Phoenix Ambulatory Blood Pressure Monitor Project
2/11/2007 Meeting Notes




* Ryan joined us.

* Carl summarized his sensor team activity. They are changing the design of the piezo film sensor to eliminate "clipping" and more accurately detect the diastolic blood pressure. Innovation, another Twin Cities IEEE study group, has made design recommendations for the sensor.

* Larry: Scaling up the tools that Germaine is using including awk and c programs.

* Bob: In investigating requirements for calibration, he looked at similar products including a pedometer which failed in 1 day. He saw an Ambulatory non-automated blood pressure monitor, with a price of $15+tax. It includes an outside box, literature, a protective bag, wrist cuff, two instruction sheets including a Quick Start in 3 languages, English, Spanish, French. He saw that a new $200 computer from MIT has a USB port for recharging. It would be nice to replace a battery in the ABPM with an inexpensive capacitor that could be periodically recharged. For a typical proprietary product, the cost of intellectual property is $200K plus $200K for each iteration (several times), plus $1.5M to launch. This cost + profit must be borne by the product's price. Our products must be able to survive in 100% humidity (humid tropics), for example, a typical circuit board may have a pool (drop) of water on it. Also, it should be able to survive a drop of three floors (down a stairwell), which occurs with childrens' book bags in primary (elementary) schools. For recording the activity, there is an accelerometer as a MEMS device from Analog Devices that will be available for $1.97 in 1000 unit quantities. In measuring, we must be careful of the dicrotic notch, which is a relative minimum in the blood pressure wave, after which BP increases again and then decreases to the diastolic blood pressure and occurs when the aortic semilunar heart valve opens.

Clinical Care Support Systems - Mini-Topic - Gerry Werth


CCSS - Vision Statement
* Clinical Care Support Systems 8include both information techology and organizational design.
* Vision of our CCCSS study group is to:
- Understand and create systems that support clinicians and patients throughout the healthcare process.
* The Goal of our CCSS study group is to:
- Create the "Apache Project" of open source clinical software.
** The goal of IT is to make CCSS look like billing and payroll. Clinical does not look like billing and payroll.
** Take over a portion of the market that isn't being served by he commercial products. Eg. Smaller patient practices.

* Medical Record / Patient Health Record. (And Personal Health Record)
* Patient Scheduling / Open Item Tracking.
* Free-Text Diagnosis / Vocabulary Mapping
* ICD-9CM coding / Diagnosis
* CPT coding / Level of Service scoring (extensible to ICD 10, and map between 9 & 10).
* Fractal Patient Records / Distributed Patient Records
* Clinical Workflow Communications.
* ...

* Clinical Domain Architect
- Gerry Werth
* Software Architect & Natural Language
- Gary Bertoski (Thompson/West) meet 3/16
* Clinical Vocabulary
- HJ (Debra Schmit - is Vergil Slees daughter, HJ is her husband, both are lawyers) & Debra Schmit (Tringa) - meet March 16.
* Alpha Clinical Sites
- Milt Seifert MD (Eagle Medical)
- David Ness MD (Parkway Family Physicians)\
-- Both David and Milt have practices that haven't sold out to the chains, so they fit the target market for CCSS.

Next Steps
* Name Project5
- CCWSS: Clinical Care Support System
- Asclepius / Aesculapius (Greek/Roman god of medicine and healing)
... (Pronounced "as kleep ee us", accent on the second syllable).
* Recruit Community Builder
* Recruit Business Analyst
* Recruit members for CCSS study group
* Recruit alpha user sites
* ...

Bob: How would you map terms to meanings? Gerry: we could use as service like the domain name service (DNS) to do the mapping.

Q&A: El: Would it be able to obtain the historical blood pressure information for public health analysis. Germaine: We would like to be able to provide trending data on a population basis and individual basis. Chris: As long as we have the unique session ID, would be able to do this without disclosing the patient identity.

Gerry's questions: Is this vision appropriate?
- Chris: I can't imagine how vision could be broader. And you don't want to go cheap on "the vision thing." You need a community builder.
- Larry: It seems too broad to implement.
- Germaine: It is flexible, yet easy implement, and comprehensive, adaptable. If it really works.
- Larry: It is a vision of a perfect system to be implemented by Gerry and his three closest friends. The community building is critical. It would help if you identify what can you build early and where can you use it.



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