Delivering care of the highest quality requires clinicians to have the most pertinent information about the patient available to them. In acute care environments, this information comes from a variety of sources, not all of them readily accessible such as medical devices.
“Devices obviously generate critical information at the patient bedside. Historically, a very small subset of that information would ever find its way to the electronic medical record because they didn’t need to archive every breath a patient took, for instance,” says Andrew Malcolmson, Director of Integrated Patient Intelligence at Covidien.
“If you’re doing clinical decision-making and trying to understand patient conditions, especially in a dynamically evolving situation, and you’re not at the bedside to look at the device firsthand, you want to be able to see everything — every loop, trend, waveform, alarm, and parameter,” he explains. “That’s the type, richness of information that just isn’t not possible to house in the EMR. That’s just too much.”
Malcolmson and his team are the driving force behind the company’s Vital Sync software, which allows clinicians to access beside medical devices from their own devices — from desktops to smartphones. “There’s an unmet need to have that bedside device information available to them wherever and whenever they needed it,” he adds.
Not only does the ability to access monitoring devices from their other devices, especially those that are mobile, extend the range of clinicians within the clinic, but it also makes possible the coordination of a patient’s care well beyond the four walls of the institution.
“A physician who isn’t in the unit and who may not necessarily be in the hospital can take a look at what’s being measured and what the devices associated with a given patient are telling them to help collaborate on improved decision-making,” Malcolmson notes.
According to Malcolmson, this shift toward medical device integration and remote monitoring is just beginning to emerge but its potential to change the way care is coordinated and collaboration among the care team takes place is clear.
“The whole paradigm of having to go to the patient bedside to get comprehensive information is something that is changing,” he continues. “Obviously, we would never encourage nor expect clinicians to not want to go to the patient’s bedside because there’s a whole universe of additional information that you can get beyond that which is just on the devices monitoring that patient.”
Tapping this potentially, however, requires device manufacturers to face the same challenges their counterparts in EHR development are currently encountering when trying to get information to flow seamlessly between data sources — that is, interoperability.
“We’re primarily exporting information to the EMR. We have an HL7 engine that is designed to handle just about any type of data requirements,” explains Malcolmson. “We’re on the cusp of releasing an ADT interface as well, which will be coming out with our next release. That will be the first element of our system that actually pulls information back from the electronic medical record system as well.”
If the EHR is to be a comprehensive record of a patient’s care, then it must comprise information from various sources not just those that are captured by clinicians. As with health information exchange at a more macroscopic level, moving information from one source to the next requires that standards and rules of the road are obeyed by all players.