Open Communications: Integrating Medical Equipment with Electronic Health Records

Article excerpt

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Imagine a facility where trending information is automatically transferred from a ventilator into an electronic health record (EHR). Doctors can view data directly from the ventilator, identify more spontaneous breathing, and consult with the respiratory therapist regarding a weaning protocol, all without ever having to call the nurse or visit the patient.

This has long been a possibility, but is now becoming a reality. Hospitals are seeing data pulled from medical devices such as physiologic monitors, vital signs monitors, ventilators and infusion pumps and transferred automatically into the EHR. Unfortunately, this is not as easy as inserting a plug into a computer.

This is where medical device connectivity solutions come into play. They allow data to be transferred from the medical device to the EHR, while solving such issues as information mapping and patient association/disassociation.

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But how will these connectivity solutions affect a health care facility? What planning and discussions need to take place to ensure that no data are lost? What infrastructure questions should be asked to make sure no problems arise? These questions and more need to be answered before a health care facility decides to move ahead with medical device integration.

Reasons for connectivity

The 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act calls for hospitals to adopt meaningful use of their EHRs through a set of objectives that a health care facility must meet to qualify for Centers for Medicare & Medicaid Services incentive payments. Part of transitioning to meaningful use for health care facilities is capturing comprehensive data from individual medical devices for better use by clinicians.

Medical devices rarely can be connected directly to the EHR to allow a free-flowing exchange of information. This is due to the differences in types of information being transferred and the format in which this information is displayed. If the fields within the medical devices and the EHR were all standardized, information transfer would be less complicated.

Given the way information is stored and displayed, a medical device connectivity solution is necessary to help connect medical devices to the EHR. For example, an infusion pump cannot transfer information directly to an EHR but, with the help of a connectivity solution, an infusion pump and an EHR can exchange information.

Currently, connectivity solutions are available from medical device vendors, EHR vendors and third-party vendors. Typically, solutions from medical device vendors and EHR vendors work with only a small number of situations (e.g., their device into the most popular EHRs) and, therefore, only cover some of the vast combinations that can occur. For this reason, most health care facilities find these solutions undesirable.

In contrast, third-party vendors are intended to be medical device- and EHR vendor-neutral. This can be advantageous because a single vendor would manage the interfaces between the medical device data and the EHR system, rather than requiring the facility to manage multiple interfaces for each type of medical device. A common interface potentially decreases cost and complexity in a health care facility.

Working as middleman

Ultimately, medical device connectivity solutions work as the middleman between the medical device and the hospital information system. They typically comprise a point-of-care (POC) component, which associates the patient to the medical device while collecting the data from the medical device and sending it to the server. The server then interfaces with the EHR-hospital information system to facilitate communication between the medical device data and the EHR.

The automation of data transfer has a multitude of benefits for a health care organization, but the main reasons can be summarized as:

Increased efficiency and improved workflow. …