Page 83 - ITU KALEIDOSCOPE, ATLANTA 2019

ICT for Health: Networks, standards and innovation

Figure 7 shows the relationship between three alarm Table 3 - Expected alarm reduction effect
priorities and the medical treatments. When an escalation
occurs, alarm priority changes from a lower level to a higher
level, as specified in Table 2.

4. CONCLUSION AND FUTURE WORKS
Figure 7 - Decision of alarm priority and medical treatment
assuming alarm-priority “Middle” We designed and implemented an alarm delivery system for
patients with intractable diseases that can be integrated with
Table 2 - Alarm priority and time duration for notification home networks used for medical IoT networks. We proposed
a prototype false-alarm reduction mechanism for highly-
controlled medical device systems including an artificial
ventilator. We investigated alarms for one year in
cooperation with a patient’s family. We focused on alarm
duration of alarm codes and decided initial and escalated
alarm priorities with trigger duration to notify caregivers
from a clinical viewpoint. We are currently working on the
next step of alarm optimization in systems having various
highly-controlled medical devices and on operational
optimization taking advantage of medical IoT network
features.
The motion alarm is removed 100%, because it appears very After that we need to tackle standardization of alarms and the
frequently with very low clinical emergency. When other treatments that are suitable for home use. The alarms are
alarms continue over the third quartile (75%) of duration of raised depending on medical devices manufactured by
the alarm code on Table 1, the system notifies caregivers as different companies. To use them at home, we need to
an initial alarm priority. The alarm time, then, lasts over two establish medical treatments following standard meanings
times that of the duration; alarm priority is escalated to upper for the same category of medical devices. There are
alarm priority. Alarms associated with the connection standards, such as IEEE 11073-10404[10] which is device
between sensors and a patient (pulse_search, sensor_off, specialization of a pulse oximeter on IEEE 11073-20601[11].
loss_of_pulse, loss_of_pulse_with_motion, no_sensor) start But it defines low-level specifications to connect to networks
from low emergency. Alarms associated with the and is not aimed at alarm management. There is still no
physiological status of a patient (spo2_lo, pulse_rate_lo, device specialization of artificial ventilators on IEEE 11073-
pulse_rate_high) start from middle priority. Three alarms 20601. IHE (Integrating the Healthcare Enterprise) PCD
(peak_press_insp_lo, peak_press_hi, insp_time_over_2) (patient care device) ACM (alarm communication model)
associated with patient respiration in the artificial ventilator profile based on HL7 [12] is directed for mainly hospital use,
start from middle priority. Other alarms in the artificial and seems to lack perspective of false alarm reduction. IEC
ventilator were omitted, because they are inner status 80001-2-5 [13] is application guidance of risk management
information of the artificial ventilator and the clinical on distributed alarm systems for IT-networks incorporating
meanings of the events are unclear from a clinical viewpoint. medical devices.
They are also of very short duration and low frequency. The
false alarm reduction rate of this method is estimated to be We expect standards in both hardware interfaces and
95.5%, as shown in Table 3. consistent alarm meanings used for patients with artificial

ventilators and their caregivers at homes to reduce false
In the current environment, all highly managed medical alarms and prevent missing alarms.
devices raise alarms when unusual conditions are detected,
even if the conditions are due to regular suction use. Lots of
alarms are raised and it may be difficult to find real alarms
among them. Caregivers, therefore, sometimes disable alarm
functions.

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