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Dialysis Product & Interface
This document summarizes research on kidney dialysis monitors. The researchers developed an optical method to monitor uremic toxins in blood to improve dialysis quality. Their project involves designing the device body/interface and communication between the dialysis machine and users. The background section describes dialysis and its importance, noting its time-consuming nature and high costs. Research methods included online research, mapping dialysis aspects/problems, observing a hospital dialysis process, and interviewing a patient. Key findings were that many patients are unaware of dialysis effectiveness and monitoring their results could positively influence them. The potential for a device with an improved interface and monitoring was identified.
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Dialysis Product & Interface
- 1. Kidney Dialysis Monitor Research Report Gina Metssalu Piret Uustal supervised by: Ruth-Helene Melioranski Martin Pärn Sven Sõrmus in cooperation with: Tehnomeedikum / Tallinna Tehnikaülikool Biomeditsiinitehnika instituut spring 2014
- 2. Introduction The researchers'team of Technomedicum have worked out and patented a new optical method to monitor uremic toxins in the blood and through that raise the quality of the dialysis process. The task for our semester project is to design - the physical body for the new device (incl. the functions, case, semantics etc) - the communication between dialysis device and users (patient, nurse, doctor).
- 3. Backround Approximately 2.2million end stage renal disease (ESRD) patients are treated worldwide, 1.5 of them are haemodialysis (HD) patients and the growth of new patients is approximately 7% a year (1). Without the treatment the patients would die rather quickly (after ca 3-4 days) due to complications caused by excessive body water and uremic toxins in the body. A large part of patients’ life quality decrease and HD expenditures are related to hospitalisations and interventions due to the side effects causing high morbidity and mortality (2). Therefore, to improve well-being of the patients and cost effectiveness, the society is interested that adequate renal replacement therapy with high quality and minimum complications is offered. What is a dialysis? · Dialysis is the artificial replacement for lost kidney function. · Eliminating waste (diffusion) and unwanted water (ultrafiltration) from the blood · Well functioning kidneys filter all the blood in your body with 30 min. · 2 leading causes of kidney disease are high blood pressure and diabetes. · It is possible to live with only one kidney. The functions of the kidney Excretory functions - remove waste products - remove excess fluid - regulate acid-base balance - regulate electrolyte levels Secretory functions - regulate blood pressure (renin) - regulate red blood cell production (EPO) - regulate calcium uptake (active vitamin D)
- 4. Treatment Modalities Hemodialysis In hemodialysis, your blood flows through a machine that has a filter which cleans the blood. This machine is called a dialyzer or artificial kidney. Hemodialysis is usually done three times a week, several hours each session. It can be done at a dialysis center or at home. To get your blood into the dialyzer, two needles are inserted into your vein during each dialysis treatment. - hemofiltration - hemodiafiltration http://clinicindelhi.com/hemodialysis/
- 5. Treatment Modalities Peritonealdialysis How does peritoneal dialysis work? A soft tube, called a catheter, is placed in your belly. This is done by minor surgery. This catheter makes it possible for you to easily connect to a special tubing which allows two to three quarts of a cleansing fluid to flow into your belly. The cleansing fluid is called dialysate. It takes about 10 minutes for the dialysate to fill a belly. When the filling is done, the catheter is capped so that it doesn't leak. The lining of a belly (called the peritoneal membrane) acts as a natural filter. It lets the wastes and extra fluid in blood pass through it into the cleansing fluid. At the same time, the lining of a belly holds back the important things a body needs, like red blood cells and nutrients. To do its job, the dialysate must stay in a belly for two hours or more, depending on body size and how much waste has to be removed. This time is called dwell time. After dwell time, cleansing fluid must be drained from body into an empty bag. In-and-out process must be repeated a number of times during the day, using fresh dialysate. PD can be done at home, at work, or while traveling. Two options: - Continuous cycling peritoneal dialysis or automated dialysis (CCPD) With CCPD, a machine called a cycler does the exchanges automatically while you sleep. You may also need to do one exchange during the day if your kidney function decreases further. - Continuous ambulatory peritoneal dialysis (CAPD) With CAPD, you do the exchanges yourself three to four times a day. http://sainternshipufs.blogspot.com/2012/06/4-5-june-2012-universitas-hospital.html
- 6. Treatment modalities Kidneytransplant A kidney transplant is an operation that places a healthy kidney in your body. The transplanted kidney takes over the work of the two kidneys that failed, so you no longer need dialysis. If you have a transplant, you must take drugs for the rest of your life, to keep your body from rejecting the new kidney. Transplanted kidney usually works well 8-10 years, after that it needs to be replaced. Currently (2014) 99 000 people are in a waiting list of kidney donor in USA. Fewer than 17 000 receive one each year. Every day 14 people die waiting for a new kidney. Alternatives UCSF researchers today unveiled a prototype model of the first implantable artificial kidney, in a development that one day could eliminate the need for dialysis. 3D printed Kidney - by Surgeon Anthony Atala. An early-stage experiment that could someday solve the organ-donor problem: a 3D printer that uses living cells to output a transplantable kidney Revital Cohen - Dialysis Sheep (2008) http://www.ucsf.edu/news/2010/09/4450/ucsf-unveils-model-implantable- artificial-kidney-replace-dialysis http://blog.sculpteo.com/2011/08/10/3d-printing-for-regenerative-medicine/ http://designculturelab.org/2011/08/06/dialysis-sheep-sacrificial-lambs-black- sheep-and-speculative-designs-publics/ http://www.medindia.net/ healthnews/kidney-transplantation-news. asp
- 7. Research Methodology Onlineresearch To map out the nature and need of dialysis, to learn the dialysis process in detail and to identify the problems that dialysis patients are experiencing. GIGAmapping Mapping out different aspects of dialysis and the problems related to it. Analysing their interconnections. Finding new connections between the parts of the process. (addendum A) On-site observation at the hospital To understand the interaction between the patient and the hemodialysis machine. To monitor the workload of nurses. To monitor the activities of the patients during the dialysis process. Interview with a patient and patient journey To recieve a feedback from the patient about the dialysis process. To map the level of his understanding of the process and the need for it. To understand patient’s daily schedule due to dialysis and his attitude towards it. The poll To get statistics. To map the level of patients understanding of the process. To measure the scope of the problem. To find out patients needs and expectations.
- 8. Overview of theresearch Reality in hemodialysis · 2,2 million ESRD patients worldwide (about 1,5 million HD patients) · 7 % annual growth rate · time consuming: 4-5 hrs, 3-4 times/week · Life expectancy if a person starts dialyse in the age over 75 years: 25 % - 1 year 60 % - 5 years · Life expectancy if a person starts dialyse in twenties: 20 or in some cases even 30 years · complex medical and dietary regimen · expensive- ca 50 billion USD annually · complications Patient needs a dialysis process 3-4 times in a week and it takes 3-5 hours. Blood urea concentration over a time of period (several dilaysis) Wed Fri Mon Wed Fri Blood urea concentration mmol/l 25 20 15 10 5 -20 30 0
- 9. Overview of theresearch http://www2.nephrocare.com/global/en/ products/5008.html On-site observation at the hospital - Majority of the patients are under the care of nurse * safer environment * fear of doing hemodialysis at home - Newer hemodialysis machines have patient-friendly screens and operating principles and can be operated by the patients themselves. - Younger and more fit patients interact with new machine themselves. - During the dialysis the nurses are required to fill out patient records manually Newest machines at the hospitals now. Patient friendlier. Self service. Current machines at the hospotal. No patient-machine interaction takes place. Older machines. Currently stocked aways and used only if really needed.
- 10. KIDNEY DIALYSIS WHATIS A DIALYSIS? Dialysis is the artificial replacement for lost kidney function. It is an artificial process of eliminating waste (diffusion) and unwanted water (ultrafiltration) from the blood. Kidneys do this naturally. If a kidney is failed or damaged and cannot carry out the function properly - a person may need dialysis. Kidneys filter all the blood in your body with 30 min. 90 000 people die of kidney desease (more than Breast and Prostate cancer combined) Hospital Addendum A STAKEHOLDERS FAMILY EMPLOYER PATIENT HOSPITAL SUPPLIERS SYSTEM COMPETOTORS SELLING DIALYSIS MACHINES Patient 2 leading causes of kidney desease are high blood pressure and diabetes. It is possible to live with only one kidney. BABY CHILD TEENAGER STUDENT HEMODIALYSIS AT THE HOSPITAL 3-4 x week 3-5 hours stuck to the machine wasted time painful vein infection For patients with other health problems and for elderly people MON TUE WED TH FRI SAT SUN MON under medical care less infection “social club” get out of house meet other people HEMODIALYSIS AT HOME PERITONEAL DIALYSIS For patients with no needles no pain suitable for kids flexible schedule less dietary restrictions doable at night easy to travel 4 times in a day 30 min risk of infection 3 x week 3-4 hours 5-7 x week 2 hours 8 Home Doctor Nurse Data of dialysis effectiveness in 2 days Preparing the machine Sterilyzing flites Start pump and timer Measure blood pressure in every 30 minutes Removing the tubes from the patient in 3-5 hours Patient recovery 10-15 minutes Possible aftereffects PROCESS Measure: kg temperature blood pressure when standing and sitting Measure: kg temperature blood pressure when standing and sitting FACTS based on data of USA 1 out of 10 people (over 18 years old) have reduced kidney function Currently (2014) 99 000 people are in a waiting list of kidney donor. Fiewer than 17 000 receive one each year. Every day 14 people die waiting for a new kidney. Today’s dialysis machines are far from perfect. Their efficiency is only around 10% of that of a functioning kidney, and when used three times per week, they are incapable of controlling unhealthy fluctuations in the concentrations of metabolites such as urea in the blood. Life expectancy if a person starts dialyse in the age over 75 years: 25 % - 1 year 60 % - 5 years Life expectancy if a person starts dialyse in twenties: 20 or in some cases even 30 years. SCHEDUAL HEMODIALYSIS
- 11. FEELINGS QUALITY OFLIFE SCHOOL WORK VACATION http://designculturelab.org/2011/08/06/dialysis-sheep-sacrificial-lambs-black- Business - new device sheep-and-speculative-designs-publics/ by Piret Uustal I Gina Metssalu I 2014 supervised by Birger Sevaldson STUDENT PARENT ELDERLY YOUNG WORKING PEOPLE fear uncertainty lack of motivation helplessness routine no freedom being a burden uselessness no finances uncertain of future depressing waiting allone what’s the point time lost want to enjoy the last years of your life 8 % of all dialysises (in USA) with no other health problems infection 6 x week 6-8 hours Every other night 6-8 hours Due to longer/more frequent dialysis: feel better less/no nausea less/no “washed out” feeling less/no headache less/no cramping fexible schedule more toxins removed risk of infection need long training need “care partner” (family member) need to hire a “care partner” POTENTIAL IDEA growing number of patients - 6 % in a year currently on dialysis - 3 million people currently on hemodialysis - 1.3 million peoplew Instant data of Dialysis quality SAVE TIME SAVE MONEY shorter tiem of dialysis new use of old machines (eg. in poor countries) See the future Be like others Feel useful Financial independence Do what you love Freedom Motivation Enjoy the life patient diary easy data handling data sharing Doctor-Nurse-Patient-Family member UCSF researchers today unveiled a prototype model of the first implantable artificial kidney, in a development that one day could eliminate the need for dialysis. 3D printed Kidney - by Surgeon Anthony Atala. An early-stage experiment that could someday solve the organ-donor problem: a 3D printer that uses living cells to output a transplantable kidney Revital Cohen - Dialysis Sheep (2008) http://www.ucsf.edu/news/2010/09/4450/ucsf-unveils-model-implantable-artificial-kidney-replace-dialysis http://blog.sculpteo.com/2011/08/10/3d-printing-for-regenerative-medicine/ Alternatives HEMODIALYSIS MACHINE ADDED SCREEN ADDED SENSOR HOSPITAL FAMILY patient diary at home .............. ................ .................. http://sainternshipufs.blogspot.com/2012/06/4-5-june-2012-universitas-hospital.html by Piret Uustal I Gina Metssalu I 2014 supervised by Birger Sevaldson
- 12. Overview of theresearch Interview with a patient / patient journey Male I 81 years old I dialysis patient over 2 years - had kidney failure after heart surgery when he was given wrong medicine (overdose of Potassium) which injured his kidney functions. -kidney dialysis every Mon, Wed, Friday, from 8-12 - patient himself is responsible monitoring his heart rate during the dialysis. If its too low or high the patient moves the position of the bed to raise his legs. - the patient is not aware of the effectiveness of the dialysis in the end of the process. He is not monitoring the display of the machine (even if there is screen it is not visible nor understandable for the patinet). - if the display would be visible and understandable to the patient he would be interested and positively influenced to see the effectiveness of the dialysis process. - the patient follows the remaining time of the dialysis process from the sepparate wall clock. He does not see the timer from the machine. - he feels fairly good after the dialysis. He walkes home 15-20 minutes and needs to sleep 2 hours to feel completely well. - the patient claimed that when he was sometimes placed under an older model of hemodialysis machine he did not feel comfortable and did not trust the effect of the dialysis as much - the inability to use restroom during the dialysis process is sometimes a problem Older hemodialysis machine
- 13. Overview of theresearch Patients In order to get overview of patients habits and their awareness of hemodialyses process we conducted a research among the hemodialyses patients in estonia. There is about 200 regular HD patients and we got answers from 32. It makes ab 16 percent of all patients in Estonia. Age Working?
- 14. Overview of theresearch Patient awareness of the dialyses process 44 % of the patients are not aware what is happening with their blood during the dialyses process 64 % NOT aware what does the data displayed on the machine (such as Kt/v) means. 79% NOT aware how clean is their blood after the dialysis. 48% believe that knowing the results of the dialysis process effectiveness would influence them positively. 80% following their blood pressure during the process.
- 15. Overview of theresearch Dialyses at home? 80% NOT willing to do dialysis at home 43% believes dialysis at home would affect their daily routine Main reasons: - no conditions - don’t dare - not sterile enough - live alone - fear of blood, needles and whole process 25% would be more encouraged to have dialysis at home if the doctor has overview of the process in real time.
- 16. Findings Hemodialysis machineand sensor - The benefits of real-time measurement are obvious: if Kt/ V is only checked monthly or quarterly, it may be months before suboptimal dosing is discovered. By measuring online during every therapy, the new sensor is able to identify suboptimal dosing immediately, support timely adjustments in treatment parameters and also eliminate common process- related factors influencing the previous reference method (taking of blood samples). In medicine, Kt/V is a number used to quantify hemodialysis and peritoneal dialysis treatment adequacy. K - dialyzer clearance of urea t - dialysis time V - volume of distribution of urea, approximately equal to patient’s total body water Increase blood flow Improvement in clearance Positive effect on Kt/V There are 4 ways of how the doctor, nurse or patient can influence the Kt/V during dialysis process thanks to the costant information of dialysis quality given by new sensor:
- 17. High concentartion ofsubstances Reduce blood flow Increase dialysate flow Longer dialysis time Improvement in clearance Positive effect on Kt/V Improvement in clearance Positive effect on Kt/V Improvement in clearance Positive effect on Kt/V
- 18. Findings Patient -The patient is interested in knowing and following the effectiveness of dialysis during the process. - The patient would be positively motivated if he was able to monitor the effect of the process. - Newer dialysis machine and a machine that is understandable to the patient raises trust towards the process and makes the patiet interact with the machine (more independence to the patient, less work to the hospital stuff)
- 19. Findings Doctors /Nurses -The ability to receive constant feedback of the patients dialysis quality eliminates the “guess work” of the nurses and doctors in setting the machine parameters before an during the dialysis process. The optimal dialysis process for each patient can be figured out faster and is based on reliable data. - The machine could ease the workload of nurses by automatically saving the information of the dialysis process (work that is now done manually). - In case the patient recives dialysis in a different clininc (e.g. while traveling) the data of the patients dialysis parameters will be available to the nurses and doctors in a new clinic as well. Nursing file what now is filled by hand for each patient
- 20. Findings Market -Older models of hemodialysis machines that have new sensor can be used in a more effective way. - Hemodialysis machines can be made avaialable to more patients. Older machines that would be otherwsie disregarded can be taken more clinics and to rural areas so the patient would not have to travel long distances to receive dialysis. - Less developed countries with older dialysis machines can offer better dialysis quality to their patients and make it avaialble to more people. - Lower costs than purchasing brand-new hemodialysis machines. Regulations - There are several laws and regulations in Estonia for producing, maintaining and handling medical devices (3), but as far as we talking about adding the new sensor only as a affix to outlet hose, then we are not influenced by them directly.
- 21. Findings Existing solutions The first integrated dialysis dose monitor in the world, utilising the UV-technology, is the Adimea system (Option Adimea, BBraun Avitum AG) (B. Braun Avitum AG 2010). The heart of the Adimea system is the optical sensor DiaSens, integrated into the HD machine, delivering values of real-time Kt/V or URR for the dialysis team during a treatment
- 22. Goal Increase patientmotivation to take better care of their health through raising awareness of the dialysis process.
- 23. Focus The existinganalysers are built in the whole kidney dialysis apparatus. The aim is to develop a standalone analyser which suits with dialysers produced by different companies. Today the procedure takes place in the hospital under the control of the medical personnel. The new system is connected with internet and should be able to work also in the other environments out of hospital and patient should be able to manage with it alone. The disadvantages of the existing methods for uremic toxins determination are utilization of disposables or chemicals, rather complicated and expensive measurement procedure. To overcome those difficulties, a monitoring system would be preferable. Recently a good correlation between ultraviolet (UV)-absorbance and several small removed waste solutes (urea, Cr, UA) has been found, indicating that UV-absorbance may enable monitoring of several uremic toxins linked to the malnutrition–inflammation complex syndrome and the risk factors of CVD. The obtained results demonstrate the possibility to follow a single hemodialysis session continuously and to monitor deviations in the dialysator performance by using UV-absorbance. The UV-method does not need blood samples, any disposables or chemicals, is fast, and allows continuous measurements of the standard dialysis adequacy parameters (e.g. Kt/V, URR). http://www.bbraun-avitum.ro/cps/rde/xchg/av-avitum- ro-ro/hs.xsl/7370.html http://www.cb.ttu.ee/ee/edu/DBB0070/Biooptics_HD_ public.pdf
- 24. Focus External sensor · Real- time measurement system · Photometric sensor that continuously measures light absorption in spent dialysate · Estimating the reduction of substances concentration, which is linearly related to their concentration in blood · Capable of delivering Kt/V in most treatment models, including HDF, HD and single needle treatment Advantages · continous, on-line monitoring. Other methods- once in every 25 min. New sensor every 6 sec ( Kt/V) · no blood sampling · without any disposables or chemicals · evaluates delivery of prescribed treatment dose (Kt/V) · can estimate TRU, PCR, URR · possibility to measure other solutes besides urea · estimation until the target is achieved · no interference with dialysis machine’s operation
- 25. Values Values forpatient Values How? - simple, understandable,always visible screen - blood result instantly shows if patient has been taking care of his health (eg. correct diet) - practice in the hospital, simplicity of the process and awareness encourages to do dialysis at home - aware what is happening - cares more of his/her health - independence
- 26. Values for nurse Values How? - patient data stored in the device and easily accessible when needed - most data saved automaticaly to the new screen during the process -machine setup based on exact blood data. Alarm if goal not achived. - easy data handling and storing - save time - easier setup of dialysis machine Values
- 27. Values Market Currently,there is about 600 000 old hemodialysis machines in the world. Many of these machines are in good condition, but miss certain functions limiting the treatment modalities a clinic can perform. Those functionality could be raised significally by adding them percise sensor and extra screen.
- 28. Concept in use Patient journey CHOOSE MACHINE Nurse waches and marks down the weight OLD MACHINE MANUAL PROCESS MACHINE TESTING AND SETUP ca 15 min INSTALL FILTER, TUBES, DIALYSATES CONNECT PATIENT WITH MACHINE CONNECT PATEINET TO MEASURE BLOOD PRESSURE (connect with machine) CHOOSE PROGRAM -Hemodialysis -Hemodiafiltration (HDF) - Ultrafiltration BLOOD PRESSURE starts screening in a patient page view MACHINE ADJUSTS AUTOMATICALLY ACCORDING TO PATIENT ALL SETUP MADE INSTANTLY CHANGES CAN BE MADE START (MACHINE) Can blood pressure be measured at the same time in 2 places (in dialysis machine and on NEW SCREEN) 2 connections. So blood pressure could be followed from the screen. what happens if blood pressure will be shown only on NEW SCREEN. What changes in Dialysis machine? Does it affect anything? Is bloodpressure data usually saved to magnetic card also? Is it needed for that? MAGNETIC CARD WEIGH THE PATIENT NEW MACHINE 1 2 3 4 5 6 7 8 Prebooks always new Weights herself and remembers it machine Sets up the machine parameters- with magnetic card Nurse prepares machine Connects herself-needles, sensors etc Patient chooses pro-gram Starts machine Start of new screen-automatically, after fluid starts flowing- TIME AND BLOOD PRESSURE as a screen saver BLOOD PRESSURE as a screensaver Just comes every mondey, wendsday and friday at 8 oclock Nurse prepares machine Nurse connects with machine Nurse sets up the machine Nurse choses program Nurse STARTs Machine Security code necessary? Nurse gets info about PREvIOUS SESSION PARAMETERS Start of new screen-automatically, after fluid starts flowing- TIME AND BLOOD PRESSUREin a patient page view CAN IT START AUTOMATICALLY AFTER FLUID STARTS RUNNING? PORTABLE SCREEN for INSERTING WEIGHT INSTANTLY already in “weighting Cabinet” JAAK, 62 Pensioner. Doesn’t work, lives alone in Mustamäe. PIIA, 32 Works as a project manager, studies administrative management in TTU-s master program. Mother of two chil-dren. Travels a lot HOME MENU-PATIENT SELECTION-INSERTING WEIGHT MACHINE NEEDS TO BE SET UP Piias actings Jaaks actings Nurses actings NEW SCREEN Ns- Piias acting Ns- nurse acting Ns- Jaak acting
- 29. SENSOR ALARM -changesomething HOW DOES PATIENT FEEL 75% of GOAL FOOD DIARY SYNC NURSE ENTERS CHANGES TO THE SCREEN: - BLOOD FLOW -DIALYSATE FLOW - UF PROFILE +/- NURSE CHANGES PARAMETERS ON MACHINE: - BLOOD FLOW -DIALYSATE FLOW - UF PROFILE +/- DIALYSIS TIME ADJUSTS ON THE SCREEN GRAPH SAvE PROCESS PRINT DATA WHICH DATA NEEDS PRINTING? CAN CHANGE SETUP PARAMETERS -kg -dialysis time ... In the case of independent patient - who fills out the paper sheet for nurses now? Is patient able to do this? Is all that data always needed? FEEL + UNFASTEN THE PATIENT FEEL - low blood pressureT clogged fistula (MACHINE) arter/vein pressure blood sugar (MACHINE) cramps (MACHINE) headache (MACHINE) DISPLAYED : -previous dialysis data -usual setup parameters (kg, dialysis time) -medicaments -previous blood test results from lab - patient food DIARY CHOOSE PROGRAM -Hemodialysis -Hemodiafiltration (HDF) - Ultrafiltration 9 10 11 12 13 14 15 Takes the new Screen Inserts parameters to the New Screen Home menu- PATIENT SELECTION PATIENT PARAMETERS PRECISE GRAPH SCREEN progress is going on as predicted Usual time is up, but screen shows onlly 75% of result Becouse of upcom-ing meeting chooses to finish anyway Suggestions to the next time Prebooks for the next time longer session Disconnects herself Waches his blood pressure Calls nurse when not feeling good Weights herself PRECISE GRAPH SCREEN lack of GOAL Nurse changes parameters AUTOMATICALLY SAvES ALL WIRELESS CONNECTION? GOAL gets better GOAL is achieved Nurse disconnects nurse inserts weight SAvE PROCESS PRINT DATA Nurse takes blood sample nurse inserts BLOOD TEST RESULTS Nurse waches and marks down the weight inserts weight
- 30. Interface structure Homemenu Patient selection ô orders to stock? suggested parameters patient 1 Blood pressure (+ time) as a screensaver suggested parameters WeigHt beforeô after ô WeigHt History edit patient info treatment plan Blood tests Food diary program -Hemodialysis -Hemodiafiltration ô- Ultrafiltration uF goal time 4:00 ô patient inFo - name -barcode -doctors name -height -age -... History - date -trend graphs start treatment plan -medicaments -.... Food diary Blood tests -predictable graph -goal % -time % -blood pressure -uf rate -art press -ven press -... Back alarm - Blood FloW ô -dial. FloW ô - uF proFile ô FinisH suggestions WeigHt print The information measured by the sensor is instantly displayed on the screen. To map out the user interface and keeping in mind the goal for values we went through patients journeys and built the structure for user interface.
- 31.
- 32. Display Information displayedon the screen is translated into graphics so everyone, even elderly patient can grasp visually what is happening with their blood at this very moment. The most vital information for the patient ( blood pressure, % of the process effectiveness and time remained) is displayed as a screen saver. If it now, for example, happens that the patient has been eating nonproper food on a previous day, the result instantly shows on the screen. This will help him to understand and assess how his lifestile and diet can influence his health. And that, in turn, motivates him to take control over his health...and not leaving it to the doctors only.
- 33. Display Also thenurses will benefit of the new solution. It will make easier for them to set up the dialysis machine according to each patients needs. The setup data of the most effective process for this patient is already automatcally displayed and the nurse doesnt have to guess which process gives the most positive result to the patient. Nurses time is saved by not having to fill out papers by hand for each patient. All the data about the process wat now is edited by hand could be saved automaticallyby the screen and if paper version is still needed, it can be simply printed out.
- 34. Sensor case Processof ideas for sensor case