Guillaume Joerger, PhD1, John J Nguyen-Lee, MD1, Brian Dunkin, MD2, Marc Garbey, PhD1. 1Houston Methodist Hospital Research Institute, 2Houston Methodist Hospital
Background: Flexible Endoscopy Procedure (FEP) is an ever-growing field. Over 14 million colonoscopies are performed annually in the USA and over 7 million patients are affected by gastroesophageal reflux disorder. In parallel, endoscope and colonoscopy are used frequently for diagnosis and therapeutic treatment thus benefiting the patient. Efficiency in the management of the workflow inside the suite is now the key to optimal patient care including patient safety, avoiding delays, and improving patient satisfaction without requiring labor-intensive data entry from the staff.
Method: During the past two years, our team accumulated unique expertise in human-friendly Medical Cyber-Physical Systems for large operating room suites. As of now, our cyber-physical system has two components. First, the sensors automatically and reliably capture the different procedure states. Second, the network component that feeds the sensor data to a centralized “computer intelligence”. The hardware is composed of a low energy multi-sensor device placed close to the door frame, an acquisition card plugged into the coaxial video output of the Olympus endoscopic system, and an air quality sensor. These sensors reliably detect all the key steps on workflow and safety:
- Patient in room
- Scope ready
- Room lights off
- Scope inserted
- Procedure advancement, tool identification, and internal structure screenshots
- Scope out
- Room lights on
- Scope unplugged
- Patient out of room
- Environmental data: air quality, temperature, humidity, pressure
*Scope – Colonoscopy/Endoscopy
Results: The system has been installed in one of the most active procedure room at Houston Methodist Hospital. Data has been recorded over the course of one week and tracked 30 procedures (13 colonoscopies). Validation was performed by comparing nurses manual data to the automatically detected data from the system on 7 procedures and the average error was under the minute. Multiple inefficiencies in the workflow were detected: late first case start, long turnover time due to case cancellation or patient not showing up, no flexibility in the re-scheduling following longer than expected case. We envisage that for the surgical staff having access in real-time to the status of the procedure will automatically raise their awareness, help the efficiency of decisions, and help the overall scheduling process. For example, as the system can easily detect the last step of the procedure (retroflexion), the system can alert the manager who could start the process of the next case.
Conclusion: The goal of this project is to accustom an existing cyber-infrastructure to the specific needs of the FEP suite in order to increase the efficiency of these procedures, address safety, patient satisfaction, and revenue issues. Acquiring accurate and error-free measurements of devices use can improve the quality of services offered by the device company. The end goal is to implement two extra layers. First, the “Brain” of the system that uses a complex mathematical model of the workflow to deliver an analysis and provide real-time feedback to the management team. Second, an interface designed to efficiently share information and serves as a collaborative tool built with and for the surgical staff.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 91008
Program Number: ETP846
Presentation Session: Emerging Technology iPoster Session (Non CME)
Presentation Type: Poster