Posts Tagged ‘chemotherapy’

Toshiba Excite delivers

July 12, 2012

In the past, we have experimented with using iPads for providers when seeing patients and in the lab area to track patients.  Ankhos is a ‘web’ app, meaning it can be loaded with any browser but some work better than others. We have optimized for Google Chrome so we are prioritizing a browser that uses the Webkit rendering engine, which the iPad’s Safari does.

As many other EMR companies have found, the iPad turned out to be great for viewing data and performing simple tasks. However, the iPad is inadequate for typing MD notes, making  inpatient orders or really typing of any kind.

Enter the new Toshiba Excite 10 inch tablet (Engadget review).  I bought one of these for my personal use a few weeks ago and loved it. Naturally, the first thing I did was load Ankhos in Chrome. Amazing.  It’s smart enough to know when you want to drag and when you want to scroll . The javascript widgets we use render quickly and it is generally more responsive. It responds to user input even through latex gloves. You still wouldn’t want to type a lengthy document on it.

We only have one in the office (for now) and we are testing it in the ‘chemo hood’.  The chemo hood is an protected, ventilated workspace for mixing toxic chemotherapy drugs.

Chemotherapy mixing hood

Chemotherapy is mixed and bagged in a ventilated area

It’s a pain to get in and out of the hood to check doses and document who mixed the chemo and when.  By putting a tablet inside the hood (which stays there), we can let the mixer do their documentation in Ankhos without leaving her workspace.

I can’t wait to get a few more and see how they fare with MD order entry and short notes.

Chemo administration screenshot

May 19, 2010

**UPDATE  06/05/2012** Contains old screenshots!


This is a promised screenshot of our current iteration of the page our nurses will be using to administer chemo.  There is a LOT going on in this picture, but some of the important procedural bookkeeping that is required of the nurses is streamlined on this page.  IV notes, allergies, even plain old warnings about a patient are present here.  Also present are things like dual-signature chemo dose verification and minute-by-minute tracking of what has happened to this patient.

Keep in mind, this is a beta, and there are some debugging/feedback features here for the time being.

The orders these nurses are carrying out come from the specialized physician order interface (not pictured here).

I would love to get more into the rest of the application, but that is premature at this juncture.

Two more weeks of testing

May 2, 2010

The past two weeks have been very busy. I have been on-site at the office of Carolina Oncology Specialists working with the doctors, nurses and staff who will be using Ankhos, and there is a lot of work to be done. Two of the major improvements which have come from this most recent week have been:

Regimen creation UI: While the regimen framework has been fully able to represent and create the complicated chemotherapy regimens designed by the doctors, the UI is not yet ‘easy to use’  in this regard. The doctors and I spent some more time hashing out ideas and hopefully the next iteration will be better.

We are trying to focus more on the vocabulary of the user. For instance, being able to program “once a week for three weeks, skip a week and then a fourth treatment” is more natural to a MD than specifying “Days 1,8,15,29” for a treatment. We need to figure out how to fit that into a UI.

FTP file dump ingest:  I was able to set up the web server and get the automatic file ingest working. The lab machines are currently set up to dump a file each time a patient has their blood drawn.  This folder has never been emptied.  Ever. This means around 64 thousand files are in each of these folders (multiple machines * multiple office sites = multiple folders)
My original script simply looped through the files in the directory in Python determining, by the modification date of the file, which files to ingest. I quickly learned that this was entirely too slow. What I ended up having to do was perform a ‘ls’ or ‘dir’ command on the directory using the Python subprocess package and let the filesystem do the sorting for me. I’m sure there is a log(n) process in there somewhere, because it certainly made the ingest time acceptable.

Querying the future

March 30, 2010

One of the coolest and most impressive aspects of keeping electronic records is the ability to compile massive amounts of information very quickly. But, many offices still use paper and pencil to plan their patient scheduling and pharmacy ordering.

“How much Flouroracil will we need tomorrow?”

“Do we have enough time/space to fit another patient in at 3:00?”

“Do the amounts of controlled substances in our pharmacy match up with the amount prescribed last week? Do we have enough for the upcoming week?”

“How many nurses will we need on Friday? Can Jane take the day off?”

These questions would take hours to answer if compiled by hand, but with an electronic record/scheduling system, they could be answered in seconds…. IF they are implemented correctly.

The flagship feature in Ankhos is the ability to schedule an arbitrary number of chemo cycles months in advance, letting nurses, administrators and pharmacists know exactly what treatments are coming up in the future. If we have answers to the questions above in elecrtonic format, we can make you and the staff of your oncology office much happier, safer and more prepared.

Screenshot: Calendar and dose manipulation

January 8, 2010

**UPDATE  06/05/2012** Contains old screenshots!


What would Google do? I ask this question a lot, and for good reason. Google is one of the most successful companies in human history. I use apps like Google mail calendar and chat every day. For me, it is logical to seek out and learn from such a great company. So, I ask myself,  what has Google done that can help me write this software?