Day 1 :
Keynote Forum
Rolf Rossaint
University Hospital Aachen, Germany
Keynote: Structure and Benefits of a Telemedicine Supported Emergency Ambulance System
Time : 09:45AM - 10:45AM
Biography:
Rolf Rossaint is a Professor and Head of the Department of Anesthesiology at the University Hospital (since 1997). Prior to his present appointment, he was Associate Professor in the Clinics for Anesthesiology and Surgical Intensive Care at the Humboldt University of Berlin. He is member of the National Academy of Science Leopoldina. He has (co) authored over 500 articles in peer-reviewed journals. His clinical and research interests include pulmonary pathophysiology, ARDS treatment, extracorporeal lung assist, xenon anesthesia, coagulation management, and telemedicine in emergency medicine. He developed a holistic telemedicine system for a broad spectrum of different pre-hospital emergency cases, which acts now on a routine basis synergistically to the existing ground- and air-based rescue systems.
Abstract:
Objectives: Demographic change, rising co-morbidity and an increasing number of emergencies are the main challenges that Emergency Medical Services (EMS) in several countries worldwide are facing. In order to improve quality in EMS, highly trained personnel and well-equipped ambulances are essential. However several studies have shown a deficiency in qualified EMS physicians. Telemedicine emerges as a complementary system in EMS that may provide expertise and improve quality of medical treatment on the scene. Hence our aim was to develop, to test and to introduce a specific tele-consultationemergency system in routine care.Methods: Telemedical functionalities including audio communication, real-time vital data transmission, 12-lead electrocardiogram, picture transmission on demand and video streaming from a camera embedded into the ceiling of each ambulance and in mobile devices which were used at the scene outside the ambulance were incorporated in the hardware part of the system. The developed medical software is algorithm and guideline-based. Upon completion, technical field tests were performed under realistic conditions to test system properties such as robustness, feasibility and usability providing end-to-end measurements. Finally, the system was used in real out of hospital emergencies as part of routine care.Results: In the pilot phase six ambulances were equipped with telemedical facilities based on the results of the requirement analysis and 55 scenarios were tested under realistic conditions in one month. The results indicated that the developed system performed well in terms of usability and robustness. The major challenges were as expected, mobile communication and data network availability which was possible in >99% at the end of the development period. After demonstrating the feasibility of the telemedical approach more than 1000 patients were treated within the project phase. In the meanwhile all ambulances of the city of Aachen are staffed with this telemedicine equipment and the system has been established as an additional structure in the care of out-of-hospital EMS. So far, more than 2000 patients have been treated with the help of this telemedicine-based out-of-hospital emergency system. Conclusions: An innovative concept for the use of telemedicine for medical consultations in EMS was developed. Organizational and technical aspects were considered and practical requirements specified. The feasibility of the telemedical approach was demonstrated. Tele-consultation enabled early initiation of treatments by paramedics operating under the real-time medical direction. Tele-consultation can be used to provide advanced care until the patient is under a physician\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\\'s care; moreover, it can be used to support the paramedics who work alone to provide treatment in non-life-threatening as well as in life-threatening emergencies.
- Track-1 Access to Rural eHealth
Track-3 Role of Information Technology in Telemedicine
Track-5 Clinical Applications of Telemedicine
Session Introduction
Kaun Chun Chen
Cheng Hsin General Hospital, Taiwan
Title: When telemedicine meet acute chest pain patients: How we use in-hospital tele-ECG to improved quality of care and improved D2BT of STEMI patients
Time : 11:00AM – 11:45AM
Biography:
Kuanchun Chen received complete medical education in National Defense Medical Center, Taipei, Taiwan during 1992-1999. He completed internal medicine resident and fellowship training in Taipei Veterans General Hospital. Since 1996-November, he began to get involved in a new booming growth area: TeleHealth and now become a team member and leader of TeleCare Services Center of department of cardiology, heart center in Cheng Hsin General Hospital, Taipei, Taiwan. As the pioneer of this field, he tried many possibility of telemedicine in daily medical practice and in different disease population as acute myocardial infarction, hypertension, or diabetes patients.
Abstract:
Tele-ECG triage has been used worldwide in many difference scenarios including home monitoring for arrhythmia detection, post pacemaker or ICD implantation followed up and pre-hospital ECG triage by ambulance staffs; reasons for monitoring including arrhythmia detection, chest pain evaluation for possible acute heart attack. How to shorten diagnosis and treatment delay are challenging to clinical practice. Current guidelines recommend that >75% of patients with ST-elevation myocardial infarction (STEMI) receive primary percutaneous coronary intervention (PPCI) within 90 minutes. The goal has been hardly achievable. Many steps were associated with delay diagnosis and treatment from ED to cathroom. However, ECG reading adds PPCI activation is the most critical step. So we conducted a 2-year before-and-after study to determine the impact of emergency department (ED) tele-electrocardiographic (tele-ECG) triage and interventional cardiologist activation of the infarct team at door-to-balloon time (D2BT) and the proportion of patients undergoing PPCI within 90 minutes since arrival. This triage was successfully shorten D2BT and also associated better clinical outcomes in subsequent 3 years follow up. In my presentation, I will share our experience about what difficulty we face before and after implantation these strategy and possible influence to associated team members.
Papadopoulos Homer
National Center for Scientific Research, Greece
Title: Designing smart home environments for unobtrusive monitoring for healthier lives : The use cases of USEFIL and REAAL
Time : 11:45AM – 12:30PM
Biography:
Papadopoulos Homer holds a Physics degree and a Pre-PhD on telecommunications from the University of Athens and a Bio-design graduate certificate from Stanford University US. He has an MBA at Warwick University and he holds a PhD from IS/IT Department of Bath University UK. He has been working for NCSR \\\\\\\"Demokritos\\\\\\\" for 15 years (now under permanent contract at NCSR “Dâ€DAT) managing various European funded Research programs within the fields of e-services, mobile services and technologies and broadband telecommunication networks. He has published several papers in journals and international conferences. Recently, he has set up a spin off private company, Syndesis Ltd., with a main focus to exploit commercially state of the art bio-medicine technologies and electronic health services.
Abstract:
Elderly people face enough challenges to their independence often related to feeling loneliness to a decline in mobility or cognitive problems. These challenges cause direct or indirect health problems. Within the realm of successful implementation of EU funded projects innovative infrastructures, architectures, IoT and WoT frameworks and applications have been developed for providing e-Health and wellbeing services to cope with this problem. The use cases that will be presented intend to cope with ageing diseases providing advanced, affordable and unobtrusive monitoring and web communication solutions for seniors living independently. The developed systems enhances social care and medical service provision by exploiting “frugal†ICT solutions. The main system components that have been used are low cost video cameras equipped with wireless communication capability to provide monitoring of person’s movements, emotional and physiological parameters. Wrist-worn smart phones able to recognize daily activities and monitor some physiological parameters, tablet PC to act as one of the end-user interaction devices with the focus on provision of social awareness of friends and relatives, Web-enabled TV as the main end-user interaction device with end users, machine learning algorithms able to provide decision support and environmental and energy consumption monitoring sensors. Aim of the presentation is to demonstrate the use of these ICT technologies which were implemented and are under continuous validation over the last three years with real end users, their unofficial carers and doctors. Results demonstrate that the technology readily succeeds in meeting the study`s initial objectives.
Sarah Ben Othman
Ecole Centrale de Lille, France
Title: Augmented Reality and Hospitalized Newborn Safety
Time : 12:30PM – 13:15PM
Biography:
Sarah Ben Othman is a PhD student within CRIStAL laboratory in the Ecole Centrale de Lille (Ec-Lille) in France. Her current work handles: control flow in Emergency Department (ED), assess and anticipate ED crowding mainly in pediatric ED. She developed skills in: modeling and optimization, Supply Chain issues and Decision Support Systems. She is an automation engineer graduated from the National Engineering School of Gabès (ENIG) in Tunisia, in June 2012 and she obtained her master degree in Supply Chain Management in November 2013 from Ec-Lille in France.
Abstract:
At the hospital care of a newborn, the iatrogenic risk may be related to the specific side effects of drugs but also to errors during preparation (dilution error, calculation error, error due to combination of two incompatible products from a physicochemical point of view) and or during the administration of products (dose error, administration of a non-prescription medication) committed by the nursing staff. These errors are common and constitute a real concern of medical teams. The steps of preparation and drug administration are particularly at risk. The majority of administration errors are related to the human factor. They are associated with increased stress among nurses. These errors can have consequences for the patient, professionals, health institutions and health insurance. Many studies have proposed and evaluated measures to limit the occurrence of these errors. The research is now shifting focus towardsmultimodal approaches integrating traceability of operations. However, these measures are struggling to be integrated in daily clinical practice. Hence, the introduction of new technologies in health care system must be considered. To avoid these errors, we propose to design and develop an innovative decision support system based on the technology of Augmented Reality built into intelligent glasses freeing user hands. This system ensures traceability, usability, dynamism, security and transparency for better management of patient medicinal care. The application implemented on the augmented reality glasses have been tested by 7 nurses. Most of them estimate that the glasses enable them to gain time and to reduce the mistakes while preparing drugs.
Alessandro Grattoni
Houston Methodist Research Institute (HMRI), USA
Title: Remotely Controlled Drug Delivery Implant for Telemedicine
Time : 14:00PM – 14:45PM
Biography:
Alessandro Grattoni has obtained his PhD in Biomedical Engineering at Politecnico of Torino while working in Dr Mauro Ferrari’s team at the University of Texas Health Science Center in Houston. He is an Assistant Professor and Chair of the Nano medicine Department at HMRI. His laboratory’s research focuses on the development and validation of nanochannel membranes for long-term administration of therapeutics and cell transplantation.This includes experimental and phenomenological analyses within both in vitro and in vivo models. He has received support from NASA, NIH, CASIS, Vivian Smith Foundation, Nancy Owens Memorial Foundation and Nano Medical Systems, Inc.
Abstract:
We have developed a ceramic material-based nanochannel technology for the sustained and controlled administration of therapeutics from implantable devices. The technology leverages the nanoscale interactions between molecules and channels to achieve the tight modulation of drug transport throughout the membrane’s nanochannels. When used in “passive modeâ€, the device is capable of zero-order sustained release of drugs for months to years without the need for pumping mechanism, as demonstrated in vivo in rodent and canine models. If an electrical filed is applied across the nanofluidic network, drug release can be tuned, interrupted, reactivated with unlimited modulation capabilities. In this case, drug release is controlled by judiciously redistributing the concentration of the ions in solution at the inlet and outlet of nanochannels and generating an ionic concentration polarization. Based on this, we have developed a next generation implant technology which comprises of a drug reservoir, and electrode coated nanochannel membrane a low-energy Bluetooth antenna for RF communications and electronics. The implant can be remotely controlled through radio frequency to activate or interrupt the drug release. This technology has received the attentions of the Center for the Advancement of Science in Space, which is supporting its development in the context of enhanced capabilities for life-science investigations on the International Space Station. Beyond testing in Space, this technology holds massive potential for the implementation of telemedicine approaches on-Earth and the improvement of the quality of life of patients. Furthermore, it mays be adapted to delivering medical care to remote geographical areas or warzones.