Anesthesia and Critical Care Software

Anesoft Corporation develops and distributes medical educational software designed to help health care professionals prepare for medical emergencies by rehearsing critical scenarios using computer simulation. Our mission is to make high-quality, realistic medical simulation available to all health care professionals.

The development of our simulation software is guided by the Anesoft Medical Advisory Board. The Medical Advisory Board consists of content experts for each topic covered by the simulation programs.

Howard A. Schwid, M.D., the Head of the Medical Advisory Board, has 20 years experience directing the development of medical simulation software. Howard earned a degree in Electrical and Computer Engineering at the University of Wisconsin-Madison. There he worked on mathematical models of physiological systems under the tutelage of Professor C. Daniel Geisler and Professor Vincent Rideout. Howard continued mathematical modeling during medical school and anesthesiology residency with Dr. Ben Rusy. During a research fellowship Howard worked with Dr. N. Ty Smith at the University of California-San Diego converting the Fukui-Smith model into a screen-based anesthesia simulator with Charles Wakeland of Rediffusion Simulation Corporation. This program was awarded the Best Instructional Exhibit at the 1985 Annual Meeting of the New York State Society of Anesthesiologists.

In 1986 Dr. Schwid joined the faculty at the University of Washington and continued development of screen-based medical simulators. Early programs concentrated on left ventricular physiology (LVP), morphology of the radial arterial pressure waveform (ArtWave), and myocardial oxygen balance (Balance).

In 1987 Dr. Schwid founded Anesoft Corporation to fund additional simulator development through sales of software. Those funds, plus a grant from the Anesthesia Patient Safety Foundation in 1988 resulted in the hiring of Dan O'Donnell, a brilliant mathematician and programmer. In 1989 Schwid and O'Donnell completed the Anesthesia Simulator-Recorder, the first screen-based anesthesia simulator program with a built-in automated record-keeping system (1).

The Anesthesia Simulator-Recorder, written in Pascal for IBM compatible personal computers using DOS, included 20 different simulated cases with twelve emergency scenarios. The program was well-received and within a few months more than a thousand copies were sold. Since the program was usually used for independent study, an expert system was added to provide learning objectives and intelligent help during the simulated case and intelligent debriefing after the case. The name of the program was changed to ASC: Anesthesia Simulator Consultant to reflect the importance of the expert system consultant (2). In version 3.0, written for Windows in C++ and released in 1995, the case library grew to 80 cases and dozens of emergency scenarios, and the name was shortened to Anesthesia Simulator. CME and AANA credits were offered and sales grew to over 10,000 copies.

In addition, in 1992 Anesoft Corporation released its first simulation package for management of cardiac arrest entitled Rhythm & Pulse. Due to the many changes in therapeutic guidelines for Advanced Cardiac Life Support by the American Heart Association, the program was updated in 1993, 1995, 1997, 2000, 2002, and 2006 and renamed the ACLS Simulator.

Also in the early 1990’s Dr. Schwid and Anesoft programmers worked with the team from Link-CAE to build a mannequin-based medical simulator. The team included David Gaba, M.D. from Stanford, and Jeffrey Cooper, Ph.D. from Harvard. The Link-CAE medical Simulator had some commercial success but was sold to Eagle Simulation, then MedSim, and eventually went out of production.

In the meantime, Anesoft brought simulation to other areas of medicine with the Critical Care Simulator in 1995, and the Hemodynamics Simulator and Sedation Simulator in 1998. All these programs combine the essential Anesoft features of mathematical modeling of physiology, graphical user interface, record-keeper, and expert system for intelligent help and debriefing.

Michael Negrin became president of Anesoft Corporation in 1998. He brought years of marketing experience to Anesoft, first in the music industry and then in software at Microsoft. He has lead Anesoft in several exciting new directions, building relationships with resellers and improving distribution channels.

Due to the widely available access and popularity of the worldwide web, Anesoft decided in 2000 to make its simulation programs accessible via the internet. Kevin Miller converted all five Anesoft C++ Windows stand-alone applications to Java to operate as installed applications within browsers on standalone computers or via client-server technology on computers connected to the internet. With these programs Anesoft became the first company to deliver high-quality, web-based, real-time medical simulations.

In 2001 Anesoft Corporation attained accreditation status as an independent provider of Continuing Medical Education by the ACCME.

In addition, the Bioterrorism Simulator was completed in 2002 to assist with training for managing patients exposed to biological or chemical agents. Jeffrey Duchin, MD, Jennifer K. Brennan, MD, Ben H. Boedeker, MD, and Amitai Ziv, MD contributed their expertise to this program.

In order to further improve access to our simulation programs on standalone computers and via the internet, Anesoft is developing a new generation of medical simulators written in the new Microsoft .Net framework. The first two .Net simulation programs, ACLS Simulator (version 7), PALS Simulator (version 7) and Neonatal Simulator (version 2) are currently being distributed. A case authoring program is included with these new simulators to facilitate others in the authoring of new case scenarios, with intelligent help during the case, and intelligent debriefing following the case. We are working with content experts at 40 institutions to develop case scenarios for the new Anesthesia Simulator, Adult and Pediatric Critical Care Simulators, and Obstetrics Simulator.

What does the future hold for Anesoft?  Up till now Anesoft has concentrated its efforts to develop easy to use simulators for several medical specialties. The new case authoring system makes it fairly easy to build new cases. We intend to continue to recruit content experts to build a large library of cases for each medical specialty area in order to create a full curriculum for each specialty rather than a few case scenarios.

References

1. Schwid and O’Donnell: The Anesthesia Simulator-Recorder: a device to train and evaluate anesthesiologists’ responses to critical incidents. Anesthesiology 1990; 72: 191-197.
2. Schwid and O’Donnell: The Anesthesia Simulator-Consultant: Simulation plus expert system. Anesthesiology Review 1993; 20: 185-189.