Tag Archives: medical computer

medical computers and emr certification

How EMR Software Upgrades Can Drive Computer Hardware Updates

The demand for computer capability has increased because of encroaching software complexity; we can no longer use clunky, old hardware to help our doctors and nurses complete an entire hospital shift. It’s not just a matter of how slow a process might run on a medical computer, but rather if a computer is compatible with software in question and how physicians interact with the computers. One of the reasons aging computers put restraints on the workflow for a hospital is because of increasing software demands, so here are several ways that software may drive the necessary upgrade in hardware.

Medical Computers are Popular for Multitasking

Computers don’t always serve just one purpose—multitasking is a commonplace activity, so what’s required is enough memory in order to support the concurrent programs they run simultaneously. Not enough RAM will turn any computer sluggish—multitasking and load time will suffer. It isn’t always easy to install more after deployment depending on the system. Some are sealed shut to prevent ingress, and so installing RAM may damage the internal components. Or, if the person installing RAM isn’t careful, the entire computer could receive electrostatic discharge turning it into a nice paperweight. The best way to address this problem is ensuring each computer in a deployment has more RAM than the minimum to run a particular software product. It’s a good idea to install the recommended level of RAM or go beyond what’s recommended. Thankfully, a lot of medical computers have customization options to choose how much RAM should be installed into the system before deployment.

EMR Systems Need Processing Power

If your EMR system is running sluggish, it’s time to upgrade. Most likely it’s a problem of an aged processor that can’t handle the number of Floating Point Operations Per Second (FLOPS), one measurement among many to determine the speed of a processor. Imagine all the frustrated doctors and nurses waiting to open a patient’s chart  while the computer cycles for several minutes just to display information. With the wide processor availability on the market, it can be a little confusing on what to select for a processor. Computers with Epic certification often run 6th generation Intel Skylake processors, common CPUs for a lot of Epic’s more complex modules. Medical staff can rest assured that the processor can handle software modules with ease and won’t suffer from excessive load times or computer hang-ups.

EMR Software Modules Utilize Touch Screen

A computer’s internal components aren’t the only factor in running a software product optimally. The way a doctor, nurse, or staff member interfaces with the software is also important. Imagine installing a VESA mountable computer only to find there’s no surface for using a keyboard or mouse and the computer isn’t touch-screen enabled! Touch screen functionality is important because it frees up the hands and removes the need for a physical keyboard if there’s no space for one. Plus, some EMR software products are only compatible with screens that are 24 inches diagonally in order to display all patient information. Computers with Epic certification are typically 24 inches or wider because of the visual aspect ratio for Epic; anything smaller and the software won’t run optimally—or at all.

Dedicated Video is a Must for some EMR Software

Surgeons using EMR software to give them instant video feedback—take an endoscopy for example—can’t use unclear, low-definition, choppy video to perform successful operations on patients. Upgrading to a surgical display equipped with a dedicated NVIDIA card is best for surgeons so they’re able to see in real-time what they’re doing as they perform on patients. Integrated video cards don’t provide that level of sophistication, so they pale in comparison to what a surgical display might provide.

Increased Software Security Means Increased Hardware Security

HIPAA violations are no laughing matter, and EMR software is developed with security in mind to prevent those violations. However, the software here dictates the requirements for hardware. Without a Trusted Platform Module (TPM), patient data is at a greater risk. TPMs encrypt patient information so drives can’t be pulled out of a medical computer and installed into a different computer, adding a layer of protection to sensitive information.

At Cybernet, we work with our partners to understand the complex challenges that healthcare IT professionals face on a daily basis. Because of that, we have engineered a full line of medical grade computers specifically engineered for multiple hospital and healthcare applications. For more information you can check out our website or contact us here.

 

medical computers and their role with patient engagement in telehealth

Here’s How Telehealth is Revolutionizing the Way We Practice Healthcare

Telehealth is a topic under heavy study because it’s extremely effective at reducing time and streamlining processes for medical care. It’s a complex umbrella term that addresses physician to patient interaction, how medical records are viewed and delivered, physician care and outreach, patient infotainment systems, and other important factors. One key aspect of telehealth is patient engagement technology which we are seeing improve over time with the rise of smaller, faster medical computers. Here are some ways patient engagement technology is changing telehealth and making healthcare more convenient for everyone.

Virtual Appointments are a Reality with Medical Computers

Online videoconferencing is the first telehealth innovation that comes to mind. It’s still a common practice for people to schedule appointments months in advance for an initial diagnosis and then follow-up appointments to treat or cure an ailment. If a patient needs information from a nurse, it still requires an appointment, more waiting, travel, another waiting room, etc. With the rise of telehealth, patients are able to skip waiting rooms and connect with a doctor or nurse via videoconference with a computer in nursing. If live appointments aren’t available, patients can still leave video messages and possibly show progress of a medicine’s effect. Nurses can hold “question and answer” sessions to keep patients informed and use visual aids to help patients understand their health complications. Plus, medical records can be updated on-the-fly using EMR software, streamlining the process from patient feedback to updating medical records. Growing advancements in this field have strengthened the interconnectivity of rural areas with hospitals. According to an online source published in 2012 called The Role of Telehealth in an Evolving Health Care Environment, telehealth reduces cost and increases quality of care for patients that can’t easily access the nearest hospital. A recent dermatology study showed physicians were able to increase their patient head count by approximately 270 per month with virtual appointments. Virtual appointments are a growing trend and studies reflect it!

Online Patient Portals are More Common

Patients in rural areas don’t always have the luxury of stopping by a clinic to get medical record printouts, so now there are online patient portals dedicated to showing medical records. Patients can even take questionnaires to narrow down a medicinal recommendation from a physician, request prescription refills, look at bill and payment history, or communicate directly with nurses in an orderly system to relay information about healthcare developments. As reported from the National Coordinator for Health Information Technology, over 60 percent of hospitals let their patients view, download, and transfer their health data in 2014. It’s a real growing trend now because of technological advancements with medical computers and web-based interfaces that take the waiting process out of healthcare.

Medical Computers Have Started Remote Patient Monitoring

Patients of all types struggle with time and keeping proper records for a doctor’s evaluation. Diabetics must watch their diet and monitor their blood glucose levels to track their health records. Clinically obese individuals transfer their caloric burn rate to doctors, necessitating another appointment, more travel, and more waiting rooms. It’s the same across the board for individuals with limited lung function, insomnia, heart palpitations, dementia, and other patients with measurable results of their health problems. With the advent of telehealth, remote patient monitoring can be automated and sent to a physician almost immediately. It’s all done within the medical computer, streamlining the process of getting information to the doctors without human error introduced.  The benefits have showed in research as well. As before, the key aspect to telehealth is patient engagement, and keeping patients informed through doctors’ notes and information about their illnesses has shown increased rates of consistent medicine ingestion and other metrics. There are interactive disease management programs in the field (BeWell Mobile for instance) that let patients send their vital signs to their providers electronically with quick recommendations from their providers on what to do if their symptoms flare up. Another excellent example is called the Virtual Dental Home, a telehealth program that lets dental health professionals transfer information between each other to assist patients in remote locations.

Patient Engagement Solutions are Integrated into Hospitals

One of the most desired aspects of telehealth is connecting inpatients to their families during their (hopefully short) hospital stay. Patient infotainment systems are a standard in hospitals because hospital guests can remotely connect with anyone they desire over the internet, along with ordering food, watching movies, or calling staff when necessary. It’s part of the entire patient engagement package, ensuring patients are well-educated on their ailments so they understand their role in self-care.

These are all results of advancement in medical computer technology pushing telehealth to expand healthcare reach, cut down on waiting time, streamline communication, provide remote monitoring, increase patient engagement, connect patients remotely with doctors and family, and deliver an overall better patient care experience.

 

 

medical computer systems

3 Ways Healthcare Usage Dramatically Impacts Hardware Longevity

It’s important for medical computers to operate 24/7 since healthcare is just as demanding. Internal components do not last forever, unfortunately, and demanding uptime for computers can seriously affect the longevity of hardware. According to an analysis by the Institute of Electrical and Electronics Engineers, The FDA issued almost six thousand recalls to hardware between 2006 and 2011, with approximately 1,200 of the recalls from computer-related failures. A vast majority of those recalls affected patient health. This study alone outlines a problem that hospitals face with computer-related failures and how those have affected patients—injury or worse. The FDA monitors reports of malfunctions and other problems after their approved hardware goes into the field in order to make adjustments to their regulations, but it’s an ongoing, never-perfect process. The best that can be done with post-fielding is ensuring stricter regulations on hardware, but that doesn’t guarantee that a hospital will utilize an FDA-approved piece of hardware to monitor patient health or control a medical device. The best way to minimize adverse events and malfunctions from a computer hardware standpoint is to ensure all components in a hospital’s set of medical computer systems are used with healthcare in mind. Here’s what we mean in detail below.

Medical Computer Systems Benefit from Solid State Drives

The unseen infection is terrible for hospitals and can result in nosocomial infections, so hospitals must take all precautions possible to ward away those infections. One such precaution has to do with patient data storage. Standard platter hard drives cause problems in hospitals by circulating dust mites and airborne germs throughout the air with their moving parts. A lot of consumer-grade computers only come with one hard drive without a backup solution, so if hospitals store their patient data on a regular hard drive without redundancy or backup, that’s a risky situation from data loss and HIPAA violation standpoints. Standard platter hard drives last (according to some sources) four years on average, but that’s with standard use, not constant. A lot of medical computer systems use solid state drives that, on average, last several years longer than older hard drive technology. Why? Fewer moving parts and less dust. Typically in a sealed plastic enclosure, solid state drives in embedded PCs alleviate a hardware component’s greatest threat—dust—and don’t use moving parts to read data. Solid state drives are put to the test from manufacturing plants via rigorous read/write tests and hold up against older technology. That’s why it’s crucial to select the best components to ensure the longevity of life for a medical panel PC and to protect patient data. Plus, medical computer systems often use solid state drives in pairs for redundancy and backup, ensuring nothing is lost when a hard drive failure occurs. Use of paired solid state drives combat three problems in one—spreading of airborne illnesses and dust, better longevity because of no moving parts, and patient information backup with a second drive.

Heat in a Medical Computer System is a Terrible Component Killer

Since EMR systems receive constant software updates, it’s important to get powerful hardware (intel i7s) and strong video capability to run and view the demanding software. However, pulling a consumer-grade PC off the shelf to run as a mobile EMR system won’t operate well. Let’s say a new computer runs an intel Coffee Lake i7 8700k with 32 gigabytes of RAM and an NVIDIA GTX 1090. Great! This system is capable of running the latest software at blazing speeds. However, what’s not addressed is the power of the CPU and components. The CPU on a consumer-grade processor pulls more power, which means more heat. Without a way to dissipate heat, the processor and surrounding components can easily overheat and melt. Fans are necessary for running components at high wattage, but they are also thought of as points of failure. If a fan fails, the computer in question fails—that’s it. That’s specifically why many healthcare facilities choose to deploy fanless medical computers  which run components at much lower power ratings, usually 35 watts for the processor alone. Less power means less heat, which means higher longevity and no fans. No fans mean no dust, which means even higher longevity for computer components and less risk for patient health.

A Medical Computer System Uses Higher-Grade Components

The MTBF (Mean Time Between Failure) is considered a defining standard for hardware reliability with two “branching” standards—the Department of Defense standard and the Bellcore/Telcordia Predictive Method, the former of the two being more recognized. Consumer-grade computers by some reports have a 2-year MTBF, and it’s likely that the lifespan of such a computer may be cut short if used in a demanding environment like a hospital. If a computer needs to operate 24/7, it’s far too demanding for a consumer-grade computer to handle. Constant heat, ceaseless running fans, and excessive power draw (adding expenses to an already skyrocketing energy bill for a hospital) will guarantee a shorter lifespan than a medical computer system which is built for 24/7 operation. This lower MTBF is also on a component-based level; consumer PC manufacturers don’t use high grade discrete components (diodes, resistors, transistors, etc.) that meet the reliability standard found in medical computer systems. The lifespans for medical computer systems on the market today span typically 3-5 years.

Heat, dust, power, lower-grade components with moving parts, and other factors clearly all point to less reliability and lower longevity when using a consumer grade computer as a medical computer system. Dust is a huge internal component hazard, so it’s best to have a sealed system that doesn’t ingest it. Heat is another gigantic factor in system longevity, so keeping components operating at lower wattage ratings will increase their longevity—also removing the need for fans. Medical computers with higher-quality, military-grade components will always outlast consumer-grade computers on average, ensuring medical professionals can get the job done while avoiding computer hazards to the patient.

Understanding the Unique Requirements for Medical Computers in a Hospital Setting

Hospitals gather a large population of infected individuals in one place, so it’s difficult to keep nosocomial infections from happening. That requires different standards for hospital operation and use of equipment. One of the largest reasons for hospital beds and rooms filling up is the invisible agent—microbes and bacteria that pass on unwanted viruses and pathogens that can quickly affect a small population. Since medical computers and devices operate with patient care in mind, careful consideration of a device’s build, materials, controlling software, and other factors must pass FDA regulations and meet necessary standards. Plus, medical care is not just a “part time” task. Hospitals operate on a round-the-clock schedule—a health-related disaster can strike at a moment’s notice, especially within an intensive care unit. These specific reasons why medical computers and devices are unique to the hospital environment are examined in detail here.

Medical Computers Need Antimicrobial Housings

Medical grade computers are built with either an antimicrobial coating sprayed onto the device post production or include an antimicrobial resin mixed into the plastic housing during manufacturing. But what exactly does that mean? Antimicrobial is an umbrella term that describes a range of abilities that disinfect and ward off growth of microorganisms, often times originating from bacterial, fungal, viral, or parasitical natures. The benefit of these medical computer builds is that even with passing microbes from surface to surface, the plastic housing of these medical computers discourages microbe growth. After multiple uses from several medical professionals, a computer built with antimicrobial plastics can still help prevent the spread of germs without constant disinfection. Recent news reports detail there was a bacterial outbreak at a nationally renowned hospital that infected ten patients, thankfully none of which were fatal. The patients were infants. An online report that detailed research into an Army ICU revealed MRSA bacteria living on keyboards, a problem that could have been alleviated with antimicrobial materials. It’s clear to see why medical computers require antimicrobial housing.

Medical Grade Computers Need to Meet Standards

One might ask what kind of regulations hardware and software might need for a hospital. A lot of consumer off-the-shelf products, both hardware and software, aren’t safe for patient and medical use. Consider what the implications could be using buggy software on a medical device! For that reason there are several rules, regulations, and standards for medical devices, some set by the International Electrotechnical Commission. One of the most accepted standards is the 60601-1 electrical and radiation standard, addressing verification, design methodology, risk / safety assessment for patients and staff, and other factors. It’s not possible to determine the total number of test cases for final revisions of hardware, which is why this standard is in place. Every revision this standard goes through brings significant changes to how medical grade computers and other devices must be built, often times focusing on the medical device’s operational distance to the patient. There are three distance classifications for the standard: B, BF, and CF. Type B operates near the patient, BF makes contact with the patient, and CF makes contact with a patient’s heart. Any medical device, whether in close vicinity or making contact with the patient, must meet the standards for safety. The FDA ensures medical grade computers and devices pass these standards for the safety of patients and the professionals that use them under the 510(k) regulation, requiring that manufacturers demonstrate their product is safe. There are a number of manufacturers that claim to have medical grade products, but haven’t actually been independently tested. Be sure to do your homework before any major hardware deployment.

Hospitals Need to Operate 24/7

Hospitals need to operate on a 24/7 timeline. Fortunately, the medical grade computers in question can operate with those time demands. It’s not just a matter of having a computer that’s always on—it’s a question of the computer’s internal components and if they’re intended to be on 24/7. For instance, many medical computers have an emergency back-up battery installed in order to remain functional during a power outage. Imagine if the power went out, all medical computers shut down, and all that patient data was lost! Even though most hospitals are equipped with backup generators, the seconds between a power outage and the generators coming online could result in massive data loss. Medical computers with hot swappable batteries eliminate the need to be reliant on an AC power source completely. These computers are powered by removable batteries and can provide up to 16 hours of run time before you need to exchange the batteries.

Medical grade computers cannot operate in the same manner that consumer-grade computers do; the implications of losing data, hardware malfunction, overheating, spread of germs, and other factors are far too great to sacrifice for patients. Plus, computers with moving parts are more likely to malfunction, especially under 24/7 operation.

One Must Consider the Application as Well

Even within a hospital, different departments have different needs. Operating rooms, labs, and ICU units are often sterile environments. In these environments,  a fanless medical computer would be required. To achieve fanless operation without overheating, these computers need to be built with specialized components that commercial grade manufacturers aren’t willing to invest in. The fanless operation prevents to spread of dust and germs through the air, which could be a major contamination concern in these high specialized areas.

In a perfect world, we’d be able to stop all nosocomial infections. For the world we live in, it’s important to use the right tools for hospital use to avoid spreading infection, keep patients safe, and operate at a moment’s notice without a high risk of failure. The published studies show that these are factors required by all hospitals to operate in the best manner possible.

medical grade PCs

Extending the Life of Medical Equipment with Medical Grade PCs

The IT challenges and needs for a healthcare facility are far different than those of a traditional enterprise. Mobility, EMR compatibility, 24/7 operability as well as the need to mitigate the transfer of germs and disease must all be factored in. But even within the healthcare space, needs can vary tremendously. Consider the differences between a hospital in a large metropolitan area vs. a hospital in a rural area. In a lot of rural areas, medical facilities don’t have the luxury of large budgets or the ability to upgrade medical equipment as regularly as a larger hospital in a more densely populated area might have. Extending the life of that machinery in a cost efficient manner is vital for these types of facilities in order to provide the very best in patient care without breaking the bank.

A customer of ours recently reached out to us to let us know how they have managed to extend the life of their mobile x-ray units by integrating a medical grade computer. Their solution turned out to be a stroke of genius, and allowed their facility to move from the analog age into the digital age.

Mobility Matters in Medical Grade Computing

Our customer employed mobile x-ray units in rural areas that needed medical grade computers for control. Consumer-grade computers wouldn’t have fit the bill—carrying around a heavily-wired computer and monitor would have been insufficient and cumbersome for medical staff, so they used medical-grade PCs with hot swappable battery functionality.  With a full 16 hours of uptime running on batteries, the staff didn’t need to connect to AC power while using their mobile x-ray medical devices with the medical grade computers. Plus, there’s no downtime with computers featuring hot swappable battery technology ensuring constant healthcare. Internet connectivity is also a concern. In rural areas, internet accessibility isn’t the best which calls for a different type of wireless capability. Many mobile computers are equipped with 3 and 4G wireless technology, so even in the most distant of places medical staff can send patient data to the hospital for review if need be.

Using Surgical Grade Monitors to Enter the Digital Age

Our customer was able to connect the surgical grade monitors to the mobile x-ray devices and get an instant x-ray result on the medical computer’s touch screen. Older technologies required large film emulsion plates that took hours to process within a dark room—that obviously isn’t a mobile solution. With an instant x-ray, our customer was able to zoom in on the patient’s affected area in question and diagnose patients. Instead of having to travel several miles to a distant hospital, wait for an x-ray, process the film, and then have a doctor review the x-rays, it’s done instantly on site so the hospital doesn’t need to purchase expensive and bulky film slates for x-rays. When patient mobility is reduced, it’s up to the medical staff to transport what’s needed in the most crucial times of patient healthcare. Our provided solution fit the needs for our customer and their patients.

Medical Devices in Healthcare IT Aren’t Cheap

Our customer needed a medical grade computer that interfaced with the mobile x-ray machines without a significant price tag. Older medical devices use a serial RS-232 port, which is a legacy port not often found on consumer-grade computers. The option to upgrade to a newer set of x-ray machines wasn’t available with average prices for them ranging well over 100 thousand. In acquiring the medical grade computers, they saved crucial business funds to focus on traveling to patients with hampered mobility.

Medical Computers That Also Meet Certifications

The medical grade computers our customer used weren’t just capable of interfacing with x-ray machines for medical staff use. The computers they purchased had a full spectrum of patient safety in mind, starting with an antimicrobial plastic that inhibited the spread and growth of microorganisms. These mobile computers with the hot swappable battery function were fanless and used internal solid state drives to prevent spreading dust and germs. They also met FDA standards for patient safety with a 60601-1 certification to protect patients from electrical and radiation-related hazards.

Online sources report that 80 rural hospitals have seen closures since 2010 and approximately 600 are suffering financially, numbers likely because patients and hospitals lack mobility. These computers helped the lives of people and kept hospital doors open. There are reasons beyond mobility, however, that prompted our customer to purchase these computers—they’re medically certified for hospital and patient room use. Consumer-grade PCs don’t measure up to the standard that these computers meet! Our customer was satisfied with their purchase of these computers with the hot swappable battery function, the instant x-ray feedback, and the medical certifications to protect patients.

 

EHR Compatibility

A Few Problems Medical Professionals Face with EHR Compatibility

Per the Health IT Dashboard, 87 percent of hospitals in the United States started utilizing EHR software in 2015, a massive jump in a ten-year timespan from 25 percent in 2005. It’s clear use of EHR software has become the majority standard in a decade. Medical professionals stick by this method of health IT and information monitoring because it reduces error, streamlines processes, and ensures patient satisfaction. However, that doesn’t suggest the EHR software universe is snag-free. As with any software, problems can arise when a new EHR software product is released into a medical environment with a competing software product, and many sources note that a collective of medical professionals are raising concerns about one of the most pressing aspects of EHR software: interoperability. This aspect of EHR does not address the capability or functionality of the software itself, but rather data transfer between systems that run on medical monitors. It comes down to what’s called the CCD, or continuing care document.

In EHR Compatibility, the CCD is What Matters Most

The CCD, per Wikipedia, is an “XML-based markup standard intended to specify the encoding, structure, and semantics of a patient summary clinical document for exchange.” A compromised development by ASTM International and Health Level Seven International’s Clinical Document Architecure, it is encoded by EHR software as it contains a substantial amount of data including medications, allergies, problems, lab results, and patient chart data. This document is widely shared among medical computers and EHR devices. While not a complete medical record, the CCD includes just the most crucial information for effective medical care. It should be viewable via any standard web browser, but some voices lament that’s not always the case with a lot of EHR software, which leads to one of the most prevalent problems in healthcare IT…

EHR Compatibility Can be Terrible Because of Proprietary Formatting

Much like proprietary audio files or specific Apple chargers vs. Android phone chargers, not every EHR software product exports a CCD that will be read by another. At first glance, it may seem that transferring EHR between systems is just a file transfer, but how does that file transfer take place? If medical professionals bring their own devices, there are HIPAA security concerns—putting a patient’s data on a USB flash drive certainly isn’t secure. If one EHR system is web-based and another isn’t, how does an individual transfer the files? Does a physician-hosted EHR system function with a remotely hosted system or a cloud-based system? EHR compatibility problems can arise within hospitals—not just on a hospital to hospital transfer—if their IT departments decide on conflicting software environments, further causing connectivity problems. It’s a tough call between remaining secure, transferring the information from one medical monitor to another, and finding the quickest way to do so without compromising the data. Sometimes medical professionals have to print EHR documents and transcribe them to another platform, introducing human error and lengthening a typically automated process. EHR has been a wide success because of the Meaningful Use program and the HITECH Act, but medical staff still spend time bothering with menial tasks getting information from A to B. Health care companies are encouraging EHR software developers to start using open format file types instead of proprietary. There’s still a lot of room to improve, unfortunately.

EHR Compatibility Depends on the Medical Computer

Certain medical computers, while meeting FDA standards for near-patient use, aren’t compatible with all EHR systems—some medical monitors operate on a 4:3 aspect ratio, while EHR systems may utilize a 16:9 ratio to display a full gamut of patient information. A computer with an incompatible display may reject software installation or could limit the functionality of the software. Furthermore, highly advanced EHR systems require two-factor authentication, and if a system isn’t equipped with hardware to scan authentication methods, it may likely reject installation. Compatibility isn’t just a matter of speaking with other EHR software products—it’s a matter if the medical monitor in question can even support it.

A Way Out of EHR Compatibility Concern

Epic is one of the most prominent EHR systems used in the medical industry, and there’s a strong reason for it; interoperability is a key aspect of the Epic EHR system. There have been strides to see a universal healthcare data format for EHR systems, but it’s still a goal that not every company adheres to yet, even though Epic has been a key software product in that avenue. The Sequoia Project is an organization that advocates for nationwide health information exchange, and Carequality is a project within Sequoia designed to address interoperability between all parties in a healthcare IT network—addressing policy and technical agreements for the exchange of data. As for now, EHR compatibility can be addressed by ensuring all computers running a specific EHR—whichever it may be—remain in the same local “network.” Having a unified system with similar hardware cuts down on training time and bypasses any compatibility problems. Ensuring that the computers that run the EHR software are certified for that software is a must too—purchasing a computer deployment that ultimately doesn’t work with a given EHR system is wasted money. If your corporation goes with Epic for your EHR solution, keep in mind that many of our CyberMed computers are Epic and Cerner certified.

Hopefully in the near future we’ll see a unified, open format data file shareable among all EHR systems so we can focus on patient health instead of the technology supporting it. This unified system will take effort from several roles—the government, EHR providers, payers, and patients too. Some medical professionals argue that EHR developers must have proper incentives to cater to a unified system; it is a competitive market, after all.

 

How Inefficient Communication Hampers Healthcare Quality… and What To Do About It

In the health care setting, success requires coordination and efficient communication across multiple disciplines and specialties. Issues can occur at any stage of communication  – in the management of urgent issues, or in situations when multiple members of the care team contribute to treating a patient. The value of efficient communication in healthcare can not be underestimated – it is critical in delivering patient care, especially under the Accountable Care Act.

Poor or inefficient communication contributes to the rising costs of care. A 2010 study estimated that communication inefficiencies among care providers cost the taxpayers $12 billion per year. A 2014 Ponemon study of the economic impact of inefficient communication in healthcare estimates that number to be $11 billion per year.

Roadblocks

What are the main roadblocks that prevent organizations from addressing the communication challenges effectively? We can categorize these roadblocks as people-, organization- and IT-related.

People:

  • The way medical teams and the workflow are organized does not foster close coordination. The teams often consist of transient members providing care to numerous patients on a number of teams. The transient nature of teams hampers inter-professional relationships, camaraderie and, thus, communication.
  • A patient can go through multiple clinicians in one day. It increases the likelihood of errors, and omission of key information, which makes it difficult to align care activities and forge an overall care plan so that each clinician understands it.
  • The overwhelming workload hampers innovation. For example, EHR notifications alone take at least one hour a day from the primary care doctors’ workday. On average, doctors have to process 77 EHR notifications a day, which makes their work harder to endure because that time is not compensated in an environment of reduced reimbursements for office-based care.

Organization:

  • Organizations mostly focus on order entry, EHR, and documentation rather than efficient communication.
  • Compliance needs outweigh efficiency needs.
  • The implementation of systems that help measure performance is difficult and costly, given the complexity of the workflow.
  • Organizations often struggle to ensure shared commitment from all stakeholders to enhance communication.
  • Insufficient awareness of the decision-makers about the affordable IT solutions that solve many of the current and future communication issues.

IT:

  • Increasingly complex processes are managed with outdated technology.
  • Many IT systems work in silos, which hampers interoperability, communication, and coordination.
  • Many IT solutions lack usability, and are difficult and time-consuming to use.
  • Compatibility of new IT solutions with the legacy systems, or the lack of thereof.
  • Management of a large fleet of different devices, BYOD, and stemming security and compliance concerns.
  • Budget constraints, lack of IT staff.

Economic Impact

The Ponemon survey respondents agree that significant time goes to waste at each stage of care. The estimated economic impact of those inefficiencies amounts to $1.75 million per hospital/year, and more than $11 billion per industry a year.

  • Admitting one patient on averages takes about 51 minutes, 33 minutes of which (65%) is wasted due to communication inefficiencies. The report estimates each U.S. hospital loses about $728,000 annually due to patient admission-related communication issues.
  • Coordinating an emergency response team takes on average 93 minutes, 40 minutes of which (43%) goes to waste, accounting for more than $265,000 loss per hospital annually.
  • Transferring a patient to another healthcare facility takes about 56 minutes, 35 minutes of which (63%) is wasted, amounting to $754,000 per hospital per year.

Among the main factors hampering communication are:

  • Inefficient, outdated technology.
  • Text messaging is not allowed.
  • Wi-Fi is either not available or not allowed.
  • E-mail is inefficient.

The lack of immediate, live connectivity between team members working on the same patient/assignment/team is the problem that hampers the communication in healthcare in the first place. The availability of compliant, secure technology is another problem.

Solution

Assuming that healthcare organizations do not have sufficient funds to implement complex and risky IT innovations, the solution must provide the highest impact at the lowest cost possible. It also must be scalable, sustainable and cost-efficient in the long term perspective. Medical grade all-in-one computers and medical grade tablets possess the necessary features.

Mobility: Telehealth and mobile technology are pushing the innovation in healthcare. When your teams are empowered with medical tablets that ensure live connectivity on the go, the total time spent per patient decreases significantly. The Houston Fire Department launched a program ETHAN that has outstanding results in improving communication via video conferences, instant messaging and mobile access to EHR. We strongly suggest that you read our coverage of the HIMSS17 session featuring the ETHAN project.

EHR support: it is mission-critical that the computers and mobile devices used in hospitals are EHR-enabled. This way, physicians can update the data on the go instead of spending 2-3 hours of uncompensated time each day to catch up with the electronic “paperwork.” EHR support requires robust hardware found in medical grade tablets and medical computers, but not in consumer grade electronics.

Compatibility with legacy systems: Your IT solutions must interface easily with your legacy systems, future-proofing your new acquisition for your interoperability strategy. RS ports, HDMI, mini and standard USB, and ample capability to run the hardware with minimum wires possible – only medical grade all-in-one computers allow such flexibility.

Advanced connectivity: 3G, 4G, Wi-Fi, Bluetooth, support for any GSM or CDMA operator of your choice – look for no less than a medical tablet or medical grade computer that ships with all these connectivity options. Only that way you can ensure the communication in your organization is ongoing and efficient through secure and compliant devices.

Full-shift uptime and energy efficiency: your medical computers and medical grade tablets must be Energy Star certified. To ensure full-shift uptime, your mobile solutions must come with powerful batteries and an option of hot-swapping them for a set of spare batteries so that your teams are continuously connected. Check out our infographic on hot swappable batteries in medical PCs.

Security: RFID Imprivata Single Sign-On, biometric reader/fingerprint scanner, CAC Smart Card reader, or Kensington lock, coupled with full disk encryption, and Windows authentication ensure your medical staff does not waste time on logins. Security must be user-friendly, and medical computers or medical grade tablets that integrate these peripherals in their build make security simple to implement and use, and compliant with HIPAA.

Safety: sustainable and cost-efficient IT solutions address multiple issues at once. So, your mobile or all-in-one PC solutions must come with an antimicrobial coating. To prevent the spread of nosocomial infections, make sure you opt for builds with sealed bezels and sturdy casing that withstands disinfection with chemical solutions.

IT management, administration: to ensure hassle-free administration, updates, maintenance and troubleshooting, your medical computers and tablets must be Windows or Linux-based for ample remote management options.

Ease of use: to alleviate technology fatigue, look for solutions that make usability one of their focal concepts. Windows-based medical tablets and all-in-one PCs provide the familiarity of interfaces and ample compatibility with productivity software used by your employees.

Device consolidation: this point is critical as it helps organizations invest less but gain more. When the same medical computer or medical grade tablet is used by doctors, nurses and patients at the bedside, organizations have fewer devices to buy, manage, and maintain: EHR for the doctors, drug dispensing for the nurse, infotainment for the patients combined with instant chat options or video calls. That way, patients stay connected with the medical staff, know who their clinician is, what their care plan is, and can learn the detailed information about their condition with the help of the educational apps and slides. Likewise, clinicians and nurses have an instant access to the patient’s ePHI from a secure device and can update the EHR data on the go, or communicate with team members.

When physicians use one device, such as medical tablet, instead of a wealth of devices (desktop PC, medical cart mounted laptop, pager, personal smartphone – all with disparate operating systems and app suites) it effectively minimizes the IT and notification fatigue, reducing physician burnout.

Cybernet takes all these factors into account when designing our medical grade tablets and computers so that our solutions not only boost the communication and coordination but are cost-efficient and durable.

Integrating Computers That Serve Dual Purposes Into The Medical Space

Health IT is improving patient health, data collection and safety, care quality and efficiency, but most importantly it is helping providers restrain rising costs. Through the implementation of technology that serves dual, or often times multiple, purposes, healthcare providers are introducing new IT solutions and cutting unnecessary spending. With the advent of specialized, medical grade computers, hospitals are finding ways to address both the doctors and nurses’ efficiency and productivity issues and patient satisfaction, which is directly tied into the provider’s rewards under the Affordable Care Act.

Hospitals recognize the value of a dual purpose computer integrated into the hospital rooms. Health IT, according to a RAND research, could account for $77 billion efficiency savings per year, when implemented fully.

Doctors and Nurses

Medical computers at the patient bedside are used by doctors, nurses and patients alike, and provide an unprecedented level of connectivity and efficiency to all.

EHR implementation is urged by the government, and providers adopting it seek ways to make their EHR systems mobile and accessible in real time. When doctors are able to submit the details of admission and all episodes of care at the patient bedside, no details are left behind or forgotten.

Fully-functional EHRs supply care providers with patient data, enable physicians to enter patient care orders and help make evidence-based clinical decisions. With a medical computer running an EHR system installed in near-patient environments, doctors and nurses no longer have to rush back to the office to enter the details of care, or seek a shared computer in the hallway. The immediate availability of EHR helps medical professionals reduce duplicate entries and test orders.

Computerized physician order entry (CPOE) and HELP systems enable physicians to order laboratory tests and prescription drugs digitally, without leaving a patient room. CPOE eliminates errors associated with handwritten prescriptions that are often illegible. The system checks prescription orders for accuracy and flags any that appear inadequate, effectively reducing preventable medication errors by 55%, according to a study.

HIT, EMR, image viewing, intranet communication and physician-provider order system – useful bedside applications are numerous. They store and transfers patient information, give timely recommendations on clinical problems, alleviate staff’s workload and reduce errors.

Patient Infotainment

Infotainment systems now have hospitals’ full attention since the Affordable Care Act makes their budgets dependent on patient satisfaction. Affordable and easy-to-deploy infotainment systems integrated into the existing hospital infrastructure without compromising hospitals’ legacy equipment make their way to patient rooms. They bridge the IoT devices, vitals monitoring systems, communication and doctors’ back-end programs.

Infotainment terminals enable patients to access entertainment and productivity apps and maintain a certain degree of productivity even during their hospital stay. Communication is vital in patient satisfaction. Not only can patients keep in touch with their family, but first and foremost they can reach the nurses and doctors in real time. This often allows nurses to provide necessary recommendations and help without having to be physically present in the room. Patients benefit from such interactions by maintaining a high level of independence, self-sufficiency, and improved awareness through timely communication with their caregivers.

Self-service attributes to patient satisfaction when patients can order meals after consulting the physician’s dietary recommendations, access online shopping, or control connected curtains, beds, and lighting.

Providers reduce preventable readmissions with the help of educational videos and slide shows that explain the necessary details a patient should be aware of after discharge. Such easily accessible, personalized educational videos and interactive programs help patients understand their conditions and alarming symptoms. Patients can revisit the information, conduct online research, and ask their physicians timely questions on side effects, allergies, etc.

Combined, these capabilities create an all-new patient experience, with an aware and engaged patient sure to give their hospital stay a high rating.

Integration

For the bedside computers to deliver their promise and serve multiple purposes, several obstacles must be overcome.

Interoperability. First, the computers must be able to speak the legacy language and be compatible with the older equipment. Many systems must be linked at the bedside to serve the doctors, so the support for legacy equipment is critical.

Connectivity. Health information exchange (HIE) allows the healthcare providers exchange clinical information across a region, community or country. Besides the HIEs, connectivity is also the wired and wireless connection options. In a perfect scenario, a medical computer installed at bedside should contain as little wiring as possible, to ensure safety and protection from electrical hazards. From this perspective, computers that come with Power-over-Ethernet capability are ergonomic and cost-effective solutions.

Hardware. Computers that serve a dual purpose at patient bedside must be powerful enough to run the resource-hungry EHR programs, yet easy-to-use for the patients. Hence, such technology calls for high-quality components, long product lifecycle, low maintenance costs and low fail rate to prove their value to healthcare facilities that can not afford to replace computers too often.

Safety. Safety certifications such as ingress protection, CDC guidelines and other must be in place for a multipurpose computer installed at the patient bedside. Moreover, with the hospital acquired infections being a serious liability and readmission risk, computers must be easy to disinfect, or better yet, antimicrobial. Plastic casing and touchscreen in regular touch devices are infested with pathogens. Consumer grade touchscreens can not withstand proper disinfection, so an antimicrobial coating on touch screens and a sturdy casing that withstands disinfection with chemical solutions are a must for bedside terminals.

Security. Since dual-purpose computers are used by multiple users, the adequate data protection is necessary. Patients are becoming increasingly cautious about data privacy while doctors and nurses can’t spend too much time on complex password-reliant authorization procedures every time they need to access patient records from a bedside computer. Yet, a data breach is a serious liability under HIPAA. Therefore, medical computers must provide solid data protection mechanisms – encryption, secure user authentication with biometric readers, RFID readers, or Smart Card readers, access restriction to sensitive data, remote location and disk wiping in case of a theft. Such stringent data protection requirements call for the integration of the advanced authentication mechanisms into the build of the computer (integrated smart card or RFID reader and biometric reader).

Such computers can not be consumer versions of mobile devices running Android or iOS. Only Windows or Linux are capable of providing the complete compatibility with the security software and remote access solutions used in healthcare. Patients must feel assured that their records are accessed only by the personnel with a legitimate need to know.

Cost. The affordability of dual-purpose health IT systems is often a deal breaker, where the cost of ownership, maintenance, and fail rate must meet the industry expectations. Medical equipment is more durable than consumer electronics. Therefore, medical computers must be at par with the other equipment to provide the durability and 24/7 uptime for years to come.

When the above requirements are met, integration of dual-purpose All-in-One computers in hospital rooms is cost-effective, while its benefits are generous. Cybernet tracks the vital needs of the healthcare industry in real time, so we build our medical computers aiming to exceed our clients’ expectations.

How Hackers Can Infiltrate Networked Medical Devices

Until fairly recently the medical community was not aware of the fact that there are hackers out there who have the ability to infiltrate a hospital’s medical devices and exploit the data contained in them for profit or for other purposes. Even though these devices tend to be protected using a firewall, they are still highly vulnerable to potential hacker attacks.

What’s more, the number of devices used in hospitals has been growing for decades. Roughly 20 years ago, there was just one medical device for a single patient, on average. Today, there are approximately 10 to 15 devices per bed. In total, in the United States alone, the estimates total number of such devices is between 10 and 15 million. When a hacker is capable of infiltrating one such a device or hospital, that person has the ability to do the same with other hospitals, too, as they often use the same type of equipment.

So the first thing to ask is: what kind of data could be stolen?

The computers at hospitals often store personal information about the patients, including their Social Security numbers, dates of birth, addresses, relationships within the family, and emergency contact information.  This data can easily be used for blackmailing. On top of that, many hackers do not hesitate to assume the identity of the person whose data has been stolen, thereby engaging in insurance fraud and other types of fraudulent behavior. It’s also not uncommon for hospital PCs to also contain credit card information of the patients. This information has value to the hacker, as it can be used to make purchases online and in certain cases, is re-sold.

Devices That May Be Targeted

The list of devices certainly does not end with computers, however. There are also ventilators, CT and MRI scanners, infusion pumps and other types of medical equipment that can be accessed externally and controlled from a far distance.  This is because most, if not all of these devices, are connected to the Internet. They also tend to be inter-connected so once one of them is infiltrated, the others are usually affected as well.

Consider an infusion pump as an example. These can be found in virtually every hospital room, attached to a stand right next to the patient’s bed. What’s scary is that these pumps are usually controllable from a distant location. A capable hacker could find a way to push these buttons without a remote control and pour an overdose of a drug into the patient’s body, which could prove to be fatal. Even a slightly higher dose can be lethal in some cases.

Hackers use various tactics to get into the system. They can take advantage of email phishing and send deceptive emails to the staff of the hospital, making them believe the email is coming from an acquaintance, a colleague, or a friend. These emails often contain malware, which once installed, gives a hacker to the device. In many cases, once one device is infected with malware, a hacker can then infect other devices as well, thus gaining full control of the networked medical device system.

How to Protect Yourself

Fortunately, since there have been many attacks on hospitals in the past, hospitals can now learn from how these events took place in order to be able to anticipate such an attack and take measures to prevent it from happening. It is advisable to use up-to-date antivirus software on the computers used within the hospital and perform regular scans to decrease the likeliness of having some sort of malware on the computers. Often times, the malware is kept hidden from you and, just like viruses that attack living cells, may remain dormant for many months until a hacker realizes your computer is infected and exploits it.

If a member of the hospital staff finds out one of the devices is under a cyberattack, one thing to consider is to disconnect all of the devices from the internet. As the saying goes, anything that is connected to the internet can be hacked in one way or another. Until recently, medical devices, such as infusion pumps, were not online and so hospitals still need to get accustomed to the idea that their equipment could be attacked. Many of them simply do not consider this to be an option due to a lack of imagination. They do not see why a hacker would be motivated to choose a hospital as the target. However, there is a motivation behind such actions, as the hacker is trying to get the patients’ bank account information and other pieces of highly confidential data. Therefore, it is a bad idea to under-estimate this menace.

One thing a hospital can do to be prepared is to use medical devices created with security as the primary goal. A tablet with an added layer of ID verification can be the way to go. Such a tablet may include a fingerprint reader, so that only authorized personnel may access the data on the tablet. Furthermore, it can feature a smart card reader to allow only people with the card to access the device.

Conclusion

Cybersecurity in hospitals is a growing concern not only in health care but in defense and other areas, too. As an example, a metallurgical furnace located in Germany was cyberattacked and the iron contained in the furnace was cooled and solidified in the process. The incentive for hackers is mostly financial, but sometimes they pick an institution just because they want to do harm, just like in the case of the furnace. The most effective ways to tackle this problem and prevent security breaches within your organization are to:

  • Use modern, secured devices
  • Continuously stress the importance of security to your employees

How to Develop a Workflow for New Medical Technology

When your healthcare setting is used to working in its old ways, it can be a daunting experience trying to plan out a new addition to the workflow. New technological advances and improvements have brought out new medical equipment that can help save you space, time and money; and, most importantly, improve care practices.

Adding a new medical computer or tablet to your system doesn’t have to be difficult. If you’re considering implementing a piece of medical technology, there are ways you can put together a workflow to accommodate it.

The key to whether it is successful, or not, is pre-planning and mapping out the specific role the new device will have in terms of day to day activities. Since the device will be attached to a cart, the flexibility it offers is vast, providing more opportunities to ensure accurate and efficient patient care.

Learn How to Use It

The most important step is to learn how to use the new tablet or computer on the medical cart. You should plan a staff meeting or workshop prior to implementing it. Have all personnel that will be using it attend this meeting. Discuss the way the equipment will impact the day-to-day activities and provide educational instructions on proper usage.

Windows Tablet – These are small and portable. They may have additional functions like scanning barcodes on wristbands or prescriptions. It may come with a stylus pen that could take getting used to. You may even want to use a front or rear-facing camera. Tablets are used on the go and may require practice for those that have never used them before. When mounted to a cart they offer ultimate flexibility and versatility for a medical practice.

All-in-One PC + Medical Cart – These are used as medication carts, part of a nurse’s station or for administration to get information, like health insurance, from the patient. These carts allow the computer and keyboard to attach and move around with ease. If your healthcare setting has never used a medical cart before, this would be one to bring up and introduce as a new addition.

Once staff members are comfortable with the new addition, it is crucial to explain the role it will play in day-to-day activities.

The Role of the Device

The most important question to ask is how the new computer will be used. Implement a strategy of how the new device will impact each activity by each staff member. For example:

  • Check-in: Use device for registering patient, verifying information, alerting nurse/doctor of arrival.
  • Triage: Update specific issue or reason for the visit. Alert doctor to the patient’s presence.
  • Consultation: Doctor can use device for ordering tests or labs, prescribing medication, taking notes of the evaluation of the patient.
  • Follow-Up: Select options for front desk staff to know if new appointment is needed, what patient needs to pay and any other pertinent information.

The modern devices provide the custom setup necessary for all types of medical devices. This allows medical practices to have the devices pre-loaded and ready to go for their specific practice.

Ease It into the Workflow

After educating staff on the new piece of medical equipment it is essential to introduce its purpose and benefit to every department or staffer. It is crucial to make sure each person knows the role of the tablet or computer in their specific position. This will make the transition of not using the machine, to using it, worry and trouble free.

Administration – A medical computer in administrative and financial settings provides accounting systems like patient billing, payroll and materials management. These are typically located on desks in the office. Administration will need to back up data and ensure that no important information is lost during the transition.

Healthcare Professionals – A medical computer, cart or tablet may be introduced to a healthcare professional. Nurses who have never used a tablet before may need to learn how to use one for the first time. Nurses are very busy and you will want to make sure there’s a good plan set up before tweaking their routines. Same goes with physicians. If they are used to writing with pen on paper, a tablet with a stylus pen could be quite a change. They may be older and uneducated in computer technology. Even those who grew up when computers were coming out may have trouble learning how these new systems work.

Summary

Learning how to implement the new computer or tablet for a medical practice can take time, but when a plan is in place, it will minimize the confusion or issues that result. There are far too many medical practices attempting to introduce new technology, such as the tablet or computer cart without letting staffers know its purpose and how it will impact efficiency, patient care and productivity. Making a specific plan for workflow integration will make the entire process seamless and provide a significant ROI for the new technology.