The foetal heart monitor has become a staple of maternity wards everywhere. Doctors and nurses base crucial medical decisions about deliveries and surgical procedures upon its readings, despite the fact its output has been called difficult to interpret, and its design is not considered to be user friendly.
“That device has probably been one of the more controversial pieces of medical equipment ever built. It has a lot of inherent value in it but human beings have a hard time extracting it,” explained James Turner, vice-president of marketing and sales for LMS Medical Systems Ltd. in Montreal.
“In the medical/legal environment doctors practice in it was assumed to be a magic bullet, and quickly what happened is that whenever there was the slightest possibility of interpretations being fuzzy, physicians erred on the side of caution.”
That caution, continued Turner, took doctors down the path of performing an ever increasing number of caesarean sections, many of which were found to be unnecessary, and it was that trend that caused LMS founder and McGill University associate professor Dr. Emily Hamilton, to search for a better way of interpreting the monitors’ results.
The Computer Assisted Labour Monitoring (CALM) system she and her colleagues developed takes the ultrasound, time sequenced, waveform data captured by the foetal heart monitors, adds it to data collected from other medical devices, and in real-time, compares the results to algorithmic models her team developed. This is done in order to provide a more accurate, and easier to interpret picture of how the labour is truly progressing, how strong the baby’s health is, and whether or not surgical intervention is actually needed. The results are displayed on a touch-screen device complete with an easy to understand GUI.
Underpinning the entire system is an object-oriented database.
The G. Pierce Wood Memorial Hospital in Arcadia, Fla., is a 450 bed, civil state mental health facility. Run as part of Florida’s Department of Children and Families, the hospital is spread throughout 100 buildings on over 1,000 acres of land and all connected by a fibre network.
According to Glenn Palmiere, the hospital’s data processing manager, the facility was starting to encounter a few problems. For starters, the IT department had to support a very mobile staff.
“Our users work at different locations, and we could never guarantee they would be able to use the same interface. Sometimes they were working on a DOS terminal, then they could find themselves on a Windows 3.x machine or a 9.x machine.”
That type of diversity meant three separate training sessions had to be set up and three different interfaces had to be created whenever new modules or applications were developed.
Another problem the hospital encountered was the cost of hardware. Being funded by the government, Palmiere knew that had to stretch out the life of the PCs, which ruled out hardware upgrades every time software needed to be upgraded.
That meant when the IT department decided to upgrade its old Mumps-based applications, it wanted something that would be easy to develop, and it wanted something that was object-based.
“We knew the key to this all would be object-technology and to have a way we could utilize the Internet to deliver the solution to our users,” Palmiere said.
The hospital chose an object-oriented database as its new IT foundation.
In terms of IT trends, object-oriented database technology is always on the cusp of being the next great thing. “Next year will be the year of the OO database,” analysts are heard to shout. “Next year we will gain mainstream market acceptance,” cry the vendors. But “next year” never seems to come.
Now that’s not to say that nobody is using object-oriented databases, or nobody is selling them. LMS and Wood Memorial are just two organizations which are making use of OO offerings (Objectivity/DB from Objectivity Inc. and Cach