Web-based Collaborative Platform for Personalized Orthopaedic Applications
Diana POPESCU1, Cătălin ILIE2, Dan LĂPTOIU3, Anton HADAR1, Raluca BARBUR2
1 University POLITEHNICA of Bucharest,
313, Splaiul Independentei, 060032, Bucharest 6, Romania
2 OSF Global Services,
99, Bd. Dacia, 020053, Bucharest 2, Romania
3 Colentina Clinical Hospital,
19-21 Sos. Stefan cel Mare, 020125, Bucharest 2, Romania
Abstract: The modern requirements of personalized medicine, the need of interdisciplinary approaches in developing medical devices and also the necessity to enhance communication between doctors and engineers impose the development of new e-health applications which can support different medical specialities or respond to patient individual needs. This is the context which helped determine current research to focus on the development of an intelligent online platform dedicated to design and manufacturing of patient-specific guides for orthopaedic surgery. The platform supports surgeon-engineer collaboration and information sharing, offering online tools that allow inferring surgeon intents by using structured questionnaires adapted to the surgical intervention types and anatomical zones, and a collaborative 3D viewer for medical models and guides. Databases with medical and technical information, as well as with medical cases are implemented in the platform, being used for contextual information display and for information sharing and retrieval.
Keywords: web-based medical platform, collaborative design development, additive manufacturing, surgical guides.
CITE THIS PAPER AS:
Diana POPESCU, Cătălin ILIE, Dan LĂPTOIU, Anton HADAR, Raluca BARBUR, Web-based Collaborative Platform for Personalized Orthopaedic Applications, Studies in Informatics and Control, ISSN 1220-1766, vol. 25(4), pp. 517-526, 2016.
Bridging the communication gap between doctors and engineers, enhancing the knowledge exchange and collaboration for developing personalized medical products are important objectives for both medicine and engineering , ,  aiming at answering to the current growing demand of efficient and cost effective solutions for healthcare sector .
Personalized medicine means “providing the right treatment to the right patient at the right time” , one perspective of this approach being focused on designing, manufacturing and using customized instruments (such as surgical guides ) or implants  based on patient anatomical data.
In the same context, in the last couple of year, the number of e-health ICT systems and platforms increased significantly , all having the same general purposes: to improve the quality of care , to support medical decision , to enhance medical data visualization  or to remotely monitor patient health status .
Responding to these two trends: personalized medicine and e-health services, the research presented in this paper is focused on the development of a web-based platform for supporting the translation of orthopedic surgeons’ requirements into technical specifications for designing and manufacturing patient’ specific surgical guides (PSGs). Due to the fact these PSGs are customized to the patient anatomy they offer several important advantages: improvement of the accuracy of the surgical procedure, better orientation of the surgeon during intervention, decrease of the surgery time, risks of infections and costs.
PSGs match patient bones structures and are designed to contain geometrical features that materialize the pre-planned trajectory for a certain type of medical intervention (drilling, cutting). Their design (Figure 1) starts from patient Computer Tomography (CT) scanning data and involves: reconstructing the 3D model of the anatomical areas of interest and 3D modeling the surgical guide based on these areas, choosing the guide’ material and manufacturing process, building the physical prototype of the personalized guide (usually employing an Additive Manufacturing – AM process), sterilization and, finally, use in the operation room. Thus, PSGs’ design and manufacturing flow implies a tight surgeon-engineer cooperation and information sharing for correctly establishing the correspondence between medical requirements and design, material and manufacturing issues.
This collaboration is mandatory for all the process steps, the use of intelligent decision support systems representing the key for overcoming the miscommunication problems.
Hence the idea to develop a web-based platform (called POIGO) that provides, in a collaborative environment, the necessary knowledge and computer-aided tools for supporting the exchange of medical and technical information between surgeon and engineer.
- ALMADANI, B. et al., E-Ambulance: Real-Time Integration Platform for Heterogeneous Medical Telemetry System, Procedia Computer Science, vol. 63, 2015, pp. 400-407.
- ARORA, A., et al., Custom-Made Implant for Maxillofacial Defects Using Rapid Prototype Models, Journal of Oral Maxillo-facial Surgery, vol. 71(2), 2013, pp. e104-e110.
- CARTIAUX, O., et al., Improved Accuracy with 3D Planning and Patient-specific Instruments during Simulated Pelvic Bone Tumor Surgery, Annual Biomedical Engineering, vol. 42(1), 2014, pp. 205-13.
- ESF, Personalised Medicine for the European Citizen – Towards More Precise Medicine for the Diagnosis, Treatment and Prevention of Disease, http://www.esf.org/fileadmin/Public_documents/Publications/Personalised_Medicine.pdf 2011, accessed February 2016.
- GUPTA, V., et al., A Survey of Text Mining Techniques and Applications, Journal of Emerging Technologies in Web Intelligence, vol. 1(1), 2009, pp. 60-76.
- HISARCIKLILAR, O. et al., User-designer Collaboration in the Design Process of Surgical Instruments: New Aspects for Annotation as a Communication Tool, Conference ICED’09, Stanford University, 2009, 1-11.
- LOOI, , Interface between Engineering and Medicine, Chapter 1, Bio-engineering for Surgery, Critical Engineer Surgeon Interface, 2016, pp. 1-16.
- PAWAR, P., et al., A Framework for the Comparison of Mobile Patient Monitoring Systems, Journal of Biomedical Informatics, vol. 45(3), 2012, pp. 544-556.
- PAGLIARI, C., Design and Evaluation in ehealth: Challenges and Implications for an Interdisciplinary Field, Journal of Medical Internet Research. Vol. 9, iss. 2, 2007, pp. e15.
- POP, R. M., et al., A Web-based Nutritional Assessment Tool, Studies in Informatics and Control journal, vol. 22(3), 2013.
- POPESCU, D., et al. Workflow for Additive Manufacturing of an Individualized Surgical Template, Journal of Proceedings in Manufacturing Systems, ISSN 2067-9238, vol. 10(3), 2015, pp. 131-140.
- POPESCU, D., D. LĂPTOIU, Rapid Prototyping for Patient-specific Surgical Orthopedics Guides: A Systematic Literature Review, vol. 230, iss. 6, 2016, pp. 495-515.
- SHNEIDERMAN, B., et al, Improving Health and Healthcare with Interactive Visualization Methods, IEEE Computer, Special Issue on Challenges in Information Visualization, vol. 46(5), 2013, pp. 58-66.
- TIEMAN, J., S. L. BRADLEY, Systematic Review of the Types of Methods and Approaches Used to Assess the Effectiveness of Healthcare Information Websites, Australian Journal of Primary Health, vol. 19(4), 2013, pp. 319-324.
- TORBETT, R., Cost-Efficiency and the Road to Investment, European Alliance for Personalised Medicine, http://euapm.eu./pdf/EAPM_Cost_Efficiency_and_Road_to_Investment.pdf 2014, accessed February 2016.