Two recent news items published on the 24×7 website underscore a major transformation in medical device management that is just beginning, and will take years to complete. The effort to connect medical devices with one another and with electronic medical records will be a sea change not just for the delivery of care, but also for the people currently known as biomeds.
You can get some idea of the scale of the change to come from a report projecting that the medical device connectivity market will grow from $3.5 billion in 2012 to $33.5 billion by 2019. That translates to a compound annual growth rate of nearly 38%, huge by any standard.
The nature of the changes involved in this transformation are described in recent analysis from research firm Frost & Sullivan. It outlines both the nature of the changes in healthcare delivery over the next decade, driven by connectivity, and the challenges the industry faces in achieving that connectivity.
What I find most informative in the Frost & Sullivan analysis is that it clarifies what the effort to achieve interoperability is all about. The goal is not to meet some administrative edict to comply with Meaningful Use requirements. Rather, it is to reshape the “future of health, wellness, and wellbeing.”
The task of integrating all the medical devices in even a single facility is enormous. But for biomeds, the biggest challenge may come after installation, according to Scot Copeland, clinical systems specialist for Scripps/Mercy Hospital, Chula Vista, Calif.
“You can have a contractor or consultant or vendor come in” and do much of the heavy lifting involved in the device integration process, he notes. “But what happens afterwards is that you don’t have the organizational structures or the expertise to support it in the clinical environment.” For example, he says, a contractor may successfully connect a facility’s vital signs monitors wirelessly to its EMR system, but “then what happens when your biomed department doesn’t know how to troubleshoot the wireless network?”
Copeland notes that supporting integrated systems will involve “logistical issues” between IT and biomed departments and disciplines that have yet to be worked out. In his view, many biomeds don’t understand the networking involved when devices are integrated, or don’t understand the changes in clinical workflow involved. “They don’t understand that once you’ve hooked it up to an EMR, the old traditional dividing lines are moved. You used to say, ‘That belongs to IT, so they take care of it.’ But it doesn’t really, because it’s clinical information that goes from your machine all the way to the EMR and back to the caregiver at the bedside. So you’re responsible for the network connectivity even though you may not take care of the network.”
Interoperability will also require greater attention to how nurses use their devices, Copeland says. “We haven’t ever had to be so intimate with the nurses’ workflow with the device, and understanding exactly what they do with it.” For example, he says, “Right now we’ll have a vital signs machine in the shop, we’ll hook up our test equipment to it, and we’ll run it and the test equipment says it’s ok, and we’re done.”
However, he says, “once it has connectivity involved, and it’s interconnected with an EMR, we’re not done.” Why? “Because there is a workflow process that is used to associate the patient with the device. What are the steps they go through to take the vital signs determination and send it to the EMR? What is the path it takes to get back to the caregiver’s workstation? If they have a problem with that, they are going to be calling biomed. And we need to be able to respond, to understand how they use it and how the information flows through the system.”
Because the interoperability transformation will take years to complete, it is all too easy to put it out of mind. But the tipping point will likely come sooner than we expect. The time to prepare for it is now.
John Bethune is editorial director of 24×7. Contact him at [email protected]