patient monitoring systems were introduced in intensive care units in the 1960s, there has been very little advance made in the technology [5]
Vital physiological parameters are recorded from each patient in critical care with the help of sensors attached to the patient and viewed on Philips bedside monitors MP30 [6], a computational device which collects information from different biosensors as electrical currents and converts them into clinically relevant data such as waveform data and vital signs
One included the vital signs recorded at 5 s intervals transferred through the HL7 port from the Information Centre (IIC) wirelessly and the other waveform data recorded at 100 Hz from the bedside monitors directly via the LAN
Summary
Major healthcare information management systems were designed as basic data recording and viewing systems. Physiological data is recorded using sensors attached to the patient and the data viewed on bed-side monitors. This data is analysed and scored by the bed-side nurses on A3 size colour coded paper charts at hourly intervals. In order to view the dynamical state changes of the patient’s physiology, systems capable of real time data analysis and long term storage with annotation facilities are needed. An inability to embed code developed externally that is capable of real time analysis
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