Phoenix Ambulatory Blood Pressure Monitor Project
12/11/2005 Meeting Notes

Attendees

• Chris Adams
• Mike Balow
• Norm Bayne
• Larry Beatty
• Trung Le
• Dennis Lienke
• El Nolley
• Mary Jo Rawson
• Bob Schlentz
• Dave Skramstad
  

Discussion

Status Review:

• Mary Jo: close to obtaining all of the piezo film components. Then, she will implement and analyze the results.
• Gerry Werth: Investigating how clinical information is coded, especially in Pediatrics, and is collaborating with Vergi Slee.
• Dennis: offered to navigzte the unversity hierarchy to get a universal IP for a wiki. Get an IP, a machine installed and deploy it. Trun suggested filesanywhere.com will provide free universal IPs, 10 MB, used by organizations that need a point beyond their firewall.
• Germaine: working on an automated Cosinor program that implements the data analysis presentation in an
  Excel spreadsheet. She expects to complete it by next meeting. Also, she discussed the ABPM discussed and informed by Larry Beatty in Electronic Design, Tensys, PL150 ,
• Norm Bayne joined us and will work on a quality system, and Trung Le joined us.

Chris Adams continued leading development of system requirements, using MyPage, 2005-12-11.pdf or ppt. He summarized the major subsystems and interfaces including ABPM, ABP diary, Data Analysis Software, Medical Records System, ABPM wearer, ABPM administrator, physiologist.

• The device itself is a realtime embedded system. What are the hard realtime vs soff realtime system requirements. In hard realtime systems, missing means the system fails. In soft realtime requirements, a recovery or alternative path is used to continue.
• Device Subsystem portions:
  - clock: sample beat to beat, 1 ms resolution.
• Questions: what information do we need about the wearer.
  Bob: We only need the serial number of the instrument. The rest of the information that maps the instrument and time to the patient identify. (PII - personal identifiable information).
  Trun: Unique device identifier, and patient. Needs to be encrypted for wireless and HIPPA.
  Chris: We need to trace data to a device and to an individual. The system is intended to be highly modular.
  Norm: We might want a dual system for quality.
  Bob: For any number, you would like redundancy for error correction .
  Trun: MAC addresses are getting full, instead use RFID number. 128 bytes.

Gerry Werth: Clinical Information System mini-topic.

• The System is Losing Data.
• 1978: What does final mean, or RTFM. (read the fine manual)
  2005: Coding,
• 1978: Fungal Infection, Grand Rounds- the lab was unable to grow the organism. Lab: the system is losing data. RFTM: fungal cultures never say 'fuinal' on the printed report. MNediuical RRecords: discard paper if it didn tnot say 'final'.
• 2005: The system will not alloww the exact diagnosis to be recorded. No codes exist for the final system.
• Diagnostis/Code/Classification.
  - Diagnosis: free text used by trhe doctor.
  - Code: a thinkg substituted for something else.
  - Codes are Identifiers
  - Classification are Organizers - sets of pigeonholes in which to place other things.
• Flaws in Coding/Classification
  - Diganostic entity: no way to capture the permanent codes, exact diagnosis which the physician records.
  - Classification set: we can't tell what individal codes mean because they contain no identifiers.We must make a single classification, ICD-9-C, serves all purposes.
  - One Classification Fits All.
  - EMR The electronic medical record typically sacrifices completeness and accuracy for convenience in data input.
• Social Informatics:
  - Initially, we must do hypothesis generating, then hypothesis proving.
  . Therefore, clinical computing and business computing are different subspecialties of computing.

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