As healthcare providers feel the imperative to deliver higher-quality care, improve the health of populations and reduce costs – the so-called "Triple Aim" – a small but growing number of hospitals are looking to integrate data from medical devices into electronic health records.
"Smart" medical devices are creating a flood of data that can help in all three areas, but could also overwhelm some organizations as they try to wrangle all that new information. Those that have begun to address interoperability between devices and EHRs are also seeing roles change.
In a July report from Orem, Utah-based health IT research firm KLAS Enterprises, 55 percent of healthcare provider representatives interviewed said integration with EHRs was a "key factor" in future purposes of intravenous infusion pumps, and another 23 percent called it at least somewhat important. Only 10 percent indicated that it was not important to them.
Notably, KLAS asked survey respondents what level of benefit smart pump integration with EHRs would have on their hospitals, on a scale of one to nine. In the realm of patient safety, the average was an eye-catching 8.4. "They all felt that the patient safety gains were significant," report author Coray Tate says.
However, few have actually gone through with connecting infusion pumps to EHRs. Tate says only nine organizations nationwide were "live" with such integration at the time the report came out; one more has come online since then. Another 54 healthcare organizations are reported to be under contract for pump-EHR integration, and 18 of those plan on going live by next summer.
"This is very much just getting out of the gate," Tate says. It is "more dynamic and complicated" than just feeding data from a device into an information system, he explaines. "The process change is as significant, if not more so, than the technology itself."
David Siva, senior director of medical information systems and technology at Daughters of Charity Health System, a six-hospital organization based in Los Altos Hills, Calif., foresaw 10 years ago what connected medical devices could do and how they can better fit into clinical workflows. "We had the vision that it was going to happen," Siva says.
The six hospitals have about 20,000 medical devices among them, Siva says. Since mid-2012, the organization has been working to integrate 16,000 bedside monitors, pieces of telemetry equipment, infusion pumps and other devices with the QuadraMed inpatient EHR, prioritizing based on how much value clinicians stand to realize.
Siva and his team have been looking at how to get data both in and out of various equipment with the help of a medical device integration engine from Panama City, Fla.-based software company iSirona. The technology takes a standard, nonconnected medical device and makes it wireless , sending data to patient records once a minute. "The resolution of available data is much higher [than with manual collection]," Siva says.
It has the added benefit of showing trends over time, according to Siva. "You can retake measurements if they aren't clinically viable," he says.
Gary Barnes, chief information officer of Medical Center Health System in Odessa, Texas, presented a scenario involving patients in a postoperative recovery area. A technician taking temperatures one patient at a time might need four hours to cover the whole unit and then manually enter the readings in each patient's record. The patient's temperature might spike during that time, but the physician might be working with old data and not notice the change. With automatic population of the EHR, doctors can get immediate warnings of potential issues.
For a trial, the 402-bed Medical Center Hospital bought five "smart" blood-pressure cuffs that automatically send data to the inpatient EHR. They proved to be instantly popular. "Others started wanting them," reports Barnes.