A mobile, real-time patient information system for emergency room physicians

Last week I went to a SD Forum SAMSIG presentation about a very interesting application of mobile technology. Apparently, emergency room doctors spend a lot of time checking to see whether the test results for their patients have come back from the lab. At Kaiser, they have to first log on to a PC and then access 6 legacy systems in order to get test results and patient information. Adrian Blakey of Kaiser and Johannes Ernst of NetMesh Inc described a mobile application that provides emergency room physicians with this information in real-time. Not only can doctors use a handheld device to check the test results but they are also notified when test results are available. The application has increased the productivity of ER doctors and speeds up the flow of patients through emergency rooms.

The client consists of a HP IPaq 5550, which runs the browser-based application, and an Jabber IM client that receives notifications. The client communicates with the server over a wireless network that uses the Cisco LEAP protocol for security. The server is a J2EE web application running on Websphere Application Server. It uses NetMesh software to integrate with the legacy system. Netmesh probes periodically poll the legacy systems and store objects containing the retrieved data in a metadata-driven cache. The web application accesses the objects from the cache, which ensures that requests from the handheld never accesses the legacy systems directly. In a previous version of the application, requests from the handheld went all the way through to the legacy systems, which resulted in response times of over a minute. Using the cache improves response time and scalability and enables the application to function albeit with stale data when the legacy systems are down.

One distinctive feature of this application is that it integrates information from multiple legacy applications. In comparison, mobile applications traditionally have a stovepipe architecture where each application has its own UI. This does not work well given the limited nature of a mobile device.

Some other interesting tidbits:

• Even though the IPAQ has a thumbprint reader it can't be used to authenticate all the way to the server. Because of limitations of the technology the doctor must still login to the web app
• The application has a shared session design - The information current displayed on the handheld is displayed on a PC when they login.
• In the future technologies such as RFID and bluetooth will enable the device to sense and interact with its surroundings, e.g. an Xray machine.

Overall, it was a very interesting presentation and well worth the drive.

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