Changhua Christian Hospital
A Future Hospital Leveraging AIoT and Valuing Smart, Green and Clean
For patients whose lives are at stake of acute respiratory failure, once the primary reason for ventilation is improved or treated, it is then critical to wean them off the ventilator at the right time. But the timing to do so matters, the consequence could be either failing to extubate or increasing complications should removal happens too early or too late. To address this, CCH has developed an AIoT system which helps clinicians identify as and when appropriate a patient can be detached from the breathing device.
CCH’s system measures constantly six crucial parameters: exhaled tidal volume (Vte), respiratory rate (RR), maximum airway pressure (Ppeak), mean airway pressure (Pmean), positive end-expiratory pressure (PEEP), and fraction of inspired oxygen (FiO2). The data accumulated over seven years at CCH, coupled with extubating successful rates, are used for machine learning, which in turn yields estimates every three minutes for clinicians’ references of the chance of success in extubation in the next 48 hours.
This system is currently in use in CCH and its branches, with effectivity up to 88%.
Dr. Guo-Yang Huang, a pulmonologist at CCH, said that traditionally, weaning from the ventilation is evaluated based on the patient’s health condition, spontaneous breathing test, rapid shallow breathing index (RSBI) or cuff leak test. These assessments have 57% sensitivity and 31% specificity, which suggests it is still challenging to determine the optimal timing to proceed with weaning.
The AIoT model by CCH monitors and computes data through the said six readings shown on the ventilator, and it makes extubation predictions accordingly, enabling a rapid rollout at other hospitals whilst reducing the risk of self-extubation in patients. “It’s like you have a critical care specialist by the bedside 24/7,” Yang added.
As a member of the CCH family, Yuanlin Christian Hospital too, is a forerunning smart hospital in Taiwan, aiming to become a future hospital featuring Smart, Green and Clean.
★★★ More by Changhua Christian Hospital
Smart CCH: iStroke, Close-loop Infusion and Acupuncture Training
CCH will showcase its iStroke and teleStroke, a clinical decision-making support system (see image 1 below) that helps triage patients at risk of stroke, at the Healthcare+ Expo. The system can be accessed by neurologists on duty via a mobile application from the moment a patient is admitted by any CCH branch for medication history and provides treatment properly yet timely. With TFDA-approved devices used simultaneously, the system can extend its reach to long-distance patients to receive clinical advice.
iStroke and teleStroke have been in use for over eight years, treating nearly 740 patients, none of whom had cerebral hemorrhage (bleeding in the brain) induced by contraindication.
Changhua Christian Hospital displays its health technologies now in use (Photo courtesy: CCH)
To ensure the safety and accuracy of chemotherapy given to cancer patients, CCH’s proprietary “smart closed-loop infusion system” (image 2) takes precise steps of chemo infusion with cross-checked medical orders, barcoded medications and a smart pump integrated. The design is to avoid human errors and improve the efficiency of administrating chemo drugs, which frees up almost 100 hours of routine work per year for the healthcare team to focus more on patient care.
CCH welcomes opportunities for a technology transfer.
On top of technology-informed decision support and patient care, CCH in Chinese medicine too, delivers its values with IoT and 3D printing for acupuncture training. 3D-printed and sensor-embedded, a “smart acupuncture prosthesis” (image 3) allows trainees to practice insertion into a particular point under the skin. The sensor inside records the time and accuracy of every insertion, and transmits the data to a cloud-based platform that shows in real time how long each action takes and how accurate per insertion is made.
Green CCH: Power Saved 3.68% Every Year
Medical waste and electricity consumption are the largest sources of a hospital’s carbon emissions. CCH, in this case, has paved its way towards Green by replacing the energy-consuming hospital lighting and fixtures, rearranging the-operating-room-only piping and using water at seven and nine degrees Celsius for the operating rooms and non-surgical areas within the hospital, respectively. The latter prevents power consumption as the A/C system is no longer set at a temperature as low as the OR room requires.
Furthermore, the hospital leverages AI-assisted air quality measurement that controls in-and-out air flows, and adjusts indoor temperature and humidity following an eco-friendly standard, resulting in an average energy savings rate of 3.68% over the past three years.
Clean CCH: Wash Your Hands Like a Professional
A handwashing system that monitors hand hygiene (Photo courtesy: CCH)
Do you wash your hands properly? CCH introduces a “handwashing- do it right” system that guides the user through six steps and captures motions with image recognition in real time to feedback on how well hands are cleaned.
The system can be applied to schools and other facilities, in addition to hospitals.