How Can Couchbase Lite and Sync Gateway help if you’re hurt, and stranded on a remote mountain top?

I hope you were able to attend ConnectONLINE, our recent developer conference that featured a ton of great Couchbase product information, live demos and use cases. One of the sessions was a Healthcare panel discussion on edge computing with some of our customers. Panelists included Daniele Angeli – Founder and CEO of Molo17, Lori Most – Founder and CEO of Binary Bridge (BackpackEMR), and Gregory St Clair – Software Architect at Arthrex. Rounding out the panel was Couchbase’s very own Priya Rajgopal, Director of Product Management, Mobile & Edge Computing. The discussion was fun and fascinating as it explored how these customers are leveraging Couchbase to power innovative solutions at the edge that improve patient care and outcomes.

While all three use cases are different, they are all perfect examples of the power of Edge Computing, a strategic architecture for deploying applications that require ultra-low latency, stringent data privacy and 100% availability, even in the absence of internet connectivity.

All three companies rely on the Couchbase Mobile and Edge Computing stack to power their applications. If you’re new to the Couchbase offering here’s a quick rundown: Couchbase Lite is the embeddable version of Couchbase that’s integrated directly to mobile apps and devices. Couchbase Lite can synchronize data with other Couchbase Lite instances via Peer-to-Peer sync. Then there’s Sync Gateway that provides bi-directional synchronization between Couchbase Lite instances and Couchbase Server running in edge data centers and cloud data centers. This stack enables a distributed edge computing architecture that provides guarantees of ultra-low latency, data privacy and 100% uptime for healthcare applications.

To propel the discussion, we decided to pose a hypothetical healthcare scenario, and see how each of the solutions might be applied in the patient care journey. The scenario that we illustrated was that of an unfortunate hiker, deep in the Andes, who suffered 2 broken legs in a fall. 

Rescue from the mountain top

When talking about the Molo17 solution, Daniele explained that their product Zulu.E was an advanced platform for emergency medical services, providing communication between first responders in remote areas and hospitals and clinics in order to accelerate preparation for care.

Since the solution is focused on first response, we explored how Zulu.E would help in rescuing the hiker from the remote mountaintop.

Daniele described how medevac crews would use the Zulu.E rugged tablet device to securely capture all vital sign data from monitors and devices in the ambulance for the triage phase, which is then sent to the receiving hospital or clinic to allow them to properly prepare for care of the incoming patient. The key is that the data is captured and consolidated even in areas where internet does not exist, such as on a remote mountain in the Andes, then streamed to receiving facilities when the Internet is available. There is no reliance on the cloud for capturing the data, which means the application works regardless of connectivity.

Priya added that the Zulu.E ruggedized Android tablets run embedded Couchbase Lite, which allows them to capture and store the data locally. Then when there is connectivity, data is securely synced from Couchbase Lite to backend Couchbase Servers through Sync Gateway, with the data sync protocol providing built-in resiliency to network disruptions. She described the solution as being a classic example of an “offline first” application.

While the concept of better care through early awareness is simple, it’s impact is huge. Every second saved in diagnosing and treating a patient increases the likelihood of a positive outcome, our hiker’s prognosis for full recovery is great so far thanks to Zulu.E!

Stabilized in a remote village

Lori explained that BackpackEMR is used in the field for mobile, pop-up clinics in remote areas, providing diagnosis and treatment in rural villages and towns that lack healthcare facilities. As such it made sense to make the next stop on our patient journey a pop-up clinic in a mountain village.

Lori discussed how BackpackEMR could have easily been the recipient of the Zulu.E data to prepare for treatment, but more importantly she described how in many cases the entire clinic is offline with no connection to the internet. Even so, clinicians and staff are able to collaborate through the BackpackEMR application, syncing our patient’s data with every other device in the facility as they made their way from registration to vitals to the exam room, the lab, the pharmacy and ultimately to discharge. Data synchronization ensures quick and efficient data capture with no data loss throughout the entire clinic.

Priya noted that BackpackEMR uses Couchbase Lite embedded to the application running on iPad tablets, and uses the Peer-to-Peer sync feature to directly sync data between Couchbase Lite clients without the need for a centralized cloud based remote control point. She made the point that BackpackEMR is a perfect illustration of apps that facilitate collaboration in disconnected environments. 

Leveraging Couchbase, BackpackEMR is able to provide all the aspects of a modern hospital without Internet connectivity, and it’s greatly improving the level of care and patient outcomes in underserved areas.

Thanks to Zulu.E and BackpackEMR, our hiker is off the mountain and stabilized, now they’re headed to their home hospital for surgery.

Surgery and Onward to Recovery

Arthrex is a global leader in Orthopedics, providing interconnected surgical devices for hospital operating rooms such as endoscopic cameras, pumps, ablation devices and insufflators – devices that surgeons use for bone and ligament surgery and reconstruction. They also provide a suite of applications that connect to the devices and other systems for integration.

Greg explained how Arthrex helps with our hiker’s surgery once they’re admitted to the hospital and wheeled into the operating room. As an example, he described how an Arthrex endoscopic camera could be used in a minimally invasive way to examine the fractured bones through a small incision. The device runs a Linux-based app with Couchbase Lite embedded to store patient data, surgical data and media meta-data from captured images and videos. The embedded data storage allows the device to run regardless of Internet connectivity and speed, eliminating latency and downtime for this critical surgical instrument.

He went on to describe how the data on the device is then securely synchronized with hospital EHR systems, as well as to the cloud for the Arthrex SurgeonVault application, which allows surgeons to quickly create post-operative reports for the patients ongoing care with data from the devices used in surgery.

Priya pointed out that Arthrex is an early adopter of C-API support, a new feature introduced in Couchbase Lite and Sync Gateway 3.0 Beta (currently available for download). She mentioned that the C-API opens a broad range of new use cases in the embedded platform space, such as with the Linux-based devices that Arthrex provides.

She also said that the Arthrex use case is a classic Edge Computing example, where smart medical hardware running Couchbase Lite powered applications can sync data in real time via Sync Gateway to Couchbase Server clusters in the hospital and in the cloud.

Watch the full discussion

Thanks to Molo17, BackpackEMR and Arthrex, and to the amazing Couchbase powered functionality these modern healthcare applications provide, our hiker’s prognosis for a full recovery is guaranteed!

The panel was not only hugely informative, it was a lot of fun and illustrated how Couchbase powers apps that are improving healthcare and patient outcomes across the globe! 

Be sure to watch the discussion in its entirety here:


Posted by Mark Gamble, Dir Product & Solutions Mktg, Couchbase

I am a passionate product marketer with a technical and solution consulting background and 20+ years of experience in Enterprise and Open Source technology. I have launched several database and analytic solutions throughout my career, and have worked with customers across a wide variety of industries including Financial Services, Automotive, Hospitality, High-Tech and Healthcare. I have particular expertise in analytics and AI, love all things data, and am an emphatic supporter of data-for-good initiatives.

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