Remote Patient Vitals Module

Bhutan description: (Thanks, Wikipedia) A landlocked country in South Asia located in the Eastern Himalayas. The country’s landscape ranges from lush subtropical plains in the south to the sub­alpine Himalayan mountains in the north, where there are peaks in excess of 7,000 metres. Bhutan is a developing nation and has a government based national health system with only a few hundred doctors. Patients can visit their doctor via traditional means or via helicopter for more serious situations.

Problem: After trying out Napier, a non­free EHR that was expensive, slow, and couldn’t be customized, the doctors have moved back to a paper solution. The doctors do not like EHRs because of limited typing ability and scribes cannot be brought in due to a lack of resources, both in medical students to act as scribes and the sheer costs of such a role. Despite a lack of interest in EHRs, there is a healthy interest in setting up an electronic solution for patients to report their self measurements, based on provider orders. For instance, if a patient is hypertensive, the doctor wishes to see daily trends of the vitals rather than not being aware until a patient visit (with less information). The same use case exists for other conditions such as diabetes (glucose readings) and pregnancy (weight changes, first kick, etc) with the latter being a tad more nuanced.

Solution: The vibrant and volunteer OpenEMR community will develop an independent self measurements module with a generic interface for SMS (text message) services. With this solution, the provider can set up measurement rules and patients will be asked to input vitals on an interval basis. Providers will be able to trend data over time to provide better healthcare, without the need of an extensive patient trek to get to the practice. Users will be to use the module independently (cloud or self hosted) or within OpenEMR. Because SMS services are almost always non­free, an interface will be provided and the wiki will document non­free API interaction examples to comply with GNU. Dr. Pelgay Jamyang will work with us to test out the solution in his practice. If it’s a success, the feature will be rolled out to all Bhutan practices.

All Github issues (including mockups!) for the project can be found here: Remote Patient Vitals Module · GitHub - we need to put together a team ASAP!

Note that this has been promoted to an OpenEMR Core Roadmap project: http://open-emr.org/wiki/index.php/Roadmaps

Thanks,
Matthew

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how far have we gone with this?

Hi @Elijah_Wisdom, things have been bumpy but I actually had some contractors put together a basic version of this with Twilio! They did a great job to get it started, but obviously they don’t know about all of the various practices/patterns in OpenEMR. Should be a matter of cleaning up the code and QA’ing it. Also, we have to check in with our friends in Bhutan of course.

-m

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Hi everyone!
We’re working on a tool which allows users and/or medical personnel to track vitals remotely and it’s also has OCR functionality which automatically recognises medical devices values (blood pressure and oximeter at the moment and glucometer is on plan) and sends data to the EMR/EHR system.
Brief description is here http://health-data.tilda.ws/rpmsolution
Please let me know if this is interesting for the OpenEMR community?
Thank you

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Hi All,
Just wanted to let you know that we also have added some Machine Learning (AI) capabilities which get patient vitals and make predictions on hypertension possible problems.
Data is taken from OpenEMR and now put into patient related info so that medical personnel can see it and take necessary actions. I’ll provide you with a demo video later on but please let me know if you are interested in such soultions?

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@Timur_Mikhaylov is this feature built as a module that can be registered and installed in the codebase?

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This would be of great value even for urban patients with various risk profiles. Almost all products like this one have traditionally focused on online data entry for billing purposes. Meaningful Use requirements have coerced the developers towards actual patient care.

We for one would be very interested if these type of solutions are set up as add-on projects that can be loosely coupled with OpenEMR to be free of any stack limitations or skills constraints. These capabilities will be also a great dividend for all infra work put in by @sjpadgett and @adunsulag towards FHIR.

Looking forward to the details.

ps: Suggest discussion be in a separate thread that MU refers as Patient Generated Data.

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Hi Sherwin,
Thank you for your interest.

At the moment this is more like a standalone python app with the idea that it go through the patients, evaluate them and adds an ML conclusions into patient related entity/fields.
However, our next step will be to make this a module that can be registered and installed in the codebase.

Is this is a wearable device/tool? Did your group develop the device/tool?

I meant software. This is a web app which can be opened via mobile and then photo of a medical device screen (now blood pressure and oximeters are supported) can be made via the phone and then it got recognised and data put to EMR

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