financed by romanian government – ministry of education ... · financed by romanian government...

Contract number 4 / 2005 financed by Romanian Government – Ministry of Education and Research

h h ”E ll R h” P CEEX 2005 INFOSOCthrough ”Excellence Research” Program – CEEX 2005 INFOSOCDuration: 15.10.2005-30.06.2008

ConsorConsortiumtium

CoopUrgCoopUrg

ConsorConsortiumtium

CO - SC IPA SA Cluj Subsidiary► www.automation.ro

Project manager : sr. I dipl. eng. Ioan StoianProject manager : sr. I dipl. eng. Ioan Stoian

P1 - "Iuliu Hatieganu" University of Medicine and Pharmacy,Cluj-Napoca

wwwumfcluj ro► www.umfcluj.roProject responsible : prof. dr. Radu Badea

P2 - Clinical Institute of Urology and Renal Transplantation,gy p ,Cluj-Napoca► www.renaltransplant.ro

Project responsible : prof. dr. Mihai Lucan

P3 – University of Medicine and Pharmacy, Targu Mures► www.umftgm.ro

Project responsible : lecturer dr. Raed Arafat

www.automation.ro/coopurg 2

The Project’s ObjectivesThe Project’s ObjectivesCoopUrgCoopUrg

General Objective – The development of a telematic system based on medical intervention unitsinstated with computation and communication equipments that allow them a cooperative behavior, and

l d i i i i d i i h i li d ffon ultrasound image acquisition and transmission to the specialized emergency centers, offerstechnological support for medical assistance in case of emergency and catastrophes allowing to optimizethe diagnostic trial in trauma and to shorten the “accident – definitive therapy” duration respecting the“golden hour” concept.g p

Scientifically and technological objectives assumed in CoopUrg project :develop an integrated regional system able to provide telehealthcare services and remote transfer of medical datausing cooperative communication networks and units in order to ensure early diagnosis in case of major traumausing cooperative communication networks and units in order to ensure early diagnosis in case of major traumaenhance the performance of emergency services by connecting different specialists in order to providetelediagnosis, teleconsultancy and teleassistance for diagnostic trialoptimize the US guided low invasive maneuver according to FAST protocol

i i h i f i li i di di i b d i ll i f doptimize the entire system functionality in distress conditions by dynamic allocation of resources andimplementation of cooperative techniquesdesign the entire system as an infrastructure for biomedical data processing, data base development, dataprocessing and transmissions in normal and catastrophic conditionsi l i f ffi i l l hi f l i d ifi i fimplementation of an efficient teleultrasonographic system for evaluation and quantification of organs, aspotential transplant source.creation of a network and a database - support for research in teleassisted emergency assistance domain.launch collaborative works and establish multi-disciplinary


Project’s preProject’s pre--requisitesrequisitesCoopUrgCoopUrg

TheThe existenceexistence ofof thethe emergencyemergency assistant’sassistant’s threethree levelslevels –– prepre--hospitalhospitalg yg y pp ppservices,services, compartmentscompartments oror specializedspecialized emergencyemergency centers,centers, hospitalhospital endowedendowedwithwith traumatrauma centerscenters – offers the necessary medical support for implementing ateleassisted integrated system in emergency.

TheThe developmentdevelopment ofof telemedicine,telemedicine, emergencyemergency assistanceassistance andandperformanteperformante ultrasonographyultrasonography offers scientific and technological support forcreating a telediagnostic and teleassisted integrated system in trauma.creating a telediagnostic and teleassisted integrated system in trauma.

FASTFAST examinationexamination (Focused Abdominal Sonography for Trauma) is a highaccuracy technique for detecting the free liquid from abdominal cavity indicatedy q g q yto the hemodynamic unstable patients possible to be performed in emergencycenters an din pre-hospital (in condition of existing the necessary equipments and a qualifiedoperator ). The obtained data will be transmitted for interpretation, from pre-hospital to a specialist located in a medical imagistic hospital throughhospital, to a specialist located in a medical imagistic hospital, throughtelemedicine system.


The Project’s PhasesThe Project’s PhasesCoopUrgCoopUrg

PhasePhase 11 -- Technical study and system analysisPhasePhase 11 -- Technical study and system analysis►► 1515..1010..20052005 –– 3030..1212..20052005

PhasePhase 22 -- Hardware and Software Design►► 0101 0101 20062006 3030 0606 20062006►► 0101..0101..20062006 –– 3030..0606..20062006

PhasePhase 33 -- Elaboration of application programs at the mobile interventionunits level►► 0101 0707 20062006 1515 1212 20062006►► 0101..0707..20062006 –– 1515..1212..20062006

PhasePhase 44 -- Elaboration of programs at the telemedicine centre level►► 1616..1212..20062006 –– 2525..0909..20072007

PhasePhase 55 -- Elaboration of a complex application; testing certification,optimization►► 2626..0909..20072007 –– 1515..1212..20072007

PhasePhase 66 -- Dissemination of results►► 1616..1212..20072007 –– 3030..0606..20082008

5www.automation.ro/coopurg

The telemedicine system’s architectureThe telemedicine system’s architectureCoopUrgCoopUrg

Monitored patient

Investigation medical equipment

Supervisor medical personnel

Comm nication S pport

Local Level

Communication Support

Local Computer – data concentrator

Communication Support

Metropolitan medical network

Specialist Specialist

Central Level

…

Specialistmedic 1

Specialistmedic n…

Medical Personnel în formare 1

Medical Personnel în formare m


The component elements of the telemedicine system The component elements of the telemedicine system CoopUrgCoopUrg

The system is consist of subsystems placed at the local level of ambulances(which cooperate) and at the central level placed at :

used in catastrophes and emergency medicineused in catastrophes and emergency medicine

(which cooperate) and at the central level placed at :Emergency Room (ER),Imagistic medical centerTransplant centersp ce e

EMU1

EMU2 MCC

USMC

C2

EMU2

CC

MCC

C1

EMC

TMCC3

EMUn

EMU – Acquisition and medical data transfer equipment from the mobile intervention units CC – cooperative communications EMU - EMU

MCC – Computing and data transfer equipment from the mobile terrestrial/airy tekeassistence Center

USMC – Computing and data transfer equipment from the imagistic tekeassistence Center

EMC – Computing and data transfer equipment from the sanitary Unit of the i d i l P i h

C1 – communications EMU - MCC

C2 – communications between :

EMU - USMC

EMU - EMC

C3 – communications in the metropolitan medical network


trauma assistance – named sometimes also UPU in the present documentation

TMC – Computing and data transfer equipment from the transplant Centers

C3 communications in the metropolitan medical network

System’s architecture with the distributed local levelSystem’s architecture with the distributed local levelCoopUrgCoopUrg

C0C0

EMU 1 EMU n-2EMU n

C0C0

C0C0

C0C0

C0C0

C0C0

EMU n-1

C1C1C1C1

C0C0C0C0

C0C0

C0C0C0C0

EMU 2C1C1C1C1

C1C1C1C1

C1C1

ER

EMC mEMC 1

C2C2 C2C2 C2C2 C2C2

www.automation.ro/coopurg 8TMC

EMC mEMC 1

USMCC3C3

C3C3C3C3

......

System’s architecture with centralized local levelSystem’s architecture with centralized local levelCoopUrgCoopUrg

EMU 1

EMU n-2MCCMCC

C1C1C1C1

EMU n-1EMU n

EMU 2

C1C1C1C1

C1C1EMU 2

UPUUPU

EMC mEMC 1

C2C2

C2C2 C2C2

C2C2

C3C3C3C3 ......


TMC USMC

......

CoopUrgCoopUrg

System’s functionsSystem’s functions

FulfilledFulfilled functionsfunctions atat thethe locallocal levellevel (ambulance level) are:data receiving functions provided by the acquisition interface from the medical

yy

g p y qequipment specifically of the emergency medicine

analyzing, displaying(at request) and storing functions of the received data

bilateral communication functions with the central levelbilateral communication functions with the central level

Functions placed at the central level (dispatcher/ER ) are:Functions placed at the central level (dispatcher/ER ) are:communication functions with the local level

data receiving functions of the transmitted data from the local levels

storage functions of the received data from the medical data

alarms managing functionsalarms managing functions

data base administration and management functions with patient's medical information

connection functions between different medical centers (expert center inconnection functions between different medical centers (expert center in medical imagistic, transplant center)

processing and visualizing information from the resulted medical data base f ti


functions.

HHardwareardware architecture of the systemarchitecture of the systemCoopUrgCoopUrg

Ultrasonographical portable equipment Sonosite

Modem / cardGSM/GPRS/3G

Operator base station mobile telephony

Operator base stations

images

GSM/GPRS/3G Operator base stations mobile telephony

Medical equipments ifi f

Local data concentrator

Modem / cardUltrasonographical equipmentspecific for emergency medicine Ambulance 1

Expert center medical imagistic images

Modem / cardGSM/GPRS/3G

Ultrasonographical equipment Eco Blaster 128

Local Web server network, DB server, file server, images evaluation expert system

InternetInternet

L l d t

Central level dispacher /UPU

Ambulance NMedical equipments

specific for emergency medicine

Local data concentrator

11www.automation.ro/coopurgCentru transplant

SoftwareSoftware architecture of the systemarchitecture of the systemCoopUrgCoopUrg

TheThe CoopUrgCoopUrg WebWeb applicationapplication distinguishesdistinguishes fourfour levelslevels forfor thethe softwaresoftware modulesmodules::11.. usersusers interfacesinterfaces levellevel::

11 i t rfi t rf frfr thth l ll l l ll l ff thth b lb l llll tt i rti rt thth di ldi l d td t frfr1.1. interfacesinterfaces fromfrom thethe locallocal level,level, ofof thethe ambulance,ambulance, allowallow toto insertinsert thethe medicalmedical datadata fromfromthethe patientpatient monitoringmonitoring andand ultrasonographicalultrasonographical imagesimages caughtcaught withwith FASTFAST techniquetechnique

−− interfacesinterfaces forfor thethe dispatcherdispatcher centercenter // ERER−− interfacesinterfaces forfor thethe expertexpert centercenter medicalmedical imagisticimagistic−− interfacesinterfaces forfor thethe expertexpert centercenter--medicalmedical imagisticimagistic−− interfacesinterfaces forfor thethe transplanttransplant centercenter

22.. communicationcommunication levellevel:: assuresassures thethe communicationcommunication betweenbetween clientsclients andand andand webwebserverserver fromfrom thethe centralcentral levellevelserverserver fromfrom thethe centralcentral levellevel33.. managementmanagement levellevel ofof thethe webweb serverserver resourceresource:: receivesreceives andand processesprocesses thetherequests,requests, usingusing thethe resourcesresources assuredassured byby thethe webweb serverserver44 dd l ll l hh dd dd ii hh C UC U jj illill bb ii hh dd44.. datadata levellevel:: thethe usedused datadata inin thethe CoopUrgCoopUrg projectproject willwill bebe storagestorage inin thethe samesame datadatabasebase reunitingreuniting thethe datadata fromfrom thethe prehospitalprehospital withwith thethe onceonce fromfrom thethe ERER andand withwith thetheonceonce inin thethe imagisticimagistic unitunit

ForFor realizingrealizing thethe webweb applicationapplication itit waswas usedused thethe MicrosoftMicrosoft VisualVisual StudioStudio developingdevelopingenvironmentenvironment andand additionaladditional toolstools providedprovided byby ..NETNET FrameworkFramework.. TheThe datadata basebase waswasi l di l d dd dd i hi h Mi fMi f SQLSQL SS 20052005


implementedimplemented andand managedmanaged withwith MicrosoftMicrosoft SQLSQL ServerServer 20052005..

SSoftware oftware architecture of the systemarchitecture of the systemCoopUrgCoopUrg

Medical data structures Medical data structures witch are used in the project are:witch are used in the project are:•• prehospitalprehospital minidatasheetminidatasheet –– datadata areare assumedassumed throughthrough interfaceinterface

MomentMoment AA EmergencyEmergency minidatasheetminidatasheetMomentMoment AA.. EmergencyEmergency minidatasheetminidatasheet•• prehospitalprehospital datasheetdatasheet –– datadata areare assumedassumed throughthrough interfaceinterface

Moment A. Patient's data. Intervention. Case history of the injury mechanismMoment A. Patient's data. Intervention. Case history of the injury mechanismMoment A. FAST ProtocolMoment A. FAST ProtocolMoment A. FAST Protocol Moment A. FAST Protocol Moment A. Primary objective examMoment A. Primary objective examMoment A. TherapyMoment A. TherapyMoment A. Final dataMoment A. Final data

•• the structured answer of the imagist doctorthe structured answer of the imagist doctor răspunsulrăspunsul –– data are assumed through data are assumed through interfaceinterface

Moment A.Moment A. Imagist doctor answer•• fifi nităţiinităţii dd primirprimir r nţr nţ UPUUPU d ld l ll ii i fi f•• fişafişa unităţiiunităţii de de primireprimire urgenţeurgenţe –– UPU UPU –– dateledatele suntsunt preluatepreluate prinprin interfaţainterfaţa

Moment B. Moment B. DateleDatele pacietuluipacietului. . InterventieInterventie. . AnamnezaAnamneza mecanismuluimecanismului lezionallezionalMoment B. Moment B. ExamenExamen obiectivobiectiv primarprimarMoment B. Moment B. ExamenExamen obiectivobiectiv secundarsecundarb vb vMoment B. Moment B. TerapieTerapieMoment B. Moment B. ExamenExamen paraclinicparaclinicMoment B. Protocol FASTMoment B. Protocol FAST


•• fişafişa cuprinzândcuprinzând dateledatele pentrupentru centrulcentrul dede transplanttransplant..

Concatenation diagram of the Concatenation diagram of the CoopUrgCoopUrg

application’s functionsapplication’s functions START

Interfata principala a aplicatiei Web

Interfata de post-procesare date

STOPInterfata de configurare

Intefata medic urgentă prespital

Interfata medic specialist imagist

Interfata medic specialist UPU

Interfata medic specialist transp.

Interf. generare fisaprespital

Interf. generare minifisa

Interf. vizualizare rasp structurat

Interf. generare rasp structurat

Interf. vizualizare minifisa

Interf. vizualizare rasp structurat

Interf. generare fisa UPU

Interf. vizualizare date donori

prespital rasp. structurat minifisa

Gestiune raspunsuri structurate realizate / alertare Medic

urgenţă prespisal

Gestiune planificare la consultatii pt. Medic

ultrasonografist

rasp. structurat

Gestiune planificare pt. Medic UPU / transplant

urgenţă prespisal ultrasonografist

Gestiune planificare la consultatii pt. Pacient investigat / alertarea medici


Sistem expert pentru evaluare pacientilor şi directionarea acestora

Modular diagram of the Web applicationModular diagram of the Web applicationCoopUrgCoopUrg


Relation entity diagram of the data baseRelation entity diagram of the data baseCoopUrgCoopUrg


Relation entity diagram of the data baseRelation entity diagram of the data base CoopUrgCoopUrg


Primary interface of the Web applicationPrimary interface of the Web applicationCoopUrgCoopUrg


Login interface of the Web Login interface of the Web applicatonapplicatonCoopUrgCoopUrg


Specialist interfaces from the mobile unit of the Web Specialist interfaces from the mobile unit of the Web CoopUrgCoopUrg

application application –– minidatasheetminidatasheet


Specialist interfaces from the mobile unit of the Specialist interfaces from the mobile unit of the CoopUrgCoopUrg

Web applicationWeb application



application application –– prehospitalprehospital datasheetdatasheet


Imagistic specialist interfaces of the Web application Imagistic specialist interfaces of the Web application CoopUrgCoopUrg

–– structured answer structured answer


ER specialist interfaces of the Web application ER specialist interfaces of the Web application –– ER ER CoopUrgCoopUrg

datasheetdatasheet


Stipulated resultsStipulated resultsCoopUrgCoopUrg

Measurable results:

By direct natural quantification:Realization of a system model for interventions in case of emergency and catastrophically situationsR liz ti f i f r ti l ppli ti f r r t l di iRealization of a new informational application for emergency telemedicineRealization of a data base and medical images which will be structured ulterior under the form of knowledge base used for medical personal training form the emergency/transplant fieldStandardization echographic aspect of the various analyzed formationsStandardization echographic aspect of the various analyzed formationsThe impact over the labor force, through the specialization of the medical personal in informatics

By indirect natural quantification:The growing professional qualifications of the personalThe growing life chance of the monitored, through direct connection with the specialists in various domains in accordance with the caseTh i f h i l i f h j l d i li i i di i li jThe growing of the managerial capacity of the project leader in realizing interdisciplinary projects.


Potential beneficiariesPotential beneficiariesCoopUrgCoopUrg

Prehospital emergency unitsClinics and hospitals from the public health networkp pHeath Ministry and its territorial organismsResearch institute, superior education which display research activities in medicine,medical informatics information technologiesmedical informatics, information technologies

- the project offers work themes for young: researchers, graiuand, master students,medics


financed by romanian government – ministry of education ... · financed by romanian government...

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