Myalysis Tweetment

Though in-home technologies are allowing more people to manage their own dialysis treatments at home (with some even letting the process run overnight while they sleep), my idea for the Innovation Competition had to do with the more traditional in-clinic dialysis procedure. Borrowing from the Pecha Kucha presentation delivered in class last week, here are some of the main points of the project, involving custom-made clothing with subtle built-in access to port sites:

An Introduction to Dialysis

•Dialysis the process of removing excess water and wastes from the blood, essentially serving the function of the kidneys in the case of reduced kidney function or kidney failure
•3 options for persons with kidney failure: dialysis, transplant, death
•Main principles: diffusion and ultrafiltration
Some Recent Trends in Dialysis
• There are two main types of dialysis: hemodialysis (blood is mechanically removed from the patient, filtered, and returned to them) and peritoneal dialysis (fluids are injected into the stomach of the patient, where they interact with and bond to toxins; after a period of time both the toxins and the fluids are removed)
•For in-clinic hemodialysis, typically 3 treatments per week is normal but studies demonstrate the benefit of 5-7 (for 6-8 hours each)
•Nocturnal daily hemodialysis allows patients to dialyze while they sleep
•As of 2007 2,500 people dialyzing @ home more frequently than in a clinic/hospital setting
Who is Affected?
•The # hemodialysis patients in 2005: 97,143
•Annual growth 6.5% over last 10 years
•In general people utilizing hemodialysis (HD) are older than those using peritoneal dialysis. One can assume that a contributing factor is young people’s faith in new technologies, and their need for independence
•Transplant patients are youngest, w 50% age 45-64
•2005 rates per million HD African-Americans (940.9): White (240.5): Hispanic (463.3)

Source: United States Renal Data System (USRDS) Treatment Modalities (2007 Annual Data Report)

For my project, the Test Demographic is determined as follows:

•I will work with patients and staff at several Davita Dialysis locations
Davita, a Fortune 500 company, is one of the most popular providers of dialysis in the Southeast. “As of December 31, 2011, DaVita operated or provided administrative services at 1,809 dialysis facilities in the United States, serving approximately 142,000 patients. The company also operated 11 outpatient dialysis centers located in three countries outside the United States.” -taken from http://www.davita.com/
•I will primarily work with the South Dekalb Mall and Martin Luther King Centers
•Predominately African-American
•Ages 45-64
•No gender bias
Standard Operating Procedures at the Davita Centers (Start-up and Shut-down)
•Typically 4am
•Check-in
•Vitals
•Start-up (treatment normally 3-5 hours)
•Removal of “sticks”
•Exit vitals
•Wrap-up
•Departure
•Return to “normalcy” (inasmuch is possible)
This project hopes to improve the lives of the patients by reducing the need for them to destroy their clothing and by making them more comfortable overall
•Access is typically in same locations, making a port potentially valuable
•Patients often rip clothing instead of rolling sleeves or removing articles
•Comfort level is important, with regard to both physical (clothing sometimes presses on lines or ports causing pain) and emotional (patients would be able to live more normal lives, they feel, if their “dialysis-day” clothing would support non-dialysis activity)
•This intervention gives caregivers better access to “accesses”
•Proximity to other patients is also a privacy consideration, especially during those times when removal of clothing is necessary
The proposed intervention is:
•Clothing made specifically for “treatment days”
•Devices would be installed allowing for Built-in vital-capture, recording, and transmission
•Designed for wear out-of-clinic
•New devices allow EKG readings sent to smart-phones http://www.gizmag.com/app-to-view-electrocardiograms-on-smartphones/16664/
•Ambulatory blood pressure measured by microwave as opposed to electrodes http://rsi.aip.org/resource/1/rsinak/v81/i9/p094301_s1?isAuthorized=no
•Automated body-temperature collection http://www.ncbi.nlm.nih.gov/pubmed/8072924
Automated vitals information could be collected:
•On “dialysis days” pertinent info sent via Tweet
•Blood pressure, Temperature, Blood sugar, Body weight, etc.
CIC Considerations
•Health IT is addressed directly and indirectly; “Many aspects of healthcare delivery are expected to evolve from a historically provider-centric model to a more patient-centric model including: preventive healthcare, remote patient monitoring, telemedicine, transitions of care between providers, and in-home wellness and healthcare.”
•Societal Impact
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