By George Gray
On March 9, 2020, two days before the World Health Organization declared COVID-19 a pandemic, the U.S. Department of Health and Human Services (HHS) finalized its interoperability and patient access rules, intended to drive interoperability and finally give patients increased and better access to their healthcare data.
While the healthcare community has since rightly shifted from focusing on HHS’ rules to battling COVID-19, the pandemic has underscored the need – and value – for the industry to advance interoperability and make better use of real-time data in the delivery of care.
There’s more to interoperability than just exchanging data between medical devices and systems; true interoperability enables a significant reduction in medical errors and empowers clinicians to make more well-informed decisions.
Adoption of interoperability and real-time data
It’s important to understand that interoperability is a journey – not a destination – and its progress depends on three important factors, according to the Center for Connected Medicine’s interoperability survey:
- Commitment by senior leadership;
- Financial incentives that encourage organizations to share data with one another and with individual patients (with penalties for not doing so); and
- Advances in tools and technologies.
While these factors shouldn’t be too surprising to those in the healthcare industry, it’s critical to remember that as we shift to patient-centered care, the desire to improve patient outcomes, safety and care must be the driving force behind all interoperability efforts in medical devices and healthcare IT solutions.
One device that merits particular attention is the infusion pump. Infusion pumps are overrun with preventable injuries and recalls – of the approximately 1.5 million adverse drug events reported to the FDA each year, 54% are related to infusion-pump errors, and 61% of those events are serious or life-threatening. And with more than 90% of patients receiving an IV during their hospital stay, today’s clinicians and patients deserve better solutions.
The value of EHR-smart pump interoperability
Today’s infusion pumps were designed primarily to provide better control than what is achievable with a simple gravity infusion. Fortunately, most infusion pump vendors provide some sort of electronic health record (EHR)-smart pump interoperability, which allows for:
- Pharmacy-verified provider orders to be transmitted directly from the patient’s record to the bedside infusion pump reducing manual programming steps;
- Accurate, time-stamped infusion data automatically added to the patient record, reducing clinician documentation time and the potential for incorrect or omitted data that could result in medical errors; and
- Imported infusion data into the patient’s EHR confirming that the medication is administered correctly and the clinician is notified of potential risks the infusion may present at that time.
With technologies available today around data sharing and information technology, the real opportunity to reduce adverse drug events lies in the infusion pump’s ability to fully interoperate with a wider variety of systems, such as more extensively with the EHR, patient-monitoring systems, laboratory monitoring systems and more. Using data from these systems, infusion pumps can better support clinicians in understanding whether the infused therapy presents a risk to the patient.
A vision into real-time patient-centered care
Today’s infusion pumps are not smart enough to significantly reduce dosing errors. Though drug libraries provide a “safety net” for today’s smart pumps, they can only detect gross errors in dosing. This is because drug libraries provide dosing guidance by patient population, treating all adults the same and all neonates the same, and with dosing limits that accommodate a broad range of patients within each population.
In order to provide better dosing guidance, an infusion pump must be able to import patient-specific information and be capable of using that information to better inform the clinician. A pump that could interoperate with lab systems, for example, could guide a clinician in the proper administration of drugs like heparin and insulin. And a pump that could interoperate with monitoring systems could use vital signs or electroencephalography data to guide the administration of vasopressors or anesthesia medications.
A truly patient-centered infusion pump would, in fact, interoperate and share information with other infusion pumps connected to the same patient. This information sharing would then provide a collective, historical view of all the infusions and allow clinicians to focus on the patient and not the individual devices. These pumps would collectively track changes made to those infusions over time and the impact they had on the patient. They would even draw from syringes in order to provide visibility to IV pushes delivered to the patient. With this collective, historical data, these patient-centered pumps would be capable of providing additional insights to clinicians and views to data not typically found in the EHR.
As members of the healthcare community, we can no longer afford to sit on the sidelines. The time is right to further advance the interoperability of pumps and other medical devices delivering life-saving therapies. In doing so, we have the opportunity to significantly reduce preventable deaths and injuries from adverse drug events.
George Gray is CTO of Ivenix.