WIRELESS TECHNOLOGY MAY HELP DOCTORS TREAT
PATIENTS
HERSHEY, PA- Wireless technology may put doctors who don't rely
on desktop computers and paper charts in a better position to
treat their patients.
That theory is being tested by students in the Penn State School
of Information Sciences and Technology (IST) at the Mont Alto,
York and University Park campuses where they are developing wireless
technology for fast and secure transmission of patient information
using hand-held devices.
Last spring, the IST students developed a mobile/wireless application
prototype with a limited number of information fields. Using IBM's
mobile database product, the prototype enabled communications
between handheld devices and Penn State Milton S. Hershey Medical
Center's Acute Pain Management Database, developed by Patrick
McQuillan, M.D., and Christine Gelnett, B.S.N, R.N., at the Medical
Center's Department of Anesthesiology.
The two-way synchronization allowed for creation, updating and
deletion of patient records from any location.
"It's virtual, and it's multi-processing-it can have several
processes on at once," said Stan Aungst, assistant professor
of Information Sciences and Technology. "It allows physicians
to query the database and have the answers they need."
The project began in the Department of Anesthesiology at the
Medical Center as a way to log post-operative pain management
data on patients who had had epidural anesthesia during surgery.
Nurses would accompany doctors to patients' bedsides, and with
hand-held devices, record patients' answers to a series of questions
about their comfort and pain. Then the nurse would have to take
the information back to a desktop computer and download the information
from the hand-held device into a desktop computer. Because the
data transfer was unidirectional, medical staff would have to
leave patients to query the database - an inefficient use of time.
"The goal was to improve patient care by looking at how
well people who had certain types of procedures did with certain
types of anesthesia," said Gregg Schuler, senior research
assistant. "But not only was it cumbersome to download the
information, but as it became a research tool, we had to figure
out ways to query and transmit the information."
Schuler went through the various approvals necessary to turn
the database, which by then contained information on about 600
patients, 300 or more of whom were pediatric, into a pool of research
data.
The next step was going to wireless. But patient confidentiality
laws and regulations are strict about how patients' private medical
information can be transmitted.
"One of the problems when you go wireless is that it gets
a little easier for people from outside to hack in," Schuler
said. "So we talked with Dr. Aungst about how to create a
wireless secure acute pain management database that would allow
health care providers to put information into a hand-held device
and transmit it wirelessly to a cell phone, or some other receiver
in a secure fashion."
This is done with IBM's mobile database product, DB2 Everyplace.
With DB2 Everyplace, the students had the tools they needed to
write the software which recorded the patients' input on hand-held
devices and synchronized it wirelessly with a central database
on a desktop computer.
The students, enrolled in IST 240 and IST 495, solved the major
challenge of ensuring patient privacy over a wireless network
by encrypting data through user IDs and passwords, a secure Virtual
Private Network or VPN, and data encryption. In addition to encryption
from mobile devices to the wireless provider, there also is encryption
from the provider to the service gateway and from the gateway
to the wireless server, according to Aungst.
Users are put into groups such as doctors and nurses, with each
group having a password, said Karen Fleagle, a senior IST major
at Penn State York who worked on the prototype.
"Depending upon your user name, you can only transfer and
view certain tables," Fleagle said. "So, if you didn't
have access to patient names, for instance, then you wouldn't
be able to sync that information."
In addition, Aungst is examining different encryption algorithms
with IBM to determine the trade off between strength of encryption
and level of performance.
Two IST interns are now building an application on a larger scale
than what was done last spring. As part of that, they are converting
the anesthesiology department's database from Microsoft Access
to DB2.
Penn State Hershey Medical Center is one of two healthcare providers
beta-testing IBM's mobile database, DB2Everyplace or DB2e Version
8.1.
"It's a learning process," said Jonathan Kelly, a senior
at Penn State Harrisburg and former student of Aungst. "Every
Wednesday, there are conference calls with people all over the
world who discuss their hurdles and technical difficulties. We're
all doing wireless applications, just with different scopes."
In the future, this type of technology would allow operating
room staff to exchange information from one part of the hospital
to another, or for physicians working at a satellite location,
such as those working at an outpatient surgery center or with
appointments at the Lebanon VA Medical Center, to receive important
patient information wirelessly and privately.
"Ultimately, this way of tracking data and safely sharing
information could be extended to almost every part of our patient
care," Schuler said.