Category Archives: Health

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Health 200

Today we break down regulations, codes, standards and open-source literature governing the safety and sustainability of university-affiliated medical research and healthcare delivery facilities.   In large measure, the safety and sustainability agenda of the university-affiliated healthcare system infrastructure coincides with the private sector.   Accordingly, we confine our interest to systems — water, power, telecommunication and security; for example — that are unique to campus-configured, city-within-city risk aggregations.

We usually start with a scan of the following titles:

International Building Code (with particular interest in Section 308 Institutional Group I)

K-TAG Matrix for Healthcare Facilities

NFPA 70 National Electrical Code Article 517

NFPA 99 Healthcare Facilities Code

NFPA 101 Life Safety Code Chapters 18 & 19

ASHRAE 170 Ventilation of Healthcare Facilities

ASHRAE 189.3: Design, Construction and Operation of Sustainable High Performance Health Care Facilities

Some of the content in the foregoing links need weekly refresh.  We’ll get to that, time permitting.

Starting 2023 we break down our coverage of standards thus:

Health 200 Clinical delivery

Health 400 Research

We will thumb through the titles published by HL7 and NSF International — both Ann Arbor-based organizations.  A surprising number of medical data companies are domiciled in Ann Arbor; not far from our own offices on State Street.   We will also see if any bills and resolutions introduced into the 117th Congress will make into public law.

Finally, we collaborate with the IEEE E&H Committee on the following IEC committee projects from IEC/TC 62 Electrical equipment in medical practice.

– Common aspects of electrical equipment used in medical practice

– Diagnostic imaging equipment

– Equipment for radiotherapy, nuclear medicine and radiation dosimetry

– Electromedical equipment

 

As covered in previous posts, the original University of Michigan standards enterprise was one of the founding members of what has become ISO/TC 304 Healthcare organization management — following the lead set by Lee Webster at the University of Texas Medical Branch.  Since last month’s colloquium ISO TC/304 there has been a fair measure of the usual back-and-forth that we will cover in today’s colloquium.  We will examine the ideas in play in the links below today and try to organize them ahead of balloting:

ISO/TC 304 Catalog status

Legacy Workspace  (N.B. We are still in the process of uploading content onto the new University of Michigan Google Site facility)

Open to everyone.  Use the login credentials at the upper right of our home page.


Standing Agenda / Healthcare Facilities Monthly

More

Journal of Healthcare Management Standards: Operational Resilience of Hospital Power Systems in the Digital Age

Health Insurance Portability and Accountability Act (HIPAA)

Health care cost as percentage of Gross Domestic Product for six representative nations.

Association of Academic Health Centers

International Conference on Harmonization: The ICH guidelines provide guidance on the development of pharmaceuticals and related substances, including clinical trials, drug safety, and efficacy.

Animal Welfare Act and the Institutional Animal Care and Use Committee

Good Laboratory Practice: GLP is a set of principles that ensure the quality and integrity of non-clinical laboratory studies. It ensures that data generated from non-clinical laboratory studies are reliable, valid, and accurate.

International Code Council Representation of Interests

Gallery: University-Affiliated Healthcare Enterprises

There are few differences between university-affiliated hospitals and for-profit hospitals.  We approach university hospitals as scaled down “study units”.

National Library of Medicine: The “schola medica salernitana”: the forerunner of the modern university medical schools

 

 

Healthcare Occupancies

Healthcare Facilities Code

Wiring Fire Prevention in Hospitals

Fondazione Policlinico Universitario Agostino Gemelli / Rome, Italy

Localized fire ignition hazard in branch circuits, cords and connected equipment

Electrical Engineering Department, Sapienza Università di Roma
Italian National Fire Department

Abstract.  In electrical power systems, the fire ignition can be originated by incident energy of faults. Faults involve overheating, arcing and burning for all the wiring exposed to mechanical damage and other insulation stresses especially wiring connected by flexible cords and cables. The mechanical damage of the stranded bare conductors can degrade the effective sizing of the total cross section, causing anomalous conditions of local overcurrent. To highlight the local incident energy in case of fault, the parameters steady current and transient current densities can assist in analyzing the event. The conductors size reduction, degrading locally the thermal withstand capability, makes ineffective the protection coordination amplifying the anomalous effect of current no detectable adequately by overcurrent protective devices. The faulted cords remain so energized and present electric shock and fire hazards. Generally and especially in strategic buildings as hospitals, preventing ignition is better than promptly extinguishing. An efficient protection can be achieved by integration of active and passive techniques : by adoption of the special device Arc-fault Circuit Interrupter (AFCI) that recognize the arcing; by wiring the circuits, particularly extension cords, with Ground-Fault-Forced Cables, GFFCs, that convert faults into ground faults easily protected by ground fault protective devices (GFPDs).

Fondazione Policlinico Universitario Agostino Gemelli / Rome, Italy

 

 

Artificial Intelligence in Health Care: Trustworthiness

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Non-Contact Heart Rate Monitoring in Neonatal Intensive Care Unit using RGB Camera

Non-Contact Heart Rate Monitoring in Neonatal Intensive Care Unit using RGB Camera

Quiong Chen, et. al

Center for Intelligent Medical Electronics, School of Information Science and Technology, Fudan University, Shanghai, China

Abstract:  Heart rate (HR) measurement is crucial for newborn infant monitoring in the neonatal intensive care unit (NICU). The widely used contact HR measurement methods based on electrocardiography (ECG) and photoplethysmography (PPG) signals can lead to discomfort and possible skin irritation on neonates, which limit its application in NICU scenarios. In this work, we propose a non-contact HR monitoring method simply using a RGB camera. Eulerian video magnification (EVM) is employed to detect the subtle changes of neonatal faces results from blood circulation. The magnified signal is then transformed to the spectral domain to extract HR information. Compared with the widely investigated independent component analysis (ICA)-based HR measurement method using video recordings, the proposed method can achieve the real time HR measurement, which is a significant superiority in NICU neonatal monitoring. To the best of our knowledge, this is the first study to employ EVM algorithm in real time neonatal HR monitoring.

 

Dentisterie

Dental health enterprises present technical challenges for teaching, research  and clinical delivery.  Today we examine the literature that informs the safety and sustainability of the facilities that support this domain; necessarily cross cutting with related healthcare facility literature.

American Dental Association

American Waterworks Association

Centers for Medicare & Medicaid Services

International Code Council

2021 International Building Code Chapter 3 Occupancy Classification and Use

Related:

Specific Requirements for Dental Facilities

Dental Clinic Manual

Dental Office Design and Construction

 

Smart Medical Campus Power

University of California Berkeley

One of the standing items on our advocacy agenda for the better part of 10 years has been to promote formal reliability studies and impedance grounding methods to increase the reliability of large customer-owned power grids that are common in the education industry.   These approaches are already applied in data centers and mission critical facilities; we simply suggest scaling them upward onto medium voltage campus power grids — starting with university-affiliated medical campus power grids.   In California, for example, there are fire safety benefits to impedance grounding since California has significant seismic risks.   Impedance grounding can limit damages to campus buildings in disaster and it can hasten the return to the normal power distribution operation.   Formal reliability studies offer insight into the performance of for the utility interactive power systems common on university-affiliated medical campuses.

More details are  described in the video recordings below.

Formal reliability approaches

Impedance grounding

Issue: [11-25]

Category: Electrical, #SmartCampus, Facility Asset Management

Colleagues: Mike Anthony, Robert G. Arno, Neal Dowling, Jim Harvey, Kane Howard, Jerry Jimenez, Jim Murphy,

LEARN MORE:

IEEE PC62.92.5: Guide for the Application of Neutral Grounding in Electrical Utility Systems, Part V-Transmission Systems and Subtransmission Systems.  The scope of this document is to give the basic factors and general considerations in selecting the class and means of neutral grounding for a particular ac transmission or subtransmission system, and the suggested method and apparatus to be used to achieve the desired grounding. Definitions of grounding terms used in this part of the guide can be found in IEEE Std C62.92.1(TM)-2017.

IEEE SA PC62.92.5


Posted August 1, 2018

For the past several revision cycles of the NFPA 70 suite* of electrical consensus documents we have been advocating stronger language in National Electrical Code Article 250 (NFPA 70) for other-than-solid grounding methods for large campus power distribution systems.    These resistance system grounding methods face stiff “technical-cultural” headwinds from the electrical design and enforcement community that are most comfortable with solid system grounding methods.  Safety and reliability design approaches based upon subtleties in resistance grounding regimes are applied routinely in data centers.  They are easily conveyed onto 5 to 500 MVA campus power systems at moderate cost.

In the video presentation to the IEEE Education & Healthcare Facilities Committee we find that the University of California Berkeley has had a resistance grounded system in place for decades — a system that has dramatically reduced fault energy to which electricians are exposed and provides a signature for instrumentation to provide early warning of a condition that would lead to a forced power outage.  Forced power outages on many college and university campuses can cost millions of dollars per minute.

Click on image

NEC Code Panel 5 received public input for the 2020 National Electrical Code revision.  Of particular interest is the public input on Section II System Grounding.   The public input and the results of the balloting are available by clicking here.   The National Fire Protection Association Electrical Division is now in the process of preparing the results for public comment on July 6th.

Comments are due August 30th.

We hope to continue our enlightenment of education facility managers about the possibility of safer and more reliable campus power systems as the emergent #SmartCampus accelerates.   While there is already competition among trade associations and the event industry for ownership of the #SmartCampus space we think we have the authoritative voice.  We collaborate closely with the IEEE Industrial Applications Society that is developing a recommended practice for smarter campus power systems (see ANSI/IEEE Recommended Practice for the System Grounding of Industrial and Commercial Power Systems 3003.1).

All NFPA consensus documents are on the standing agenda of our weekly Open Door teleconference every Wednesday, 11 AM Eastern Time.  Click here to log in.   This topic and others will also be on the agenda of the September 11th online meeting of the IEEE Education & Healthcare Facilities Committee; also open to the public.   Click here to log in.

Issue: [11-25]

Category: Electrical, #SmartCampus, Facility Asset Management

Colleagues: Mike Anthony, Jim Harvey, Kane Howard, Jerry Jimenez, Jim Murphy, Richard Robben

* By NFPA 70 suite we mean the following:

NFPA 70 National Electrical Code

NFPA 70A National Electrical Code Requirements for One- and Two-Family Dwellings

NFPA 70B Recommended Practice for Electrical Equipment Maintenance

NFPA 70E Standard for Electrical Safety in the Workplace

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