We, and the medical sector at large, have discussed lacking EHR interoperability ad nauseum. The basic idea being that, despite advances in medical technology and the medical device computers that fuel them, EHR compatibility issues still run amok. This is because EHR developers predominantly deliver software that can only share information with other software and programs developed by them. Unfortunately, these issues aren’t just limited to software either. Medical professionals have also suffered from a lack of medical device connectivity for quite some time. 

In much the same way that EHRs are unable to share information with each other, medical hardware used within primary and emergency care facilities also struggle to consolidate patient data into one shared device or software solution. This is also due to the fact that hardware developers only create solutions capable of communication between devices developed by them and put little to no thought into compatibility with devices outside of their network.

In a presentation for HIMSS20, Tobias Klotz, system architect for Dragerwerk AG, emphasized that medical device connectivity issues have been felt potently, especially recently given the current pandemic. He specifically mentions that interoperability standards between life-saving devices such as fusion pumps and ventilators have been very slow in their development. And the reasons why can be easily observed if one takes a look at current medical device communication standards.

What are Medical Device Communication Standards?

Despite how troublesome medical device interoperability may seem for care providers, standards do exist for cross-machine communications, though they are definitely lacking. Many medical devices with external computer systems required to share information need to meet ISO/IEEE 11073 device connectivity certification.  

The Goals

ISO/IEEE 11073 standards apply to both personal health devices as well as acute care tech such as infusion pumps and ventilators and they outline the necessity of devices to be able to share information between different databases. In an ideal world, these certifications are intended to accomplish three goals. 

  • 1.) Promote delivery of real-time data transfer, allowing for responsive readings and timely transfer of data. 
  • 2.) Provide ease of use and a “plug and play” interface for devices where steps needed to transfer data would be minimal and simple to execute. 
  • 3.)  Improve the accurate exchange of data, meaning patient information isn’t only sent from device to device, it is sent in its entirety with no lost values.

Were these certifications a perfect solution, medical device connectivity issues wouldn’t be an issue, nor would it warrant a blog post raising awareness of its existence. Unfortunately, there is a problem that exists that stops these standards from accomplishing all three of the goals highlighted above. 

The Problems

The main issue we see providers facing is that, while devices developed by the same manufacturer may meet these standards and accomplish those device connectivity goals, devices developed by two disparate providers don’t. In several cases, two devices with different functions that both rely on the same patient data aren’t able to share that data with 100% accuracy since developers don’t account for how well their devices communicate with other vendors’ devices. It’s the same issue we’ve observed with EHRs that have resulted in shockingly high amounts of EHR physician burnout.

Because physicians can’t trust these devices to share data with complete accuracy, they need to turn to antiquated forms of vital tracking like manual note-taking. Pen and paper note-taking takes time to scribe, edit, and input manually into a device that immediately nixes the possibility of real-time data transfer. Furthermore, it hardly provides ease of use and “plug-and-play” functionality since staff needs to resort to roundabout ways to intake patient notes. And finally, it introduces the element of human error into the equation by having staff physically record notes.

Thus, we see how these standards fail across all three of the goals we highlighted earlier once we stop looking at devices that are developed by the same manufacturer and, instead, look at the very realistic environment where several devices from several manufacturers, each with their own distinct purpose and function, are present and need to share data on a single patient.

What Benefits Would Medical Device Connectivity Solutions Deliver?

Of course, these medical device connectivity issues are well known in the industry at large. In fact, in the very same HIMSS conference, Tobias Klots also mentioned that new standards are currently in the works. These new standards are intended to allow vendor-independent app developers to create applications that could consolidate all of the information drawn in by these different devices. So, should these new standards be enacted and executed well, what benefits could we look forward to? 

Optimized Care

Right off the bat, an effective medical device connectivity solution would eliminate the need for manual note-taking and vital tracking which would diminish costly and patient-endangering human error. By having all of a patient’s information accurately shared across all devices used in their care, doctors, nurses, and even new providers brought on to treat that patient can receive a comprehensive look at their healthcare journey without needing to meticulously translate inaccurately transferred data. 

Beyond that, by standardizing the way medical devices are able to communicate with each other, facilities can also send information on a patient to other facilities outside of their network knowing full well that devices on the recipient’s end can receive and understand the data being shared with complete accuracy. Functionality like this can open the door to impressive clinical collaboration use cases such as cancer boards where several specialists from different treatment facilities will often need to cooperate in caring for a single patient. 

Reduced Burnout

Imagine a patient hooked up to multiple machines, each with their own functions and vitals that are being tracked and each set to ring an alarm when the vital it’s responsible for tracking reaches dangerous levels. It’s easy to see how a set up like this can result in what’s commonly referred to as “Alarm Fatigue”, a phenomenon that occurs in both patients and physicians in which regularly blaring alarms cause increased levels of stress, anxiety, and burnout. Unfortunately, even though nearly 90% of these alarms are considered “false alarms” or clinically irrelevant, there’s always a chance that emergency care is needed and so a caregiver needs to respond to each and every one.

The reason so many of these alarms are false alarms is because each machine that’s hooked up to a patient is operating in a vacuum tracking only the vital it’s been made to track. Due to a lack of medical device connectivity, each device isn’t receiving information from the other devices hooked up to a patient which would possibly explain that the vitals it’s tracking as “dangerous” is actually normal for a given patient because of a certain treatment they’re undergoing.  

In a world where medical device interoperability is realized, all of these devices could work in tandem, tracking vitals in conjunction with one another and only sending off alarms when it’s truly necessary. Even better yet, if these new standards do right by their intentions of creating apps for physicians that consolidate these machine readings, we can even have physicians be notified on their medical cart computer or medical tablet as opposed to blaring these alarms next to the patient who is likely to become incredibly stressed hearing them.

Where Can You Start to Make Data More “Interoperable”

Unfortunately, while medical facilities wait for these new standards and then the subsequent applications to hit the market, they’re still left with the issue of alarm fatigue and inaccurate patient readings. Until then, optimizing the way your staff takes notes and records patient data can go a long way towards improving how “shareable” data is across different systems.

Notes taken in the SOAP healthcare format, for example, can ensure notes and vitals tracked by staff are easily navigable. Since this format is also especially common in many healthcare facilities, practicing this can also be helpful when sending that data off to other facilities for a second opinion or a specialist’s point of view. Of course, this is still manual data entry which opens the door for some human error, but this SOAP format can definitely help limit those errors by compartmentalizing information into categories.

If SOAP notes aren’t the way you want to go, that’s fine as well. Just make sure you have a proper training program for whatever note-taking process you plan on employing. If your entire staff is on the same page regarding note-taking and how it should be done, that’ll go a long way towards saving time and patients from human error.

Medical Device Connectivity Solutions Are on Their Way

It’s unfortunate that these new standards aren’t here when we need them most, but we can all take solace in the fact that they are being addressed and the issue of medical device connectivity is on decision-makers’ minds. Until larger changes are made, the right policies and hardware in place can go a long way towards improving the internal interoperability of your own facility. For more information on the tech you need to improve your own medical device connectivity, contact an expert from Cybernet today.