Gotta get yourself connected

More timely, inexpensive, and accurate data capture enhances a hospital’s competitive advantage, but aggregating medical devices requires real expertise, says Martin Poppelaars of Lantronix

Remote health monitoring, personal wellness, and assisted living are expanding healthcare markets that are increasing the use of mobile devices and services that can securely record, store, and share personal healthcare data. Smartphones and tablets are increasing in both consumer and healthcare sectors and there are thousands of medical and healthcare applications available.

Many machine-to-machine (M2M) analysts have forecasted that the markets for connected medical devices may not grow as quickly as deployments in areas like automotive telematics and smart grid, however Lantronix begs to differ. One key to the growth of M2M in medical applications will be data aggregation. When there are several medical devices involved in the monitoring or screening of a patient, some form of aggregation is often necessary to consolidate the data in a way that can be forwarded, analysed and reported on by a lab specialist remotely and in a coherent manner. These aggregation devices can take the form of a simple PC or can be dedicated hardware with a variety of connectivity options.

To achieve this connected medical devices (CMD) are invaluable to the medical industry. Each CMD saves from four to 36 minutes of nursing time and prevents up to 24 data errors daily. They can also save over 100 hours of nursing time per day in a typical hospital, giving nurses more time with patients and improving the quality of care. By stopping over 800 data collection errors each day, hospitals can offer greater efficiency and improved patient safety.

The benefits, therefore, are clear; but how can hospitals move easily to this type of environment, and what role does the product manufacturer play in making it happen?

The need for hospitals to connect their devices to an electronic medical record (EMR) is increasing; too many still operate as independent “islands” of functionality and data. CMDs will play a growing role in this, particularly outside of the hospital, in the management of chronic conditions and prevention of hospital readmissions.

It is the responsibility of medical device manufacturers to help translate device data into a format that can be read and understood by EMRs. They must also support industry standard wireless networking security protocols, dual band wireless communications, and multiple interfaces to help hospital customers realise the potential benefits of device connectivity.

Consumers, healthcare providers, medical equipment vendors, and lab technicians are recognising the benefits of mobile healthcare devices and services to monitor and share patient vitals with physicians, to provide personal access to aggregated health information, and to use in emergency response situations where there is limited access to infrastructure.

However, these devices, systems, and applications also present challenges around ensuring privacy and security, connecting multiple heterogeneous devices, and aggregating and sharing information.

In order to deliver high-quality care and meet regulatory mandates, hospital labs must collect increasingly detailed clinical data from inpatients, while reducing staff costs. In the near future, hospitals must also take responsibility for the data required to achieve measurably superior outcomes beyond their walls. Obtaining the additional data required to manage and coordinate care inside and outside the hospital, without spending a fortune on staff, requires the ability to automatically retrieve information from medical devices.

While device connections can be used to remotely monitor, control and configure devices, it is their patient monitoring function that adds the greatest value. Patient physiology data; drug administration data including dose, timing, rate, etc.; ventilator therapy data; and many other key pieces of information can be recorded to help medics provide optimal care to patients.

When these devices are automatically connected to an EMR the completeness, timeliness and accuracy of the data that becomes available is much greater than what could be manually charted by nurses. What is more, the potential quality and safety of care improves, while the time and cost required to collect and chart the data is greatly reduced.

In short, the best practice for preventing hospital readmissions includes the use of connected devices in care facilities and patients’ homes. By making use of remote device data, patients can be kept in the comfort of their own homes, and therefore avoid unnecessary hospital care.

Today most electronic medical devices are found in hospitals and they use a vast number of common devices, with IV pumps, physiologic monitors and vital signs monitors, making up 85% of the total. They also use dozens of other less common devices.

However, very few of these devices are currently connected to a hospital network and the number of connected medical devices in hospitals could easily grow by a factor of ten.

Reliable statistics are not available for the use of electronic medical devices outside hospitals and labs, but their number is expected to grow dramatically. The need for more accurate, timely and efficiently collected data will increase use of CMDs in nursing homes, doctors’ offices and other healthcare facilities. However, the greatest growth is expected to be in patients’ homes and other locations outside of formal care environments, because potential improvements in data collection efficiency, cost and timeliness are greater outside of healthcare facilities.

Research shows that nurses spend approximately two and a half hours per shift on documentation activities, reducing the amount of time they spend on direct patient care and increasing job stress. CMDs can automate a significant amount of nursing documentation. This in turn can help increase time devoted to patient care, which can improve patient outcomes.

In spite of the substantial benefits of CMDs there is a great deal of frustration among hospitals and medical device vendors over the technical and operational challenges of connecting their devices. The key challenges include translation of device data from numerous proprietary device formats into something that can be read and understood by EMRs and other information systems, supporting industry standard wireless networking security protocols, dual band wireless communications, and multiple interfaces in addition to serial connections, and minimising the burden of testing to ensure that devices are compatible. Device manufacturers must also balance their need for stable product designs that can last many years to earn back the high costs of device development, with the rapid evolution of technical capabilities and standards.

Meeting the technical challenges and concerns surrounding device aggregation are far from insurmountable. Hospitals, laboratories and medical device manufacturers today are doing everything they can to maintain quality and patient care while under major cost containment or even cost-cutting pressures. These pressures often leave doctors, nurses, lab technicians and engineers facing the challenge of having to work harder than ever to deliver the same quality in patient care. Therefore, with the global medical equipment market expected to reach $350 billion by 2016, and the average hospital using 800 devices this creates a growing need for device aggregation in this space that manufacturers should be looking to capitalise on.

The author: Martin Poppelaars of Lantronix