CPS: Synergy: Executable Distributed Medical Best Practice Guidance System for Emergency Care from Rural to Regional Center Hosp

Executable Medical Best Practice Guidance (EMBG) system is designed to prevent unjustified deviation from medical best practice guidance across a hospital network, consisting of rural hospitals, regional center hospital and ambulance service.

Like a GPS-enabled navigation system, EMBG provides patient state by state treatment advises based on dynamic patients' conditions and clinical environment. The safety of the EMBG system is built upon formal theoretical verifications and clinical validations in collaboration with medical professionals.

For the past year, we have studied the FDA medical device recall database to understand the root causes of medical system failures. We have identified that a main cause is due to mismatch of the assumption embedded in the software with the actual clinical environment. We have designed an initial assumption management system to assist clinicians. We have also developed a website for collecting, tagging, classifying FDA medical device recalls for future analysis.

In addition, we have also developed a framework that allows hospital resource managers and schedulers to separately and independently model resource available times and integrate the information with medical treatment models so that dynamic resource available conditions as well as patient dynamic conditions can be take into consideration while deciding a safe treatment for the patients.

Intellectual Merit

• Computational Pathophysiology: Executable model of medical knowledge in the form of networked organ disease automata and best practice automata using StateChart model tools
• Integrated Model Verification and Clinical Validation:
  • The StateChart model's stimulation capability allows close interaction with physicians to check the validity of the model
  • The computer-Aided translation of StateChart Model to UPPAAL verifies the software design integrity.
  • Clinical System Assumption Management System to help prevent assumption faults.

Broader Impact

• Cardiac Arrest Resuscitation Guidance System: Cardiac Arrest is deadly and there is no room for errors. Our system has been recently approved for Phase 1 clinical evaluation at Carle Foundation Hospital's ICU under the supervision of Dr. Karen White, Director of ICU. We are looking forward to reaching Phase 3, where it is used to assist Carle ICU in saving patients' lives.
• Sepsis Best Practice Systems
  • Carle Hospital Network: Sepsis has a high mortality rate caused by complex multi-organ failures. Our guidance system has been approved by Carle to start investigating on how to prepare for clinical evaluation involving her rural hospitals in the network.
  • OSF Children Hospital: Our current sepsis guidance has been designed for adults. We have been invited to discuss on how to extend it for children.
• Heart Transplant: We have been working with OSHU on the requirements and high level designs for a heart transplant perioperative guidance system.
• Education: We have started the discussion with the Dean of the Carle-UIUC Medical School, Dr. King Li, on extending our guidance system to be a training tool for medical students.