Patient Safety and Technology Laboratory
The Sims Lab has been involved in a variety of diverse projects. The common theme is system technology that impacts patient safety.
Dr. Sims and his colleagues invented the notion that each infusion pump should have a drug library that is configurable by a given hospital. This drug library reflects the hospital's particular practice guidelines and helps to assure safe medication delivery. A drug that will be given to a patient is entered into the pump (either manually or through the use of auto-ID) and the pump confirms that all subsequent entries for that drug (dose, rate, etc.) are safe as defined by the hospital's guidelines. This technology has been licensed nonexclusively to virtually every infusion pump company and has helped to usher in a new era of medication safety.
Anesthesia Drug Labeling
The Sims Lab team developed an application that enables safer administration of anesthetic drugs. Some drugs that are used during surgery are made by the anesthesiologist and placed by the patient should they be needed. Obviously, these syringes should be labeled. The Sims Lab application reads the barcode of the original drug vial, then automatically prints a color label with all the appropriate information, including the ASA standard colors, to be placed on the syringe. The label also contains a unique barcode that allows rapid, accurate documentation of the administration of the drug.
Vital Signs Capture
This solution allows data from disparate, legacy medical devices such as vital signs monitors to be automatically captured and entered into the electronic medical record (EMR). A key innovation is that the solution is sensitive to the context in which it is operating. This is accomplished through the use of barcodes containing rich data. For example, a medical assistant (MA) may scan a barcode on her ID badge, scan a barcode on the patient's encounter form and scan a barcode on a scale. These bits of information will be processed and the system will automatically communicate with the scale to get the patients weight, then prompt the MA to enter the patient's height (which is always collected with weight) and then publish the data to the LMR. One objective of the project is to capture blood pressure with every patient encounter with the hope of identifying hypertension precursors earlier.
This work-in-process is a system to remind clinicians to wash their hands. "Protection Zones" are established around a patient or other protected area, as well as hand-washing areas (sinks or antiseptic dispensers). If a clinician enters a protection zone for a period of time without washing their hands first, a pager-like device silently vibrates to remind them to wash.
The Sims Lab has ongoing work on new physiological monitoring systems. The general theme here is around small, wireless, ubiquitous monitors that can be used to provide a safety net for patients who do not have traditional cardiac monitoring. For example, it is our belief that if every patient had a simply, reliable respiration monitor many unexpected outcomes could be eliminated. Therefore, we are working on both new respiration monitors and new ob-body wireless platforms.
Life Signs Detection System
This completed project was designed to detect if a downed warrior needs immediate assistance. A small on-body system monitors heart rate, respiration rate, temperature and position. The system is worn by warriors in the most austere battlefield environments, so must be extremely robust. This data is relayed to a processor that determines a warrior's status in a simple "green light, yellow light, red light" fashion.
Smart Pump Education
Working with ECRI and others, the Sims Lab has an ongoing effort to educated the medical filed about smart pumps, IV drug safety, and more recently, the importance of approaches to restrict the total amount of fluids patients receive through IVs.
Patient Care Kiosk
Working with Dr. Ron Dixon, a primary care physician at Mass General, a Sims Lab team has been developing a health kiosk. This device supports both real-time (synchronous) and non-real-time (asynchronous) visits between a patient and a physician. The kiosk contains two-way video and audio links and can monitor blood pressure, heart rate, SpO2, peak-flow, weight and blood coagulation times. The objective of this project is to empower physicians and patients with more convenient approaches routine care as well as to provide access to traditionally people who are traditionally underserved by the conventional healthcare system.
This research project attempts to automatically determine what medications a patient is on through reading their pill bottles. The vision is that a patient brings all of their medication bottles with them in a small bag when they visit the doctor. The contents of the bag are dumped into a hopper that reads each individual medication bottle's label, reconciles the data with the meds the patient is known to be on, and prints an exception report for the physician. The objective is to get patient medication data in a more convenient, accurate way.
Single- and Multi-Doser Antibiotic Delivery Systems
These projects are inexpensive, mechanical systems to safely give antibiotics over approximately 30 minutes. They eliminate the need to tie up an expensive electronic infusion pump while still freeing up the nursing staff to care for other patients.
The MyMice system was designed to address current gaps in caring for laboratory mice by capturing vital cage information and individual animal status then storing and making available this information over the internet. One of the key parts of this sensing system is a digital video system. The system can be easily retrofitted onto an existing cage rack to monitor each cage on the rack and every mouse in each cage. MyMice can be programmed to take 10 seconds of video data per cage four times an hour and then process and store this information. The data can be used to determine:
- The exact location and identification of each cage, by rack and by room
- The number of mice in the cage
- Individual mouse activity and behavior, including signs of illness or fighting
- Individual mouse breathing rates
- Ambient light level in each cage (that may affect animal behavior, physiology, and reproduction)
- Humidity level in each cage (by reading a small color changing paper barometer)
- Food level in each cage (to avoid animals starving)
- Functionality of drinking water systems, based on how frequently mice are observed drinking (mice that are thirsty will attempt to drink more often)
- Flooded cages caused by watering system failures