Clinical engineering's role in managing clinical alarm risk.

This manuscript highlights the role that clinical engineering can play to minimize the risk of problems associated with clinical alarms. AAMI held a town meeting on clinical alarm management and integration during its 2005 Annual Conference & Expo. The meeting highlighted some excellent suggestions on how the whole concept of improving clinical alarm design and implementation must be addressed in a systematic way. Examples of how the clinical engineering profession can contribute to this effort include participation in more AAMI town hall meetings and other conferences, providing design suggestions to medical device manufacturers, and participation in the development of alarm-related standards.

Technology for successful aging.

Americans are living longer, and research shows that seniors are embracing independence, and will benefit from living in the same place. These are the rationale for 'Aging in Place' and the development of Tiger Place, an 'Aging in Place' Environment in Columbia Missouri. Our goal is to minimize intrusion, allow the resident complete control over privacy and treatment (if any), and to provide substantive improvement in quality of life. Nevertheless there continues to be significant risks to the elderly which results in reduced functional and cognitive activity. While there has been much technology developed to ameliorate these factors, there is no comprehensive evaluation of the benefit of these devices nor a comprehensive strategy to improve the quality of life of seniors as determined by functional ability and possibly later cognitive ability. With our partners at the University of Virginia we are developing a system of sensors, to monitor the activity of seniors in their residences. We measure motion, footfalls, sleep and restlessness, we have stove sensors and sensing mats, all connected wirelessly to a computer which performs an initial evaluation and data transfer to a secure server for further study. Based upon the monitor data we will implement an intervention to ameliorate functional decline. Focus group studies determine the attitudes, concerns and impressions of the residents and staff. We find that senior's attitude to technology is healthy and they will try helpful approaches. In addition to the statistical comparisons, we model the data using hidden Markov models, integrate or fuse the monitor data with video images, and reason about behavior using fuzzy logic. The results of this work will additionally reduce the workload on caregivers, foster communication between residents and family, and give these seniors independence. We have requested and received IRB approval for this study.