Medicine is often at the cutting edge of technology, and two new projects aim to vastly improve patient care, writes CLAIRE O'CONNELL
COMPUTERS CAN be impersonal things. But two new projects showcased in Dublin last week are looking to add the human touch to technology and help improve patient care – whether it’s offering doctors virtual training in giving a nerve-block before they carry it out on real patients, or analysing a chronically ill patient’s language over time for signs of problems brewing.
The approaches featured at a conference on Thursday in the National Digital Research Centre (NDRC) on emerging digital health technologies.
One, called Haystack, allows anaesthetists to get a feel for administering a type of nerve block that can save time and money, according to Karl Quinn, a commercial development associate at the NDRC.
“If you were to break your wrist today and if surgery were needed, you would get a general anaesthetic and you would probably be in hospital overnight,” says Quinn.
“But with a peripheral nerve block, instead, they use an ultrasound to locate a cluster of nerves in your shoulder, and they put anaesthesia around those nerves to numb the arm. They would carry out the procedure and probably send you home that night, you wouldn’t feel as drowsy or sick as after a general anaesthetic.”
Many surgical procedures could be carried out under such an ultrasound-guided peripheral nerve block, but there’s a lack of training and expertise in it, notes Quinn, and non-virtual training methods don’t tend to let the learner know how they are doing.
“At the moment if you were to buy a training tool, you might get a lump of meat from the butcher, you would use a real ultrasonic machine and put a needle in part of it, but it doesn’t give you any feedback – and that’s what Haystack does,” he explains.
“You sit in front of and hold what resembles an ultrasound device in one hand and a fake needle in the other, then you carry out the procedure on the screen. As you push the needle into the body you feel the pinprick, it’s actually like you are doing it, and it’s always monitoring and assessing, and the metrics we use are aligned to real world errors.”
The technology draws on the expertise of Prof George Shorten and his team at Cork University Hospital, explains Quinn.
“In essence we have captured their method in software and we are teaching people around the world how to do it using forced-feedback hardware,” says Quinn.
“Imagine someone walking in to carry out that procedure on the first patient, and imagine they had worked on a simulator – the learning curve is more flattened and they have confidence, that’s what we try to instil.”
The project, which is a collaboration between CUH, the NDRC and UK company MedaPhor, hopes to spin out a company and see sales later this year.
Another project being supported by the NDRC also looks to harness computers to improve the human experience: the Patient Journey Record (PaJR) is using software to analyse the language that patients with chronic illnesses use to describe how they feel.
“We are monitoring the patient during the journey of their health,” says Regina Reulbach, also a commercial development associate at the NDRC.
“Over one-third of the Irish population have a chronic illness and right now the population is young, but with age increasing, the incidence of chronic illness is increasing as well.”
The PaJR approach asks patients a series of questions about their health and environment and then uses software to analyse records of the narratives over time. In this way potential problems could be flagged early on and may be sorted out with a reasonably easy intervention, rather than missing early signs and allowing the problem to develop.
The software doesn’t aim to replace human contact with patients, but adds a layer of semantic analysis to the patient record along with the “harder” physical data, explains Reulbach.
“We are looking at more the soft facts, how people rate their health, how do they feel about it, the attitude they have about it,” she says, citing an example that cropped up during recent trials.
“Over Christmas we saw that as the snow was really heavy people couldn’t get out, and for people who are really ill and couldn’t access daily tasks, that is a difficulty. Then because they face these difficulties they may get more unstable, and we are trying to pick up on that.”
If a problem looks to be developing, the PaJR system can alert medical and healthcare staff and offer them information to help them decide on the best course of action.
“It’s really about the early detection, the earlier you can detect that people are moving towards an unstable phase, the more you can keep them on a lower level of healthcare.”
While the research and trials are ongoing, ultimately she sees PaJR being rolled out through a call centre and linked in with community clinics and hospitals. The technology is being developed in collaboration with GP Dr Carmel Martin, Prof Carl Vogel at Trinity College Dublin and GroupNos Technologies.
