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Introduction Architecture Intelligent Prescription System Rural Data Capture Critical Alert Engine Solution Positioning Value Addition

What is Critical Alert Engine (CAE) ?
In a typical multi-storey hospital complex, the Intensive Care Unit (ICU) is located in a specific portion of the building. But the doctors keep moving about the entire hospital complex, attending to various patients, and locating them or contacting them quickly at a time of emergency becomes an issue of concern.

Critical Alert Engine (CAE) empowers the nurses and other medical professionals involved in treating critical patients in the ICU, by enabling real time communication between the ICU and the doctor. A Pocket PC with wireless connectivity is provided to the doctors, nurses and other medical professionals involved in treating the ICU patients. The nurses can send critical alerts and notification messages to doctors about the status of a patient and ask for immediate action to be taken. Hence it becomes easier to track a doctor assigned to a specific patient in real time. This results in improved collaboration and coordination within the team, thus providing mission critical care to patients.

Example: If a patient’s heart rate crosses a certain value, it could mean that the patient needs immediate attention. In such a scenario, the nurse could send a message to the doctor (through her Pocket PC), with critical details like current heart rate, blood pressure, pulse rate etc. As the communication happens instantly in real time, the doctor would respond immediately (either through a reply message giving directions for first-aid to the nurse or by physically coming to the ICU)

CAE System Design

CAE System Design

The CAE possesses a two-tier architecture viz. the PocketPC Front End and the Hospital Back-End. These components are explained below:

  1. PocketPC Front End:
    This component of CAE is built as consisting of the following three sub-components:

    1. CAE Alert Capture Interface: The CAE Alert Capture Interface provides the necessary UI to gather the required critical data about the ICU patient who needs immediate attention. The doctor’s id to whom an alert needs to be sent is also entered and the alert is dispatched. The form is designed to be simple and quick-to-fill. A screen shot of the CAE Alert Capture Interface obtained on a PocketPC Emulator is shown below:

      CAE Alert Capture Interface in Action

    2. Critical Data SQL Server CE Database: The Critical Data SQL Server CE Database is an efficient local store on the PocketPC, of the critical patient data obtained in the ICU from the the CAE Alert Capture Interface. It comprises a single table called CriticalData with a schema suited to store critical patient data. SQL Server CE makes application development easy while providing a consistent development model and API. It is also a robust, feature-rich mobile database solution with a relatively small footprint. It includes a query processor, merge-replication and synchronization capabilities.

    3. AlertDoc XML Web Service Client: In order that a doctor who receives the alert from the ICU take suitable actions, it is necessary that the data obtained at the ICU be communicated to the doctor. CAE provides a mechanism for this purpose through a simple XML Web Service made available on the hospital server (as we shall discuss soon). The AlertDoc XML Web Service Client is a client of this XML Web Service and runs on the PocketPC. When invoked, the client connects to the hospital server via Wi-Fi connectivity, makes a call to the XML Web Service, funnels the ICU patient data to the XML Web Service (which in turn fires an alert to the doctor packaging the data with the alert).

  2. Hospital Back-End:
    This component of CAE is built as consisting of the following two sub-components:

    1. AlertDoc XML Web Service: As mentioned earlier, CAE provides a XML Web Service based solution for communicating the critical ICU patient data gathered on the nurse's PocketPC to the doctor. AlertDoc XML Web Service is the XML Web Service which runs on the hospital server and enables the PocketPC to push the ICU patient data. It should be noted that the AlertDoc XML Web Service receives from the PocketPC, the ID of the doctor to be alerted. Individual doctor profiles are stored on the hospital servers with details on mode through which the doctor can be reached at specific times. Currently supported communication modes are Email and SMS. The AlertDoc XML Web Service reads the profile of the doctor to be alerted and gets the mode through which the doctor has to be contacted currently. The AlertDoc XML Web Service then sends an Email to the doctor or an SMS to his/her cellphone as the case may be. To provide for redundancy in communication, AlertDoc uses a pre-configured database of back-up doctors in case the alert cannot be successfully delivered.

    2. Hospital SQL Server Database: The Hospital SQL Server Database is persistent store at the hospital site which houses the profiles of individual doctors. The AlertDoc XML Web Service uses this database to determine the mode by which an alert has to be delivered to the doctor. In addition, each ICU alert is logged in the database for future reference.

Summary
Thus the CAE enables real time alerts between the ICU and the doctors. The critical patient details are packaged along with the alert so that the doctor may be made aware of the actual patient state even before he reaches the ICU. There is enhanced collaboration among the members of the hospital team; timely, mission critical care is made available to the patients.



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