Brainstorming

HealthSystem PSS HS Concept Design

Blood Testing via Microchip; brief discussion of (!) future vision of blood testing at home with handheld devices []

12-lead ECG Gant glove - this is very new, only a few articles: []

Copied from main page: -__Insulin pumps__ are similar to our idea in the sense that they're a medical device that must be worn, that shouldn't have the "white coat" effect. Here's a link to to site. They look like walkie talkies, or pagers, very non-threatening and can be cusomized: []

-I thought of the __Swatch__ brand, because they're known for thin, lightweight and stylish timepieces and accessories for men and women,. There's a huge variety, so one can customize to suit their own style; I would suggest looking at the watch and Bijoux sections [] Personal Tech � fitness monitoring ideas http://www.nytimes.com/2009/12/03/technology/personaltech/03FITNESSGEAR.html

Health and Wellbeing Gizmos � see the others at the bottom of the page http://www.gizmag.com/go/7218/

Biosensors � in vivo http://www.clemson.edu/c3b/projects.html

Health care system ideas []

Potential testing requirements - ie. what needs to be able to detect []

Medical devices in the home - needs and requirements [] [|http://www7.nationalacademies.org/dbasse/Medical Devices and Equipment.pdf] Thoughts for design considerations - user requirements []

Here is a link to needleless syringes - they work with pressure to put medication under the skin. Unfortunately, nothing works in reverse to draw blood from vessels - the challenge is that one must break into the vein to extract blood... []

Here is a link to infrared spectroscopy which has potential for a number of non-invasive measures via blood vessels (such as oxygenation) - if interested, I can get the full article - I'm not sure what the technology involves... []

You won't believe what I've stumbled onto - it appears we weren't the first ones to think of wearable and home health monitoring systems: In fact this issue of Engineering in Medicine and Biology (IEEE) has several articles about home and wearable health monitoring devices and systems - see below.

Interestingly, most of the systems discussed either deal with a health concern (such as obesity and fitness and activity monitoring), or a diagnosed condition such as Parkinson's. There is some discussion of the problem of compliance with the systems - because few are unobtrusive - or FUN and trendy and enjoyable to wear...that might be our twist?

One more - this one has great pictures:

Michael - March 24, 2011

Two links for blood pressure monitoring using the finger. An example of a system : http://www.amazon.com/Lumiscope-Automatic-Finger-Pressure-Monitor/dp/B00005M06G Review and comparison of home based blood pressure monitoring: http://www.nature.com/ajh/journal/v13/n3/full/ajh200043a.html

Jason De Freitas: Feb 10, 2011 Here are the pages written form todays meeting. The images wouldn't go onto the web page correctly, so I saved them in a PDF instead. I'm sorry about the confusion with the topics we dealt with today. To some of us, it may seem like a setback, but we still have the information required and will still work, it will just take some adjustments and a new thought process to connect everything to where we want it. I will work on this and have a working, if not complete version of what we need for the PDS and we can fill it in or use it as an example when we meet up again.



From Anna: -a small blood droplet would be mixed in with another liquid to form an emulsion with two layers that don't mix. This would happen on the microchip. -the samples would be dispensed electronically, tested by sensors, and the data from the tests would be sent wirelessly to a computer. -It's meant to be an automatic process, which would reduce handling, human error or contamination.
 * UPDATE:** __On blood testing through a microchip__ - the development came from Canada's own University of Calgary Schulich School of Engineering. The summary is:

Have a look:
[] And here's the academic paper from the journal Lab on a Chip, if anyone is interested in in-depth reading about it;

Jason D, Feb 13, 2011: Product characteristics V 2.0 Here is a copy of a new set of Product characteristics that is based on our original, but done with the focus on the product, not the brainstorming concepts. New version with Functional requirements added.



Michael - Feb 14, 2011: See the file for notes from today's call. As well, it also includes my thoughts of a usage scenario for an agent in the current system. I have it with the goal of health assessment but I don't know if it is labeled as well as it could be. Since it's in a word document, feel free to alter it. If there is a better way to include it on this page, give it a try.



Judy - Feb 15, 2011: thanks for uploading the usage scenario Michael - cool drawing! Is this depicting the "current" system, or meant to capture the usage of our new system? I'm thinking it looks like our current system where one must go to the doctor, then to the lab for tests, then back to the doctor for results - all in the name of prevention. We probably should have (maybe you did this) a loop where the person who doesn't go to the doctor eventually has more serious symptoms and winds up in hospital or the clinic. If we're including or contrasting the new device - should we show "person monitored by system" followed by information sent to person and doctor (bypassing the first appointment and the lab appointment) - then seeing the doctor only if something is detected - can we visually contrast the change this would make?? Just some thoughts.

I dug a bit into what tests would be most appropriate for prevention and the frequency of testing. Links below are to the BC guidelines for carviovascular disease and the Canadian Cardiovascular Society consensus guidelines (disregard the treatment stuff in these). We must remember however, that these guidelines (eg. getting blood triglycerides tested every 2-3 years for low risk patients) assume the current health care model where visits to the doctor and lab are costly. If we assume our system costs less and that visits to the doctor and lab are not needed unless a test indicates a problem - the logic would follow that we may argue for more frequent testing - i.e. prevention. The challenge here is that as soon as a patient moves from low risk to having some risk factors, the frequency of testing increases dramatically.

So basically - according to current medical practice - testing for prevention looks something like this: -less than 40 years old, no risk factors of cardiovascular disease (CVD) (eg. no smoking, no family history, no obesity, no diabetes etc) - blood tests would be done every year (for some at annual physical) or every 2-3 years (although we could argue more frequently) and blood pressure would be done monthly -as soon as a risk factor presents (eg. high cholesterol), the frequency of testing bloodwork increases to every 3-4 months - and if moderate increases in blood pressure appear - it may be suggested that the person buy a blood pressure cuff to monitor daily at home -if diabetes risk factors appear - CVD risk goes up dramatically - blood sugar tests may be done several times a day if diabetes is full blown and other bloodwork may be done monthly or more frequently - blood pressure would be done daily.

-I also had a discussion about heart rate and EKG measures - and (according to the Dr interviewed), these two measures are not as useful in prevention. Blood pressure is the key and heart rate can be obtained from this. EKGs really only help when something has been diagnosed - or where shortness of breath or other indications of arrythmias appear.

So, it looks like our focus could stick to blood samples and blood pressure for most effectiveness - with even the possibility down the road of the blood tests being used to screen some cancers (as technology and markers become available)....any thoughts?





Jason D. Feb 15, 2011: PDS Draft Here is the first draft of the PDS. I have made some alterations compared to my notes due to found repetition on points. I have also reworded some points to sound more appropriate to the pds. I am providing the visio file incase people want to edit the pds amd a pdf version for those of you who don't have visio.



Anna M. Feb 16, 2011

Went through the above documents and read your summary, Judy. I think this is great - it allows us to narrow down the technology and abilities of our device.

I jumped ahead a bit and did a quick search of blood glucose testers, to see what's available. I really liked Bayer's product offerings, this is something we may want to look at once we reach concept design. I summarized them (whttp://pdfcast.org/pdf/a-pain-free-lancet-with-a-small-needle-for-glucose-measurementithout much paraphrasing) in the file below.



Hi all (Judy here) - it appears studies have been done measuring pain response to needle pricks - 0.15 mm diameter is the smallest available and has been shown to be "pain-free" - just what we want (see attached) - this can be added to our constraints (max diameter of 0.15 mm)

[]

FLASH - Concept Idea (formulated while going for a run in the forest after class)

Consider the millions of commercial drivers and operators of heavy equipment (think logging trucks, forklifts, mining equipment, long-haul truck drivers, construction equipment, oil and gas pick-up truck drivers, bus drivers, taxi drivers, etc. etc) - many of these folks live in small and remote communities - and many of them have high risk factors for CV disease (overweight, sedentary lifestyle, smoking, poor diet)...now imagine that our health care monitoring system is linked to operation of their vehicles - for example, every 6 months the operator is prompted for "tests" and cannot start the engine of their vehicle/equipment until the test is done (sort of like the breathalizer concept). They do the tests because that is their livelihood. The monitoring device is provided from the health care system to employers free (because monitoring and preventing saves money in the long run). There is also an incentive for the employer to install the devices, because they get a kick-back (rebate) on their health care premiums that they pay for their employees (reduces their costs). Perhaps the worker also gets a kick-back after taking the test - a rebate in the portion of health care premiums they pay. The test information is secure and not provided to the employer (no confidentiality issues) - and after the test, the device asks whether the worker wants results texted or emailed to them personally. They could also be asked whether they want information about how to lose weight, quit smoking, reduce blood sugar or cholesterol, etc. (thus education if wanted) - picture the device talking to them: "say YES if you would like more information...." - it won't solve all the world's problems - but this demographic of the population is a big one....perhaps this will spring-board other ideas, Judy

Anna and Judy worked on the inputs/outputs and transformation relations today - we have a draft C-map showing the transformational systems. Please feel free to provide edits, comments, suggestions....

Petrit - February 20 2011 Hi All Attached is the new version of the PDS. Remove Widget

Judy Here - Well done team - the PDS looks really good - very comprehensive! Will chat with everyone Tuesday about next steps - it feels like this has propelled us...

New C-Map with Interrelationships between tranformational relations



From Anna, Feb 23rd

I read this interesting article in the NY Times Magazine from Jan. 30th - it discusses how the new iPod Nano can become become a new watch accessory. There is a company that manufactures watchbands for it...it looks pretty cool. There are limits to the look, since its primary function is to be an MP3 player, but I found it nifty. I thought this could be useful for us - for the customization/marketability part of our device.



Jason D, Feb 24, 2011.

Here is the Parwise comparison that we did on Tuesday. In the file, the second sheet is to be used to the Subsystem identification that we will do today. I will do the editing for simplicity sake, but I have it there so that everyone can see whats going on. This step is from his notes regarding the development of the PAS. For more details go to []



Jason D, Feb 25, 2011: Here is the first draft of the PAS with the 1st level subsystems and the inputs and outputs that were created yesterday. All that remains are the connections. I have the visio file and a Pdf file available so everyone can access it.



Judy: Feb 28th, 2011: As Anna and I were defining the inputs and outputs to our subsystems, we found ourselves revising the pairwise comparison since some of the functions no longer seemed to fit. I've attached the revised pairwise comparison. Anna will post the systems diagram chart with our additions shortly.



Anna: March 1, 2011 Below is the PAS that Judy and I completed today. CMap File:

Judy Feb 28th, 2011: I was looking at the links in Fil's concept notes - Siemens (see link below) is releasing a new home monitoring system in mid-2011 for the elderly which will be watch-like and transmit data to health care systems:

[]

Also check out this info on the electrochemical camera - microfluidic diagnostic systems - a different "chip" I believe from the one Anna found - but can analyze proteins for heart diseases in a drop of blood:

http://www.siemens.com/innovation/apps/pof_microsite/_pof-spring-2010/_html_en/trends-targeting-nano-frontier.html

Anna March 2, 2011

I looked at Ideo's website - a really cool company that specializes in design, similarly to how we're doing this project. They designed the Health Buddy, a system similar to what Judy found from Siemens. It's not watchlike, but a tabletop device, but it does provide for remote monitoring of the elderly and chronically ill. Its base accommodates ports for various health-monitoring devices a patient may already have, to enable data transmission. It's one of their most popular products. And Ideo, not surprisingly, is behind one of the the innovative glucose monitors I found earlier from Bayer, the one that's like a USB stick. The link is below.

[]

March 3rd, 2011 Ideation File

Jason D, March 3, 2011: updated draft of PAS

Here is a modified version of the PAS that has some lines drawn in. I have not determined what type of connection they are yet (mass, energy or information) I am first thinking of what input/outputs and systems connect with each other. Determining the type can be done afterwards to keep everything in small steps which keeps things simple.





Petrit Dode, March 6,2011: Attached is Version 3 of the PAS. It is the cleanest job that I could do :-(.

Judy, March 6, 2011: The PAS is looking quite good - thanks for all your hard work.

Preliminary Concept Ideas (focusing especially on the target population and incentives): Please feel free to add to these - expand them - or extend the list...

1. Quick Health Check at the Liquor Store Check-out - invitation to do a quick health check while checking out at the liquor store - "doing" the health check provides a rebate on bill. Information is sent if person chooses on their mobile phone or by email or by telephone (options) - otherwise it is sent to healthcare system only.

2. Credit-card linkage - at pre-determined time periods (as indicated by health status of person), credit card usage will prompt person to do a health check - health monitoring device is available (and linked?) to credit card machines - doing the health check provides an instant credit to the credit card.

3. Grocery Store Kiosk - similar to blood pressure checks in the pharmacies of grocery stores - a kiosk at the front of the store allows patrons to enter their name and healthcare number for a quick check of their vitals (heart rate, blood pressure, blood sample and tests) - information can be sent to them and healthcare system through various options. May need more incentive to get people to use the kiosk - perhaps it has fun screens and interactive devices (game-like) - or perhaps the user plays a video game-like scenario in the kiosk competing for high score (while being monitored) and high scores get awarded prizes regularly. From Anna - prizes could be extra reward points for the store, ie. Airmiles, PC points, Sobey's points, and if at Shopper's Drugmart, Optimum points

4. Steering Wheel of Work Vehicle/Equipment - (discussed above) - vehicle/equipment prompts operator to do health check (at indicated times, such as every 6 months) and the vehicle won't operate until test is done (like breataliser) - employer incentive to keep workers healthy and reduce their health insurance rates. Steering wheel could continuously collect heart rate data (like exercise machines).

5. Cell phone Reminder/Incentive - A text message or cell call is made to user at appropriate interval to remind them to do a quick health check. The equipment/monitor needed could be embedded within the cell phone and data transmitted through the cell phone. From Anna - added incentive: the user receives bonus minutes or data for texting or browsing for completing the test

6. Wrist watch - trendy watch, worn regularly - can collect heart rate continuously and do blood pressure periodically (concept discussed in one of the research links above). It must prompt however for blood collection - the watch has the capability for testing, analyzing and transmitting results.

7. Coffee Maker/Health Monitor - display on coffee maker reminds user of need for quick health check (at appropriate time indicated by their health status) - monitor contained within coffee maker.

8. From Anna - radio alarm clock/ health monitor - similar idea to the coffee maker, just included in the alarm clock. Could program it to say the message to the user; to play a different song (if alarm clock has cd player/ipod dock) on the testing day

9. For those who regularly care for their appearance at salons (men and women) - include a reminder with the next haircut/shave/manicure, receiving a bonus treatment during the following appointment for completing testing. The salons would have to be connected to this health network and would need to receive incentives...need to think this through more.

Michael - March 7, 2011 Thought this may be interesting to look at. I found it while perusing Google with the search "implantable biosensor" http://blogs.discovermagazine.com/sciencenotfiction/2010/08/20/wifi-medicine-implantable-biosensors-that-could-email-your-doctor/ It highlights the challenges between implantable (long life and biocompatible) versus external (patients forgetting and carrying multiple monitors). The article goes on to talk about an implantable sensor that is akin to a bunch of small antennas picking up the different biological frequencies and transmitting them to an external receiver.

Or see page 22 of this link for the book on Body Sensor Networks <>

Anna - March 7, 2011

Health Hero Network - health network tailored to individual health care monitoring. Read through "About Health Hero" and through "Products and Services". I think it could be helpful: []

Judy - March 9, 2011

Great finds Micheal and Anna - we don't have a concept yet for an implantable device...I think it's worth including one.

An observation and suggestion based on our last meeting: At this stage I don't think we should be critical of concepts or ideas...I think we want to hear from each group member with their unique ideas regardless of how fully developed they are - little "gems" can be the basis for brainstorming and creating other synergistic ideas - so rather than discourage these - let's encourage and rif off these gems to perhaps create even better ideas...I don't think we're ready to evaluate and rate our concepts. I'd like to see a creative brainstorming with the concepts to expand and develop them more fully - we all have different expertise to bring together on this....any other thoughts?

Jason-March 9, 2011

Yes, I have a comment on the concept creation. Where I agree that some of these ideas can lead to great concepts, we cannot forget what this project is about. We are to design "something" that can fill the requirements that we have set out. The concepts that are created NEED to address those requirements above all else, or else the "something" is pointless. Please keep that in mind when coming up with concepts and try to encompass something that does the job (testing and information distribution) within those designs. It doesn't really matter if it exists or not, or if it works or not, but something needs to be there.

Another aspect to keep in mind with the design in physical parameters. All these components like sensors, testing chips, etc. take up space and require power. These things need to be considered in a design and should be added in the concept as it will make the detailed design easier later on.

Lastly. We have about 4-5 weeks left and we shouldn't take too much longer on these steps because coming up with the details can take just as long.

Anna - March 9, 2011

This is worth a read - it's a business perspective on mobile devices in healthcare. It is something we could include if we choose to address the profitability of our device, its position with the telecom companies etc.

"How Can Mobile Phones Transform Healthcare" []

Heart Rate Monitors in Exercise Equipment The Wikipedia explanation is pretty good - it discusses a variety of heart rate monitoring methods, the strapless ones (those not requiring a strap around the chest) are the ones that would be part of exercise equipment []

Jason - March 11, 2011

Here are the pictures I took of the board when we did our ideation session last week. I put then all into a document because I have not had luck with putting multiple pictures on the wiki.



Judy - March 12, 2011

Thanks for the photos Jason - Did someone take down the ideation ideas in their laptop too from out meeting? Would it be possible to post the lists so we can have them in front of us and refer to them when we do our generation of further concepts on Monday....thanks

Judy March 14, 2011 Revised ideation with "incentives" added