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Hopkins, Microsoft to develop app for ICU management

Dr. Peter Pronovost, director of Johns Hopkins Medicine’s Armstrong Institute for Patient Safety and Quality. Photo from Johns Hopkins Medicine

Dr. Peter Pronovost, director of Johns Hopkins Medicine’s Armstrong Institute for Patient Safety and Quality. Photo from Johns Hopkins Medicine

Researchers from Johns Hopkins Medicine have developed a tablet app to track the needs of patients in intensive care units. Now, they’ll be building on that work through a partnership with Microsoft.

The computing giant will work with the Johns Hopkins Armstrong Institute for Patient Safety and Quality to quickly scale the efforts of the institute’s Project Emerge program, which created a way to collect data from electronic medical records and hospital equipment, such as beds and ventilators, and identify potential risks to patients.

Project Emerge’s goal is to reduce preventable, hospital-acquired illnesses and complications — what researchers call harms — increase efficiency and reduce costs, said Dr. Peter Pronovost, director of the institute.

Between 210,000 and 400,000 patients die each year from such harms, making them the third-leading cause of death in the United States, according to Johns Hopkins Medicine.

Part of the problem is that much of the equipment in a hospital room isn’t integrated — the machines don’t talk to each other — so a lot of time is spent looking at data from different machines and checking it against a patient’s records, Pronovost said. That means ICU staff can end up with long checklists for each patient, he said.

Patients on ventilators, for example, should be taking breaths that are proportional to their height, which means a ventilator’s settings need to be manually set based on data from the patient’s chart, Pronovost said.

But if the machines were fully integrated, the ventilator would take the height from the patient’s electronic medical records and automatically adjust the size of each breath, he said.

The head of a patient’s bed should also be raised at a 30-degree angle to prevent pneumonia — something nurses have sometimes used paper protractors to measure by hand. But placing an inexpensive electronic sensor on each bed can instantly show whether the angle is correct, Pronovost said.

Bridging that communication gap is the tablet app, developed by the Armstrong Institute with help from the Johns Hopkins Applied Physics Laboratory. It collects information from hospital devices and offers caregivers — and the patients themselves — a visual display of tasks to do or adjustments to be made, Pronovost said.

Patients’ families can also use the app to learn how to assist the clinical staff — such as by brushing the patient’s teeth or hair.

Initial tests of the app were conducted by Hopkins and the University of California, San Francisco. But when it came time to expand, researchers needed help.

“We’re not commercial software developers. We can’t scale it,” Pronovost said. But for a large and successful company like Microsoft, that won’t be a problem, he said.

Hopkins and Microsoft plan to build on the institute’s work and develop an enhanced, cloud-based system to let physicians access patient data from any approved, Windows-based device. The two plan to start pilot programs in 2016, according to Johns Hopkins Medicine.

“Through our joint work, Johns Hopkins and Microsoft will empower health professionals with easy-to-consume, data-driven insights, allowing them to focus more on patients and less on technology and process,” Michael Robinson, Microsoft’s vice president of U.S. health and life sciences, said in a statement.

Pronovost said engineers from the Applied Physics Laboratory expect that integrating devices could help boost productivity by 40 percent — and with increased productivity and fewer harms will come lower costs, he said.

“A third of what we spend on health care is spent on things that don’t get patients well,” Pronovost said. “Think of what we can do with those resources.”