1、医疗设备即插即用(Medical Device Plug-and-Play),Qixin Wang Assistant Professor, Dept. of Computing, The Hong Kong Polytechnic University June 21, 2009,June 21, 2009,Qixin Wang, for non-profit academic use,2,目录,需求,现有的工作,前瞻和计划,June 21, 2009,Qixin Wang, for non-profit academic use,3,目录,需求,Existing Efforts,Visio
2、n and Roadmap,June 21, 2009,Qixin Wang, for non-profit academic use,4,我们为什么需要医疗设备即插即用 (MDPnP)? (特别是无线医疗设备即插即用?),柔性（Flexibility）、更多的医疗应用/手段,安全性（Safety）,舒适性、更高的工作效率（Convenience and Efficiency）,独立性（Independence）：不再受制于设备厂家,June 21, 2009,Qixin Wang, for non-profit academic use,5,当今的医院已经在使用数万、数十万种医疗设备；而多数
3、设备是被设计成单独使用的，不开放,Figure Credit: P. Carleton, RN,June 21, 2009,Qixin Wang, for non-profit academic use,6,允许医疗设备柔性组合将使更多医疗方法称为可能,病人自控的麻醉 (PCA),疼痛按钮,病人,护士,June 21, 2009,Qixin Wang, for non-profit academic use,7,病人自控的麻醉(PCA),疼痛按钮,常规生命指标监视设备,特殊生命指标监视设备,自动注射器,病人,计算机,允许医疗设备柔性组合将使更多医疗方法称为可能,June 21, 2009,Qi
4、xin Wang, for non-profit academic use,8,医疗设备间的互联/互锁有助于提高安全性,测量血压,47/74,正确,June 21, 2009,Qixin Wang, for non-profit academic use,9,测量血压,49/59,错误,医疗设备间的互联/互锁有助于提高安全性,June 21, 2009,Qixin Wang, for non-profit academic use,10,测量血压,49/59 47/74,自动校正,建议：病床和血压计通过MDPnP互联/互锁,医疗设备间的互联/互锁有助于提高安全性,June 21, 2009,Q
5、ixin Wang, for non-profit academic use,11,常见事故：心肺体外循环 与 呼吸机,心肺体外循环机,呼吸机,正确操作,医疗设备间的互联/互锁有助于提高安全性,June 21, 2009,Qixin Wang, for non-profit academic use,12,医疗设备间的互联/互锁有助于提高安全性,常见事故：心肺体外循环 与 呼吸机,心肺体外循环机,呼吸机,正确操作,June 21, 2009,Qixin Wang, for non-profit academic use,13,医疗设备间的互联/互锁有助于提高安全性,常见事故：心肺体外循环 与
6、呼吸机,心肺体外循环机,呼吸机,正确操作,June 21, 2009,Qixin Wang, for non-profit academic use,14,医疗设备间的互联/互锁有助于提高安全性,常见事故：心肺体外循环 与 呼吸机,心肺体外循环机,呼吸机,粗心失误,June 21, 2009,Qixin Wang, for non-profit academic use,15,医疗设备间的互联/互锁有助于提高安全性,常见事故：心肺体外循环 与 呼吸机,心肺体外循环机,呼吸机,粗心失误,June 21, 2009,Qixin Wang, for non-profit academic use,1
7、6,医疗设备间的互联/互锁有助于提高安全性,常见事故：心肺体外循环 与 呼吸机,心肺体外循环机,呼吸机,粗心失误,June 21, 2009,Qixin Wang, for non-profit academic use,17,“. In the second case, the anesthesiologist forgot to resume ventilation after separation from cardiopulmonary bypass. The delayed detection of apnea was attributed to the fact that the
8、audible alarms for the pulse oximeter and capnograph had been disabled during bypass and had not been reactivated. Both patients sustained permanent brain damage.”Anesthesiology. 87(4):741-748, October 1997,医疗设备间的互联/互锁有助于提高安全性,常见事故：心肺体外循环 与 呼吸机,心肺体外循环机,呼吸机,粗心失误,June 21, 2009,Qixin Wang, for non-prof
9、it academic use,18,MDPnP 总控单元,建议： 多种医疗设备通过MDPnP互联/互锁,二氧化碳计,血氧计,医疗设备间的互联/互锁有助于提高安全性,常见事故：心肺体外循环 与 呼吸机,心肺体外循环机,呼吸机,June 21, 2009,Qixin Wang, for non-profit academic use,19,事故：X-光机 与 呼吸机,Picture provided by Mu Sun,医疗设备间的互联/互锁有助于提高安全性,June 21, 2009,Qixin Wang, for non-profit academic use,20,图像模糊,Picture
10、 provided by Mu Sun,医疗设备间的互联/互锁有助于提高安全性,事故：X-光机 与 呼吸机,June 21, 2009,Qixin Wang, for non-profit academic use,21,Picture provided by Mu Sun,医疗设备间的互联/互锁有助于提高安全性,事故：X-光机 与 呼吸机,June 21, 2009,Qixin Wang, for non-profit academic use,22,Picture provided by Mu Sun,医疗设备间的互联/互锁有助于提高安全性,事故：X-光机 与 呼吸机,June 21, 2
11、009,Qixin Wang, for non-profit academic use,23,Picture provided by Mu Sun,医疗设备间的互联/互锁有助于提高安全性,事故：X-光机 与 呼吸机,June 21, 2009,Qixin Wang, for non-profit academic use,24,Picture provided by Mu Sun,“A 32-year-old woman was having a laparoscopic cholecystectomy performed under general anesthesia. . At some
12、 point, the anesthesiologist glanced at the EKG and noticed severe bradycardia. He realized he had never restarted the ventilator The patient ultimatedly died.”APSF Newsletter, Winter, 2005.,医疗设备间的互联/互锁有助于提高安全性,事故：X-光机 与 呼吸机,June 21, 2009,Qixin Wang, for non-profit academic use,25,Picture provided b
13、y Mu Sun,建议： X-光机与呼吸机通过 MDPnP互联/互锁,医疗设备间的互联/互锁有助于提高安全性,事故：X-光机 与 呼吸机,June 21, 2009,Qixin Wang, for non-profit academic use,26,事故：输氧与激光刀,医疗设备间的互联/互锁有助于提高安全性,June 21, 2009,Qixin Wang, for non-profit academic use,27,建议： 激光刀与氧浓度监测计通过MDPnP互联/互锁 含氧量超过30%时，气管激光手术被禁,医疗设备间的互联/互锁有助于提高安全性,事故：输氧与激光刀,June 21, 20
14、09,Qixin Wang, for non-profit academic use,28,传染病人向护士紧急呼救,医疗设备间的互联/互锁有助于提高安全性,June 21, 2009,Qixin Wang, for non-profit academic use,29,烈性传染病：必须配戴防毒面具！,医疗设备间的互联/互锁有助于提高安全性,传染病人向护士紧急呼救,June 21, 2009,Qixin Wang, for non-profit academic use,30,电子病历 数据库,烈性传染病，必须配戴防毒面具,护士工作站,建议: 电子病历、护士工作站、生命指征监测仪通过MDPnP互
15、联,医疗设备间的互联/互锁有助于提高安全性,传染病人向护士紧急呼救,June 21, 2009,Qixin Wang, for non-profit academic use,31,医疗设备即插即用（MDPnP），特别是无线MDPnP，有助于提高舒适性（安全性）和工作效率,手术室现状与隐患：狼藉不堪,Picture quoted from www.mdpnp.org,June 21, 2009,Qixin Wang, for non-profit academic use,32,公告板，有助于医生、护士有条理地合作,Picture quoted from www.mdpnp.org,医疗设备即
16、插即用（MDPnP），特别是无线MDPnP，有助于提高舒适性（安全性）和工作效率,June 21, 2009,Qixin Wang, for non-profit academic use,33,LiveData OR Dashboard,Picture quoted from www.mdpnp.org,公告板，有助于医生、护士有条理地合作,医疗设备即插即用（MDPnP），特别是无线MDPnP，有助于提高舒适性（安全性）和工作效率,June 21, 2009,Qixin Wang, for non-profit academic use,34,管线缠绕的手术室,Picture quoted
17、from www.mdpnp.org,医疗设备即插即用（MDPnP），特别是无线MDPnP，有助于提高舒适性（安全性）和工作效率,June 21, 2009,Qixin Wang, for non-profit academic use,35,医疗设备即插即用所引入的互联/互锁 会进一步加重手术室的管线密度,Picture quoted from www.mdpnp.org,医疗设备即插即用（MDPnP），特别是无线MDPnP，有助于提高舒适性（安全性）和工作效率,June 21, 2009,Qixin Wang, for non-profit academic use,36,管线缠绕的手术室
18、 和 无线手术室 对比,Picture quoted from www.mdpnp.org,医疗设备即插即用（MDPnP），特别是无线MDPnP，有助于提高舒适性（安全性）和工作效率,June 21, 2009,Qixin Wang, for non-profit academic use,37,独立性：医院使用数以万计的不同种类设备，不想受制于某个供货商,Figure Credit: P. Carleton, RN,June 21, 2009,Qixin Wang, for non-profit academic use,38,我们为什么需要医疗设备即插即用 (MDPnP)? (特别是无线医
19、疗设备即插即用?),柔性（Flexibility）、更多的医疗应用/手段,安全性（Safety）,舒适性、更高的工作效率（Convenience and Efficiency）,独立性（Independence）：不再受制于设备厂家,June 21, 2009,Qixin Wang, for non-profit academic use,39,MDPnP 对谁有益？,医院: 独立性、医疗能力、安全性,医生: 医疗能力、安全性、舒适性,病人: 医疗能力、安全性、价格,政府: 责任事故调查能力、医保成本,供货商: 更大的市场,科研机构: 典型的计算机物理系统一体化课题,June 21, 2009
20、,Qixin Wang, for non-profit academic use,40,目录,Demand,现有的工作,Vision and Roadmap,June 21, 2009,Qixin Wang, for non-profit academic use,41,IEEE 1073 工作组,IEEE 1073 (5/1996): 总体架构 overall network/middleware architecture,ISO/IEEE 11073-10101 (6/2004): 用词规范 nomenclature,ISO/IEEE 11073-10441 (1/2009): 心血管监测
21、设备具体规范 device spec. cardiovascular fitness and activity monitor,ISO/IEEE 11073-20601 (9/2008): 中间件交互管理 middleware group management and communication protocol guideline,ISO/IEEE 11073-30200 (1/2000): 电缆通信 cable PHY transportation layer,June 21, 2009,Qixin Wang, for non-profit academic use,42,American
22、 Society for Testing and Materials (ASTM), International Standardization,Draft ASTM TC F29.21 N21 (2008): 医疗设备与系统 病人集成医疗环境（ICE）中医疗设备的基本安全要求 第一部分：总体要求与概念体系结构 Medical Devices and Medical Systems Essential safety requirements for equipment comprising the patient-centric integrated clinical environment
23、(ICE) Part 1: General requirements and conceptual architecture,June 21, 2009,Qixin Wang, for non-profit academic use,43,美国政府的工作,美国食品药品管理局 FDA: Draft Guidance for Industry and FDA Staff: Radio-Frequency Wireless Technology in Medical Devices, draft released for comment on Jan 3, 2007,June 21, 2009,Qi
24、xin Wang, for non-profit academic use,44,总统科技顾问委员会 Presidents Council of Advisors on Sci. & Tech. (PCAST): 2007 Report on Federal Networking and Information Technology R&D list Cyber-Physical Systems as the top of the eight priorities for federal research investments.,美国政府的工作,June 21, 2009,Qixin Wan
25、g, for non-profit academic use,45,美国自然科学基金 NSF: Call for Proposals: Cyber-Physical Systems (CPS), solicitation 08-611, deadline: Feb., 2010. “. Research advances in cyber-physical systems promise to enhance societal wellbeing (e.g., assistive technologies and ubiquitous healthcare monitoring and del
26、ivery) NSF are spear-heading the Cyber-Physical Systems (CPS) program becaues of its impact critical to U.S. Security and competitiveness, including healthcare .”,美国政府的工作,June 21, 2009,Qixin Wang, for non-profit academic use,46,国家网络信息技术研发协调中心 National Coordination Office for Networking and Informati
27、on Technology Research and Development Program (NCO/NIRTD): 高可靠性的医疗设备：面向21世纪医疗的计算机-物理系统 High-Confidence Medical Devices: Cyber-Physical Systems for 21st Century Health Care, Feb., 2009,美国政府的工作,June 21, 2009,Qixin Wang, for non-profit academic use,47,工业界、学术界的工作,MDPnP: http:/www.mdpnp.org, 发起人:,Source
28、: www.mdpnp.org,June 21, 2009,Qixin Wang, for non-profit academic use,48,MDPnP: http:/www.mdpnp.org,发起人:,Source: www.mdpnp.org,工业界、学术界的工作,June 21, 2009,Qixin Wang, for non-profit academic use,49,CIMIT: http:/www.cimit.org 医疗与创新技术集成中心：一个由12家单位发起的组织。创始成员包括马萨诸塞总医院、哈佛医学院、麻省理工、波士顿退伍军人医疗管理局等。现有四十余家成员。Cent
29、er for Integration of Medicine & Innovative Technology, a non-profit consortium initiated by 12 institutes, including Mass. Gen. Hospital, Harvard Medical School, MIT,VA Boston Healthcare System etc.More than 40 industry partners.,工业界、学术界的工作,June 21, 2009,Qixin Wang, for non-profit academic use,50,I
30、EEE Computer: Insup Lee, George J. Pappas, Rance Cleaveland, John Hatcliff, Bruce H. Krogh, Peter Lee, Harvey Rubin, Lui Sha: High-Confidence Medical Device Software and Systems. IEEE Computer 39(4): 33-38 (2006),CPS Week: since 2008 (NSF CPS Summit), involving RTAS, IPSN, HSCC,CPS Track: since 2007
31、, IEEE RTSS,工业界、学术界的工作,June 21, 2009,Qixin Wang, for non-profit academic use,51,目录,Demand,Existing Efforts,前景和路线图,June 21, 2009,Qixin Wang, for non-profit academic use,52,设备生产商的机遇,可靠的电缆通信底层：交换器、网卡,可靠的无线通信标准和设备：交换器、网卡,中间件、操作系统、MDPnP总控机、互联/互锁软件,June 21, 2009,Qixin Wang, for non-profit academic use,53,Healthcare CPS can involve and stimulate the growth of nearly every CS area.,Telemedicine,Medical Device Systems (MDPnP),Medical Information Systems,June 21, 2009,Qixin Wang, for non-profit academic use,54,Demand,Existing Efforts,Vision and Roadmap,谢谢！,
