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E-ARMOR: An Online Tool to Evaluate Polypharmacy in Elderly Persons. E-ARMOR Group Jacob Brown – Domain Expert Jordan Fish – Project Manager Kajal Miyan – Facilitator Yang Yang - Configuration Manager. PART I: OVERVIEW. Project Overview. Motivation for project
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E-ARMOR: An Online Tool to Evaluate Polypharmacy in Elderly Persons E-ARMOR Group Jacob Brown – Domain Expert Jordan Fish – Project Manager Kajal Miyan – Facilitator Yang Yang - Configuration Manager
Project Overview • Motivation for project • Many prescriptions by many Doctors • No longer needed • Wrong dose • System Goals • Evaluate prescribed medications • Optimize prescribed medications
Overview of Features • Given patient data… • Compute • Ideal Body Weight • Creatinine Clearance • Glomerular Filter Rate • Assess drug impact • Without storing data • Limit system access
Domain Research • Polypharmacy tools • ARMOR • Physician’s Desk Reference • Mosby Drug Reference • Formulae • Cockcroft-Gault • Devine formula
Risk Analysis • Risks • Data protection • Result integrality • How to mitigate risks? • Secure Web Server • HTTPS • Don’t store patient data
Description of Use Case Diagram • Generate Drug Report • User enters data • Vital Stats • Prescriptions • Basic Lab Panel • System • Computes stats of interest • Looks up drug data • Reports results to user
Description of Class Model Single Access Point Singleton Proxy Interpreter
Behavior Model: Sequence Diagrams Exceptional Normal
Related Work • START • Set of rules used to determine omitted drugs in elderly patients • STOPP • Set of rules used to identify inappropriate drugs • Both tools are non-electronic like the ARMOR tool
Lessons Learned • Design principles • Client-Server architecture • Inherent for web application • Central Control • Singleton proxy • Easy to maintain the medication information • Provide access control and uniform interfaces
Lessons Learned (cont.) • In retrospect - • Clean requirements document • More efficient Customer interaction for procuring Domain Knowledge • Time management • Prototype can be a huge temptation
Lessons Learned (cont.) • Future work • Communicate with EMRs • Smart phone application • Identify potentially redundant medications • Threshold values to immediately notify danger • Encrypted connection
Prototype: Login • Provides Access controls
Video demonstration • http://www.cse.msu.edu/~cse870/Input/SS2010/E-ARMOR/video/demo_natural.mp4 • http://www.cse.msu.edu/~cse870/Input/SS2010/E-ARMOR/video/demo_natural.html
Live Demonstration • Workflow • Login • Enter data • View/print results • Logout • http://www.cse.msu.edu/~cse870/Input/SS2010/E-ARMOR/web/
References • Barry, P. J., et al. "START (screening tool to alert doctors to the right treatment)—an evidence-based screening tool to detect prescribing omissions in elderly patients." Age and Ageing (2007): 632-638. • Gallagher, Paul and Denis O'Mahony. "STOPP (Screening Tool of Older Persons’ potentially inappropriate Prescriptions): application to acutely ill elderly patients and comparison with Beers’ criteria." Age and Ageing (2008): 673-679. • Haque, Raza. "ARMOR: A Tool to Evaluate Polypharmacy in Elderly Persons." Annals of Long-Term Care (2009): 2-6.