1. 1 Doctor’s Office Information System May06-22 team: Adam Oberhaus Kevin Schmidt Srdjan Pudar Saalini Sekar Faculty advisor: Dr. Clive Woods Client:Senior Design 2/16/2006

2. May06-22 Doctor’s Office Information System2 Agenda Introduction Project Activities Resources & Schedules Closing Material

3. May06-22 Doctor’s Office Information System3 Definitions EMR: Electronic medical record IVR: Interactive voice response RFID: Radio frequency identification SQL: Structured query language GUI: Graphical user interface

4. May06-22 Doctor’s Office Information System4 Problem Statement Medical patients often miss or forget crucial information during/after doctor visits. This information should be presented to the patients in another manner or presented again so the patients are more likely to remember the most important information. Any solution must be easy to use for most medical patients and should not require computer literacy.

5. May06-22 Doctor’s Office Information System5 Solution Approach Innovative solutions that a wide base of patients can utilize Research current doctor-patient communication procedures Focus on one clinic Focus further narrowed to prescription information Provide way for patients to review information outside of doctor’s office Create easy to use kiosks where patients can print out desired information Research feasibility and design requirements for automated phone system

6. May06-22 Doctor’s Office Information System6 Operating Environment Kiosk  Pharmacy/drug stores  Controlled temperature 60˚-80˚ F  High traffic area Phone System  Controlled central location  Controlled temperature 50˚-70˚ F  Physically accessible only to administrators

7. May06-22 Doctor’s Office Information System7 Intended Users and Uses Kiosk  Used to review pertinent prescription information outside of doctor’s office by nearly any patient (elderly, young adults) who picks up prescriptions from a pharmacy/drug store Automated phone system  Used to review pertinent prescription information from home or any phone by any patient able to use a phone (non-hearing impaired).

8. May06-22 Doctor’s Office Information System8 Assumptions Prescription procedures will be definable and available in some manner Access to medical software used by clinic Access to specifications which allow interfacing the end product systems with an EMR system Design completed by second semester EMR database will have SQL interface

9. May06-22 Doctor’s Office Information System9 Limitations No access to actual records Prescription bottles must remain compact Cost must be minimal for patients Quick and easy to use for patients and doctors Access to information must be readily available

10. May06-22 Doctor’s Office Information System10 End Product and Deliverables Proof of concept of stand alone kiosk using RFID tags to view prescription information Detailed requirements and specifications for successful automated phone system with IVR

11. May06-22 Doctor’s Office Information System11 Present Accomplishments Familiarized with current doctor-patient communication procedures at McFarland Clinic in Ames Familiarized with current medical information system at McFarland Obtained RFID evaluation kit Started testing RFID reader and software capabilities

12. May06-22 Doctor’s Office Information System12 Milestones TaskDue% Complete Project Plan23-Sept-05100 Design Report11-Nov-05100 Design Review12-Dec-05100 Poster28-Feb-0665 Software Development10-Mar-0625 Software Testing24-Mar-06-- Final Report31-Mar-06-- IRP Presentation25-Apr-06--

13. May06-22 Doctor’s Office Information System13 Research Activities Current medical information practices Electronic medical records (EMR) Barcode/RFID Comparison Automated phone systems

14. May06-22 Doctor’s Office Information System14 Current medical information practices Interviewed Director of Medical Records Services at McFarland Clinic in Ames, IA  Paper version of entire record stored  Parts of medical records stored/created electronically (i.e. radiology, doctor’s notes)  Currently researching electronic medical record software  Hoping to propose a particular solution soon  Use of printed materials (i.e. brochures)

15. May06-22 Doctor’s Office Information System15 Electronic medical records Government support and push for electronic medical record systems within 10 years EMR makes information sharing easier and faster than paper records Some allow for customized print-outs EMR system could allow remote access to records with proper authentication

16. May06-22 Doctor’s Office Information System16 Technologies Chosen Low-frequency RFID Automated IVR phone system

17. May06-22 Doctor’s Office Information System17 RFID vs. Barcode RFIDBarcodes  Does not require line of sight  Read distance limited to a few feet for some tags  Scan accuracy near 100%; not prone to peeling/tearing/etc  Easier to locate for reading (just needs to be in range of the reader)  Barcodes are line of sight technology. Scanners have to “see” the barcode to read it.  Bar code stickers may peel or tear off, making a barcode unusable  Scan accuracy near 100% for undamaged barcodes

18. May06-22 Doctor’s Office Information System18 Automated phone systems Researched systems offered by various companies  Price ranges ($5,000+)  Features (Max users, voice/keypad interaction, customizability) Decided system would be too expensive for senior design to purchase Requirements for implementing such a system will be created instead

19. May06-22 Doctor’s Office Information System19 Overall system block diagram

20. May06-22 Doctor’s Office Information System20 Interactive voice response system Provides a phone-based interface to the EMR database  SQL interface Ties into the same database as the RFID solution Patient information is retrieved via key presses or spoken word Would be purchased and then customized by implementing team

21. May06-22 Doctor’s Office Information System21 Interactive voice response system Advantages  Ease of use by patient  Access from any phone  Easy to maintain Disadvantages  Cost – roughly $10k for a basic system  Authentication  More difficult to use by the hearing impaired

22. May06-22 Doctor’s Office Information System22 IVR system block diagram

23. May06-22 Doctor’s Office Information System23 RFID / touch-screen system Reads authentication information from an RFID tag Accesses a central EMR database Presents the information to the patient via a touch-screen interface Clinics and pharmacies equipped with these systems Terminal allows patients to print information Images courtesy of (respectively): http://news.softpedia.com/news/RFID-between-spying-and-utility-868.shtml http://www.barcoding.com/rfid/choosing_rfid_reader.shtml

24. May06-22 Doctor’s Office Information System24 RFID / touch-screen system Advantages:  Low cost to patients  Relatively simple to use  Access mechanism (prescription bottle) unlikely to be lost  Not time-intensive for doctors  Provides anonymity to answer medical questions Disadvantages:  Pharmacy would have to purchase system  Information from tag can be read only at pharmacy  Some users may have trouble with the computer interface

25. May06-22 Doctor’s Office Information System25 RFID tag data breakdown Six data fields First three contain information used to access the EMR database Last three contain additional patient information to validate and connect with EMR database All six fields encoded to maintain patient privacy This is an idealized tag breakdown which requires cost prohibitive technology for a proof-of-concept

26. May06-22 Doctor’s Office Information System26 RFID tag data breakdown Similar to bank checking system:  Hospital ID : Bank ID  Patient ID : User account number  Bottle number : Check number Used solely to get records from the EMR database Records contain important information for the patient With proper standardization, patients could access their records nationwide

27. May06-22 Doctor’s Office Information System27 RFID system block diagram

28. May06-22 Doctor’s Office Information System28 RFID evaluation kit Donated by Texas Instruments to senior design Consists of:  RFID Reader S2000 with RS232 interface  Several RFID tags RO, RW  Evaluation software and manual  Antenna  Cables, power supply Images courtesy of Texas Instruments http://www.ti.com/rfid/docs/products/products.shtml

29. May06-22 Doctor’s Office Information System29 Patient Access Team-developed software that implements RFID/touch screen system Utilizes RFID evaluation kit Windows GUI application  Simple interface Coded in.NET 2005  Straightforward GUI design  Easy communication with reader board Accessible for elderly and ill patients  Color themes  Large font

30. May06-22 Doctor’s Office Information System30 Patient Access - Screenshot

31. May06-22 Doctor’s Office Information System31 Difficulties Problem statement was difficult to define properly Possible solution space was dependent on clarifying the problem statement Some solutions already being researched by other institutions and are outside the scope of the project Some solutions already considered by McFarland Clinic Solutions limited by time and background constraints Necessary resources beyond the scope of the project

32. May06-22 Doctor’s Office Information System32 Total Personal Effort

33. May06-22 Doctor’s Office Information System33 Financial Requirements ItemWithout Labor With Labor Materials: Poster$60 RFID Kit$0 (Donated) Subtotal$60 Labor at $10.00 per hour: Kevin Schmidt $1,620 Saalini Sekar $1,570 Srdjan Pudar $1,480 Adam Oberhaus $1,420 Subtotal $5,990 Total$60$6,050

34. May06-22 Doctor’s Office Information System34 Project Schedule (Original vs. Revised)

35. May06-22 Doctor’s Office Information System35 Closing Material Commercialization Recommendations Risks and Risk Management Summary

36. May06-22 Doctor’s Office Information System36 Commercialization Need to find best solution for security issues Convince pharmacies/drug stores of need for kiosks Gather details on EMR systems used by many clinics Create possibility for checking from many remote locations across the country/across the world

37. May06-22 Doctor’s Office Information System37 Recommendations for Future Work Kiosk  Continue to define standard tag data fields for use across the country with multiple hospitals/clinics  Implement encoding of RFID tags  Interface with actual EMR database Phone System  Find best way to integrate with EMR

38. May06-22 Doctor’s Office Information System38 Risks and Risk Management Loss of a team member  Solution: Tasks would be spread out appropriately between remaining members. Inadequate budget  Solution: Team members may contribute personal funds or seek outside funding. Insufficient knowledge/background  Solution: Between four team members, work can be distributed efficiently so each member has work they are comfortable doing. Much of the first semester was also dedicated to research to fill the knowledge gap. Loss of RFID reader  Solution: Team will concentrate on detailed design specifications for end products instead of developing proof-of-concept code. Usable RFID tags contain less data than required  Solution: Include less information on tags than initially proposed (eg hospital code and patient ID only). Can’t interface with EMR  Solution: Create an emulated database to show a proof-of-concept design until software can be interfaced with an actual EMR database.

39. May06-22 Doctor’s Office Information System39 Closing Summary Problem Summary  Patients often miss or forget crucial medical information during/after visits to the doctor’s office  This problem is being considered already by local clinics, but the same is not being done with prescription information Approach Used  Focus on a local hospital/clinic (McFarland Clinic)  Design two end products, which together would serve a broad range of users/patients  RFID/Touch-screen Kiosk and Automated Phone System chosen Solution Summary  Products will be created that will provide patients with the information they need, on demand, with minimal technical background or time required.

40. May06-22 Doctor’s Office Information System40 Questions/comments?