Children's Hospital helps researchers improve their efficiency by

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					Children's Hospital

Children's Hospital helps researchers improve
their efficiency by reducing paperwork,
introducing Windows CE-based Handheld PCs
Published: August 27, 2002




Solution Overview
Company                                                     Software and Services
Children's Hospital                                           Microsoft Handheld PC
                                                              Microsoft SQL Server 7.0
Customer Profile                                              Microsoft Windows CE
Children’s Hospital in Richmond, Virginia, is a pediatric     Microsoft Windows CE Toolkit for Visual Basic 6.0
facility that focuses on rehabilitation, orthopedics,
neurosciences and child development.                        Vertical Industries
                                                            Healthcare and Healthcare Insurance
Business Situation
The hospital’s Motion Analysis Laboratory performs          Country/Region
critical research in areas related to neuromuscular         United States
diseases, but researchers were bogged down by reams
of paperwork necessary to conduct studies.

Solution Description
An IT specialist at the hospital created a Microsoft®
Windows® CE-based application that has eliminated
most of the paper forms involved in clinical studies,
which in turn has increased the efficiency of researchers
while reducing data errors.

Benefits
   Much greater efficiency for researchers, who now only
have to enter data once.
   Windows CE-based forms are created to ensure that
all data is entered during patient visits, eliminating
instances of missing data that can hold up completion of
studies.




Delving into the mysteries of neurological diseases is a time-consuming and long-term process, one in which
researchers and physicians need to focus as much energy as possible on the illness while eliminating
external distractions. At the Motion Analysis Laboratory at Children's Hospital in Richmond, Virginia,
researchers can do their jobs more efficiently because of a new tool that is making their data collection much
more efficient.

The new development, which is attracting attention in the wider medical community, involves use of
Handheld PCs running the Microsoft® Windows® CE operating system in studies of childhood muscular
diseases. This application of portable computing technology dramatically simplifies procedures by
automating most data collection and reporting that were previously accomplished only with piles of
paperwork. A single Children’s Hospital IT staff member without any external development help created the
application. And yet it is drawing the attention of doctors and researchers throughout North America,
because its simple elegance promises to increase the speed of analysis, while helping researchers focus
more of their efforts on the medical tasks at hand.

Studying Patients in Motion

The application developed by George Masiello, the Motion Lab’s technical director, resulted from advances
in computer technology that coincided with a pressing need for better data collection procedures.

The hospital’s Motion Analysis Laboratory, which was launched in 1988, combines state-of-the-art
equipment, software, and a professional staff to provide precise measurement and descriptions of
movement in studying patients who suffer from muscle-related illnesses and conditions. A patient's gait
pattern can be documented using points of light attached to the body, camera equipment, and computers to
provide valuable information for diagnosis and patient treatments.

Masiello was responsible for one of the lab’s first big breakthroughs in computer technology, when several
years ago he created Windows-based software that drastically cut the time to enter, retrieve, and
understand data collected during motion studies. The software was part of a larger trend in which the lab
started moving away from mini-computers to Windows-based PCs.

Then in late 1997, the lab became involved in a grant to perform studies on spinal muscular atrophy, or
SMA, a group of inherited neuromuscular diseases that cause disintegration of the nerve cells in the brain
and spinal cord that control voluntary muscles. The grant and related activities opened up opportunities for
developing more and more sophisticated Windows-based applications that could be used for multiple
purposes.




“I bought a set of ActiveX® data objects for
use with the Microsoft Visual Basic®                  We were able to easily overcome
development system, and wrote a Windows-              physician hesitation about using new
based software package. The resulting                 computer technology because the
software allowed us to collect real-time              Windows-based interface is so intuitive
quantitative data that we could feed into a           and easy to use. It really simplifies their
Windows-based database,” Masiello says.               tasks. The physicians who use it are now
“The researchers really loved it. But it              going entirely paperless.
highlighted the fact that for every patient, we
would have to fill out about 12 forms, each
with multiple sheets of paper. Data was               George Masiello
entered and collated by hand, which was               Technical Director - Motion Analysis
slow and sometimes created errors. We                 Laboratory, Children's Hospital
started thinking that there had to be a better
way.”

Building on Windows CE and the Clio

In late 1998, Masiello and his colleagues were exploring the possible use of laptops to combine Windows
functionality with easy portability when they saw an advertisement for the Vadem Clio, a Windows CE-based
Handheld PC with a “SwingTop” screen that can be used as both a tablet for entering information via a
stylus, or with a keyboard. Masiello says the combination of the relatively large Clio screen and other
Windows CE functionality -- including instant on, long battery life, and easy portability -- offered a great
platform for researchers working in the lab.

“It was easy for me to get up and running on developing for Windows CE because I was familiar with Visual
Basic,” Masiello says. Using the Windows CE Toolkit for Visual Basic, Masiello quickly created some
prototype electronic versions of the forms used in the lab. Proving that they would work, he expanded the
job to include most of the forms used by the lab.
The Windows CE devices contain all the basic information that physicians and researchers collect on the
paper forms. They include question-and-answer check boxes, and areas for entering patient statistics, such
as age, height, weight, and blood pressure. At the bottom of each screen are two buttons, “Finish Later” and
“Continue.”

“We designed it so the only way to save information is to finish the form that they are working on,” Masiello
says. He explains that the software forces users to complete information that, under the old paper-based
system, might have been overlooked -- thus hampering successful completion of a study. Using a
straightforward logic path, the forms walk users through necessary fields until all relevant information is
entered, and even offers pop-up question forms so researchers can double-check information has been
entered and is accurate.

“With paper forms,” Masiello adds, “there is no logical path unless a nurse yells that you left out the birth
date.”

Using ActiveX data objects (ADO) for Windows CE, information is collected in a database on Pocket Access,
one of the “Pocket” applications included with the Windows CE operating system. In between patient visits
or at the end of the day, the data is then transferred via Microsoft ActiveSync® technology to either a laptop
or desktop. From there, the information is sent to a Microsoft Access database, which the hospital plans to
upgrade in 2000 to Microsoft SQL Server™ 7.0.

Positive Reception from Doctors

Although the initial deployment at Masiello’s organization was small, involving only about half-a-dozen units,
there is a lot of potential for the solution to take off. The Clio devices, equipped with variations of Masiello’s
application, will be used in clinical studies of Duchenne muscular dystrophy, a genetic childhood disease
that forces most sufferers -- almost exclusively boys -- into a wheelchair by the time they are teenagers. The
application also got a big reception when presented at a recent meeting of the American Academy of
Neurology in Toronto.

“All the physicians loved it,” Masiello says. “We were able to easily overcome physician hesitation about
using new computer technology because the Windows-based interface is so intuitive and easy to use. It
really simplifies their tasks. The physicians who use it are now going entirely paperless.”

For More Information

To learn more about Microsoft products or services, call the Microsoft Sales Information Center at (800) 426-
9400. In Canada, call the Microsoft Canada Information Centre at (800) 563-9048. Outside the 50 United
States and Canada, please contact your local Microsoft subsidiary. More information via the World Wide
Web is available at the following Web sites:

    •    Microsoft Corporation http://www.microsoft.com
    •    Children's Hospital/Motion Analysis Laboratory http://www.childrenshosp-richmond.org/gaitlab/

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THIS SUMMARY. Companies, names, and/or data used in screens and sample output are fictitious, unless otherwise
noted.


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