By Kurt Woock
In August, Jeff McGeath was named co-chair of the Integrating the Healthcare Enterprise (IHE) Patient Care Device (PCD) Domain Technical Committee. McGeath, VP of patient care device integration at Iatric Systems, has decades of experience in healthcare IT. 24×7 spoke with McGeath to learn about the current state of device interoperability and where he hopes to steer the committee’s focus in the next 2 years.
What is your professional background?
I’ve been in IT for 20+ years now—16 of those years have been focused on healthcare. I started on the provider side at a few hospitals in Texas. Having both a solid IT background and several years of provider-side experience, I saw some gaps in the market when it came to interoperability. Vendors were doing a great job with creating niche products for clinical areas and their specific workflows, but what wasn’t happening well was the integration of all of those systems together. Hospitals needed to have a longitudinal view. I saw that gap in the market and started my own business.
We started Accent on Integration in 2006 and focused on integration in the healthcare space. We made some big bets early on. We knew sharing information outside of hospitals and across hospitals was going to be big. We also felt another area that was going to emerge and become a vital part of data and data analysis was the medical device market.
Our two major goals were the connected community, which eventually evolved into the RHIO and HIE space, and medical device integration. Seven years later, we were acquired by Iatric Systems, which now has a broad new division dedicated to patient device integration and interoperability, which I manage.
What’s the primary goal of this new endeavor?
In my role at Iatric Systems, I’m looking for ways to make medical device integration even better. Many device manufacturers have devices that produce data that the rest of the community can’t really leverage. My goal is to make sure we’re developing solutions that can connect to all the medical devices. The other side of the equation, the side that people seem to forget, is that we need to get it into the EMR. Right now, EMRs don’t really provide cross-vendor standards to consume that type of data. One part of the equation is getting the data. The other side is making sure we are delivering solutions that integrate to the market.
When did you get involved with IHE PCD, and what is the group responsible for?
I got involved with the IHE PCD in 2010. IHE splits up their structure by domain. For example, there’s a cardiology domain, an IT infrastructure domain, etc. I’m involved with the patient care device (PCD) domain. Inside that domain, we have two main bodies that help guide our group—a planning committee and a technical committee. I’m co-chair of the technical committee. Our goal is to try to advance the PCD domain: Promote the technical standards that are used to communicate between systems, keep an eye on emerging standards, and ensure we are making the best use of already approved and potentially mainstream standards released by standards development organizations (SDOs). You can almost think of IHE as an orchestration vehicle—IHE doesn’t define standards like a traditional SDO, but we look at standards and determine the best way to marry them together, go to market, and deliver best practices.
Inside the patient care device domain, we have the same process. We know what clinical workflow is. Now let’s take the best and most well-known standard for info exchange within hospitals, which is HL7, and look at problem areas for device integration, and keep the group on track.
We sit down with competing vendors and talk through what the best ways to do things are. Sometimes we need to put competitive nature aside and determine what’s best for patient care. My job is to keep pulling the conversation back to that.
As you begin your time as co-chair, what does the current landscape of device integration look like?
Well, right now, I am all of 5 days into my new role, as I started September 1. We are getting ready for our fall face-to-face meetings with vendors and the committee in Boca Raton, Fla. We meet face-to-face twice a year, but we have conference calls weekly. We have working groups for various aspects of patient care devices.
If you just look at medical devices as a whole, big topics right now are terminology and terminology mapping. We need to make sure codes are semantically interoperable.
With smart pumps, in my personal opinion, the market is very ripe for some very innovative products. The pump and smart pump groups are working toward finding ways for smart pumps to not only export information but also input information, instructions, etc. There are so many financial as well as patient safety improvements that can be made if we can push data to the pump and get information from it. For example, it would be helpful to obtain the time the infusion started and ended. There are reimbursement issues surrounding that: Payors have rules around reimbursement, and being able to document accurate start and stop times can drastically impact reimbursement.
Where do wireless and security concerns come into the discussion?
Both are very central to the discussion. And not just from a standards point of view. Some of it is communicating more efficiently. How do you report to the biomed community that the last security update for device X was Y number of months ago? A lot of that is still done with paper. It is important that data be better managed, but everyone must also go a step beyond … not just managing information, but also helping manage the devices themselves. It’s good to know that a certain device is X years old, which we can find out now, but it would be helpful to also know what firmware a device is running. Do I even know where the device is? When it comes time for the director to run weekly or monthly report, not only can he or she get a list of devices and serial numbers, but he or she can get a listing of where the devices are. If the interoperability of these devices improves, then the management of them can improve as well.
How can better interoperability lead to better security?
If you’re going to do a better job of managing devices, patching software, etc, you’ve got to begin with connectivity. You’ve got to have ways to connect and communicate with devices. The groundwork that we’ve laid for data integration goes a long way. Just getting the devices to communicate heart rate is a starting point. Once we do that, then we have a pathway, a conduit to communicate, and now we can start talking about how to multipurpose those channels we’ve opened up bidirectionally.
In addition, each of these vendors on their own when they go back to their corporate environment, they know they need to do a better job of securing devices. The IHE PCD domain allows a forum for those guys to come in, collaborate, and devise a standard we can agree on. They can communicate in the same way.
Your term lasts 2 years. What do you hope to accomplish in that time?
The first few years of IHE PCD were really focused on integrating the device to the network—getting the data into some sort of outbound format. That needed to be the focus early on. As a result, many of the members come from the medical device manufacturer space. I hope what I can bring is a more holistic view and involve the EMR vendors more. We’ve done a great job of laying the foundation and groundwork for standards-based approach for getting data off the device. The next question is, “OK, now what are you going to do with the data?” I feel I can give people a different lens to look through. Together, we can do a better job of that last mile—getting it all the way into EMR or patient chart.
What challenges do you face in achieving that?
The biggest obstacle is probably getting enough of the EMR vendor attention. They are so consumed right now with Meaningful Use conversations. We have to figure out how we can get some of these vendors to the table and convince them that there are patient safety and financial advantages to doing so.
How will you know if you’ve been successful?
If we are able to demonstrate unambiguous interoperability standards, get them published, and have those frameworks available and tested at the Connectathon, that would be a success. I would say our two main measures of success are 1) getting these new profiles that are more EMR-focused to Connectathon and 2) see EMR vendors release commercially available solutions based on those IHE profiles.
Kurt Woock is associate editor of 24×7. For more information, contact firstname.lastname@example.org.