The RiskWatch team, from left: Grant Kruger, James M. Blum, Kevin Tremper, Albert Shih, Chi-Jung Chiang, and Darragh Buckley.
Researchers from the ME Department and the Department of Anesthesiology are collaborating on the development of a novel integrated data display and monitoring system for use in critical care and operating room (OR) environments to improve patient outcomes and safety.
The system, called RiskWatch, collects patient specific information from various monitoring devices, such as blood pressure monitors and electro-cardiogram traces, as well as from databases, such as medical history, lab results and pre-operative data. These data sources and streams are integrated, features extracted, and the real-time high-level patient state presented in a graphical modality for quick and easy interpretation. This clear and concise display of information is a significant improvement to current monitoring systems.
“When you go into an OR now, the data is poorly presented to you as an anesthesiologist,” said Dr. James Blum, Director of Critical Care Research in the Department of Anesthesiology. As an added benefit, the system alerts practitioners to potential risks for the patient during an operation as determined by his or her medical history and the real-time data being collected. If, for example, a patient were at increased risk for cardiac arrest, the practitioner would be made aware of the risk by a change in color of the outline around the heart image on the RiskWatch display. The alerts are based on a large amount of medical domain knowledge as well as many years of published research. The system also has the capability of showing physicians the publication which the alert is based on if they so wish.
A screenshot of the RiskWatch system.
Development of RiskWatch for the OR began in 2008, when Dr. Kevin Tremper, Chair of the Department of Anesthesiology, led efforts to begin working with ME Professor Albert Shih, Research Investigator Grant Kruger, Research Fellow Scott Miller (currently Assistant Professor at University of Hawaii) and graduate students Kate Sanders, Chao Chen, Darragh Buckley and Alex Chiang.
Although RiskWatch does not fall under the category of a traditional manufacturing endeavor, much of the technology towards creating this system has been well-developed and applied in manufacturing. Kruger, whose background is in electrical engineering and mechantronics, and Blum, whose pre-med training was in computer science, have been especially pivotal in designing RiskWatch’s software and alarms. Other collaborators on the project include Jan Gombert and Brad Barnich, computer support staff from the Anesthesiology Department. In parallel, Blum and Dr. Andrew Rosenberg, Chief of the Division of Critical Care in the Anesthesiology Department, are also developing a similar system, called Hyperion, for the critical care environment. Combining both systems will provide a comprehensive high-level tool to aid physicians in delivering improved care.
The system has obtained a provisional patent and a non-provisional patent is pending. Currently, the team is working to further refine and validate the knowledge base and reasoning engine and is obtaining prospective clinical performance evaluations from RiskWatch in OR at University of Michigan Health System. The development of RiskWatch demonstrates the symbiotic relationship between engineering and medicine and the potential of cross-disciplinary collaboration for the advancement of healthcare technology.