The Hospital Operating Room Network (HORNET) is a set of computer hardware and software now functioning to monitor patients in operating rooms and perform related administrative functions. In addition to monitoring, it has been used to obtain, analyze, and collate physiological, demographic, and administrative perioperative information. We describe here the monitoring component, PONI (for Pulse Oximeter, Non Invasive blood pressure monitor), organized as a system to alleviate proliferation of monitoring devices and false alarms coming from them. PONI has thus far been applied to relatively healthy patients undergoing day surgery (usually relatively minor procedures), and may require modification for major procedures in the main operating rooms which have been included in the network. We have accumulated and analyzed statistically a data base of hemodynamic behavior in such patients, e.g., pulse rate and blood oxygenation, where difficulties first become manifest. From this we have been able to derive prototype knowledge rules regarding the reliability and cross-interactions of the monitoring devices included in PONI.In order to meet patient needs, and to minimize the costs and the number of people involved, the Hospital of the University of Pennsylvania has set up the Hospital Operating Room Network (HORNET). Cnrrent information-handling needs of this system include scheduling, intraoperative monitoring of patients, preparation of repons, permanent storage of perioperative information, and research. Recent changes both within the operating room, such as an increase in instrumentation, and in its relations with the world outside. exemplified by demands for more information or documentation of procedures and tests by insurers and external review organizations. have led to an increase in the amount of information which must be handled. In consequence, there is a new. large, and specialized demand for information handling.A subset of HORNET is the monitoring component PONI (for Pulse Oximeter, Non Invasive blood pressure monitor), organized as a system to alleviate proliferation of monitoring devices and false alarms coming from them.Three types of automated physiologic monitoring devices are incorporated in the network. Pulse oximeters (model N-I 00 by NELLCOR Inc.) measure patient heart rate and oxygen saturation at 10 second intervals. Dinamaps (model 1846SX by Critikon Inc.) measure mean arterial, systolic and diastolic blood pressure (in mmHg), and pulse (beats per minute). The mass spectrometer (Perkin-Elmer Advantage) provides data on inspiratory gas, expiratory gas, alarm records, raw gas composition, respiratory mark record, and blood gas record.These devices are connected into the network through pons on the HORNET communications servers. These ports, dedicated to individual monitoring devices, are characterized by device dependent transmission parameters (baud rate, number of data bits and stop bits, flow control, and buffer size). The system coordinates the timing of the data-gathering operations from the...
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