Our next meeting will occur on January 23rd and we'll continue meeting each 2nd and 4th Sunday of the month.
Franz asked us to emphasize that the ABPM is both automatic and usable in the home, and use should not be restricted to just a hospital, clinic or doctor's office.
We continued developing software requirements. Chris summarized our software requirements project, specifically the Use Case process.
We are extending our user profiles beyond the typical criteria of: male/female and under 40/over 40 years old.
We discussed the diary. Franz suggested that we include: waking, exercise, emotions, conflict, grief, mood. needs time stamp. The main categories are 1) mood (scale) and 2) activity. We realized we needed to include food/drink/missing a meal and 3) Ad Hoc.
There was a local newspaper article about 14 high school students who won an award in diary design for blood pressure measurement. We need to interview them before the information is lost and the students leave the area for college. Specifically we want to know: What information they recorded, how they recorded it, what would they do differently, the positives and negatives of what they did. The article was about Richie and Ryan in the Minneapolis Paper, finished on 12/21, in the high school news section. Franz will send us a copy of the article.
Use Cases - The key actors include:
We are not clear on whether Technicians are actors.
Clinicians are divided into roles: physician, nurse, educating patient & fitting and training, trouble-shooting & phone support, follow-up, return device. These are roles at the beginning, middle and end of patient use.
We discussed how physicians are continually characterizing reliability in terms of their uncertainty and their uncertainty about their uncertainty. Also, physician information is highly context-based, and this is often difficult for engineers to understand.
We noted the issue of "Is the diary physically separate from the monitor?"
We also discussed what is an appropriate sampling cycle and to use the monitor to do this. We decided that we need to configure the monitor to accept different intervals other than just 30 minutes. Also, Franz suggested that the data need not be equidistant, though this is highly desirable. We noted that A&D's monitor has intervals of 5, 10, 15, 20, 30, 60, 120 minutes. Bob noted that 5 minute intervals are used immediately following surgery to determine when and if key patient metrics return to normal values.
We also need types of alarms. The hardware needs to have it so that software can implement it. Such alarms need to be: 1) get to the hospital now, 2) take a specified action. We noted that having an alarm that indicated a specific action other than 'call your doctor' could require much more rigorous regulatory approval.
What is the difference between clinics and public health? Franz said that restrictions are often reduced for public health because they do preventative medicine and clinics do more clinical (post event) medicine. Gary said that public health treats populations and a clinic treats individuals.
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