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Rules-based innovation


An old friend of mine, Anders Björlin, has just won a 2009 Humanitarian Impact award from The Itanium Solutions Alliance. The press release says:

Judges selected Kiwok of Sweden for its BodyKom(TM) Series remote ECG monitor. Deployed in conjunction with caregivers and health systems, BodyKom allows heart patients to live independently while their heart is monitored through a reliable wireless network powered by Itanium-based hardware. The Kiwok system provides automatic, real-time notifications as well as furnishing long-term data for diagnosis and treatment. Utilizing a Itanium-based server to ensure the heart monitoring information is reliable, secure and highly available at all times, Kiwok’s technology saves significant resources by freeing up hospital beds and providing immediate feedback on the effects of ongoing treatments.

Besides being Itanium-based, Kiwok’s system uses a business rules management system to make constant operational decisions – does the data coming from this heart monitor justify some kind of intervention. The rules are based on medical know-how as well as the specific understanding that a doctor has for his or her patient. Personalized, real-time decisions.

Previously, when a patient had heart problems, hospitals hooked up a device to a patient and took recordings for 24-48 hours. Then a doctor analyzed the recording. Unless the problem showed up during the recording you got no useful data. Anders, one of the founders, had a heart problem and went through this process 4 times before the doctor saw the problem. He could not understand why it was not possible to monitor someone constantly. As a result Kiwok built a solution for constant monitoring device and used rules to “watch” the information flow.

The system uses standard hardware for monitoring heart activity, connects it using mobile phone technology to transmit the data to servers. This allows real time monitoring of the heart and uses GPS/GSM network to locate the person. However, each patient generates 25-28Mb of data a day and clearly it is no use having a doctor just watch a bunch of screens as they cannot effectively watch very many. To manage this they run rules created by the doctor and patient together – each case is unique and so needs their own rules. Doctors can set up alerts and new monitoring rules and patients can identify relatives and others to get alerts too. Personal information is not transmitted but managed within the hospital systems and combined with the heart information when it arrives.

They defined 21 standard templates for various kinds of rules like pulse limits in certain time windows or certain patterns of heart activity. This allows doctors to create rules easily for each patient (templates being one of the secrets of business user rule maintenance). The doctors can also define how much data they want to see when there is a incident and how they want to be notified etc. The system does not necessarily transmit data all the time – it might be triggered by particular activity or by a fall. Patients like the peace of mind of continuous monitoring, doctors like the custom monitoring and the healthcare system saves money. Personally I think this kind of intelligently monitored remote medical device is going to play a huge role in the future.

Congratulations to Anders and his team.


Comments on this entry are closed.

  • José Gabriel García August 29, 2009, 1:01 am

    This is a very interesting implementation of BRMS. From Delta-R in Spain we are looking for a partner for an R&D by 2010 in the health sector. I think it is a sector with many interesting applications of BRMS.

    José Gabriel García
    CEO – Delta-R

  • Sara Kinderspiele September 2, 2009, 6:54 am

    Interesting article. The system you wrote about souldslike a really discover in the health sector. I think governement should devote more funds to research in this field.