Pilot program using the "Genie"or TCx-I

[funnygarcia]

My dh's center (Davita) is participating in a pilot study using the Genie (TCx-I) to do auto charting (possibly remote monitoring).

This is the device attached to the re-formatted jewel box
http://www.blhealthcare.com/TCx-I_dedicated%20system_solution.html

It has a series of screens to input info that is normally on a flow sheet. Some must be manually entered.. sak lot, cartridge lot, your temp.  Others are automatic via its own devices.. weight (scale), blood pressure machine. Routine patient info like dialysis orders, dry weight, cycler number etc are already in the memory.

Various screens have prompts to remind the user of actions.. weight, prepare access, start treatment...

It prompts for each half hour check, records blood pressure and all of the other info like volume, pressures, etc.

It has options to record saline, missed treatment due to.. , terminated early due to.... It will give prompts to call the nurse if you answer the pre treatment question for example yes if you have shortness of breath, or hospitalized.. etc..

At end of treatment, we hit send and the information is sent via email to our center. It has it's own cellular service like a smart phone.

As part of training today, we are entering information manually. We are also still doing paper flow sheets as part of the study. Tomorrow we will set the Genie to record automatically. We will continue to need the paper flow sheets until end of the study, two months.

Anyone else using the Genie?

I'm thinking it's a tool for Davita to jump to nocturnal in the future. 

[Trikkechickk]

I'm doing the same thing - as of yesterday.  Now I'm on my own.

I call it the Privacy Invader - Hippa Hippa Hooray!

[Trikkechickk]

Funny G

I'm from Minnetonka and go the the Mpls Davita Home Hemo....

[funnygarcia]

I'm doing the same thing - as of yesterday.  Now I'm on my own.

I call it the Privacy Invader - Hippa Hippa Hooray!

 

I like your way of thinking!

[funnygarcia]

Pictures in use....

[funnygarcia]

More...

[funnygarcia]

A few issues that I hope they correct

It needs to sit somewhere for the user to reach.
It's too big to sit on the pureflow cabinet, too bulky for the lap.
Smaller and thinner would be ideal, IPad size?

I would like to change the order of the prompts for some things .. why not enter SAK and Cart numbers before you do weight, sit/stand blood pressure, temp.

It does not give an audible signal when half hour checks are due, it blinks red in the "Time since treatment started" window.

It only has set options of 0, 10, 20, 30.. etc.. for post bleeding time. It would make more sense to have a manual entry. (Typically 3 minutes for dh).

However, I would like a selection of how many thousands of units used for heparin, too few taps of the zero or too many taps , frustration city!

Why did they not put a film cover on the screen? (Like the type used on I Touch or PDA/Smart phone)  I can see my smudgy finger prints with just one use. I'm thinking, tap screen with gloves on and maybe blood squish on it.. yum yum!

My teenagers looked at and said "Oh, it's an I-Davita, how can we jail break it and to add some games? " 

 

[M3Riddler]

funnygarcia,

Who actually monitors this device and info? Is it hooked to the internet and relay the info over anywhere or is it just being saved to a server somewhere.

I know if there was an alarm, and if there was actually someone monitoring the data in real time and they called because of the alarm, i really dont think i would be taking time to answer a phone for someone to tell me i have an alarm, but rather trying to resolve the alarm.

///M3R

[funnygarcia]

It has its own cellular service.
Reading from the designers website, it relays the info to a secured server.
Our center staff use a web interface to see the information.

At this point there is no direct/live remote monitoring.
No one gets the info until we hit "send".

I wouldn't be surprised if that changed in the future, it could be a way for DaVita to agree to "extended" NX Stage treatments. We're told "it's coming", same line they told us two years ago. 

I informed the neph and the nurse that other centers are already offering it, they didn't believe me. 

I thought that was amusing, Why would I lie??   

[funnygarcia]

Okay, someone please toss this piece of plastic junk out the window.

The nurse called to double check cycler number as it was not communicating on her end. Do they not look at the faxed flow sheets, we had a swap out months ago ??  She was here just after the swap out to have the software installed on the jewel box.

Now the Genie won't communicate with the jewel box, but still marks as "sent".

No way were we going to go back and edit each interval manually.
"Not our problem" as dh said.
Hmm, good point. 

[M3Riddler]

It has its own cellular service.
Reading from the designers website, it relays the info to a secured server.
Our center staff use a web interface to see the information.

At this point there is no direct/live remote monitoring.
No one gets the info until we hit "send".

I wouldn't be surprised if that changed in the future, it could be a way for DaVita to agree to "extended" NX Stage treatments. We're told "it's coming", same line they told us two years ago. 

I informed the neph and the nurse that other centers are already offering it, they didn't believe me. 

I thought that was amusing, Why would I lie??   

Funnygarcia,

If your neph does not believe that anyone is using NxStage for Nocturnal Use, Just have them go to the NxStageUsers Forum and can see for themselves those posting their questions about it. It is written off label, but yes, it is being done more and more.
Im sure that as soon as NxStage has the FDA approval, you will see Nocturnal starting up. Just a matter of time...

///M3R

[tyefly]

 I have never heard of this genie ......but it is interesting.....  will be hard to use with the new warmer plate which is on top of the machine now.....
   I am working on nocturnal as well.... I have my Doctors approval.....and we are working with the clinic  admin now .....  between my doctor and I we have been giving our clinic alot of information.....   we are very close to completion...... and  I will be the first in the area to start nocturnal..... the clinic is very new to Nxstage  and they  did believe anyone was doing nocturnal until I show them what they were doing up in Seattle.....  the Nxstage formus.....Bill Peckhams web page and all the good videos...... 

    it will come..... just takes some time and some politics......