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E-ARMOR: Online Polypharmacy Evaluation for Elderly

E-ARMOR is a tool to assess and optimize prescribed medications in elderly individuals, utilizing various calculations and risk analyses without storing patient data. The system aims to mitigate risks through secure web servers and HTTPS protocol.

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E-ARMOR: Online Polypharmacy Evaluation for Elderly

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  1. E-ARMOR: An Online Tool to Evaluate Polypharmacy in Elderly Persons E-ARMOR Group Jacob Brown – Domain Expert Jordan Fish – Project Manager Kajal Miyan – Facilitator Yang Yang - Configuration Manager

  2. PART I: OVERVIEW

  3. Project Overview • Motivation for project • Many prescriptions by many Doctors • No longer needed • Wrong dose • System Goals • Evaluate prescribed medications • Optimize prescribed medications

  4. Overview of Features • Given patient data… • Compute • Ideal Body Weight • Creatinine Clearance • Glomerular Filter Rate • Assess drug impact • Without storing data • Limit system access

  5. Domain Research • Polypharmacy tools • ARMOR • Physician’s Desk Reference • Mosby Drug Reference • Formulae • Cockcroft-Gault • Devine formula

  6. Risk Analysis • Risks • Data protection • Result integrality • How to mitigate risks? • Secure Web Server • HTTPS • Don’t store patient data

  7. PART II: MODEL-BASED VIEW OF SYSTEM

  8. Description of Use Case Diagram • Generate Drug Report • User enters data • Vital Stats • Prescriptions • Basic Lab Panel • System • Computes stats of interest • Looks up drug data • Reports results to user

  9. Description of Class Model Single Access Point Singleton Proxy Interpreter

  10. Behavior Model: Sequence Diagrams Exceptional Normal

  11. E-ARMOR State Diagram

  12. DrugDataProxy State Diagram

  13. Related Work • START • Set of rules used to determine omitted drugs in elderly patients • STOPP • Set of rules used to identify inappropriate drugs • Both tools are non-electronic like the ARMOR tool

  14. Lessons Learned • Design principles • Client-Server architecture • Inherent for web application • Central Control • Singleton proxy • Easy to maintain the medication information • Provide access control and uniform interfaces

  15. Lessons Learned (cont.)‏ • In retrospect - • Clean requirements document • More efficient Customer interaction for procuring Domain Knowledge • Time management • Prototype can be a huge temptation

  16. Lessons Learned (cont.)‏ • Future work • Communicate with EMRs • Smart phone application • Identify potentially redundant medications • Threshold values to immediately notify danger • Encrypted connection

  17. PART III: DEMONSTRATION

  18. Prototype: Login • Provides Access controls

  19. Prototype: Main Page

  20. Prototype: Results

  21. Video demonstration • http://www.cse.msu.edu/~cse870/Input/SS2010/E-ARMOR/video/demo_natural.mp4 • http://www.cse.msu.edu/~cse870/Input/SS2010/E-ARMOR/video/demo_natural.html

  22. Live Demonstration • Workflow • Login • Enter data • View/print results • Logout • http://www.cse.msu.edu/~cse870/Input/SS2010/E-ARMOR/web/

  23. References • Barry, P. J., et al. "START (screening tool to alert doctors to the right treatment)—an evidence-based screening tool to detect prescribing omissions in elderly patients." Age and Ageing (2007): 632-638. • Gallagher, Paul and Denis O'Mahony. "STOPP (Screening Tool of Older Persons’ potentially inappropriate Prescriptions): application to acutely ill elderly patients and comparison with Beers’ criteria." Age and Ageing (2008): 673-679. • Haque, Raza. "ARMOR: A Tool to Evaluate Polypharmacy in Elderly Persons." Annals of Long-Term Care (2009): 2-6.

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