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Analysis of Logs and Forensic Analysis

Key Points
We have:

  • Carried out studies of logs from hospital infusion pumps that have highlighted problems with the pumps’ designs.
  • The results have been used to alert hospitals to the issues so they can raise awareness of the problems amongst clinicians who use the pumps.
  • The studies have also suggested improvements to the way the data loggers work that would better support the investigation of safety incidents by providing stronger evidence of what happened.

Background
Data loggers record the history of a device’s use. For example they record all data entered, and when important device events occur, such as alarms being triggered. The information they store helps manufacturers diagnose problems, and identify shortcomings of the device and so helps them to improve its design.

Data loggers are not just useful to the manufacturer of a device, however. They are particularly important for safety critical medical devices such as infusion pumps because they provide data for investigators about what actually happened when an incident occurs. During forensic investigation of incidents, such as a drug overdose, data loggers can help investigators work out the exact sequence of events that led to the incident. This then allows a deeper understanding not just of what happened but why it happened. This can then lead to redesign of the device or the way it is used so that similar incidents do not occur again.

Achievements
We conducted two pilot studies that involved the analysis of logs of infusion pumps in use in hospitals across the UK. The first study involved the analysis of logs from 131 infusion pumps used for up to 2 years in one large acute hospital. It focused on alarms, and provided useful insights to device trainers and device managers about shortcomings and issues with the devices.

The second study involved the analysis of 19 devices from another large acute hospital. It focused on number entry errors, and provided insights to device manufacturers about improvements to medical device logs to support an evidence-based analysis of medical device safety. The results are also potentially useful for hospital procurement staff, suggesting what they should look for in the logging software when buying new pumps to help improve safety.

Publications
2014
Cauchi, A. (2014). Using analytical and empirical techniques for improving medical device number entry systems design. PhD thesis, Swansea University.

Oladimeji, P. (2014). Designing number entry user interfaces: a focus on interactive medical devices. PhD thesis, Swansea University.

2013
Monroy Aceves, C., Oladimeji, P., Thimbleby, H. & Lee, P. (2013). Are prescribed infusions running as intended? Quantitative analysis of log files from infusion pumps used in a large acute NHS hospital. British Journal of Nursing, 22(14): CareFusion supplement, 15–21.

Cauchi, A., Thimbleby, H., Oladimeji, P., & Harrison, M., (2013). Using medical device logs for improving medical device design. Proceedings of IEEE International Conference on Healthcare Informatics (ICHI 2013), 56–65.

2012
Lee, P. T., Thompson, F., & Thimbleby, H. (2012). Analysis of infusion pump error logs and their significance for health care. British Journal of Nursing (Intravenous Supplement), 21(8), S12-S20.

Lee, P., Monroy Aceves, C., Oladimeji, P., & Thimbleby, H. (2012). Are prescribed infusions running as intended? Poster presented at Third National Infusion and Vascular Access Society Conference, London, May 2012

2011
Masci, P., & Curzon, P. (2011). Checking user-centred design principles in distributed cognition models: A case study in the healthcare domain. Proceedings of the 7th Conference of the Workgroup Human-Computer Interaction and Usability Engineering of the Austrian Computer Society (USAB 2011), 95-108. Lecture Notes in Computer Science, vol. 7058. Springer.

Oladimeji, P., Li, Y., Cauchi, A., Eslambolchilar, P., Gimblett, A., Lee, P., & Thimbleby, H. (2011). Visualising medical device logs. Paper presented at the 1st BCS Health in Wales/ehi2 Joint Workshop, at the 4th International Conference on Internet Technologies and Applications (ITA'11), Wrexham, North Wales.

2010
Thimbleby, H. (2010). Think! Interactive systems need safety locks. Journal of Computing and Information Technology, 18, 349-360.

Thimbleby, H. (2010). Interactive systems need safety locks. Proceedings of 32nd International Conference on Information Technology Interfaces (ITI-2010), 29-36. IEEE Conference Publications.

Disclaimer
The information provided on this web page is for academic research purposes only. We make no claims as to the completeness or correctness of this information. We encourage academics and others to experiment with this work and report their results to this web page so that everyone involved may benefit from the work.