Görges Matthias, West Nicholas C, Petersen Christian L, Ansermino J Mark
Department of Anesthesiology, Pharmacology & Therapeutics, The University of British Columbia, Vancouver, BC, Canada.
Research Institute, BC Children's Hospital, Vancouver, BC, Canada.
JMIR Perioper Med. 2019 Aug 5;2(2):e13559. doi: 10.2196/13559.
In the perioperative environment, a multidisciplinary clinical team continually observes and evaluates patient information. However, data availability may be restricted to certain locations, cognitive workload may be high, and team communication may be constrained by availability and priorities. We developed the remote Portable Operating Room Tracker app (the telePORT app) to improve information exchange and communication between anesthesia team members. The telePORT app combines a real-time feed of waveforms and vital signs from the operating rooms with messaging, help request, and reminder features.
The aim of this paper is to describe the development of the app and the back-end infrastructure required to extract monitoring data, facilitate data exchange and ensure privacy and safety, which includes results from clinical feasibility testing.
telePORT's client user interface was developed using user-centered design principles and workflow observations. The server architecture involves network-based data extraction and data processing. Baseline user workload was assessed using step counters and communication logs. Clinical feasibility testing analyzed device usage over 11 months.
telePORT was more commonly used for help requests (approximately 4.5/day) than messaging between team members (approximately 1/day). Passive operating room monitoring was frequently utilized (34% of screen visits). Intermittent loss of wireless connectivity was a major barrier to adoption (decline of 0.3%/day).
The underlying server infrastructure was repurposed for real-time streaming of vital signs and their collection for research and quality improvement. Day-to-day activities of the anesthesia team can be supported by a mobile app that integrates real-time data from all operating rooms.
在围手术期环境中,多学科临床团队持续观察和评估患者信息。然而,数据可用性可能仅限于某些地点,认知工作量可能很大,团队沟通可能受到可用性和优先级的限制。我们开发了远程便携式手术室追踪应用程序(telePORT应用程序),以改善麻醉团队成员之间的信息交流和沟通。telePORT应用程序将手术室的波形和生命体征实时数据与消息传递、帮助请求和提醒功能相结合。
本文旨在描述该应用程序的开发以及提取监测数据、促进数据交换并确保隐私和安全所需的后端基础设施,其中包括临床可行性测试的结果。
telePORT的客户端用户界面采用以用户为中心的设计原则和工作流程观察方法进行开发。服务器架构涉及基于网络的数据提取和数据处理。使用步数计数器和通信日志评估基线用户工作量。临床可行性测试分析了11个月内的设备使用情况。
与团队成员之间的消息传递(约每天1次)相比,telePORT更常用于帮助请求(约每天4.5次)。被动手术室监测经常被使用(屏幕访问量的34%)。无线连接间歇性中断是采用该应用程序的主要障碍(每天下降0.3%)。
基础服务器基础设施被重新用于生命体征的实时传输及其收集,以用于研究和质量改进。一款集成了所有手术室实时数据的移动应用程序可以支持麻醉团队的日常活动。