Doctor’s Office Information System

1. Doctor’s Office Information System May06-22 team: Adam Oberhaus Kevin Schmidt Srdjan Pudar Saalini Sekar Faculty advisor: Dr. Clive Woods Client: Senior Design 2/16/2006

2. Agenda • Introduction • Project Activities • Resources & Schedules • Closing Material May06-22 Doctor’s Office Information System

3. Definitions • EMR: Electronic medical record • IVR: Interactive voice response • RFID: Radio frequency identification • SQL: Structured query language • GUI: Graphical user interface May06-22 Doctor’s Office Information System

4. Problem Statement • Medical patients often miss or forget crucial information during/after doctor visits. • This information should be presented to the patients in another manner or presented again so the patients are more likely to remember the most important information. • Any solution must be easy to use for most medical patients and should not require computer literacy. May06-22 Doctor’s Office Information System

5. Solution Approach • Innovative solutions that a wide base of patients can utilize • Research current doctor-patient communication procedures • Focus on one clinic • Focus further narrowed to prescription information • Provide way for patients to review information outside of doctor’s office • Create easy to use kiosks where patients can print out desired information • Research feasibility and design requirements for automated phone system May06-22 Doctor’s Office Information System

6. Operating Environment • Kiosk • Pharmacy/drug stores • Controlled temperature 60˚-80˚ F • High traffic area • Phone System • Controlled central location • Controlled temperature 50˚-70˚ F • Physically accessible only to administrators May06-22 Doctor’s Office Information System

7. Intended Users and Uses • Kiosk • Used to review pertinent prescription information outside of doctor’s office by nearly any patient (elderly, young adults) who picks up prescriptions from a pharmacy/drug store • Automated phone system • Used to review pertinent prescription information from home or any phone by any patient able to use a phone (non-hearing impaired). May06-22 Doctor’s Office Information System

8. Prescription procedures will be definable and available in some manner Access to medical software used by clinic Access to specifications which allow interfacing the end product systems with an EMR system Design completed by second semester EMR database will have SQL interface Assumptions May06-22 Doctor’s Office Information System

9. Limitations • No access to actual records • Prescription bottles must remain compact • Cost must be minimal for patients • Quick and easy to use for patients and doctors • Access to information must be readily available May06-22 Doctor’s Office Information System

10. End Product and Deliverables • Proof of concept of stand alone kiosk using RFID tags to view prescription information • Detailed requirements and specifications for successful automated phone system with IVR May06-22 Doctor’s Office Information System

11. Present Accomplishments • Familiarized with current doctor-patient communication procedures at McFarland Clinic in Ames • Familiarized with current medical information system at McFarland • Obtained RFID evaluation kit • Started testing RFID reader and software capabilities May06-22 Doctor’s Office Information System

12. Milestones May06-22 Doctor’s Office Information System

13. Research Activities • Current medical information practices • Electronic medical records (EMR) • Barcode/RFID Comparison • Automated phone systems May06-22 Doctor’s Office Information System

14. Current medical information practices • Interviewed Director of Medical Records Services at McFarland Clinic in Ames, IA • Paper version of entire record stored • Parts of medical records stored/created electronically (i.e. radiology, doctor’s notes) • Currently researching electronic medical record software • Hoping to propose a particular solution soon • Use of printed materials (i.e. brochures) May06-22 Doctor’s Office Information System

15. Electronic medical records • Government support and push for electronic medical record systems within 10 years • EMR makes information sharing easier and faster than paper records • Some allow for customized print-outs • EMR system could allow remote access to records with proper authentication May06-22 Doctor’s Office Information System

16. Technologies Chosen • Low-frequency RFID • Automated IVR phone system May06-22 Doctor’s Office Information System

17. RFID vs. Barcode May06-22 Doctor’s Office Information System

18. Automated phone systems • Researched systems offered by various companies • Price ranges ($5,000+) • Features (Max users, voice/keypad interaction, customizability) • Decided system would be too expensive for senior design to purchase • Requirements for implementing such a system will be created instead May06-22 Doctor’s Office Information System

19. Overall system block diagram May06-22 Doctor’s Office Information System

20. Interactive voice response system • Provides a phone-based interface to the EMR database • SQL interface • Ties into the same database as the RFID solution • Patient information is retrieved via key presses or spoken word • Would be purchased and then customized by implementing team May06-22 Doctor’s Office Information System

21. Interactive voice response system • Advantages • Ease of use by patient • Access from any phone • Easy to maintain • Disadvantages • Cost – roughly $10k for a basic system • Authentication • More difficult to use by the hearing impaired May06-22 Doctor’s Office Information System

22. IVR system block diagram May06-22 Doctor’s Office Information System

23. RFID / touch-screen system • Reads authentication information from an RFID tag • Accesses a central EMR database • Presents the information to the patient via a touch-screen interface • Clinics and pharmacies equipped with these systems • Terminal allows patients to print information Images courtesy of (respectively): http://news.softpedia.com/news/RFID-between-spying-and-utility-868.shtml http://www.barcoding.com/rfid/choosing_rfid_reader.shtml May06-22 Doctor’s Office Information System

24. RFID / touch-screen system • Advantages: • Low cost to patients • Relatively simple to use • Access mechanism (prescription bottle) unlikely to be lost • Not time-intensive for doctors • Provides anonymity to answer medical questions • Disadvantages: • Pharmacy would have to purchase system • Information from tag can be read only at pharmacy • Some users may have trouble with the computer interface May06-22 Doctor’s Office Information System

25. RFID tag data breakdown • Six data fields • First three contain information used to access the EMR database • Last three contain additional patient information to validate and connect with EMR database • All six fields encoded to maintain patient privacy • This is an idealized tag breakdown which requires cost prohibitive technology for a proof-of-concept May06-22 Doctor’s Office Information System

26. RFID tag data breakdown • Similar to bank checking system: • Hospital ID : Bank ID • Patient ID : User account number • Bottle number : Check number • Used solely to get records from the EMR database • Records contain important information for the patient • With proper standardization, patients could access their records nationwide May06-22 Doctor’s Office Information System

27. RFID system block diagram May06-22 Doctor’s Office Information System

28. RFID evaluation kit • Donated by Texas Instruments to senior design • Consists of: • RFID Reader S2000 with RS232 interface • Several RFID tags RO, RW • Evaluation software and manual • Antenna • Cables, power supply Images courtesy of Texas Instruments http://www.ti.com/rfid/docs/products/products.shtml May06-22 Doctor’s Office Information System

29. Patient Access • Team-developed software that implements RFID/touch screen system • Utilizes RFID evaluation kit • Windows GUI application • Simple interface • Coded in .NET 2005 • Straightforward GUI design • Easy communication with reader board • Accessible for elderly and ill patients • Color themes • Large font May06-22 Doctor’s Office Information System

30. Patient Access - Screenshot May06-22 Doctor’s Office Information System

31. Difficulties • Problem statement was difficult to define properly • Possible solution space was dependent on clarifying the problem statement • Some solutions already being researched by other institutions and are outside the scope of the project • Some solutions already considered by McFarland Clinic • Solutions limited by time and background constraints • Necessary resources beyond the scope of the project May06-22 Doctor’s Office Information System

32. Total Personal Effort May06-22 Doctor’s Office Information System

33. Financial Requirements May06-22 Doctor’s Office Information System

34. Project Schedule (Original vs. Revised) May06-22 Doctor’s Office Information System

35. Closing Material • Commercialization • Recommendations • Risks and Risk Management • Summary May06-22 Doctor’s Office Information System

36. Commercialization • Need to find best solution for security issues • Convince pharmacies/drug stores of need for kiosks • Gather details on EMR systems used by many clinics • Create possibility for checking from many remote locations across the country/across the world May06-22 Doctor’s Office Information System

37. Recommendations for Future Work • Kiosk • Continue to define standard tag data fields for use across the country with multiple hospitals/clinics • Implement encoding of RFID tags • Interface with actual EMR database • Phone System • Find best way to integrate with EMR May06-22 Doctor’s Office Information System

38. Risks and Risk Management • Loss of a team member • Solution: Tasks would be spread out appropriately between remaining members. • Inadequate budget • Solution: Team members may contribute personal funds or seek outside funding. • Insufficient knowledge/background • Solution: Between four team members, work can be distributed efficiently so each member has work they are comfortable doing. Much of the first semester was also dedicated to research to fill the knowledge gap. • Loss of RFID reader • Solution: Team will concentrate on detailed design specifications for end products instead of developing proof-of-concept code. • Usable RFID tags contain less data than required • Solution: Include less information on tags than initially proposed (eg hospital code and patient ID only). • Can’t interface with EMR • Solution: Create an emulated database to show a proof-of-concept design until software can be interfaced with an actual EMR database. May06-22 Doctor’s Office Information System

39. Closing Summary • Problem Summary • Patients often miss or forget crucial medical information during/after visits to the doctor’s office • This problem is being considered already by local clinics, but the same is not being done with prescription information • Approach Used • Focus on a local hospital/clinic (McFarland Clinic) • Design two end products, which together would serve a broad range of users/patients • RFID/Touch-screen Kiosk and Automated Phone System chosen • Solution Summary • Products will be created that will provide patients with the information they need, on demand, with minimal technical background or time required. May06-22 Doctor’s Office Information System

40. Questions/comments? May06-22 Doctor’s Office Information System