1. E-ARMOR: An Online Tool to Evaluate Polypharmacy in Elderly Persons
04/26/10
E-ARMOR: An Online Tool to Evaluate Polypharmacy in Elderly Persons
E-ARMOR Group
Jacob Brown – Domain Expert
Jordan Fish – Project Manager
Kajal Miyan – Facilitator
Yang Yang - Configuration Manager

2. 04/26/10
PART I: OVERVIEW

3. Project Overview Motivation for project System Goals
04/26/10
Project Overview
Motivation for project
Many prescriptions by many Doctors
No longer needed
Wrong dose
System Goals
Evaluate prescribed medications
Optimize prescribed medications

4. Overview of Features Given patient data… Limit system access Compute
04/26/10
Overview of Features
Given patient data…
Compute
Ideal Body Weight
Creatinine Clearance
Glomerular Filter Rate
Assess drug impact
Without storing data
Limit system access

5. Domain Research Polypharmacy tools Formulae ARMOR
04/26/10
Domain Research
Polypharmacy tools
ARMOR
Physician’s Desk Reference
Mosby Drug Reference
Formulae
Cockcroft-Gault
Devine formula 5

6. Risk Analysis Risks How to mitigate risks? Data protection
04/26/10
Risk Analysis
Risks
Data protection
Result integrality
How to mitigate risks?
Secure Web Server
HTTPS
Don’t store patient data

7. PART II: MODEL-BASED VIEW OF SYSTEM
04/26/10
PART II: MODEL-BASED VIEW OF SYSTEM 7

8. Description of Use Case Diagram
04/26/10
Description of Use Case Diagram
Generate Drug Report
User enters data
Vital Stats
Prescriptions
Basic Lab Panel
System
Computes stats of interest
Looks up drug data
Reports results to user

9. Description of Class Model
04/26/10
Description of Class Model
Single Access Point
Singleton
Proxy
General layout of class model
Why model is constructed this way
Identify the design patterns used for system (use color or other means to distinguish design patterns).
Explain the rationale for the design pattern use
Interpreter 9

10. Behavior Model: Sequence Diagrams
04/26/10
Behavior Model: Sequence Diagrams
Exceptional
Normal

11. 04/26/10
E-ARMOR State Diagram

12. DrugDataProxy State Diagram
04/26/10
DrugDataProxy State Diagram

13. Related Work START STOPP
04/26/10
Related Work
START
Set of rules used to determine omitted drugs in elderly patients
STOPP
Set of rules used to identify inappropriate drugs
Both tools are non-electronic like the ARMOR tool
screening tool to alert doctors to the right treatment 13

14. Lessons Learned Design principles Client-Server architecture
04/26/10
Lessons Learned
Design principles
Client-Server architecture
Inherent for web application
Central Control
Singleton proxy
Easy to maintain the medication information
Provide access control and uniform interfaces

15. Lessons Learned (cont.)‏
04/26/10
Lessons Learned (cont.)‏
In retrospect -
Clean requirements document
More efficient Customer interaction for procuring Domain Knowledge
Time management
Prototype can be a huge temptation

16. Lessons Learned (cont.)‏
04/26/10
Lessons Learned (cont.)‏
Future work
Communicate with EMRs
Smart phone application
Identify potentially redundant medications
Threshold values to immediately notify danger
Encrypted connection

17. PART III: DEMONSTRATION
04/26/10
PART III: DEMONSTRATION

18. 04/26/10
Prototype: Login
Provides Access controls

19. 04/26/10
Prototype: Main Page

20. 04/26/10
Prototype: Results

21. 04/26/10
Video demonstration
010/E-ARMOR/video/demo_natural.mp4
010/E-ARMOR/video/demo_natural.html

22. Live Demonstration Workflow
04/26/10
Live Demonstration
Workflow
Login
Enter data
View/print results
Logout
2010/E-ARMOR/web/

23. References
Barry, P. J., et al. "START (screening tool to alert doctors to the right treatment)—an evidence-based screening tool to detect prescribing omissions in elderly patients." Age and Ageing (2007):
Gallagher, Paul and Denis O'Mahony. "STOPP (Screening Tool of Older Persons’ potentially inappropriate Prescriptions): application to acutely ill elderly patients and comparison with Beers’ criteria." Age and Ageing (2008):
Haque, Raza. "ARMOR: A Tool to Evaluate Polypharmacy in Elderly Persons." Annals of Long-Term Care (2009): 2-6.