Sherman Hospital in Elgin, Ill., wanted to integrate patient monitoring devices with its electronic health records system. However, it quickly determined that the enabling data transfer technology from its EHR vendor was not up to the task. To compound the issue, Sherman's primary medical device vendor said some older devices could not even be integrated with the EHR and suggested buying new ones at a substantial cost.

Instead, the 240-bed hospital turned to Andover, Mass.-based Capsule Technologie, a vendor that has built an interface library for more than 415 medical devices. Capsule's bedside medical device interfaces rely on device drivers that are specific to each vendor, type and version of medical device. Moreover, incorporating them into the clinical setting is a plug-and-play proposition, says Matthew Perry, R.N., a systems analyst at 240-bed Sherman Hospital. It only took a week in April 2008 to prepare some 100 devices - comprising 12 different categories - to transmit data. "The device drivers are the heart and soul of the BMDI connectivity," Perry notes.

But it took the hospital the rest of the year to fully configure and test the connections to the EHR from Kansas City, Mo.-based Cerner Corp., he recalls. That's because the task of making sure that specific vital signs data goes into the proper data field in the EHR is laborious. It's one thing to make sure heart rate data goes into the heart rate data field. But the hospital had to configure about 50 parameters of data. For instance, there are three types of parameters each for systolic and diastolic blood pressures.

The tedious task of configuring the EHR isn't specific just to Cerner's products, Perry says. "Generally, that's where the grunge work with any EHR system takes place when implementing BMDI."

To interface a monitoring device, Perry downloads the appropriate device driver from Capsule's Web site to software from the vendor called Data Captor. The software captures the data flowing out of medical devices, and then Perry can filter out extraneous data he doesn't want to stream into the EHR, such as the version of software running on the medical device.

End Result

Once the device interfaces and the EHR are configured properly, the benefits of having a direct data stream come almost immediately, Perry says. The entire site license for Capsule was less than half what Sherman Hospital's primary device vendor, Waukesha, Wis.-based GE Healthcare, wanted for new devices. About 70% of the hospital's devices come from GE.

With device data now streaming into the EHR, physicians don't have to go to specific units, such as surgery and intensive care, to leaf through papers and find the most recent vital signs. "Once it's in the EHR, physicians can see it from anywhere," Perry notes. The EHR also displays trends and generates alerts when appropriate. Lessons that Sherman Hospital learned along the way include:

  • When reviewing vendors for bedside medical device interfaces, ask specific questions about how many and what types of device drivers they have in their library. "There are options for BMDI other than having to go with your device or EHR vendor," Perry says. "When we began the journey, we didn't know there were options."
  • Involve clinicians in the EHR configuration work. A computer technician may look at a monitor and see a heart rate from the EKG and a heart rate from the finger-attached lead that collects oxygen saturation data. But a clinician knows that the EKG heart rate data is more accurate and should be the data collected. "It can be very difficult for a computer technician to configure this on their own," Perry says.
  • Once configuration appears to be done, "test, test, test" until you are assured the data is validated and patients can be treated without fear, Perry says.
  • Monitoring device data in the EHR provides opportunities to do data mining and analysis.

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