Code Blue is a cross-disciplinary collaboration between Carnegie Mellon’s Biomedical Engineering department and the Entertainment Technology Center.
The cutting-edge left ventricular assist device (LVAD) can improve quality of life for patients with end stage heart failure. It even has the potential to extend their life expectancy. However, the medical and ethical decisions involved in electing to have the surgery can be complicated and scary for potential LVAD recipients and their caregivers.
Code Blue is building tools for these patients to understand their diagnosis and the options available in a clear, sympathetic way. Leveraging mobile technology, they will be able communicate their goals and needs to caretakers and medical providers.
In time, Code Blue’s patient-centered approach to health could be generalized to other operations associated with severe medical conditions.
Good afternoon, we are team Code Blue, and welcome to our halves presentation.
I’m Sarah, the producer and programmer. This is Aly, our artist, Boyao, our programmer, and Tony, our science guy. Our faculty advisors are Shirley Yee and Scott Stevens.
Our client is a group of researchers from the CMU BioMed department, led by Jim and Lisa. We are also working with some doctors and nurses from the University of Colorado, Denver.
With medicine’s ever expanding array of life-prolonging technologies,
older and sicker people are increasingly offered
more and more invasive interventions. However, these interventions are often life-saving, and have the power to improve the patient’s quality of life.
more and more invasive interventions. However, these interventions are often life-saving, and have the power to improve the patient’s quality of life.
One such technology is the LVAD, or left ventricular assist device, a continuous flow pump which helps the heart do its job. It is connected via a driveline through a wound in the stomach to an external battery pack and controller. The entire thing weighs almost 10lb in total.
The LVAD is offered to patients with end stage heart failure, especially as a form of destination therapy, or DT. This means that getting an LVAD is permanent, and the patient will have to carry it around for the rest of their life.
As you can imagine, the decision to accept an LVAD or not is a major one which requires a lot of consideration. Due to limited face time with healthcare providers, patients are often given decision aids, a balanced, medically sound guide to the risks and benefits of getting an LVAD.
Due to limited face time with healthcare providers, patients are often given decision aids, a balanced, medically sound guide to the risks and benefits of getting an LVAD.
And here’s the problem: every single LVAD decision aid out there is industry sponsored, fails the International Patient Decision Aid Standards, and is biased towards getting an LVAD.
The only non industry sponsored LVAD decision aid is a video created by the researchers in CU Denver, whom we are working with. However, the video is 30 minute long, not very engaging, and content incomplete. Here’s where we come in -- together with CMU BioMed, we are creating a new, comprehensive objective decision aid.
The only non industry sponsored LVAD decision aid is a video created by the researchers in CU Denver, whom we are working with. However, the video is 30 minute long, not very engaging, and content incomplete. Here’s where we come in -- together with CMU BioMed, we are creating a new, comprehensive objective decision aid.
For our project, at first our client simply wants a synthetic interview based on the video sarah talked about. But it gives us some concerns. The synthetic interview rarely makes people feel natural and the video that our client gives us is poorly suited. Also if the final product is a synthetic interview it will be really difficult for them to update it while maintaining continuity. Another problem is if we just make a synthetic interview, we will not have much space to explore.
During quarters, a lot of faculty wanted us to reshoot.
So we came up with an idea of reshooting some parts of video at beginning which we found was also problematic. In the future our client will refilm the video and that will make our work useless. Also if we just reshoot some parts of the video our final product will be a proof of a concept and that means we will not have much to show. For the video itself is shot by others, if we want to reshoot it, the ip concerns may become a big problem. At last, due to medical policy, it will be really hard for us to get in touch with our target people, so how to test our product will be a big problem.
Based on the problems we have, our design our final product to be a website application including 4 sections.
Hypertext FAQ: If patients don’t have any questions, they can simply click the hypertext and we will show the video.
Also we will have a searchable video library. That means they can type the question they want to ask and we will show the video that is related to their question.
And in the patient prognostic information part, we will try to combine our product with a database of patients health information.
At last, we will record the patient’s response after they watch the video to see if they fully understand what we want them to know.
Based on the problems we have, our design our final product to be a website application including 4 sections.
Hypertext FAQ: If patients don’t have any questions, they can simply click the hypertext and we will show the video.
Also we will have a searchable video library. That means they can type the question they want to ask and we will show the video that is related to their question.
And in the patient prognostic information part, we will try to combine our product with a database of patients health information.
At last, we will record the patient’s response after they watch the video to see if they fully understand what we want them to know.
Here is a flowchart of our product. In the flowchart different colors represent different function.
The pink represents the infrastructure of our client which is already exist.
Blue is the patient prognostic information and
orange is hypertext FAQ.
Green means the video clips.
At the end of flowchart is purple and we will record patient response there.
We spent the first few weeks doing research on our target audience: senior citizens and their caretakers. Because of their age, they have some special considerations to keep in mind when designing UI.
This includes a clear and consistent UI throughout, easy to read type, no bright colors, and clearly labeled buttons.
As mentioned by Boyao, our client originally wanted a synthetic interview, where the users could speak to the application, and ask any question they wanted. They would then be directed to the section of the provided video that answered their question.
However, we found that most users didn’t actually know what to ask, and that some questions require prior medical knowledge. Our solution was to create a Hypertext FAQ.
For example, if they click on Quality of Life.
They are brought to another page where they can navigate through a list of common questions.
When a question is clicked on,
it leads the user to either a text or video answer, based on their user preferences. At this point, we’re nearly finished with it and starting to wrap up its development.
Survey participants will receive spoofed patient prognoses.
Outcomes will vary from very positive (~90% survival to 1yr
to very poor (~10%)
Also include mixed results (high survival chance but risks complications, e.g.)
If DA is successful, likelihood of LVAD recommended should correlate to prognosis (ANOVA)