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Span the Digital Divide: Device Connectivity and the EMR
By Dave Dyell

Picture this: A nurse scribbles a patient’s vital signs onto a scrap of paper before hustling to the next bed. The scrap of paper goes into the nurse’s pocket. The same thing happens with the next patient. For the third patient, the vital signs are scribed onto the edge of an antiseptic wipe packet and into the nurse’s pocket it goes. By midday, our steadfast nurse has a pocketful of miscellaneous materials covered in data that belongs in an EMR.

Enter medical device integration (MDI), the great unifier of the digital data generated by individual devices in a hospital. MDI, or device connectivity, automates the flow of data from medical devices directly to a patient’s EMR, resulting in improvements in productivity, safety, and access to data throughout a hospital.

Take vital sign monitors, for example. These devices are typically not connected to the EMR. As a result, care providers often collect a patient’s vital signs from a device, write them down on a piece of paper, then enter them into the EMR later in batches.

To assess this type of process, Texas-based Wise Regional Health System (WRHS) documented the amount of time its nurses spent charting patient data. The findings? Nurses were spending 25% of their time charting.

After implementing a software-based MDI solution, that number dropped to 15% at WRHS. This workflow efficiency improvement shows what can happen when caregivers have the ability to import rather than enter patient data into an EMR. It’s worth mentioning that, as a result of this efficiency, nurses at WRHS reported they were spending up to 5% more time delivering direct patient care. For those who believe the quality of patient care can drive hospital revenues, this is a particularly relevant MDI benefit.

MDI also increases safety through reduced errors. Manually transcribing data is inherently problematic. According to a Welch Allyn presentation delivered in January 2009, 10% to 15% of all transcribed test results are errant. Problems such as indecipherable handwriting, data entered in the wrong chart, and lost notes are all too common. Device connectivity greatly reduces these risks through seamless data capture and delivery.

Automated data capture results in more immediate access to patient information as well. At WRHS, an average of 12 hours passed between the time a device generated patient data and when the data were validated in the EMR. After implementing a software-based MDI solution, that time was reduced to two hours. According to Mary Carr, a clinical analyst and registered nurse, the availability of data is critical within the clinical setting. “These data-latency improvements enable doctors and caregivers to make better decisions—from diagnoses to prescriptions—based on comprehensive, up-to-date EMRs,” she says.

Despite the facilitywide benefits of MDI, many hospitals hesitate to move forward. Implementing MDI involves change, which involves some level of effort and cost. Furthermore, there are multiple MDI solutions on the market to consider. It is helpful to contemplate the four Cs as defined below when evaluating a potential MDI solution.

• Coverage: Does it work in all clinical environments? What about bedside and mobile devices? Will it collect all the data, regardless of patient location? Many connectivity solutions are location centric; they rely on location information, or bed numbers, to authenticate a patient to a device. Other solutions are more patient centric and involve patient authentication at the point of care.
• Compatibility: Though standards have emerged for radiology and cardiology equipment, many point-of-care devices are designed to run as stand-alone networks. Connectivity for these kinds of devices is achieved in several ways. In assessing your MDI options, ask whether the solution will leverage existing investments in hardware (such as PCs in the room and workstations on wheels). Some solutions require new, single-use hardware investments, which can be costly and are often impractical given how rapidly technologies advance.
• Confidence. Will it ensure data are documented to the correct patient? How does the solution deal with information before it is charted? For clinicians to make decisions with confidence, they have to know the EMR is always complete, accurate, and current.
• Costs. Look at implementation costs, proprietary (single-use) hardware requirements, implementation and training time, ease of use, and scalability. Additionally, assess whether the solution can embed into the existing clinical information system. This will reduce the learning curve for clinical staff, saving time and money.

With thousands of medical devices on the market and more coming every day, it’s undoubtedly important to find an MDI solution that can integrate all of them. It’s equally important to include all the stakeholders—from doctors and nurses to IT personnel and chief information officers—in any MDI investment.

“While the actual connection is the first thing most people think about, it is how a connection automates workflow that determines the success of a connectivity application,” says Tim Gee, owner of Medical Connectivity Consulting.

In other words, MDI is a hospitalwide endeavor. Healthcare organizations need to focus on MDI technologies that are scalable and part of an overall IT strategy. The best solutions are flexible enough to accommodate new devices and mature the EMR.

— Dave Dyell is CEO of iSirona, a provider of simplified solutions for medical device connectivity.