Photo Credit:  CareFusion

This month, TechNation asks the experts to weigh in on the latest trends in the infusion therapy equipment market. Responders include Brian Lucey, account manager for Tenacore Holdings; Eric Sato, senior director of marketing for Baxter’s U.S. infusion systems business and Dr. Tim Vanderveen, vice president of the CareFusion Center for Safety and Clinical Excellence.

TechNation: What are the biggest trends right now in the infusion therapy equipment market?

Lucey: Medical device manufacturers are focusing more on producing smart pumps that use wireless technology for features such as barcode scanning to ensure that patients are receiving the correct medications. Some of these smart pumps can even be controlled and programmed wirelessly by the clinician from a central station.

Sato: Two of the biggest trends right now in the infusion therapy equipment market are enhancing electronic medical records (EMR) connectivity and improving Dose Error Reduction Software (DERS) functionality and compliance.  Both are critical to guiding safe infusion therapy and must be intuitive. If a system is easy to use, compliance increases. With bi-directional wireless connectivity and advanced DERS safety features built in, fully integrated systems will enable hospitals to share real-time electronic information with nurses and clinicians to enhance patient safety at the point-of-care.

Vanderveen: With an estimated 65 percent of the U.S. market having already adopted smart IV pumps, most hospitals are now focused on maximizing the safety afforded by infusion technologies. Adopting wireless connectivity to infusion pumps has facilitated management of drug libraries, provided continuous quality improvement data, and created new opportunities for interoperability between the pumps and other elements of the medication use process.

TechNation: How will the market for infusion therapy equipment evolve in the next five years?  How will that affect service of the equipment?

Lucey: It appears that medical device manufacturers are focusing on designing pumps with more controlled safety features to reduce medication error. Many smart pumps nowadays record every keystroke in the history log. Some medical companies such as CareFusion and B Braun have even come out with pumps that require purchase of proprietary software in order to use them.

With this proprietary software, the medical companies have more control of the servicing market, which will affect third-party repair vendors since they will not have access to the software.

Sato: Systems will become ever smaller and more compact, making them more portable and saving space. Additionally, servicing equipment will become more modular, with faster turn-around time for typical repairs, either in-house or by a manufacturer or other third party. Information technology and biomedical personnel will likely become more integrated in a broader team approach to solving the most difficult technology challenges in house.

Vanderveen: Integrating infusion devices into healthcare information technology (HIT) systems will be the primary focus over the next decade. Without this integration, it will be difficult to realize additional safety and productivity gains. At the same time, integrating infusion pumps with computerized physician order entry systems, expanding bar code medication administration system to infusion pumps, directly documenting therapies from the pumps to the patient’s medical record, and incorporating pump alarms into “smart” alarm systems are high priorities and will usher in a new era of infusion therapy.

TechNation: What are some of the biggest challenges of purchasing and servicing infusion therapy equipment today?

Lucey: The biggest challenge would have to be when the OEM decides to stop support on pumps. Finding alternative sources to purchase replacement parts becomes the real challenge.

Sato: One of the biggest challenges is trying to balance the needs of various stakeholders at a single facility. Biomedical and clinical engineering leaders can and should become more involved in the purchasing decision, helping to determine the best infusion therapy equipment to purchase from a servicing perspective.

Vanderveen: When purchasing infusion devices, hospitals must ensure the infusion pump they select will be compatible with their enterprise HIT system and other information technology solutions in order to create a seamless system that maximizes safety, efficiency and effectiveness. The average infusion pump should last between seven to 10 years, so hospitals also need to consider the vendor’s customer support and service, as well as their future capabilities to adapt and respond to changing technology so the devices do not need to be replaced prematurely.

In the 2010 “Smart Pumps: Avoiding Buyers’ Remorse” report from KLAS, KLAS researchers found that 99 percent of interviewed customers of the CareFusion Alaris® System would repeat this purchase. The report also recognized that “Purchasing infusion pumps is a multi-stakeholder decision, and Alaris has shown its ability to satisfy nearly every stakeholder at almost every type of facility.” In addition, the report stated that “CareFusion clients rave about wireless capabilities and do not typically complain about wireless issues.”

For more information, please visit the CareFusion Patient Safety Center: http://www.carefusion.com/safety-clinical-excellence/perspectives/medication_management.aspx

TechNation: Please share your advice for people in hospitals that are faced with these challenges.

Lucey: There are many choices when it comes to service organizations. Do your due diligence and look for quality standards, national, standard of performance and customer service.

Sato: Wherever possible, leverage memberships with organizations such as AAMI, ECRI and others, and take advantage of learning opportunities at annual and local association meetings (such as biomed and clinical engineering association conferences) to better understand and share best practices in the industry.

Vanderveen: The challenges of achieving infusion integration system-wide include cost, technology, implementation and culture. Of these, cultural barriers can be the most difficult to overcome. The level of service required varies widely, depending on the connectivity function. However, any hospital wanting to have a wireless system that incorporates infusion safety systems should plan for full auto-programming, since this important safety capability will undoubtedly become widely available over the next several years. Auto-programming requires both the necessary technology (near-real-time wireless connectivity) and a fundamental change in clinical workflow at the point of care to associate both the device to a patient and a caregiver to the device. It also requires image recognition (currently barcode scanning) to initiate the programming process.

TechNation: What else do you want TechNation readers to know about purchasing and servicing infusion therapy equipment?

Lucey: Due to the down economy, we see a lot more focus on the cost of repair rather than the quality. That can sometimes resort to the use of vendors who are not even qualified or properly trained to repair certain pumps. Although cost should be a factor, it is also important to remember that these are life saving devices, and quality should always come first.

Sato: One of the first steps is to assemble an in-house cross-functional team to provide input and help you to secure the most appropriate equipment for your institution.  Typically the teams should be comprised of nursing, pharmacy, biomedical engineers, information technology and materials management personnel.

In its most recent reports, independent third party, KLAS, found that ease-of-use, a drug library, wireless functionality, cost and value were the most common factors in smart pump selection.  The more intuitive a device is, the easier it will be to integrate into an institution’s existing information systems.  Additionally, for most institutions, system cost and value is critical to pump selection; facilities want to see the return on their investment.  KLAS gave the SIGMA Spectrum Infusion System the highest overall performance score in its “2011 Top 20 Best in KLAS Awards: Medical Equipment & Infrastructure Report” based on overall performance, reliability and delivery of technology.

In addition to the system itself, cost of individual and complementary components should be taken into consideration.  For example, institutions should seek out infusion systems that work with standard sets, therefore potentially eliminating the need for costly teardown at each stage of treatment.

Vanderveen: Although pump interoperability is considered by many to be the “holy grail” in IV infusions, this interoperability has not come easy. In addition to having a vision and strategy to achieve the next level of safety and productivity, biomeds should remain realistic in their expectations as regulated devices and non-regulated HIT systems begin to merge. Wireless connectivity to pumps was first introduced in 2004, and seven years later, the number of fully integrated pumps and HIT systems is very limited. In addition, interoperability will increase interdependencies – and the need for very close cooperation – between the hospital’s biomed staff, the information technology team and the infusion vendor.