Archive for March, 2010

Recording Test Results with Home-Based Medical Equipment

Advancements in home-based medical equipment and Internet technology have had a positive impact on the both patients and clinicians around the world.

Electronic medical records are expected to revolutionize the way medical offices manage the flow of patient information, and allow patients to easily access their medical charts from home. While detractors may worry about the privacy issues inherent to any online database, the benefits of electronic health management far outweigh the costs.

A good example of how electronic medical records will be of value in patient care is the increase in available home-based medical equipment for patients with chronic illnesses. Instead of traveling to and from the doctors’ office for frequent testing, many patients will opt to take advantage of miniature Bluetooth-enabled medical devices that perform the same type of monitoring from home. Using a miniature handheld pulse oximeter or glucose monitor, for example, a patient’s test results can be instantaneously transferred to a web-based medical record at their doctor’s office.

Some of the challenges to this type of monitoring include the graphically detailed nature of data that is transmitted. Some of the more complex tests, such as ECGs, involve the transmission of a waveform, which can present challenges if the data arrives in an incomplete form. However, by using some new products like USB isolators, a more reliable connection can be established between the patient monitor and the clinician’s office.

As medical equipment and home monitoring systems become more advanced, it is expected that more and more patients will take advantage of the ease and convenience of Bluetooth-enabled devices for many diagnostic tests.

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Miniaturization in Medical Equipment: Pulse Oximetry

In keeping with the trend toward miniaturization in durable medical equipment, new strides have been made recently in creating tiny versions of pulse oximeters. A pulse oximeter monitors the blood-oxygen level in a patient by displaying the percentage of hemoglobin in the bloodstream. Normal acceptable ranges are between 95 and 100 percent, but values that fall as low as 90% are still common.

As a noninvasive measurement tool, the pulse oximeter typically uses a pair of LEDs (light-emitting diodes) that face a photodiode, usually through a translucent portion of the anatomy like an earlobe or fingertip. Using both red and infrared wavelengths, a measurement of hemoglobin absorption is calculated based on the ratio of light absorption between the two. Because the signal of a pulse oximeter bounces in conjunction with the heartbeat, the detection of a pulse is essential for the monitor to function.

The miniature versions of these devices have been greatly enhanced by the availability of miniature LEDs that will function within the required wavelengths. These devices also utilize an analog microcontroller to perform all of the required measurement and electronic control within a single microchip. Miniature pulse oximeters will be useful in any situation outside of a hospital where a patient’s blood oxygenation may become unstable. They can be used in settings as diverse as mobile emergency units and pressurized aircraft’s. Essentially, no vital sign is more important than the body’s ability to absorb oxygen.

So important is the implementation of compact pulse oximeters that over half of the major international medical equipment manufacturers in China were exporting producers of these devices. One of the world’s foremost manufacturers of home-based monitors is Nonin Medical. Last year they introduced the first Bluetooth-enabled handheld device to measure pulse oximetry through the fingertips. This device, and others like it, enables doctors to remotely monitor their patient’s oxygen saturation levels through the use of a computerized home telemedicine system.

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Netherlands Team Proves Concept of MR-Guided Radiotherapy

Recently, there has been a scientific breakthrough by a research team in the Netherlands to test MRI-guided radiation therapy in a clinical atmosphere. The main goal is to accurately target tumors using “real-time image guidance” with radiotherapy. This particular design of medical equipment can be beneficial when used in conjunction with an MRI because it integrates a linear accelerator with an MR scanner. The researchers were able to prove that MR imaging did not corrupt the MR scanner or the linac performance. In addition, they discovered that they can avoid critical structures and reduce side effects.

Both the accelerator and the MRI were modified to enhance operation so it was simultaneous and unrestricted. This was important to prove that quality diagnostic MR imaging and irradiation were attainable. In addition, the redesign of the MR magnet allowed the radiation to beam through and vertically maximize the irradiation field. Most of the external field was canceled, because the magnet was actively shielded and side effects were reduced.

In addition to redesigning the medical equipment, researchers modified the arrangement of the treatment room. This enabled researchers to shield the accelerator and the remaining portion of the treatment room. Also, with the magnet actively shielded, most of the external field generated by the inner coils is canceled, which provides enhanced imaging performance and a steroidal low-field zone around the magnet.

More research must be explored before this type of medical equipment can be used in radiotherapy clinics. However, research has proven that having an active shield enhanced the MRI performance while the radiation beam was on. This was achieved because the active shield can achieve both magnetic and RF decoupling.

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With Medical Equipment, the Trend toward Miniaturization Continues

Anyone who pays attention to innovations in the medical equipment industry is aware of the shrinking size of medical devices. This relatively new push for miniature medical devices has affected all areas of the industry, from EKG machines to pulse oximeters and ultrasound technology. An increasing number of hand held devices are allowing for a more mobile approach to patient care for both clinicians and patients.

In the world of medical equipment, miniature-sized lab equipment, patient monitors and imaging machines are being promoted not only for their compact profiles; in many cases they are also far more advanced in terms of technology. Some machines, such as portable hand held glucose monitors, can be used by the patient at home without the need to travel to and from a medical facility.

Other portable monitors include the release of a personal blood monitor that can be used for coagulation testing. These machines are used at home by patients who are on anti-coagulation therapies, such as Coumadin, without necessitating frequent trips to a lab or clinic. Patients simply draw a single drop of blood, which is place on a temperature-sensitive strip that produces on-the-spot results.

For medical equipment manufacturers, these revolutionary portable devices represent a new stream of revenue as more and more patients opt for miniaturized testing equipment. Patients are able to save the money and time it takes to be monitored in a clinical setting.

While greatly improving the accessibility and convenience of health care, the trend toward miniaturization has its own set of challenges, including the skill level of the person conducting the test. This is why medical equipment manufacturers are working to ensure their diagnostic devices are very simple to use, even by an elderly patient with limited dexterity and poor vision. It is also critically important that these devices need little or no user-performed calibration. This way, the results will be consistently accurate and reliable.

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The End of the Hospital “Lost and Found”

Thanks to their use of Wi-Fi on the campus of Ohio State University Medical Center, medical professionals can now use software to track medical equipment. Using this new technology, OSU plans to tag up to 15,000 pieces of equipment, including patient monitors, EKG machines and IV pumps, as well as 200 hospital beds. This is being done by attaching a small box on each item that will emit a signal that can be tracked on the hospital’s Wi-Fi network.

This type of medical equipment tracking isn’t necessary everywhere, but in high-risk emergency departments and units with psychiatric patients, the system will come in handy. The same tracking devices can be used to track patients with dementia or other neurological issues.

But this is just the beginning. In the future, the medical center expects to use the same equipment to assess how long it takes for patients to be treated, and how these delays are affecting the operations and effectiveness of the hospital.

In addition, the system will eventually alert staffers whenever medical equipment is taken into a trash area or whether sensitive items are receiving proper refrigeration.

Because the OSU Medical Center covers an area of over five million square feet, it is easy for a piece of equipment to become lost. Sometimes, a monitor or IV pump is accidentally moved into a remote area of the unit, which can cause medical staff to spend a lot of time searching for it. Missing equipment can increase expenses and reduce productivity.

The system includes a software program and thousands of matchbook-sized electronic tags that can be tracked on the center’s Wi-Fi network. Signals associated with each tag will be visible on a floor plan map, allowing staff members to easily track every item – or person – they wish.

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