Saphire combines patient monitoring with clinical decision support
26 November 2007
The EU-funded Saphire project is developing an intelligent healthcare
monitoring and decision-support system on a platform integrating wireless
medical sensor data with hospital information systems.
Information technology has long promised to improve healthcare by
assigning a scarce resource, a doctor’s time, wherever and whenever it
is needed, but so far it has struggled to deliver on the promises. The
problem is that patients' records, for example, are often stored on
different platforms in various formats.
Saphire solves that problem by converting diverse data formats into one
that can be combined with other data.
The five-country research team initially used ontology mapping to link
different sets of information. “Later on, we noticed that XSLT mapping
can also perform some of the conversions adequately in much shorter time,”
said Mehmet Olduz, a researcher with Saphire. “So, the team included XSLT
mapping ability as well as ontology mapping which has given a considerable
performance improvement to the system.”
XSLT converts one type of XML, a Web 2.0 programming language, to
another type. The result is more effective translation with less work.
Techniques like these can translate medical records into a standard
format and integrate them with patients’ real-time vital signs.
The team also initially used web services to access patients'
electronic healthcare records (EHR), but they finally switched to a
standard called Healthcare Cross-Enterprise Clinical Document Sharing
(IHE-XDS) instead. It is widely accepted in the industry, and also
adopted by many countries for implementing their national healthcare
“I think what makes Saphire unique is the semi-automatic deployment
of clinical guidelines to healthcare institutes,” Says Olduz. Clinical
guidelines are the distilled wisdom of medical research and doctors’
experience and they identify the most reasonable response in specific
For example, percutaneous coronary infusion (PCI) — inserting a
balloon into a blocked artery to re-establish blood flow — is the
recommended procedure for STEMI, a particular kind of heart attack,
according to the Australian medical association.
If a patient presents late to a medical centre without PCI, the
guidelines state it is better to transfer a patient to a hospital with
PCI if it takes less than two hours to get there. If it takes more, it
is better to treat immediately using whatever method is available at
hand, typically drug-stimulated fibrinolysis, which thins blood clots.
That is just one simple example. There are literally thousands of
guidelines for the multitude of emergency conditions a doctor can face.
And they change all the time as new information refines established
therapies. It is essential information for effective treatment, but
right now it relies on a doctor’s knowledge and experience.
But with Saphire, that knowledge is updated regularly, matched
against a patient’s real symptoms and vital signs, and at the doctors’
fingertips via mobile phone messaging (SMS), pager, email, web browser
or PDA, whenever doctors’ need it or an emergency occurs.
“There had been efforts to computerise the guidelines and
automatically execute them, for example Guideline Interchange Format
(GLIF),” explains Olduz. But these attempts mainly focused on sharing of
guidelines and had to be manually deployed to the computer or device.
The European-funded Saphire solves this, suggests Olduz.
The team have finished the technical implementation and now they will
go forward with two pilot applications, one to monitor cardiovascular
patients in a hospital in Romania and one for homecare monitoring of
cardiovascular patients in Germany.
The aim is to enable some patients to be transferred to regular wards
sooner, freeing beds in critical care units. The system will also aid the
training of young doctors and it should minimise the risk of medical errors.
It could also result in better level of home care.
Source: ICT Results
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