philips 創新智慧生理監控 - tnma100.org.t• philips...

28
Philips 創新智慧生理監控 Anic Liu 劉文超 Healthcare PCMS clinical specialist Sep. 12 ,2014

Upload: others

Post on 21-Sep-2020

2 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: Philips 創新智慧生理監控 - tnma100.org.t• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視 器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中

Philips 創新智慧生理監控

Anic Liu 劉文超 Healthcare PCMS clinical specialist

Sep. 12 ,2014

Page 2: Philips 創新智慧生理監控 - tnma100.org.t• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視 器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中

Agenda

• eICU---ICU 顧問式服務 • Digital Accelerator Lab – Google Glass 應用

Page 3: Philips 創新智慧生理監控 - tnma100.org.t• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視 器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中

Confidential

Hot Topics in ICU Patient Monitoring

病患警告

設備 /系統互通性

感染控制 無線 /移動性

工作流程 /協作 病患安全

+

成效

3

Page 4: Philips 創新智慧生理監控 - tnma100.org.t• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視 器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中

Confidential

Home Out-patient Emergency & OR ICU General Ward Out-patient Home

Current costs

Future costs

Preventative care

&

chronicle diseases

Acute care

Healthcare 資源 擴展照護範圍以突破ICU瓶頸

4

Preventative care

&

chronicle diseases

Page 5: Philips 創新智慧生理監控 - tnma100.org.t• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視 器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中

Confidential

Home Out-patient Emergency & OR ICU General Ward Out-patient Home

Current

Future

Acute care

Healthcare 資源 Philips 解決方案今昔

5

Preventative care

&

chronicle diseases

Preventative care

&

chronicle diseases

Page 6: Philips 創新智慧生理監控 - tnma100.org.t• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視 器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中

eICU---ICU 顧問式服務 Intellispace Consultative Critical Care

Page 7: Philips 創新智慧生理監控 - tnma100.org.t• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視 器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中

Confidential

The concept – IntelliSpace Consultative Critical Care

• 創新概念,透過整合最新技術和臨床

專業,開啟重症照護的新頁。

• 軸-幅式系統概念,遠端管理多個照護

單位 (Hub and spoke model)。

• 管轄單位的病患生理狀況,可以持續

地全面監控。

Command Centre

(HUB)

Remote ICU

(Spoke 1)

Remote ICU

(Spoke 2)

Remote ICU

(Spoke 3)

Remote ICU

(Spoke N)

7

Page 8: Philips 創新智慧生理監控 - tnma100.org.t• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視 器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中

Confidential

The Innovation – IntelliSpace Consultative Critical Care

8

Page 9: Philips 創新智慧生理監控 - tnma100.org.t• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視 器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中

Confidential

eICU in USA

• eICU/Revolutionizing Critical Care

https://www.youtube.com/watch?v=4aW4WbBkZFc

Page 10: Philips 創新智慧生理監控 - tnma100.org.t• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視 器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中

Confidential

ICU Hospital Infrastructure

LAN

Command Center

5 mbps Firewall

Firewall Intensivist on the move

2 mbps

HIS, LIS, LAB IS, Pharma IS

Inte

rne

t V

PN

A

cce

ss

Monitors, Devices, ICCA, PIIC

General Topography – ICCC Solution

11

Page 11: Philips 創新智慧生理監控 - tnma100.org.t• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視 器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中

Confidential

Example – Implementation in India

12

Page 12: Philips 創新智慧生理監控 - tnma100.org.t• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視 器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中

Confidential

The Command Center - Hub

• 同時連線多個 ICU

• 多組工作站同時運作

• 每個工作站使用4~6組螢幕呈現資訊

• 可利用語音和影像和連線之ICU雙向溝通

• 配置人力為加護病房醫師、受訓完成的資深護理師和資訊專員

Command Centre

(HUB)

Remote ICU

(Spoke 1)

Remote ICU

(Spoke 2)

Remote ICU

(Spoke 3)

Remote ICU

(Spoke N)

13

Page 13: Philips 創新智慧生理監控 - tnma100.org.t• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視 器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中

Confidential

The Command Center – Monitor Configuration

• 資訊儀表板

• Philips 重症暨麻醉臨床資訊系統 ICCA

• 生理監視器遠端監控

• 床邊影音雙向溝通設備

• 其他系統連線需求 ex: PACS and or HIS client

PACS Client

PACS Work list / HIS Client

Remote Monitor View

Dash Board ICCA

AV – View of Bedside

14

Page 14: Philips 創新智慧生理監控 - tnma100.org.t• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視 器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中

Confidential

Innovation Development

15

Page 15: Philips 創新智慧生理監控 - tnma100.org.t• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視 器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中

Confidential

攝影鏡頭 – on a height adjustable mount

顯示螢幕與中心溝通資訊 – swiveling possible to face patient

臨床資訊系統工作站 – enables bed-side charting

收納空間 – opens the AV/UPS cabinet

推車把手 – for easy handling

推車基座 – Large base wheels agility and stability

Mobile Cart – In Remote ICU (Spoke)

Command Centre

(HUB)

Remote ICU

(Spoke 1)

Remote ICU

(Spoke 2)

Remote ICU

(Spoke 3)

Remote ICU

(Spoke N)

16

Page 16: Philips 創新智慧生理監控 - tnma100.org.t• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視 器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中

Confidential

Straw man proposal - Command Center 層級規劃

Extends to other

telehealth

applications

Conducts

proactive

surveillance

Stands by and

responds to

on-demand

requests from

peripheral

ICUs

Reactive

Proactive

ICU

Other

Specialties

• Episodic = Event Driven

• Remote = Involving a clinician physically in another location

• Consultation = Seeking expertise advice

17

Page 17: Philips 創新智慧生理監控 - tnma100.org.t• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視 器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中

Confidential

Straw man proposal - Level 1 :依據需求提供 ICU 諮詢

• Complete patient data

and monitoring data

continuously captured

and made available to

CCC

Peripheral ICU (bedside team)

Central Command Centre

(CCC)

• Stands by for multiple

peripheral ICUs

• Responds to requests

on demand

• Centre of expertise

• Centre of excellence

• Bedside team

consciously filters and

extends to CCC for

help for complicated

cases

network capable

of supporting 2-

way audio-video

communication

Instructions & Guidelines

Near-real-time patient data

Real-time

Collaboration

Request for remote

consultation

18

Page 18: Philips 創新智慧生理監控 - tnma100.org.t• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視 器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中

Confidential

Straw man proposal - Level 2:主動進行 ICU 監控

Peripheral ICU (bedside team)

Central Command Centre

(CCC)

• Also continuously and

proactively monitors

patient data from

peripheral ICUs

• Patient acuity scoring

• Triggers dialogue with

bedside team and care

actions

Instructions & Guidelines

Near-real-time patient data

Real-time

Collaboration

network capable

of supporting 2-

way audio-video

communication

CCC proactively

• Rea-time patient data

and monitoring data

continuously captured

and made available to

CCC

• Bedside team follow

the instructions &

Guidelines from CCC

for complicated cases

19

Page 19: Philips 創新智慧生理監控 - tnma100.org.t• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視 器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中

Confidential

Straw man proposal - Level 3 :不同單位的遠距醫療應用

ICU

Hemodynamic

Management

Transfer to

Tertiary facility

“drip & ship”

Very Rapid

Assessment

Tertiary Hospital

CT images

eCareMobile ED

1

2

Stroke Specialist

3

Transfer

to ICU

Tele-stroke Example

20

Page 20: Philips 創新智慧生理監控 - tnma100.org.t• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視 器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中

Confidential

• 醫院的 50% 死亡案例發生在 ICU。

• 透過 持續監控 和觀察病患變化,對

於照護結果有明顯的改善。

• ICU的死亡率降低 68% 和 46%

(compared to two baselines)

• 醫院的死亡率降低 33% 和 30%

(compared to two baselines)

• ICU 併發症發生率 降低 44% 和 36%

(compared to two baselines)

Literature References:

• Team care: beyond open and closed intensive care

units: Pronovost, Peter J. et al.; Current Opinion in

Critical Care; December 2006 - Volume 12 - Issue 6 - p

604-608;

• Intensive care unit telemedicine: alternate paradigm

for providing continuous intensivist care: Rosenfeld BA,

Dorman T, Breslow MJ, Pronovost P, Jenckes M, Zhang

J, Anderson G, Rubin H; Crit Care Med; 2000 Dec;

28(12): 3925-31.

• Tele-ICU: Experience To Date: Craig M.Lilly, MD and

Eric J. Thomas, MD, MPH; J Intensive Care Med;

September 2009

臨床實例

This data is based on the VISICU eCareManager based eICU implementations within the United States

21

Page 21: Philips 創新智慧生理監控 - tnma100.org.t• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視 器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中

Confidential

穿戴式科技應用 Google Glass IntelliVue Solutions

Page 22: Philips 創新智慧生理監控 - tnma100.org.t• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視 器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中

Confidential

穿戴式裝置變革

Page 23: Philips 創新智慧生理監控 - tnma100.org.t• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視 器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中

Confidential

Page 24: Philips 創新智慧生理監控 - tnma100.org.t• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視 器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中

First proof of concept for delivering vital patient data via Google Glass

• Philips’ newly created “Digital Accelerator Lab” a cross-sector innovation platform with labs based in the Netherlands and India.

• Collaborated with researchers from Accenture Technology Labs to explore the potential use of Google Glass in clinical settings

Dr. David Feinstein with Philips and Accenture developers test out Google Glass before entering OR simulator lab.

Page 25: Philips 創新智慧生理監控 - tnma100.org.t• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視 器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中

Google Glass proof of concept

https://www.youtube.com/watch?v=ssldTFWBv3E

Page 26: Philips 創新智慧生理監控 - tnma100.org.t• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視 器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中

Topics for research may include: • Accessing a near real-time feed of vital signs in Google Glass • Calling up images and other patient data by clinicians from anywhere in the

hospital; • Accessing a pre-surgery safety checklist • Giving clinicians the ability to view the patient in the recovery room after

surgery; • Conducting live, first-person point-of-view videoconferences with other

surgeons or medical personnel • Recording surgeries from a first-person point-of-view for training purposes

Page 27: Philips 創新智慧生理監控 - tnma100.org.t• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視 器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中

創新智慧的生理監視方式

• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視

器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中

管理應用的目的。

• 每年超過 1.9 億人使用 Philips 病患生理監視器。透過創新讓世界更健康、

更永續發展。目標在2025年前每年改善30億人的生活。

Page 28: Philips 創新智慧生理監控 - tnma100.org.t• Philips 提供廣泛多樣的病患生理監測方式;從床邊到穿戴式病患生理監視 器,結合臨床決策支援工具和移動式應用,達到即時取得病患資訊並集中