Presentation on theme: "Medical Device Integration"— Presentation transcript:
1 Medical Device Integration Steve MerrittInfrastructure EngineerBaystate Health
2 Why Are We Here? Background Barriers to adoption Momentum moving us forwardHow IHE is breaking down these barriersLets get to work!Panel discussion
3 Key Benefits of Point of Care Medical Device Interoperability More accurate data(10 to 20% errors introduced with data transcription)Improved patient safety and care outcomesImproved discharge decisionsImproved Case Management, Infection Prevention and QAMore “real time” data available to MD, clinicians and care managersMore clinically sound diagnosis and ordersEarlier initiative of appropriate interventions and therapiesPrevention of undetected patient deterioration (“failure to rescue”)More “proactive” patient management (LOS, reimbursement)Better outcomesIncreased MD productivity and satisfactionIncreased Nursing productivity and satisfaction1 to 1.5 hrs day savings per RN or CANOutcomes data warehousing
4 Interoperability: A Brief History of Time Pre 1990’s – analog outputs (e.g. 0-3V)1990’sDICOM: Imaging devicesHL7: Healthcare informatics, ADT, orders, resultsISO/IEEE 11073: Medical devices2000’sIHEHITSPContinuaASTM F29
6 Barriers: Market Forces Healthcare organization financial prioritiesWhere is the ROI for medical device interoperability?Each solution must be justified financiallyReimbursement driversAre you willing to pay more for standards?Would anyone buy an ultrasound without “DICOM”Vendors marketing one-size-fits-allDo they really make financial sense?Don’t listen to these marketing or sales guysTalk to people who have actually implemented“Sure, we can interface these widgets to your EMR”
7 Safely, EffectivelyRigorous validation, verification, and testing of medical devices is requiredThis slows development to market timelinesWe’re creating complex systems of systems requiring analysis
8 Complex ProblemsMost healthcare organizations do not have the staff to understand requirements of medical device interoperabilitySure it “interfaces” does to your EMR but what does that mean?We need to simplify the integration requirementsVendor salespeople wouldn’t be able to blow as much smokeImaging devices as an example
9 CulturalClinical Engineering and Information Systems have traditionally worked in silo’sClinical Systems EngineerA Hybrid employeeTrend is partnering CE with ITNeither one can do this aloneAAMI-ACCE-HIMSS CE-IT Community
10 What Is Driving Us Today? Trend to organizations and government initiatives to move this forward.These are not Standards Delivery Organizations (SDO’s)HITSP (Healthcare Information Technology Standards Panel)Wide focus on harmonizing and integrating standards across healthcareContinuaFocus on Personal Health DevicesIHEPatient Care Devices DomainWhere at least one actor is a regulated point-of-care medical device
12 PCD Overview Sponsored by HIMSS and ACCE The IHE Patient Care Device Domain, working with regional and national deployment committees, will apply the proven, Use Case driven IHE processes to:Deliver the technical framework for the IHE-PCD;Test conformance with published IHE-PCD profiles using test plans, tools and scripts at Connectathons; andDemonstrate marketable solutions at public trade shows.IHE-PCD profiles:Improve patient safety and clinical efficacy,Reduce healthcare delivery cost by improving efficiency, reliability, and operational flexibility for healthcare providers,Enable innovative patient care capabilities, andExpand the international marketplace for patient care device vendors.
13 PCD Status[ACM] Alarm Communication Management enables the remote communication of point-of-care medical device alarm conditions ensuring the right alarm with the right priority to the right individuals with the right content (e.g., evidentiary data).[DEC] Device Enterprise Communication supports publication of information acquired from point-of-care medical devices to applications such as clinical information systems and electronic health record systems, using a consistent messaging format and device semantic content.[PIV] Point-of-care Infusion Verification supports communication of a 5-Rights validated medication delivery / infusion order from a BCMA system to an infusion pump or pump management system, thus "closing the loop.“DPI, MEM, WCM, IDCO
18 IHE PCD Collaboration Helping to harmonize standards IHE PCD and Continua team upHITSP IS77 Remote MonitoringContent - HL7 v2.6 messages using IHE PCD-01 Vocabulary - Constrained to IEEE/ISO / xx (PHD Device specialization) nomenclatureICE-PAC: Collaboration with CIMITNIST: Test tooling
19 Leveraging IHE for purchasing How do you get IHE Integration Profiles?Specify IHE capabilities as requirementsState in the RFP which IHE Actors and Integration Profiles you want.What do IHE Integration Profiles cost?Nothing in most casesAny cost should be a fraction of the overall
20 The business case for implementing IHE Profiles Enables you to efficiently manage the array of integrated information systems necessary to support effective healthcareThe alternativeBuilding site-specific interfacesMore expensiveRequires maintaining these custom interfaces for the life of the system involved.Integration via IHE is less costly at the start and makes future acquisitions easier to plan and executeIHE Profiles give clear definitions of how the pieces fit togetherIHE Profiles come with initial unit testing done
21 What Can You Do? Plan, Evaluate, Purchase IHE Conforming Devices In continuing discussions with vendors – at all levelsPush IHE InteroperabilityRefer to lower deployment, maintenance costsEncourage vendors’ active IHE participationLower development, installation, support costsRefer to profilesLeverage public and objective commitmentsIn RFPsRefer to profiles, Conformance StatementsUse Conformance Statements to “nail down” vendor’s representationsAdopt very specific languageDon’t forget to look ahead – what is being developed, what is the upgrade path?21
22 Sample language“The device shall support the IHE Device Enterprise Communication (DEC) Integration Profile as the Device Observation Reporter (DOR) Actor.”“The pump shall support the IHE Point-of-Care Infusion Verification (PIV) Integration Profile as the Infusion Order Consumer (IOC) Actor.”“The device shall support the IHE Alarm Communication Management (ACM) Integration Profile as the Alarm Reporter (AR) Actor.”
23 Help Break Down Barriers IHE PCD Call for Work Item ProposalsDue 9/25User handbookJoin the technical workgroupsJoin us at the Face to Face meetingsOct 5-9
25 PANEL DISCUSSION: INDUSTRY STANDARDS WHICH STANDARDS WILL BE ADOPTED AND WHY? 5 minutes each followed by audience questionsJulian M. Goldman, MD, Medical Director of Biomedical Engineering, Partners HealthCare System, Director, CIMIT Program on Interoperability and Medical Device Plug-and-Play Interoperability Program, Massachusetts General HospitalJohn Harrington, Vice President Research and Development, Hill-Rom IT SolutionsSudheer Matta, Product Manager, Wireless Networking Business Unit, CiscoDick Moberg, President, Moberg Research, Inc.Bridget Moorman, CCE, President, BMoorman Consulting, LLCRobert Rinck, Manager, Clinical Engineering, Spectrum HealthVaughan Zakian, Founder & CTO, Nuvon, Inc.
26 My Background Past Position: Clinical Engineering, IT Specialist M.S. Biomedical Engineering, University of ConnecticutFocus on Clinical EngineeringCo-chair IHE Patient Care Devices Planning Committee2 years in Desktop and Server Support5 years in Clinical Engineering4 years as Hybrid CE-IT roleI’m not a standards guy, I would just love to see more of them
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