Computer Technology Computer Technology and Pediatricsand Pediatrics

Nursing 140 Nursing 140 Ashley AlexanderAshley AlexanderBetsy CockerhamBetsy Cockerham

Brittany Pirko Brittany Pirko Rachel Werth Rachel Werth

Computer Technology in PediatricsComputer Technology in Pediatrics

Telemedicine SystemsTelemedicine Systems Child Health Improvement Through Child Health Improvement Through

Computer AutomationComputer Automation JPL Software Links Pediatric Doctors With JPL Software Links Pediatric Doctors With

New ResearchNew Research

Telemedicine in PediatricsTelemedicine in Pediatrics

Telemedicine in pediatrics: is the use of Telemedicine in pediatrics: is the use of electronic communications technology to electronic communications technology to provide and support health care for infants, provide and support health care for infants, children, adolescents, and young adults children, adolescents, and young adults when distance separates the practitioner when distance separates the practitioner from the patient, parent, guardian, or from the patient, parent, guardian, or referring practitioner referring practitioner

Telemedicine in healthcareTelemedicine in healthcare

There are many different ways that There are many different ways that telemedicine is useful in health care. telemedicine is useful in health care. Computers are used all throughout Computers are used all throughout radiology, mental health, dermatology, radiology, mental health, dermatology, cardiology, emergency and transport cardiology, emergency and transport services, child abuse, school health, and services, child abuse, school health, and many more many more

School healthSchool health

Some school systems are experimenting Some school systems are experimenting with telemedicine links to lengthen the with telemedicine links to lengthen the range of services of school- based clinics range of services of school- based clinics and lower absenteeism for illness and and lower absenteeism for illness and disease control problems disease control problems

Child Abuse Child Abuse Expertise in child abuse and neglect and Expertise in child abuse and neglect and

the interdisciplinary communication that the interdisciplinary communication that often is important for an adequate child-often is important for an adequate child-maltreatment investigation present maltreatment investigation present challenges that telemedicine could help to challenges that telemedicine could help to address address

It is helpful by the use of a software It is helpful by the use of a software package specifically marketed for the package specifically marketed for the sharing of still photographs in child abuse sharing of still photographs in child abuse consultations consultations

Other ServicesOther Services

Other services that have shown promising Other services that have shown promising results using telemedicine include results using telemedicine include pediatric dentistry, neonatal pediatric dentistry, neonatal ophthalmology, and interpretation of ophthalmology, and interpretation of radiographs by Neonatologists radiographs by Neonatologists

Research ProblemsResearch Problems

There are few studies that indicate There are few studies that indicate that telemedicine has important that telemedicine has important implications for accessing pediatric implications for accessing pediatric subspecialty services subspecialty services

However it is shown that However it is shown that telemedicine does help in telemedicine does help in determining future health care determining future health care requirements, and improving requirements, and improving communications with parents of sick communications with parents of sick and ill children and ill children

Technological Advancements in Technological Advancements in TelemedicineTelemedicine

Telemedicine involvesTelemedicine involves the delivery of medical the delivery of medical care over a distance using care over a distance using telecommunication technologies telecommunication technologies Health care programs involving electronic Health care programs involving electronic

communication are becoming more predominant communication are becoming more predominant throughout the nationthroughout the nation

Telemedicine in pediatrics uses a combination of Telemedicine in pediatrics uses a combination of computerized technological advancements to computerized technological advancements to improve the care of children throughout the improve the care of children throughout the nation.nation.

Benefits of TelemedicineBenefits of Telemedicine Telemedicine allows health care providers to Telemedicine allows health care providers to

electronically interact with patients at remote electronically interact with patients at remote cites cites

Since most rural area hospitals are not staffed Since most rural area hospitals are not staffed with specialists in every area of pediatric care, with specialists in every area of pediatric care, telemedicine is becoming an effective way for telemedicine is becoming an effective way for specialists to treat children in urban areasspecialists to treat children in urban areas

Telemedicine increases access to pediatric Telemedicine increases access to pediatric specialist health care servicesspecialist health care services

It reduces medical expenses by decreasing the It reduces medical expenses by decreasing the amount of patient travel and transportation timeamount of patient travel and transportation time

TelemedicineTelemedicine

Telemedicine technology is considered to Telemedicine technology is considered to be “acceptable means of delivering be “acceptable means of delivering specific pediatric subspecialty consultation specific pediatric subspecialty consultation services to children with special health services to children with special health care needs, living in rural areas” (“Use care needs, living in rural areas” (“Use of”)of”)

Telemedicine EquipmentTelemedicine Equipment

Interactive audio and Interactive audio and video capabilities by video capabilities by using:using: diagnostic quality camerasdiagnostic quality cameras medical instrumentation medical instrumentation

• StethoscopeStethoscope• OphthalmoscopeOphthalmoscope• Otoscope Otoscope

Telemedicine EquipmentTelemedicine Equipment

This computerized technology allows:This computerized technology allows: Image captureImage capture Image storageImage storage Image transferImage transfer Interactive collaborationInteractive collaboration

Telemedicine Systems Telemedicine Systems

Telemedicine systems allow doctors Telemedicine systems allow doctors (located at major hospitals) to (located at major hospitals) to observe the actual examination of observe the actual examination of patients (located in rural areas) by patients (located in rural areas) by using cameras and electronic using cameras and electronic medical instrumentsmedical instruments

The examinations are performed by The examinations are performed by the rural area clinic nursesthe rural area clinic nurses

Telemedicine SystemsTelemedicine Systems

The doctors have immediate access to the The doctors have immediate access to the images and data collected from the images and data collected from the examinations and are therefore able to make a examinations and are therefore able to make a recommendation or diagnosisrecommendation or diagnosis

The physician can then consult with the patient’s The physician can then consult with the patient’s family via telecommunication capabilitiesfamily via telecommunication capabilities

Telemedicine is a suitable alternative for children Telemedicine is a suitable alternative for children who live long distances from primary hospitals who live long distances from primary hospitals but it should not be the sole method a medical but it should not be the sole method a medical treatment treatment

Georgia Study Georgia Study

A recent study in the state of A recent study in the state of Georgia confirmed that Georgia confirmed that telemedicine is an effective way to telemedicine is an effective way to improve and advance health care improve and advance health care services services

The Children’s Medical Services The Children’s Medical Services (CMS) of Georgia and the (CMS) of Georgia and the Pediatrics Department of the Pediatrics Department of the Medical College of Georgia Medical College of Georgia (MCG) collaborated to develop a (MCG) collaborated to develop a telemedicine program telemedicine program

Georgia StudyGeorgia Study The program was enacted in order to provide The program was enacted in order to provide

appropriate care to children with special needs appropriate care to children with special needs throughout the state throughout the state

In general, the patients and their parents were In general, the patients and their parents were satisfied with telemedicine servicessatisfied with telemedicine services

Physicians and Faculty members attitudes Physicians and Faculty members attitudes concerning telemedicine improved as they concerning telemedicine improved as they became more experienced with the technology became more experienced with the technology

This study showed that telemedicine has the This study showed that telemedicine has the potential to play a vital role in the future of health potential to play a vital role in the future of health care services care services

Child Health Improvement Child Health Improvement Through Computer Through Computer

Automation Automation

CHICA System Combines CHICA System Combines Medical Guidelines with Medical Guidelines with

Information from Patient’s Information from Patient’s FamilyFamily

New Technology in PediatricsNew Technology in Pediatrics

Latest innovation in Latest innovation in medical care for childrenmedical care for children

Blends “just-in-time” Blends “just-in-time” concept with increased concept with increased parental participationparental participation

Produces care guidelines Produces care guidelines for pediatricians for pediatricians individualized for each individualized for each patient that are patient that are delivered at the delivered at the patient’s office visit.patient’s office visit.

How does it Work?How does it Work?

Targets children Targets children instead of adultsinstead of adults

Utilizes hand written Utilizes hand written information taken information taken from child’s parents in from child’s parents in waiting room along waiting room along with preexisting data with preexisting data from country’s oldest from country’s oldest operational medical operational medical record to provide record to provide information and information and clinical reminders to clinical reminders to pediatricianspediatricians

Introduction of CHICAIntroduction of CHICA Took place at MedInfo Took place at MedInfo

2004 (the premier 2004 (the premier international meeting international meeting of the medical of the medical informatics community)informatics community)

Researchers introduced Researchers introduced CHICA, which combines CHICA, which combines patient pediatric patient pediatric guidelines with history guidelines with history learned from the learned from the patient’s family.patient’s family.

Further enables Further enables physicians to provide physicians to provide individually targeted individually targeted care. care.

How it works…How it works…

The parent or family member fills out a simple CHICA The parent or family member fills out a simple CHICA waiting room prescreening form which includes waiting room prescreening form which includes information, including reason for visit.information, including reason for visit.

Responses scanned and uploaded into computer Responses scanned and uploaded into computer system system

Items then used on customized form by physician Items then used on customized form by physician Information tracked from visit to visit.Information tracked from visit to visit.

Benefits of the CHICA systemBenefits of the CHICA system

Information attained Information attained from families informs from families informs physicians of physicians of important clinical data important clinical data such as guns within such as guns within homes, abusive family homes, abusive family situations, and situations, and maternal depression.maternal depression.

Information received Information received from families would from families would not have been known not have been known otherwise if not for otherwise if not for CHICA system.CHICA system.

About CHICA…About CHICA…

CHICA is an extension CHICA is an extension of the Regenstrief of the Regenstrief Medical Records System Medical Records System (RMRS), a computer (RMRS), a computer based inpatient and based inpatient and outpatient information outpatient information system that contains system that contains more than 30 years of more than 30 years of patient information. patient information.

Includes reminder Includes reminder system that offers system that offers suggestions regarding suggestions regarding diagnosis, tests, and diagnosis, tests, and treatment.treatment.

More Benefits…More Benefits…

Busy pediatricians often have to rely on memory, Busy pediatricians often have to rely on memory, and computerized guidelines can often be costly.and computerized guidelines can often be costly.

CHICA solves both the information overload and CHICA solves both the information overload and cost problems while helping the pediatrician focus cost problems while helping the pediatrician focus on the patient’s specifics. on the patient’s specifics.

How it Helps…How it Helps…

““Combining Combining pediatric pediatric preventative care preventative care guidelines with a guidelines with a dynamic scannable dynamic scannable paper user interface paper user interface enables [the enables [the physicians] to physicians] to better serve [their] better serve [their] patients and their patients and their families.” families.”

Beliefs for CHICABeliefs for CHICA

CHICA will enable the parents and physicians of 55,000 CHICA will enable the parents and physicians of 55,000 pediatric patients in the Wishard Health System (site of pediatric patients in the Wishard Health System (site of study), making better healthcare decisions.study), making better healthcare decisions.

It is believed that CHICA will become an indispensable It is believed that CHICA will become an indispensable tool to many pediatricians and will gradually spread to tool to many pediatricians and will gradually spread to other systems, improving pediatric healthcare. other systems, improving pediatric healthcare.

JPL Software Links JPL Software Links Pediatric Doctors With Pediatric Doctors With

New ResearchNew ResearchAdvancing Technology and Advancing Technology and

Pediatric HealthcarePediatric Healthcare

Engineers created a software that will connect information from various hospitals all over the world into one VIRTUAL intensive care unit.

The system will link doctors who need detailed and specific information with researchers willing to share their data about pediatric medicine.

For example… If a pediatrician in NC

wanted to find information about the most advanced treatment in for a child with bone cancer, he could search the database and find the latest medical studies conducted by researchers all over the country.

The software is called Object The software is called Object Oriented Data Technology Software Oriented Data Technology Software and was modeled after the and was modeled after the Planetary Data System, Planetary Data System, which is a which is a large software network that helps large software network that helps space scientists translate used in space scientists translate used in local databases into standard local databases into standard language.language.

MarsMars

Similar software is Similar software is used to support the used to support the Mars Exploration Mars Exploration Rovers, currently Rovers, currently exploring the martian exploring the martian environment. environment.

What Led to The Use of This What Led to The Use of This SystemSystem

Conjoined twins from Conjoined twins from Guatemala and the Guatemala and the Philippines were Philippines were separated after separated after numerous surgeries numerous surgeries in the US, since their in the US, since their communities lacked communities lacked the quality medical the quality medical care for the care for the procedure.procedure.

Ctn’d…Ctn’d…

As a result, engineers at As a result, engineers at NASA’sNASA’s Jet Jet Propulsion Laboratory in Pasadena, Propulsion Laboratory in Pasadena, CA, are working with doctors on a CA, are working with doctors on a computer system that may soon computer system that may soon allow high tech surgeries to be allow high tech surgeries to be performed in a remote country using performed in a remote country using this virtual pediatric system.this virtual pediatric system.

The problem…The problem… Dan Crichton, a JPL Dan Crichton, a JPL senior computer senior computer scientist, has stated scientist, has stated that the problem is that the problem is that information has that information has been primarily used been primarily used for local use, and for local use, and now scientists are now scientists are discovering the value discovering the value of sharing research of sharing research within various within various communities.communities.

This has been true in This has been true in Biomedicine, Planetary Biomedicine, Planetary Medicine, and now in Pediatric Medicine, and now in Pediatric medicine.medicine.

Planetary medicine

BiomedicinePediatric Medicine

Educating Other Doctors• Pediatricians can also record patient

information directly from bedside monitors, using extended databases, regardless of their location.

• The computer system is also capable of storing the information so that other doctors can use it for clinical trials and help other doctors dealing with similair

patients.

As of Now…As of Now…

The virtual pediatric The virtual pediatric system is being system is being developed and tested developed and tested at the Los Angeles at the Los Angeles Children’s Hospital.Children’s Hospital.

Next year it will be Next year it will be extended to the John extended to the John Hopkins Children’s Hopkins Children’s Center, Baltimore, Center, Baltimore, and Cornell University and Cornell University Medical Center in NY.Medical Center in NY.

““THE GOAL”THE GOAL”

The goal of the virtual pediatric system is to enable us The goal of the virtual pediatric system is to enable us to practice in one critical care unit where we will to practice in one critical care unit where we will have all the latest information available to care for have all the latest information available to care for critically ill children, said Dr. Randall Wetzel, critically ill children, said Dr. Randall Wetzel, director of critical care medicine at Children’s director of critical care medicine at Children’s Hospital in Los Angeles.Hospital in Los Angeles.

In the Next Few YearsIn the Next Few Years This virtual pediatric This virtual pediatric

intensive care unit is ideal intensive care unit is ideal for hospitals without for hospitals without advanced intensive care advanced intensive care units. Engineers hope to units. Engineers hope to install networked install networked cameras in the next few cameras in the next few years, allowing doctors to years, allowing doctors to check on their patients in check on their patients in remote areas and assist remote areas and assist their colleagues working their colleagues working in isolated centers.in isolated centers.

PartnershipPartnership

• The JPL Innovative Technology The JPL Innovative Technology Transfer Partnerships Office has Transfer Partnerships Office has welcomed the opportunity to welcomed the opportunity to collaborate with outside collaborate with outside companies to develop and companies to develop and transfer dual-use technology transfer dual-use technology through NASA’s Innovative through NASA’s Innovative Partnership Program.Partnership Program.

How Many?How Many?

• There are about 275 There are about 275 pediatric intensive pediatric intensive care units around care units around the country.the country.

• Also, every year Also, every year about 50,000 about 50,000 infants and children infants and children who need constant who need constant care are admitted care are admitted into these centers.into these centers.