Collaboration Technology for Real-time Treatment of Patients

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Phase 2 Quarterly Report

January 1 - March 30, 1997

Task 1 Demonstration of Computer-assisted Collaboration in Specialty Areas

The objective of this task is to demonstrate the usefulness of computer-assisted collaboration technologies in patient care, where the general practitioner in charge of a patient's care is not physically collocated with an appropriate expert consultant. This task will demonstrate remote consultation in two specific instances: 1) between a primary care obstetrician and a tertiary care perinatologist and 2) between a primary care provider and a tertiary care radiologist.

A. Current Status:

The Meeting on the Network (MONET) system has been deployed in all of the sites in Huntington. The support environment for the radiologists' consultation scenario is currently being developed. This involves scanning and archiving X-ray images and supporting the retrieval and display of high-resolution X-ray images. The design and development of the referral system, and the customization of the image sharing facility, are also underway.

B. Work Accomplished During this Period:

During this phase, the major work included:

• testing of the most recent version of MONET on Windows95 PCs. The audio system works well with various kinds of drivers, including half-duplex drivers, and a variety of video compression standards such as Microsoft's Video for Windows, Cinepak, Quicktime, and others. The system is interoperable across Windows and UNIX; and
• further progress on the Java-based whiteboard. The whiteboard is now operational, and video works well with both analog and digital cameras.

Task 2 Collaboration Technology for Community Care Networks

Community health care primarily involves preventive and primary health care for community residents through the participation of individual practices, group practices, federally-funded clinics, community centers, and hospitals. Collaboration and cooperation among these multiple parties is essential for effective healthcare delivery. Limited resources and medical staff, coupled with the lack of proper health education and awareness among the population, make it difficult to provide healthcare in rural areas. The objective of this task is to develop a community care network (CCN) that will allow a community of healthcare professionals to provide quality care to a rural population.

A. Current Status:

In this quarter, the ARTEMIS system received significant national attention. We continued to improve system performance and have now reached a point where Dr. Merkin and a select few others will start using it. Currently, the only holdup is the hiring process for the transcriptionist, which has now taken over two months. We expect the transcriptionist to be on board in the next few weeks and controlled experimentation to begin soon thereafter.

B. Work Accomplished This Period:

The following work was completed in this reporting period:

• performance tuning of the dictation and transcription interfaces at Huntington;
• initial training of the providers in the use of the system;
• demonstration of ARTEMIS to the news media (Wall Street Journal, ABC evening news, and several other organizations);
• completion of a prototype version for matching patient identifiers across clinics and hospitals; and
• completion of prototype version for referrals.

Task 3 Open Systems Architecture for Collaboration in Health Care

The objective of this task is to develop a domain-specific reference architecture for statewide collaboration in the health care domain that can serve as a model for promoting the use of such technology. Through direct experience with the experimental tasks, Tasks 1 and 2, we expect the architecture to evolve in its construction over the course of the project.

This task manages the planning and installation of infrastructure elements, networks, computers, etc., in the community care network. It also contributes to the overall effort to evaluate the effectiveness of the network and its individual elements.

A. Current Status:

We are actively involved in a number of activities related to the overall architectural frameworks for healthcare. One such activity is the CORBAMed effort jointly sponsored by OMG and MRI. We are also participating in a series of workshops in the Master Patient Index area to define a common framework for developing such indices.

Evaluation efforts have been put on hold for this period as we await VHS to hire a transcriptionist. This has taken longer than we had anticipated.

We received free hardware modules from a vendor which permit the straighforward administration and collection of questionaire-based data. We expect to use these in our next round of data collection.

B. Work Accomplished This Period:

The major work during this period included:

• a paper discussing the initial prototype of a Master Patient Index submitted to the Symposium on Computer Application in Medical Care (SCAMC);
• revisiting security issues in light of publicity about the project in the Wall Street Journal and ABC evening news;
• demonstrating our system at HIMSS to favorable responses;
• collecting and analyzing partial data on turn-around time of dictation notes;
• analyzing partial data on missing information under three categories: lab results, radiology reports and other;
• adjusting work sampling results using partial data on "after work" documentation time collected by providers themselves;
• submitting a paper entitled "The Web-Based ARTEMIS Project: Multilevel Evaluation in a Rural Health Care Network" to the American Medical Informatics Association (AMIA) for a fall 1996 symposium; and
• acceptance of a paper entitled "Application of Collaboration Technology from Engineering to Health Care" for publication in the Proceedings of International Workshop on Computer Supported Cooperative Work in Design to be held in Beijing, May 1996.

Task 4 Integration of Patient Care Information Legacy Systems

The objective of this task is to demonstrate open and easy access to patient information from legacy hospital information systems. This task is now focusing on integration at Cabell Huntington Hospital (CHH).

A. Current Status:

We currently have CERC personnel on-site at St. Mary's to work on integration issues. We expect to report significant progress linking both St. Mary's and Cabell Huntington this quarter.

B. Work Accomplished This Period:

The major work for this period included:

• evaluation of alternatives for integrating St. Mary's dictated reports to the ARTEMIS network. One technical staff member spent two months at St. Mary's to determine the final option.

http://www.cerc.wvu.edu/nlm/artemis/project_reports/p2q6.html
September 3, 1997, by Mary Carriger

Copyright © 1997 Concurrent Engineering Research Center