Right now, only a small percentage of hospitals are collecting data from medical devices in real time. That’s partly because hospitals have other technical challenges to handle first (including the development of interfaces between major enterprise systems), and partly because device makers aren’t offering easy connectivity options.
But providers are prodding medical device makers — hard — to offer device-to-EMR links. As medical connectivity consultant Tim Gee notes, it’s kind of a no-brainer at this point. “What’s the use of automating the EMR if users have to write down numbers read from medical device displays and then manually type them into the EMR?” Gee asks, sensibly enough.
Unfortunately for hospital IT managers, the situation hasn’t gotten much better since my colleague Katherine Rourke shared Gee’s impressions last April.
Let’s start with the ugly conclusions. From what Gee says, exporting medical device data to an EMR is a complicated mess, and neither vendors nor hospitals are likely to solve this problem anytime soon.
In theory, the set-up is fairly simple. The device must be capable of exporting data digitally, and be set up to feed into a centralized data aggregation server. The server then must pass the device data through an HL7 interface and push that transformed data to the EMR.
Making that happen is harder than it seems, however. For one thing, using HL7 doesn’t necessarily get the job done, Gee notes. After all, EMR you’ve installed may use HL7 standards in one way, and the device-maker might pick another set of options. It’s a Tower of Babel situation at that point. There’s kludges to work around HL7 compatibility problems, but they involve a lot of testing and configuration prior to launch.
At present there’s no obvious solution to these problems. You’ll probably want to stay informed on the IHE-PCD (patient care device) project, though. IHE-PCD creates integration profiles for medical devices, and has already released profiles for 20-odd devices and applications. IHE-PCD profiles have already been used to pass along data from common devices like infusion pumps, ventilators and anesthesia workstations. Members are creating workflow solutions for problems like alarm management, too.
Also, keep an eye out for big medical device investments and acquisitions by cash-rich EMR vendors. (My bet is that it’ll prove easier for EMR vendors to buy connectivity solutions than create them.) This may make your life easier, as vendors will come to the table with device interfaces which already work.
Of course, using both their devices and EMR may lock you in rather firmly to that vendor, but it may be worth the trouble. Deciding whether it’s worth the risk may be one of the big decision points you face in say, 2013. In the mean time, get prepared. This issue is going to be a pain in the neck for some time to come, it seems.