Friday, February 19, 2010

Making a difference in Haiti...

Guest entry by Jeffrey Henry, Medweb Engineer in Port-a-Prince, Haiti (Tuesday, February 16, 2010)

I’m about to change someone’s world by printing them a 180 page X-ray user manual. He will be an X-ray tech the rest of his life, and probably be able to provide a much better home for his wife and child because of it.

In my not so humble opinion, this trip has been a resounding success. Ever since I set up the view station right next to the Medweb, the doctors have been running back and forth non stop from their patient to the PACS view station. It was awesome to see this. The Medweb PACS has truly helped people get their studies read in a timely fashion; it has enabled them to compare old X-rays to new ones, determine the rate at which people are healing, and decide if they can be discharged. I’m confident Medweb’s donation has helped reduce the length of time people are suffering, and has helped save some peoples lives.

I helped my new Haitian friend Fetner send all the old studies needed by the doctors one image at a time for review.

Before I leave, I am going to print out 1 copy of the Medweb plug-in user manual and staple it together and leave it near the View station for incoming doctors when I am not here. Come to think of it, I should train Fetner to train the Haitian docs. I love how things work out sometimes.

I definitely miss my home, friends and coworkers. If we are coming here on another trip, I will help make a drive to get donations. I cannot stress to you enough how much is needed here.

-Jeffery Henry

PACS up and running in Haiti!

A Guest Entry from Jeffrey Henry, Medweb Engineer in Haiti (Monday, February 15, 2010)

The Univ. of Miami Medishare hospital has been running X-rays non-stop. I was able to get a view station set-up next the X-ray station in the adult tent. A local arrived who was trained in the machine and can take the X-rays and scan in the cartridges. The traffic here at the hospital has picked up. We are full; the massive rain last night caused schools to collapse and some people came in with major issues.

I have to say, the trip thru town was atrocious; the city is non-stop rubble with a lot of people living in tents made of bed sheets. The international response is everywhere, but at the same time, seemingly minimal. Every country with the capability to do so has sent something, but nothing comes close to the US presence.

I also got some great intel on how the medical efforts are going and where the needs are most vital and how this Medweb server in particular could be used most efficiently.

When I got back to the Miami Medishare facility, one of my laptops had been liberated and hooked up to a projector in the kids' tent to show a French version of Peter Pan. You just can't get "mad" though - these poor kids just tug at your heart and if a little bit of relief in a movie that tells them it's ok to not have to grow up overnight - then that's a part of why we are here, too. There is still another view station in this room. I will leave my tough book here with a user account for Medweb viewing and I will give the password to the docs who need it.

Tonight my to-do list is to send 37 studies from X-ray to PACS so they can compare priors and secure view station, setup near X-ray machine so the doctors can read NEAR the X-ray machine for faster reads.

As I was writing, I was interrupted by a doc who needed to read. Patient had a femur fracture that they patched up and put a cast on and were ready to discharge. They were very happy.

Tuesday, February 16, 2010

Our Hearts Go Out to Haiti: Medweb Team & Technology in Port-a-Prince

The stories and images tug at our hearts. Today, news reports called the Haitian earthquake of January 2010 the worst natural disaster in world history - per capita, it has killed more people than the tragic Indonesian Tsumani of five years ago - which laid claim to the not-so-desirable title previously. As the media presence begins to wane, the need will go on for decades. For one of the world's poorest countries, recovery will be long and slow, but maybe, just maybe with enough help from the outside, we can help the people of Haiti to rebuild better, stronger and more resilient communities.

Jeff Henry, one of our engineers, is currently returning from a one week initial deployment and assessment in Haiti. While there he was touched, moved and saddened by all that he saw. His words are vivid, and as such, I invited him to do a guest blog. Here are his words regarding the Medweb PACS supporting University of Miami's/Medishare 240-bed Expeditionary Medical Facility (EMF) at the Port-a-Prince airport.

SATURDAY, FEB 13

Last night I got in and it was chaos. The airport here isn’t really functional; luckily the US military was there with hummers and big guns to keep people in line, literally. :-)

I was able to unload the servers from the plane myself. I asked, "Is there a conveyor belt at the airport?" The military guy laughed at me and told me that I was the conveyor belt. I was so pleased when I got the servers to my sleeping quarters, opened them up and found them to be fully intact.

As soon as I got here they needed an OB and delivered 2 babies last night. There are about 150 patients here with a support staff of about 50.

I went to all the [hospital compound] tents and saw their c-arm, X-ray machine and ultrasound. I am so glad that they all have Ethernet ports. The CT at Heart Check America sent fiber. I need to get both modalities networked, then get them sending to the Medweb. We have spools of cat6 to facilitate this.

If you wanted to send these people something useful, send boxes of carnation instant breakfast, you couldn’t send enough. A couple thousand packets should do.

We could use tablet computers to help doctors do their charts. A decent high speed scanner would be awesome for scanning in charts. We need a badge maker, we need to track patients, if we could get the barcode arm band things that would be a miracle.

Need more blankets, need more tents, need more sleeping mats and sleeping bags.
We could really, really use more mosquito nets. People are actually getting malaria around me, I am so glad I am on the malaria prevention pill.

Something that would be incredibly useful for the supply room and OR are NSF shelves, the big metal shelves you can buy at Costco for around 70 dollars.

We need a scale, a rectal thermometer, infinite fans, otoscope speculums, LFT (liver function test), troponin, B-natriuretic peptide. We need a DENGE test.

I got to sleep last night really late, I walked the grounds with Dave, head of logistics and a pastor handing out blankets and just helping anyone who looked like they needed it -- a family member of a patient sleeping on a bench outside a medical tent. We went and got blankets and water and tucked them in.

I met with Sam, head of IT here. He is 150% awesome. This guy lives excellence. We ran around looking for the best place to put the Medweb server. We chose the main ops tent, which is air conditioned and has good network infrastructure. We ran cat6 cable around the tent to their switch and put the Medweb out of the way on the floor. I installed it and setup a UPS for the Medweb and them to use.

I booted up the Medweb servers and logged in and checked the raids and everything is fine. So the Medweb is up, on their LAN.

I walked around with Sam and his coworker Eric who helped me run cat cable to the Medweb, analyzing their modalities and discussing how we are going to get them networked. Currently they are not networked.

They have an X-ray machine in the pediatric tent, it clearly has an Ethernet port and a super easy interface, I am confident it will be sending to the Medweb server in a couple of hours.

I got to walk into the OR while they were operating. I focused on the C-arm, they have two; one is turned on and plugged in. It has a dual monitor viewing station built on. I saw no Ethernet port, no way to network it. It did have a support contact number and serial number and all that good stuff, so I am merely going to call support, explain the situation and then hope they can assist me in getting this machine networked.

Then I walked over to their ultrasound, it looks like an awesome ultrasound, it has multiple different kinds of US devices, ones for gastro, ones for abdomen, ones I don’t even recognize. I also could not find a network port on that device, bit it also had the support number for the ultrasound and I will call them and ask them how to network it.

We are about to network the X-ray machine, it should be easy it is the closest machine to the Medweb server. It is in another tent, we may put another switch in there.

The c-arm and Ultrasound are on the other side of camp. They will be the biggest challenge. In my opinion, those devices are not as important to get hooked up with the Medweb because they are for more immediate need. I.E. they are literally in the O.R. they are used in a quick fashion like, for instance, if a patient is on the table, and they need a quick scan, they wheel over the C-arm and look inside the patient and then instantly make a diagnosis, rather than the X-ray which will have the studies sent.

I just got approached by a doctor asking to help make the X-ray machine itself work. I ran over there, having never inserted a cartridge before, I copied the support info, and then rebooted the WinXP side of the machine, no dice.

I called support. He told me to reboot the scanner part of the machine and that I needed a physical key to switch it, I ran and got the key and used it to reset the scanner device. It took forever to warm up and then it began working seamlessly.

There was literally a little girl on a table just waiting to be scanned. It’s hard to describe the feeling I got when everyone was relieved that the machine was scanning plates again and they could continue. That moment alone made this whole trip worth it for me. At the doctors’ request I called back the support guy and requested documentation, he emailed it to me and I am getting it printed out now. He also gave me verbal directions on configuring the X-ray to send to the Medweb. X-ray is up and sending, everything that gets accepted by the X-ray machine automatically sends to the Medweb server, the Medweb totally received it and it all works great. We are pumped! Everyone is shaking my hand. So awesome.

In the meantime I fixed a regular old printer for a nurse here. No big deal. They are keeping me busy and I love it. It’s great seeing people work together. The volunteers here just instantly work together on any problem until it’s fixed.

We need viewing stations. Send us the cheapest dell laptops with the widest screens. So, weak processors, minimal hard disk space and wide screens would be 100% awesome.

-- Jeffery Henry, Medweb