Raphael L. Aquino, MS
Health care has traditionally lagged behind other industry sectors in implementing cross-functional teams, but in recent years there has been a significant shift in organizational structure and the alignment between clinical, IT, and biomed. While there may not yet be a chief biomedical information officer, biomedical should have a seat at the table when it comes to driving technology advances in the hospital setting, particularly in biomedical device integration (BMDI). Here are four key areas of medical device integration that biomed should drive:
Device Walk-throughs: Biomed knows the history of the hospital’s medical devices and landscape of device units better than everyone else. They know where the devices are located within the hospital, how they are connected, how they are being used by the clinicians, and other critical information needed when making the decision of how to design the BMDI infrastructure.
Inventory Control: Since biomed has access to the inventory management system, they know the total number of devices in the hospital. This count is critical to figuring out how many devices are in the scope of the project and are capable of integration.
Device Testing: At the testing phase, IT joins biomed as software is integrated at the medical device level. Biomed has an operating knowledge of the medical devices and how each device should be connected in order to align with patient values. For instance, during testing, a lot of the updates and missing values are discovered. Biomed has the unique ability to service the medical devices, and, in conjunction with IT, update software or firmware and see it back through to inventory control.
Gap Analysis: During this phase, biomed works closely with IT and nursing to look at every aspect of integration. They will need to look at everything from architecture and infrastructure, to devices that need connection, to change control and FDA regulations, to workflow, training, and clinical effectiveness of BMDI. By doing this in-depth gap analysis they can help outline the necessary steps to be taken in moving what is current-state to the future-state of device connectivity.
One Hospital’s Journey
Sentara, operating in more than 100 care sites in Virginia and North Carolina, is a highly integrated health care organization. It has a BMDI team focused on device integration as well as a separate biomed department. “For standard integrations, we work with the biomed department to obtain inventory counts and device-related information, the clinical staff to understand workflows and requirements, other IT teams to complete configurations and mappings, and all the teams to work through any issues that arise during the testing phase,” says Mike Freeman, manager of Sentara’s eCare BMDI team. “Without the BMDI team, focus on the projects could easily suffer from the day-to-day responsibilities of the other teams.”
As Sentara began its initiative to implement the Epic EMR system, it looked at ways to improve patient safety and nursing efficiency in the acute areas and other clinical departments that chart frequent vital signs. The hospital identified device integration as a solution that would free nurses from the time-consuming task of manually transcribing patient vital signs data and keying it into the EMR. Finding a device-integration solution that would work in multiple areas of the hospital, providing standardization for the integration of a variety of different end points, and cost-effectiveness were priorities for Sentara. It chose a vendor-neutral solution from Capsule that allows the hospital to connect a variety of devices quickly and add devices as needed. The solution also ensures that all data from all connected devices, including vital signs and device data, integrates with its existing Epic information system.
To date, Sentara’s BMDI team has integrated more than 1,800 medical devices across a number of care departments. The BMDI project has improved clinical workflow and satisfaction, and allowed clinical staff members to focus more of their time on patient care. This would not have been possible without cross-functional expertise within the BMDI team, and it remains a key to the hospital’s continued success. Currently, Sentara is device-integrating its operating rooms, as it adds the OpTime module to its Epic EMR. Anesthesia machines and bedside monitors for 23 operating rooms across two hospitals have been integrated, and the hospital is looking to complete a full enterprise roll-out to six more hospitals by the end of 2012. Sentara is also testing integration with dialysis machines, rolling out to radiology for MRI machines, and evaluating mobile capabilities for med-surg nursing.
Ultimately, a fully integrated BMDI team made up of experts in biomed and IT, along with input from clinicians, is indispensable in the design, test, and implementation of BMDI. As hospitals continue to seek a collaborative approach to aligning technology with patient care processes, cross-functional BMDI teams will play a major role in setting the table for meaningful outcomes in clinicians’ use of technologies to further hospital efficiency and improve patient care.
Raphael L. Aquino, MS, is technical sales engineer at Capsule, Andover, Mass. He has more than 10 years of IT experience. Prior to joining Capsule, he was the integration manager for Sentara Health Network IT. For more information, contact .
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