Wireless Capsule Wireless Capsule EndoscopyEndoscopy

Presented by: Chad J. Vick, RNPresented by: Chad J. Vick, RN

ObjectivesObjectives

1. Describe Wireless Capsule Endoscopy.2. Describe and evaluate the hardware and

software utilized with this trend.3. Describe and evaluate the information

system used with this trend.4. Assess the role and functions of the nurse

informaticist when working with this trend. 5. Examine related legal/ethical issues.6. Discuss the Advantages/Disadvantages from

nursing perspective.

Wireless Capsule Wireless Capsule EndoscopyEndoscopy

(Wikipedia, 2009)(Wikipedia, 2009)

Wireless Capsule Wireless Capsule EndoscopyEndoscopy

• Traditional endoscopy’s reach from Traditional endoscopy’s reach from the mouth – duodenum.the mouth – duodenum.

• Traditional colonoscopy’s only view Traditional colonoscopy’s only view the colon.the colon.

• Specialized for small bowel imaging.Specialized for small bowel imaging.• Important tool in detecting Crohn’s Important tool in detecting Crohn’s

disease, gastric ulcers, and colon disease, gastric ulcers, and colon cancer.cancer.

(Marks, 2008)(Marks, 2008)

Wireless Capsule Wireless Capsule EndoscopyEndoscopy

• Approved by the US FDA in 2001.Approved by the US FDA in 2001.• ““Pill sized” camera that is Pill sized” camera that is

swallowed and transmits imaging.swallowed and transmits imaging.• Used to diagnose diseases and Used to diagnose diseases and

disorders of the gastrointestinal disorders of the gastrointestinal tract.tract.

• Less invasive alternative to Less invasive alternative to traditional endoscope.traditional endoscope.

(Marks, 2008)(Marks, 2008)

Types of HardwareTypes of Hardware

• Given Imaging HardwareGiven Imaging Hardware• AGILE CapsuleAGILE Capsule• PillCam ESOPillCam ESO• PillCam SBPillCam SB• Data RecorderData Recorder

• OLYMPUS EndoCapsuleOLYMPUS EndoCapsule

(OLYMPUS KeyMed, 2009)(OLYMPUS KeyMed, 2009)

• The premier non-invasive diagnostic The premier non-invasive diagnostic tool for visualizing the entire small tool for visualizing the entire small bowelbowel

• >800,000 ingestions to date>800,000 ingestions to date• >900 peer-reviewed journal articles >900 peer-reviewed journal articles

publishedpublished• Produces 55,000+ images per study Produces 55,000+ images per study • 30- to 60-minute reading time per 30- to 60-minute reading time per

studystudy

(CapsuleEndoscopy.org, 2008)(CapsuleEndoscopy.org, 2008)

Types of SoftwareTypes of Software

• RAPID 5 Given Imaging SoftwareRAPID 5 Given Imaging Software• QuickviewQuickview• RAPID AtlasRAPID Atlas

• Olympus EndoMed Capsule SoftwareOlympus EndoMed Capsule Software• Dedicated Diagnostic SoftwareDedicated Diagnostic Software• Real Time ViewerReal Time Viewer

(OLYMPUS KeyMed, 2009)(OLYMPUS KeyMed, 2009)

RAPIDRAPID®® 5 Features 5 Features

QuickView v5Setting Selectable: High/Normal/Low

Image AdjustmentOne-click on/off

IA button

Lewis Score

Study Manager

A–Mode or M-mode

(when RAPID is M-mode enabled)

(CapsuleEndoscopy.org, 2008)

Software Usability Software Usability EvaluationEvaluation

• Axiom 1Axiom 1

• Axiom 2Axiom 2

• Axiom 3Axiom 3

Information SystemInformation System

• Endoscopic Electronic Medical Endoscopic Electronic Medical Record SystemsRecord Systems• Interfaces with hospital electronic Interfaces with hospital electronic

medical records.medical records.• Incorporates imaging, data Incorporates imaging, data

management, communication, and management, communication, and inventory.inventory.

• Ex. Endoworks 7.3, CORI, gCare, and Ex. Endoworks 7.3, CORI, gCare, and Provation.Provation.

(ASGE, 2008)(ASGE, 2008)

Endoscopic Electronic Endoscopic Electronic Medical Record Medical Record

SystemsSystems

• Administrative and Clinical Administrative and Clinical Information SystemInformation System

• Usage by multiple health care Usage by multiple health care professionals.professionals.

• Workstation MainframeWorkstation Mainframe• ICD-9 ICD-9

(ASGE, 2008)(ASGE, 2008)

AdvantagesAdvantages

• Painless & noninvasivePainless & noninvasive• Eliminates G.I. bleed riskEliminates G.I. bleed risk• Procedure requires no sedationProcedure requires no sedation• 3x length examined compared to 3x length examined compared to

ColonoscopyColonoscopy• More accurate than ColonoscopyMore accurate than Colonoscopy

(Johnson, 2008)(Johnson, 2008)

DisadvantagesDisadvantages

• Capsule can be hard to swallowCapsule can be hard to swallow• Unable to perform biopsyUnable to perform biopsy• Possible poor visualizationPossible poor visualization• Inability for precise locationInability for precise location• Capsule retentionCapsule retention

(Johnson, 2008)(Johnson, 2008)

Ethical & Legal IssuesEthical & Legal Issues

• Patient privacyPatient privacy• PricePrice

Informatics Informatics CompetenciesCompetencies

• Generalized training for software Generalized training for software useuse

• Yearly competencyYearly competency• Continuing educationContinuing education

Functions & Functions & ResponsibilitiesResponsibilities

• Patient privacyPatient privacy• Patient educationPatient education• User trainingUser training• UpdatesUpdates

SummarySummary

• Non traditional, less invasive than Non traditional, less invasive than colonoscopycolonoscopy

• Greater imaging with less patient Greater imaging with less patient restrictionsrestrictions

• Less side effectsLess side effects• Results easily accessible via e-chartResults easily accessible via e-chart• Better data management and Better data management and

trendingtrending

ReferencesReferences

• ASGE (2008).TECHNOLOGY STATUS ASGE (2008).TECHNOLOGY STATUS EVALUATION REPORT: Endoscopic electronic EVALUATION REPORT: Endoscopic electronic medical record systems . medical record systems . Gastrointestinal Gastrointestinal EndoscopyEndoscopy, , 6767, 590-94., 590-94.

• CapsuleEndoscopy.org, (2008, October). CapsuleEndoscopy.org, (2008, October). Physicians Resources. Retrieved June 22, Physicians Resources. Retrieved June 22, 2009, Web site: 2009, Web site: http://www.capsuleendoscopy.org/PhysicianRehttp://www.capsuleendoscopy.org/PhysicianResources/Pages/default.aspx sources/Pages/default.aspx

ReferencesReferences

• Given Imaging, (2009). Capsule Endoscopy Given Imaging, (2009). Capsule Endoscopy Hardware. Retrieved June 22, 2009, from Hardware. Retrieved June 22, 2009, from Given Imaging Web site: Given Imaging Web site: http://www.givenimaging.com/en-us/HealthCarhttp://www.givenimaging.com/en-us/HealthCareProfessionals/Products/Pages/Hardware.aspx eProfessionals/Products/Pages/Hardware.aspx

• Johnson, C. (2008). Clinical Role of Capsule Johnson, C. (2008). Clinical Role of Capsule Endoscopy. Retrieved August 5, 2009, from Endoscopy. Retrieved August 5, 2009, from Wireless Capsule Endoscopy Web site: Wireless Capsule Endoscopy Web site: http://biomed.brown.edu/Courses/BI108/BI108_http://biomed.brown.edu/Courses/BI108/BI108_2008_Groups/group11/clinical.html 2008_Groups/group11/clinical.html

ReferencesReferences

• Marks, J.W. (2008, February 02). Capsule Marks, J.W. (2008, February 02). Capsule Endoscopy (Wireless Capsule Endoscopy). Endoscopy (Wireless Capsule Endoscopy). Retrieved June 4, 2009, from MedicineNet.com Web Retrieved June 4, 2009, from MedicineNet.com Web site: site: http://www.medicinenet.com/capsule_endoscopy/arhttp://www.medicinenet.com/capsule_endoscopy/article.htmticle.htm

• OLYMPUS KeyMed, (2009). Capsule Endoscopy. OLYMPUS KeyMed, (2009). Capsule Endoscopy. Retrieved June 22, 2009, from OLYMPUS KeyMed Retrieved June 22, 2009, from OLYMPUS KeyMed Web site: Web site: http://www.keymed.co.uk/index.cfm/page/products.http://www.keymed.co.uk/index.cfm/page/products.index.cfm/cid/3269/navid/860/parentid/771index.cfm/cid/3269/navid/860/parentid/771

ReferencesReferences

• Wikipedia, (2009, June 3). Capsule Endoscopy. Wikipedia, (2009, June 3). Capsule Endoscopy. Retrieved June 4, 2009, from Wikipedia Web Retrieved June 4, 2009, from Wikipedia Web site: site: http://en.wikipedia.org/wiki/Wireless_capsule_ehttp://en.wikipedia.org/wiki/Wireless_capsule_endoscopyndoscopy