Wednesday, July 09, 2008

"Plug and Play" Hospitals

Continued from page 1

By Kristina Grifantini

Goldman's second plug-and-play demonstration simulates a self-administering pain medication pump, a device widely used in hospitals despite its occasional adverse effects. Monitoring devices strive to eliminate the risk that patients will accidentally overdose, but they set off many false alarms. Goldman speculated that if a computer received data from two or more monitoring devices, it could much more easily distinguish false emergencies from real ones. In his demonstration, simulated patient data is fed to an oximeter and a respiratory monitor. The program sounds an alarm only when both sensors suggest that the patient is undergoing a crisis.

Goldman admits that, while his demos are relatively straightforward, obstacles to device interoperability remain. Monitoring systems are expensive for hospitals to replace, he says: "We've made it too difficult to integrate systems to have smart alarms." Another barrier is old-fashioned competitiveness. A vendor that produces medical equipment tends to make its devices compatible only with each other.

But as Goldman points out, many emergency rooms need such specialized equipment that no one vendor can produce all of it. So selecting a single vendor won't solve the interoperability problem. "We're probably a ways off from true interoperability," Rosendale says. "However, there is clearly momentum growing in this area. As computer technology and device dependence grows, that means interoperability is going to be more and more obvious."

"I think everyone recognizes that there's a lot of data generated for patients, but it's not always used as effectively as it could be," says Daniel Nigrin, chief information officer and senior vice president for information services at Children's Hospital Boston. "Over the course of the last 5 to 10 years, there have been several studies that came out that showed basically that there's room for enormous improvement in reducing errors in medicine. That's why efforts like [Goldman's are] so crucial." Nigrin suggests that hospitals are slowly starting to move toward medical devices that share data with one another and with electronic medical-record systems. "There are instances where you're starting to see some of the devices connected. Whether that's having monitoring systems or ventilator systems attached to electronic medical records, you're starting to see some systems like that implemented in a real-world environment," he says.