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Published 2 papers and 1 video

mobile chain of survival
Just recently my colleague and I have published two research papers. I am very proud of the first one titled “Mobile phone in the Chain of Survival”, which was published after a lot of research in the Resuscitation journal. This short paper gives an overview of vast possibilities possessed by mobile phones to be of assistance in medical emergencies. It represents a continuation of my work with CPR mobile applications. I have also now published a video of the lecture I gave during the Resuscitation 2010 congress about the same subject. You can watch my 10 minute lecture here, and read our paper at the Resuscitation website.

The second paper we wrote appeared in the Croatian journal Lijecnicki Vjesnik (in English this would be something like Physician’s Newsletter). It is a case report demonstrating a patient with smell disorders, which we suspect were caused be lacidipine, a calcium channel blocker used to treat hypertension. So far this drug has not been linked with smell disorders, but other calcium channel blockers from the same group are well known to cause such problems. The paper is written in Croatian, but its abstracts is available in English – Can lacidipine cause smell disorders? A case report.

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AirStrip CRITICAL CARE

The Apple Worldwide Developers Conference (WWDC) is taking place in San Francisco right now. On the first day Apple introduced the new iPhone 3G S. They also continued their tradition of presenting some interesting upcoming applications.

AirStrip Technologies has presented its new medical app called Critical Care. I really don’t have any comments at this moment other than WATCH THE VIDEO IT WILL BLOW YOUR MIND!

AirStrip CRITICAL CARE features include:

  • Virtual Views – Remote, virtual real-time monitoring of live cardiac rhythm strips and other waveform data such as pulse oximetry, end tidal CO2 and peak ventilator pressures.
  • Strip Zooming – The zoom feature maintains relative size of waveforms and the background grid allows for easy assessment and measurements.
  • Automated Caliper – The automated caliper measures designated intervals, both automatically and manually.
  • Strip Scrolling – The scroll function allows users to quickly scroll through stored waveform data, such as telemetry strips.
  • Patient Data Display – Tidal volume, airway pressure, flow and volume readings are also available in virtual real-time, directly from patient monitors.

AirStrip already has one interesting application available in iTunes store called AirStrip OB. This application, intended for obstetricians, delivers vital patient waveform data — including fetal heartbeat and maternal contraction patterns — in virtual real-time directly from the hospital labor and delivery unit to a doctor’s iPhone.

If you are interested you can watch the whole Apple WWDC 2009 Keynote Address.

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Clinical Trials app: video review and giveaway

Recently Kat Sanders presented Clinical Trials app for iPhone in a guest post on my blog. Now I am bringing you a video review of this great app.

But that’s not all! Geoffrey Young of StopWatch Media, makers of Clinical Trials app, was kind enough to offer us 4 promo codes which you can use to download and install this app for free on your iPhone. We will be giving away these codes to 4 fastest readers. Let me just remind you that this app is worth $25.

UPDATE!!! Giveaway is over. Congratulations Richard, Matija, Martin and Peter!

Here is what you have to do:

  • Watch the video review
  • Write down in which minute of the video I talk about “Top Studies via Clinical Trials.app”
  • Send me an e-mail with your full name and correct answer
  • If you are fast enough, you will receive one promo code and instructions how to download Clinical Trials app for free!

Good Luck!

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Nintendo Wii Fit for physiotherapy

Wii Fit

Interesting press release regarding use of Nintendo Wii Fit to benefit young patients undergoing physiotherapy.

Two Lancashire hospitals have taken the unusual step of introducing the Wii Fit computer console into their Physiotherapy Departments to aid the rehabilitation of young patients.

The idea was the brainchild of a 12-year old patient and staff at Lancashire Teaching Hospitals NHS Foundation Trust, which run Chorley and South Ribble Hospital and Royal Preston Hospital, have purchased two game consoles and fitness games to benefit youngsters undergoing treatment.

The Nintendo Wii Fit aims to promote health and fitness through active games.

Lesley Walters, Head of Physiotherapy, Lancashire Teaching Hospitals NHS Foundation Trust, said: “We provide a paediatric and adolescent physiotherapy service. One of our patients suggested it would be a good idea and new and fun way to get youngsters to undertake physiotherapy.

“Physiotherapy sessions for children and young people often use play or diversion techniques to get them to overcome any discomfort or stiffness they may feel.

“Wii Fit is a great way of using computer games to stimulate interest while performing exercises which can be uncomfortable.

“We encourage people to have fun while undergoing physiotherapy and the use of a computer games console which encourages fitness is a fantastic innovation for physiotherapy.

“Two consoles have been purchased and we will be using them in our paediatric and adolescent physiotherapy services at Chorley and South Ribble Hospital and Royal Preston Hospital. It is being used in an increasing number of NHS Physiotherapy departments and I’m sure that it will prove very popular in Lancashire.”

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Exclusive interview: Dr. R.A. Brest van Kempen, CEO of RS TechMedic

RutgerHere is a treat for all you medical gadget lovers. An exclusive interview with Dr. R.A. Brest van Kempen who just happens to be the CEO of RS TechMedic. His company has produced some amazing high tech medical devices over the years. One of their most revolutionary product on the market today is a telemedicine device called Dyna-Vision. Only for you, Dr. R.A. Brest van Kempen talks about his company’s products and shares news about the development of software which will enable you to monitor your patient in real time using your iPhone.

Could you tell me more about yourself, about your background?

I studied at the Catholic University of Leuven in Belgium and have been a “clinical perfusionist” in cardiovascular surgery for 10 years in 3 leading hospitals in Belgium and the Netherlands. I started my MBA study in 2006. In 1999 we founded RS TechMedic, a company developing medical technologies. I am responsible for marketing and sales, the operation of the company and the machine-to-man interfacing design of the products. With our dedicated hardware and software engineers we’ve developed 9 medical devices and clinical software so far and our latest development is focused on the fast growing telemedicine market.

Please shortly describe the history and milestones of your company, RS TechMedic?

We developed products for Terumo CardioVascular Systems, Maquet, Martil Instruments, and a number of other companies. These products were all high-tech developments and are on the market as we speak. The most advanced product was our automatic micro-air removal device for heart-lung machines. With this technology we are able to significantly reduce the postoperative cognitive dysfunction in heart surgery patients. Out of 160 companies, we were granted the Innovation Award 2002 for this product.

dyna-visionCurrently one of your major products is Dyna-Vision. Tell me a little bit more about it and the ways it differs from similar products on the market?

Dyna-Vision is developed with the latest available technologies. What we often see is that other companies are “upgrading’ existing products to be used for telemedicine. We are convinced that this is not the best solution. We created a wish list of physicians and their patients and developed a new technology based on these requirements. This is a different strategy and makes that we can offer the most recent technology.

We are a bit careful with making comparisons as Dyna-Vision as we really see Dyna-Vision as a new “type” of products and not as one of the existing ones. Our device gives you 3, 5 or 12 lead ECG, Heart Rate, Heart Rate Variability, RR-time, Plethysmogram and Oxygen Saturation.

Basically, the device creates a data file to be used in different software for analyses. Currently we certified 4 packages: Cardio, Monitoring, Health and Fitness and Research. This makes Dyna-Vision a multi-purpose device. Physicians can use Dyna-Vision for different indications optimizing there return-on-investment.

Dyna-Vision is the first and only device in the world with an integrated mobile phone. With this connection the recordings are transmitted to a remote server for analysis by a physician. This process is fully automated so there is no action required by the patient to transfer the data. A physician can download the recordings for analysis from anywhere at any time. Also, we offer the unique feature of real-time remote monitoring. For example, a patient has symptoms and contacts the physician who can simply login to the server to monitor the actual streaming parameters on a computer !



Dyna-Vision is supported by several software packages (Cardio, Health & Fitness, Research , Monitoring) aimed at different types of users. Which one is the most popular so far?

  • Cardio is far ahead of the others as cardiologists are very used to recording and analyzing ECG. That makes that we can offer our Dyna-Vision as the “next generation” holter recorder. The patients are connected to the device in their practice. When the patient leaves the practice, the ECG is continuously transmitted to the cardiologist. The patient can be monitored for longer periods of time and does not have to come back to the practice to “download” data from the device. With Dyna-Vision, the patient has more freedom and can be sure that the cardiologist can always analyze the ECG, also when the patient is at home.
  • Monitoring is closely related to Cardio and it is commonly used to monitor remote patients.
  • Health and Fitness is rapidly growing since the wellness sector is focusing more on preventive medicine lately to expand their offering to their clients. When our test shows underlying health problems they refer their client to a physician for further analysis.
  • Research is used by universities but it is a very specific market. This is a niche which does not grow fast.

If I choose to use Dyna-Vision in my medical practice how much security can I expect regarding my patients’ data?

Dyna-Vision “creates” a data file with the recorded parameters. This data file is encrypted before transmission and it does not contain the name of the patient. The files are transferred from the server to your PC Software after entering a security code. After download, the files are decrypted and attached to the correct patient record. Although it will probably never be possible to design an unbreakable security, we took great care of making our product as safe as possible.

You have announced that your company will be launching the first real-time streaming patient monitor on the iPhone platform. How did you come up with this idea? Did you receive any requests from your customers for such a monitor on iPhone?

Well, when I demonstrate Dyna-Vision to cardiologists they always ask me if it is possible to receive ECG data on their mobile phone for a quick analysis. Until now we were a bit hesitating to develop such a tool as it seems more easy than it actually is. Besides that, there are a number of security issues you have to take care of and finally, the processor speed and screen resolution of the phones are still not really suitable for high-resolution multi-parameter monitoring. But, then the iPhone came with the high resolution screen and some very useful programming tools to graphically optimize the streaming data to make it technically possible.
Now we can offer a true telemedicine system for ambulant patients where patients can call their physician when they experience symptoms. The physician can immediately look at the streaming ECG.

In your opinion how did the iPhone influence the whole telemedicine field? Does it offer anything new regarding the mobile phones already on the market?

I must say that I found only a few interesting applications on the iPhone for medical use. The actual use has to grow I believe and this will take time. The main problem is that Apple made it difficult to distribute applications through the central appstore and this brings uncertainty to commercial developers. We had the same discussion within the company: do we develop an iPhone application with the risk of difficult distribution after development or even removal from the Appstore… or do we develop a “common” web application that we can freely distribute. This is a difficult decision but we choose the iPhone for the technical specifications. On the side, the added value of an iPhone to our own Dyna-Vision must not be forgotten. The graphical interface is fun to use and is relatively fast. The iPhone does offer new features that are not found in other phones yet, but other brands are coming up with new products that have somewhat similar specifications.

Explain some of the key features of the iPhone software for Dyna-Vision?

With the software the physician can login to the server and start a live data streaming session. After authentication, the data stream starts and the software automatically starts in monitoring mode. The user can change the layout of the screen and the colors of the graphs. The application is touch screen controller (obviously) and makes use of “flips” to graphically enhance the interface.

Will iPhone be able to communicate with Dyna-Vision unit only by GPRS or also via bluetooth?

Initially we will launch it with the GPRS connection. However, the next release by the end of this year will also support the Bluetooth connection.

When do you expect that iPhone version of your software will be available?

We are introducing the iPhone Telemedicine Application during the Medica in Dusseldorf, Germany to be held from 19-22 November 2008. Immediately after that it will be commercially available. However, it is only sold to licensed physicians who need to register with our company. We will authorize them in the system so that they are able to use the iPhone application.

Was it difficult for your software engineers to start developing for the iPhone platform using the tools from Apple?

The Software Development Kit from Apple needs some work so to say before you are able to use it to its full extend. On the other hand, if you have an experienced software engineer this is not a problem. Also, you do not have to take care of compatibility with other platforms as is the case when developing JAVA applications. So in the end, it is less difficult than developing for other platforms.

How do you comment on the likely ban of iPhone sales in the Netherlands? Will it in any way interfere with your plans?

Assuming that you are referring to the internal battery I do not worry about it. First of all, Apple is already discussing the new law with the government and it seems that there are three escapes that Apple can use to bypass the law.. The most important one is the use for medical purposes where the battery is an essential part for the correct functioning of the product. When it is easily removed, this creates issues with data storage and patient safety.
By law, medical devices have a waiver for this requirement and as we are selling it as a part of our medical device… probably we are okay. Nevertheless we are facing this challenge not only for the Netherlands as it is a European Law..

We will not only sell the iPhone Telemedicine Application in the Netherlands but all over Europe. As an example we just made an agreement with a telecom provider that has 35 million subscribers. Early next year we will expand to the USA and Asia. We have contracts with different telecom providers for monthly iPhone plans. We just have to wait and see how things will end up but my hopes are that Apple will work hard on solving the battery problem urgently…

Now that you have stepped into Mac arena, can we expect the Macintosh version of your Dyna-Vision software for desktop computers?

Of course it is already possible to use Dyna-Vision Software on Macintosh with a windows emulator but we are working on a OSX version. We have no release date scheduled but I estimate this will be ready Q1 in 2009.

There you have it! Something to look forward to, a new and revolutionary way to monitor your patients on the iPhone is coming soon. We will keep you updated.

A big thanks goes out to Dr. R.A. Brest van Kempen for this interview.

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HOPKINS

On June 26th, ABC News started airing its six-part series called “Hopkins” which takes an intimate look at the men and women who work at The Johns Hopkins Hospital. Each episode follows a few characters, both healthcare workers and patients, and their stories. The series is greatly produced and is very inspiring to watch. So far, two episodes came out and here are their summaries:

Episode 1

Twenty-one years ago Dr. Alfredo Quinones-Hinjosa climbed a 20-foot border fence so he could join other illegal immigrants picking fruit in the lush valleys of central California. Today he is one of the nation’s elite brain surgeons. He tells ABC News about his remarkable journey as viewers watch him try to save a man’s life.

Karen Boyle is among the new generation of surgeons. She is the first female attending in urology at Hopkins, and determined to maintain a balance between her family and her job. But what sets her apart from other surgeons is the candid counseling about sexual health and intimacy she offers to her patients.

Brian Bethea has made it to the top of one of the most difficult residencies in medicine, cardiothoracic surgery. After nine years of apprenticeship he is ready to join the ranks of the nation’s most illustrious heart and lung surgeons. But the demands of residency have left his family life in shambles. Repairing a ruptured aorta may be easier than saving his marriage.

Episode 2

Brenda Thompson is dying from an obscure and always fatal lung disease. After two failed marriages, her third husband seems to be the man of her dreams. But time is running out. Only a lung transplant can save her. And a new lung may not become available in time. When a donor does become available in New England, there is jubilation. But events take an ominous turn when the donor lungs turn out to be damaged.

Brian Bethea, the promising cardiothoracic surgeon with marital problems, has been sent to harvest the new lungs that turn out to be damaged. Nothing seems to be going right for him. When Brian returns home, he must explain to his daughters that he and their mother are separating and he has found his own apartment.

Mustapha Saheed is in his third year of emergency medicine. At six foot, seven inches tall, this self-described “big black man” cuts a striking figure as he dashes through the ER. Despite the advice of a colleague to not marry the “girlfriend who got you through residency,” Saheed makes plans for the altar.

You can watch Hopkins on ABC News website

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