Sandia Medical Devices (SMD) - Running Case study
Medical monitoring technology has advanced
significantly in the last decade. Monitoring that once required a visit to a health-care facility can now be performed by devices located in a patient's home, or carried or worn at all times. Examples include measures of glucose level (blood sugar), pulse, blood pressure, and electrocardiogram (EKG). Measurements can be transmitted via telephone, Internet connection, and wireless data transmission standards, such as Bluetooth. A particularly powerful technology combination is a wearable device that records data periodically or continuously and transmits it via Bluetooth to a cell phone app. The cell phone app can inform the patient of problems and can automatically transmit data and alerts to a central monitoring.
Health-care providers and patients incur significant costs when glucose levels are not maintained within acceptable tolerances. Short-term episodes of very high or very low glucose often result in expensive visits to urgent care clinics or hospitals. In addition, patients with frequent but less severe episodes of high or low glucose are more susceptible to such expensive, long-term complications as vision, circulatory, and kidney problems.
Sandia Medical Devices (SMD), an Albuquerque manufacturer of portable and wearable medical monitoring devices, has developed a glucose monitor embedded in a wristband. The device is powered by body heat and senses glucose levels from minute quantities of perspiration. SMD is developing the Real-Time Glucose Monitoring (RTGM) device in partnership with New Mexico Health Systems (NMHS), a comprehensive health delivery service with patients throughout New Mexico.
SMD will develop the initial prototype software for smartphones with Bluetooth capability running the Google Android operating system. If successful, NMHS and its patients will have free use of the software and SMD will resell the software to other health systems worldwide.
1. Sandia Medical Devices (SMD) and New Mexico Health Systems (NMHS) are developing the system jointly. Project staff will include analysts, designers, and programmers from both organizations. Three technical staff members from each organization have been assigned initially, and the budget includes sufficient funds to add other personnel for short-term assignments as needed. In addition, NMHS will assign a physician and a physician's assistant to the project one day per week.
2. It is anticipated that SMD personnel assigned to the project will work primarily at NMHS facilities in office space and with computer equipment dedicated to developing the RealTime Glucose Monitoring (RTGM) system.
3. NMHS anticipates recruiting a handful of its own diabetic employees to provide requirements and to test the prototype RTGM software.
4. SMD and NMHS anticipate a six-month development schedule for an initial version of the
server software and Android-based client-side software. That will be followed by a threemonth period for evaluation and another three-month period for development of
improved software versions and support for a wider range of mobile phone operating
5. The Real-Time Glucose Monitoring (RTGM) software on the client (patient) side apart from tracking glucose level and alerting physicians will have the following feature.
1.The ability for the patient to view alerts received on the phone and also respond back to the alerts received from the physicians.
2. Enables the patient to view historical data pertaining to glucose levels and alert sent and received by the patient along with annotations/ detailed description of glucose levels.
3. Provides a messaging platform for the patient to interact with the physician by sending and receiving messages with the ability of voice control to read out messages
As the project began, interviews with patients and physicians about potential RTGM capabilities and interaction modes identified several areas of concern that will need to be incorporated into the system requirements and design. The relevant patient concerns include:
• Viewing and interpreting data and trends. Patients want to be able to view more than their current glucose level. They would like to see glucose levels over various time periods, with a specific focus on time periods during which their glucose was within and outside of acceptable ranges. A graphical view of the data is preferred, although some patients also want to be able to see actual numbers.
• Entering additional data. Some patients want to be able to enter text notes or voice messages to supplement glucose level data. For example, patients who see a high glucose alert might record voice messages describing how they feel or what they had recently eaten. Some patients thought that sharing such information with their health-care providers might be valuable, but others only wanted such information for themselves. Physicians expressed these concerns:
• They do not want to be the "first line of response" to all alerts. They prefer that nurses or physician assistants be charged with that role and that physicians be notified only when frontline personnel determine that an emergency situation exists.
• They want to be able to monitor and view past patient data and trends in much the same way as described for patients.
• They want all their actions to be logged and for patient-specific responses to be stored as part of the patient's electronic medical record.
1. Develop a context diagram
2. Briefly describe some possible nonfunctional requirements for RTGM.
3. Identify all the Roles that will use RTGM.
4. Using the roles that you identified in question 5, develop a list of user stories.