Hospitals can generate enormous benefits for patients and increase their own productivity by creating technology networks that enable medical devices to share information. Those that are able to achieve this goal will be able to improve accuracy and timely access to real-time data, monitor patients remotely, reduce paperwork and improve decision-making. They will also generate enormous gains in productivity, giving nurses and clinical staff significantly more time to care for patients instead of manually monitoring hospital equipment.
During the past five years, I’ve served as the healthcare technology project manager for Crothall Healthcare at several hospitals that have made the leap to a seamless technology network. Bulky manual charts were replaced long ago with network-based systems, giving caregivers the ability to manage “big data” and making the timing right for more hospitals to undertake this task now.
How BMETs Can Help
To build a network that will connect a hospital’s biomedical equipment, it’s important for BMETs to understand several pieces of information.
For starters, they need to know that one protocol – Health Level 7 – is now the international standard used to transmit all health and medical records electronically. Commonly known as HL7, this protocol can send specific messages to key personnel. For example, ADT is Admission, Discharge, and Transfer messages and data. The channel transmits data about bedside admitting and for patient transportation within the hospital.
To connect a hospital’s technology network, it’s also important to understand the hardware in a Bedside Monitor Device Inferface (BDMI) configuration, largely because nursing floors and operating rooms are moving to BDMI. The key hardware components include:
BMETs will also need to understand mapping, which connects HL7 outputs to meaningful entries into all electronic medical records. To create the map, a list of data headers is needed from the device manufacturer. This information will be cross-referenced with information in the electronic medical record chart entries.
Finally, measuring vital signs is a unique challenge because of the device’s mobility. An additional module must be purchased from the EMR vendor to connect this equipment to the network. This is a critical aspect to understand and ensure a successful implementation.
Building a Coalition to Succeed
As a project manager, I’ve worked closely with the nursing, informatics and information technology departments, as well as the device manufacturers. The role includes needs assessment, design concept, gathering price quotes and working with subcontractors. Teamwork among all of these groups is the key to developing, implementing and connecting the biomedical equipment.
In most cases, the IT department will be charged with connecting all of the biomedical equipment into the technology infrastructure. Because the nursing and clinical informatics departments use the equipment to monitor patients, their expertise and buy-in is critical to the integration.
BMETs can play a strong role as well, especially if they can demonstrate basic knowledge of BMDI equipment and other devices. Because of the number of different groups involved in creating the network, it’s important to organize and create partnerships among these different groups from the start.
Once all bedside monitoring devices have been integrated into a single network, the return on investment for the hospital can be extraordinary. Connecting electronic health records with the BMDI immediately enables clinicians to focus much more of their efforts on the patient instead of manually monitoring a slew of equipment.
How it Can Work
In 2016, I helped lead a team of hospital managers that implemented a comprehensive patient monitoring solution, as well as some other medical device integration, at a 150-bed hospital in Texas.
The hospital’s IT department developed a network cabling plan, and installed the middleware and a gateway. We worked closely with Cerner, the device’s manufacturer, to map all data points for all electronic medical records to the network.
Once the connections were made, we were able to monitor a patient’s heart rate, vital signs, EKG, blood pressure and ventilator data. Without the network, medical staff would be needed to monitor this information every 15 to 30 minutes. A clinician would need to manually enter all data points. This is not only time-consuming and a poor use of this person’s time, but one typographical error could lead to a possible misdiagnosis of a patient. Now, instead of focusing on the computer, the clinician was focused on the patient. They were getting more data and were more productive.
Even with these benefits, there is one note of caution; hospitals must be wary of creating the possibility of potential security breaches. HIPAA data can reside on any biomedical device or on network devices, so this information must be cleared when a device is retired or sent to service depots. In addition, viruses and malware are especially risky on scaled-down operating systems, such as embedded Windows. As security threats continue to emerge, BMETs will be a crucial part in any hospital’s technology solution.
Ryan Sanders is a Resident Regional Manager for Crothall Healthcare in Tyler, Texas.
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