Anesthesiology - QA System

Monitor

Overview

The Anesthesiology Quality Assurance (AQA) system is intended to analyze monitor data streams, both live and stored, to identify conditions that are associated with adverse clinical outcomes.

Medical monitors are used today in diverse clinical settings, for operating rooms to Intensive Care Units to Emergency Rooms. In many of these settings, multiple monitors are employed, yet data from these units are rarely combined to determine more predictive measures. Moreover, the data are rarely captured and associated with outcome data in a way that would identify monitor data predictors of adverse outcomes.

The AQA project is developing a system architecture for the integration and analysis of medical monitor data. The project leverages the development of the Universal Medical Monitor System (UMMS), in which a diverse set of medical monitors can be accessed through a single software interface and the monitor data can be synchronized so that each connected monitor is generating data at exactly the same time points.

System Architecture

EEDS is composed of the following major components:

1. A database into which monitor data is stored and from which monitor data is retrieved, at both disclosure and QA resolution. In addition, the database contains outcome data, and supports retrieval of monitor data based on outcome criteria.The current version of the database and persistence layer supports some modest user queries.
2. A configurable filter stream in which monitor data is processed and combined through a set of stages. Each stage accepts an incoming data stream and passes out a modified data stream.
3. A user interface to display graphic and tabular version of the data, both original and filtered. This module also supports the display of graphic indicators that present the overall state of the data.
4. Outcome data capture system. Outcome data is available through operating room anesthesiology systems and though post-operative follow-up surveys. The system does not currently include any actual outcome data.

Current Research

In the 2003-2004 academic year, we are extending the system in the following ways:

1. Database - the database and persistence layer is being extended to support various outcome data. In addition, storage of monitor data is being examined to ensure that the data is compatible with the architectural approach to streams.
2. Configurable filter streams - this module is in the early stages of design, so various approaches are being examined and tested.
3. User interface - a pure data display system is being expanded. This display will present a scrollable graph along with a corresponding table of data. Alternative displays of higher level measures will be designed, developed, and tested.
4. Outcome data capture - an associated project, the Anesthesiology record Keeper, is being examined to incorporate the capture and export of outcome data.

Collaboration

The system is being developed in collaboration with the Stony Brook Health Science Center (MSRC) and Dr. Alvin Bicker.