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Live from EBRC - mobile healthcare monitoring

Next up are my old friends from Kiwok - Rules to improve care processes and patient quality of life. The Kiwok solution being discussed is for heart monitoring. Previously, when a patient had heart problems, hospitals hooked up a device to a patient and took recordings for 24-48 hours. Then a doctor analyzed the recording. Unless the problem showed up during the recording you got no useful data. Anders, one of the founders, had a heart problem and went through this process 4 times before the doctor saw the problem. He could not understand why it was not possible to monitor someone constantly. As a result Kiwok built a solution for constant monitoring device and used rules to "watch" the information flow.

The system uses standard hardware for monitoring heart activity, connects it using mobile phone technology to transmit the data to HP non-stop servers. This allows real time monitoring of the heart and uses GPS/GSM network to locate the person. However, each patient generates 25-28Mb of data a day and clearly it is no use having a doctor just watch a bunch of screens as they cannot effectively watch very many. To manage this they run Blaze Advisor rules on HP Nonstop servers. The rules are created by the doctor and patient together - each case is unique and so needs their own rules. Doctors can set up alerts and new monitoring rules and patients can identify relatives and others to get alerts too. Personal information is not transmitted but managed within the hospital systems and combined with the heart information when it arrives. They defined 21 standard templates for various kinds of rules like pulse limits in certain time windows or certain patterns of heart activity. This allows doctors to create rules easily for each patient (templates being one of the secrets of business user rule maintenance). The doctors can also define how much data they want to see when there is a incident and how they want to be notified etc. The system does not necessarily transmit data all the time - it might be triggered by particular activity or by a fall. Patients like the peace of mind of continuous monitoring, doctors like the custom monitoring and the healthcare system saves money.

The solution supports diagnostic use (for someone who just had a new episode) and for ongoing care and Kiwok has worked with a leading Swedish medical institute for all this. They point out that as populations age the need for this kind of solution will only grow - fewer people must provide healthcare to more, older patients. Their focus is on heart disease, blood pressure and diabetics as these are expensive problems but things like monitoring pregnant women and so on. They are working with pilots using smaller and smaller devices with more and more intelligence. I blogged about them before here and they are discussed in this podcast. Personally I think this kind of intelligently monitored remote medical device is going to play a huge role in the future. His slides are here.

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