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The VA Takes a Stand

January 1, 1998
by Charlene Marietti
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STANDARDS HAVE THE opportunity to make a difference only when there is a consensus of agreement about using them. Usually, users get caught in the middle between two or more business interests. In the case of one standard, the Institute of Electrical and Electronics Engineers (IEEE) 1073 Medical Information Bus (MIB) standard, there may be hope of achieving the elusive goal of plug-and-play interoperability among patient bedside devices.

For one, it’s a rather new standard. Second, it serves a niche market with existing proprietary operating systems spread among several vendors’ systems. Third, the company manufacturing the MIB component for original equipment manufacturers and system integrators is actively educating anyone who will listen. And last, but perhaps most importantly, an organization large enough to be taken seriously has taken a stand.

A 10-year timeline
Work on the medical information bus standard that captures clinical data from patients’ bedside devices and transfers it to existing hospital information systems in a standard data format has been under way since 1984. Approval, however, for the IEEE 1073 MIB standard did not come until the end of 1994. In fact, Steven Wexler, chief biomedical engineer at the U.S. Department of Veterans Affairs (VA) in Washington, D.C., reports that even though he had been keeping an eye on its progress, he almost forgot about it. When recent reports indicated that it was a mature standard, it seemed the right time for the VA to request a fully functional interface for the MIB from its vendors.

It was time to put a toe in the water, says Wexler--and the VA did. Recent negotiations for physiological monitoring systems through its National Acquisition Center included the specification that all such equipment include an embedded interface based on the IEEE 1073 MIB standard. But the VA didn’t stop there. Because many of its member hospitals purchase low-end devices such as infusion pumps and pulse oximeters directly, it educated its biomedical engineers on the advantages of the MIB in those devices as well.

Pursuing the goals of better, cheaper and faster, VA engineers want to be able to pass information in a standard format to existing hospital information systems from medical devices--no matter who supplies them. Regarding actual implementation of the MIB standard, Wexler says, "I’m not sure we’re there yet, but that’s OK. We’ve seen other standards come along over the years. Hopefully, this one will be mature enough."

Although there were some initial concerns that the demand for the MIB standard would backfire, that doesn’t seem to be the case. In fact, at least one major contract has already been awarded.

Money matters
Even though some portions of the MIB standard remain to be developed, its validity is based on existing International Standards Organization standards and is not in question. According to Louis Costa, senior applications engineer at LinkTech Corp., Bohemia, N.Y., a data communication and data conversion company and manufacturer of a turnkey MIB standard bus, the problem boils down to a financial one. Since most device manufacturers have implemented proprietary interfaces on their equipment, standardization will require up-front engineering and the associated costs. Most manufacturers are reluctant to incur the additional costs until hospitals demand inclusion of the standard.

The VA has taken a stand on the issue. By specifying the inclusion of the medical information bus standard on future purchases from manufacturers, its team of professionals moves the organization one step closer to interoperability and sets an example to others committed to that process.

Charlene Marietti is senior technology writer at Healthcare Informatics.