Development and Validation of a Portable Platform for Deploying Decision-Support Algorithms in Prehospital Settings

A. T. Reisner; M. Y. Khitrov; L. Chen; A. Blood; K. Wilkins; W. Doyle; S. Wilcox; T. Denison; J. Reifman

doi:10.4338/ACI-2013-04-RA-0023

Applied Clinical Informatics, Inhaltsverzeichnis

Appl Clin Inform 2013; 04(03): 392-402
DOI: 10.4338/ACI-2013-04-RA-0023

Case Report

Schattauer GmbH

Development and Validation of a Portable Platform for Deploying Decision-Support Algorithms in Prehospital Settings

A. T. Reisner

¹Biotechnology High Performance Computing Software Applications Institute (BHSAI), Telemedicine and Advanced Technology Research Center (TATRC), U.S. Army Medical Research and Materiel Command (USAMRMC), Fort Detrick, MD, USA

²Massachusetts General Hospital Department of Emergency Medicine, Boston, MA, USA

,

M. Y. Khitrov

¹Biotechnology High Performance Computing Software Applications Institute (BHSAI), Telemedicine and Advanced Technology Research Center (TATRC), U.S. Army Medical Research and Materiel Command (USAMRMC), Fort Detrick, MD, USA

,

L. Chen

¹Biotechnology High Performance Computing Software Applications Institute (BHSAI), Telemedicine and Advanced Technology Research Center (TATRC), U.S. Army Medical Research and Materiel Command (USAMRMC), Fort Detrick, MD, USA

,

A. Blood

²Massachusetts General Hospital Department of Emergency Medicine, Boston, MA, USA

,

K. Wilkins

³Boston MedFlight, Bedford, MA, USA

,

W. Doyle

³Boston MedFlight, Bedford, MA, USA

,

S. Wilcox

²Massachusetts General Hospital Department of Emergency Medicine, Boston, MA, USA

³Boston MedFlight, Bedford, MA, USA

,

T. Denison

³Boston MedFlight, Bedford, MA, USA

,

J. Reifman

¹Biotechnology High Performance Computing Software Applications Institute (BHSAI), Telemedicine and Advanced Technology Research Center (TATRC), U.S. Army Medical Research and Materiel Command (USAMRMC), Fort Detrick, MD, USA

› Institutsangaben

Abstract

Summary

Background: Advanced decision-support capabilities for prehospital trauma care may prove effective at improving patient care. Such functionality would be possible if an analysis platform were connected to a transport vital-signs monitor. In practice, there are technical challenges to implementing such a system. Not only must each individual component be reliable, but, in addition, the connectivity between components must be reliable.

Objective: We describe the development, validation, and deployment of the Automated Processing of Physiologic Registry for Assessment of Injury Severity (APPRAISE) platform, intended to serve as a test bed to help evaluate the performance of decision-support algorithms in a prehospital environment.

Methods: We describe the hardware selected and the software implemented, and the procedures used for laboratory and field testing.

Results: The APPRAISE platform met performance goals in both laboratory testing (using a vital-sign data simulator) and initial field testing. After its field testing, the platform has been in use on Boston MedFlight air ambulances since February of 2010.

Conclusion: These experiences may prove informative to other technology developers and to healthcare stakeholders seeking to invest in connected electronic systems for prehospital as well as in-hospital use. Our experiences illustrate two sets of important questions: are the individual components reliable (e.g., physical integrity, power, core functionality, and end-user interaction) and is the connectivity between components reliable (e.g., communication protocols and the metadata necessary for data interpretation)? While all potential operational issues cannot be fully anticipated and eliminated during development, thoughtful design and phased testing steps can reduce, if not eliminate, technical surprises.

Keywords

Decision-support algorithms - prehospital care - device connectivity - vital-sign data - combat casualty care

Volltext

Referenzen

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