Connectivity and integration are inherent challenges for hospitals using disparate biomedical devices across a complex care setting. Virtua, a four-hospital health system based in Marlton, N.J., has taken a serious look at the issue following a review of its patient-care IT portfolio of applications. Although Virtua had embarked on installing an EMR system well ahead of meaningful use as part of the Health Information Technology for Economic and Clinical Health (HITECH) Act, recording the data from bedside devices was still a manual affair, according to CIO Al Campanella.
“We are vendor-neutral, so like many health systems over the years, we trend to accumulate many different brands of biomedical devices,” Campanella says. “Even within those brands you tend to have different model numbers.” That’s a significant problem, because many of the devices have embedded software that doesn’t change during the lifetime of the device, and the data streams are proprietary to the device vendor, he says. He estimates that the four-hospital system uses roughly 10,000 medical devices.
About two months ago, Virtua went live with a middleware solution (supplied by Nuvon, Inc., Marlton, N.J.) that streamlines the collection of data and eliminates the need to record the data manually from the device, Campanella says. Its first implementation was in the hospital system’s ORs—one of the tougher environments, because of the large amount of data being pulled from many devices, he says.
Campanella notes that the system uses a device manager that acts as a bridge between the biomedical device and a server at the back end. He says the system has a robust firmware library that can read proprietary data streams from many types of biomedical devices. The data is translated into standard HL7 format, passes the information through the system’s server, and is then fed into the EMR, he explains.
Since installing the system, information is recorded in real time from the medical devices and is fed into the perioperative EMR (supplied by Picis, Inc., Wakefield, Mass.). The data is populated on the EMR’s screen, where it is refreshed once a minute. Since installing the system, clinicians no longer have to enter data manually, Campanella says. “Every minute there is a new set of values popping. Not only is it recording faster than is humanly possible, but it is a 100-percent accurate,” he says.
Campanella says the system is plug-and-play. “This is all automatic, which helps, because you don’t need a technician to pick off of a screen what device is being connected,” he says.
He notes that implementation has been relatively simple. “The actual technical part was not that difficult,” he says. The most difficult part was to create an inventory list of all of the hospital’s medical devices, in order to choose which types of devices would be part of the implementation. In Virtua’s case, the four major types of biomedical devices in its ORs were comprised of upwards of 20 different varieties. Part of the implementation process was working with the EMR vendor to make sure that the EMR was able to handle the high rates of data coming into the system, he adds.
Another benefit of the system is the ability to monitor the biomedical devices, through a utility function that surveys the connected devices to determine if they are on or off, and if the data is being transmitted to the EMR. If there is a problem, the help desk can tell within seconds if there is a problem; in case a biomedical device has to be swapped out, it can be done so easily, because of the plug-and-play capability of the system, he says.
Data collection has potential longer term benefits in addition to those associated with the immediate procedure, Campanella says. The data stream is associated with the patient identification information from the EMR. Once the data is populated in the EMR, it’s re-usable for analysis purposes, he says. The data is time stamped and encrypted, he adds.
Virtua is scaling up on the system’s implementation, Campanella says. Next up is the acute care rooms, where bedside monitors will be linked through the system to the Siemens Soarian EMR. That implementation has been tested successfully, and will go live following an upgrade to the EMR this summer, he says.
Following that will be implementing the system to Virtua’s 36 physician offices, where biomedical devices will be linked to the NextGen EMR. Eventually, the system will be implemented in Virtua’s two nursing homes as well, Campenella says.