Towards a cyber-medical model for device configuration safety in acute care

The safety and efficacy of acute patient care depends on continuously proper use of medical monitoring and therapeutic devices. The device configuration safety depends on the rapidly changing patient condition. Therefore, the constraints to be enforced must be adapted dynamically. In this paper, we model the patient condition as communicating organ state machines, and the change of patient condition is modeled as the transition between organ states. The states are represented based on a pathophysiological model, which captures the changes in organ states as a results of one or more diseases. Applying the proposed patient state representation, we have a different set of device configuration requirements for each state. We introduce a new process for runtime validation of monitoring/ therapeutic configuration safety requirements using the proposed communicating organ state machines. We illustrate the usefulness of the proposed approach using a cardiac arrest scenario.