A Cancer Patients Future Technology Journey: From Clinical Presentation to Survivor

Group 2 Joseph Adams Charan Dhanoa Melody Dungee Annamarie Hendrickx

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Agenda

Information flow between various facilities providing diagnosis and treatment. Role of technology to enhance patient care and physician decision support.

Patient Portal
Patient logs in from home
to pre-register request appointments pay bills and manage health records via the web communicate with health care team

iHealth PHR

Secure way for patients to create a personal health record (PHR) Summarizes the health information Makes information available via internet Allows Patients to Communicate with their physician Prescription renewal requests

MediKiosk
Make positive patient identification

Diminish patient registration times

Identify & triage critical-need patients sooner Triage earlier and respond faster!

e-TABLET

Tablet PC Tablet PC Docking Station

Electronic Consent
Digital Signature Capture
Effective electronic signature capture is essential to ensuring the completion of legally valid documents
informed consent forms advance directives patient instructions

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http://www.dialogmedical.com/ePads.htm

EMR Interoperability within the Hospital Facility

IMAGING -reports -images LAB -orders
-results

.
PATIENT KIOSK

PATIENT PORTAL

PHARMACY -medications
-allergies

PHR
OUTPATIENT INPATIENT AMBULATORY

-orders -results
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Access to Patient Information

as needed
when needed where needed by the authorized care provider with security and confidentiality

RHIO
.

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Source: Indiana RHIO

Background

Fred, A 35 year old male, has a grand mal seizure. His first grand mal seizure was 7 years ago. At that time, he was prescribed anti-epileptic medication, but has continued to have 2 episodes of focal motor seizures per year. Otherwise, he is in healthy condition, does not drink and has never smoked.

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The Physician Office

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The Physician Office

110 70 71 155 98.3

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The Physician Office

The Physician Encounter

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The Physician Encounter

What brought you here today? Well I woke up this morning around 8 and felt fine.Then about 10:30 I had the seizure. Really scared the Mrs.

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The Physician Encounter

Weakness in right hand no facial birthmark

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The Physician Decision

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Background
In 1980, the average American had a medical radiation dose of 0.54 mSv. By 2006, that amount increased 600 percent, to 3.2 mSv per capita. The worldwide average background radiation dose is estimated at 2.4 mSv per year. James A. Brink, M.D. 2007 RSNA Annual Meeting

Strategies for reducing imaging-caused radiation dose exposure are getting more attention as awareness of radiation risks increases. Often, mitigating dose exposure requires finding a fine line between controlling dose and obtaining enough information for a confident diagnosis. John C. Hayes, Editor, Diagnostic Imaging

RHIO

CPOE with Decision Support

Radiation Dose Information and Alerts Exam Appropriateness Contraindications
Type of Exam
Pacemaker vs MRI

Imaging Contrast Agents

Allergies Medicine Reconciliation

CPOE with Decision Support

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CPOE with Decision Support

CPOE with Decision Support

CPOE with Decision Support

CPOE with Decision Support

Scheduling

Imaging Center

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Imaging Center
RIS

Digital
Radiography

PACS Viewing Workstation

Imaging Center
RIS

MRI with Sedation

PACS Viewing Workstation

Imaging Center

Imaging Center

Next Steps

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Visual Aid to Explain Diagnosis Uncertainty

Next Steps
Medical information retrieved from RHIO. Consult with Neurologist. Referred to Neurosurgeon

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Next Steps
Fred checks in at the Hospital.

Medication Reconciliation is done.

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Medication Reconciliation

Next Steps
Biopsy performed Biopsy results received

Treatment Decision Tree

Gamma Knife

Chemotherapy
Chemotherapy at home
8 doses Blood tests required after 1st dose for white blood cell count.

Who is involved:
Fred take medication, get blood test Lab results from blood test Neuro-Oncologist checks lab results, orders next round of therapy. Pharmacist Make sure Fred picks up his medication and provides extra information to Fred and his family

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Chemotherapy Data Communication

Chemotherapy Data Communication

Chemotherapy Data Communication

Chemotherapy Data Communication

Chemotherapy Data Communication

Chemotherapy Care Communication

Fred with Neuro-Oncologist
When next dose is to be taken Reminder call Check up call on day medication taken

Fred with Pharmacist

Side effects and alleviation Make sure someone is with you for 24 hours

Neuro-oncologist with pharmacist

Alert if Fred does not pick up medication Discusses side effects

Summary

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References
http://www.ncr.com/products_and_services/software/healthcare/ncr_ patientportal.jsp Dr. Liebovitz, Class 402, Session 6 PowerPoint Problem Solving in Clinical Medicine, From Data to Diagnosis. Paul Cutler, MD http://www.umanitoba.ca/cranial_nerves/trigeminal_neuralgia/manus cript/rhizotomies.html http://path.upmc.edu/divisions/neuropath/bpath/cases/case6/images /micro4.jpg http://www.cisco.com/web/FR/press/phototheque/photos/unifiedcom/ originals/Cisco_TelePresence_3000_2.jpg

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References
http://www.rsna.org/Publications/rsnanews/January2008/Ra diologistsUnite_feature.cfm - Radiation Dosage http://www.diagnosticimaging.com - Radiation Dosage http://www.medical.philips.com - Digital Radiography http://www.novoinnovations.com/siteResources/files/docum ents/Brochure_EMR_Interoperability_11_26_06.pdf http://www.emrexperts.com/why-emr.php