Baxter's Wireless Pump
Baxter's Colleague CX pump received its 510k about 2 months ago for adding wireless connectivity and monitoring. Using their Patient Care System with the pump, Baxter provides local formulary in the pump (with wireless update), patient context in the pump, pump settings automatically pushed to the pump, and PDA-based alarm management.
Here is a use scenario: the caregiver uses a PDA-based barcode scanner to scan the patient, the bag and the pump. Baxter's server then pushes the patient context (name and ID) into the pump along with pump settings for that order. Integration with clinical systems provides patient demographics, orders, and nurse-to-patient assignments. The nurse uses a PDA to view pump status on their patients. The PDA also provides primary alarm notification. There are also client apps for the nursing station and pharmacy with role based access patient views.
Baxter takes a caregiver-centric approach to their system. Pump settings, status and alarms are availaible in the palm of their hand via a PDA. The user interface is a very reasonable one for a PDA — always a challenge. Each caregiver is presented with a list of their patients. They can also pull up a list of all the patients in their unit. Baxter software also provides for nurse-to-patient assigments by the nurse manager or caregiver if your current CIS does not support this function.
Their WLAN link is 802.11 b/g, using an off the shelf card.
Alaris Wireless Pump
Alaris currently has 200 Medley customers (with Guardrails, their smart pump/formulary/anonymous CQI database). At four of them, nurses enter the patient ID through a bubble keypad on the pump so they can pull pump data into their EMR via HL7.
This summer, Alaris will release the ability to establish patient context in the pump via barcodes — no more bubble button pushing. The care giver scans the patient, themselves and IV meds with a barcode reader attached to the pump. At some point I would expect Alaris to leverage Cardinal/Pyxis meds delivery in some kind of value-added bundle.
This release announced at HIMSS includes a patient identifiable database and client apps for surveillance and therapy viewing. In addition to indicating alarm conditions, therapy viewing shows the caregiver the volume administered and the status of the pump. Therapy views also help the pharmacy to minimize waste because they can see when meds have been discontinued, perhaps before the change is reflected through Order Entry.
In addition to remote alarms at the nursing unit, Alaris will have the ability to push alarms out to nurse worn devices. Using Emergin middleware, they can “talk” to Vocera pendants, pagers, and phones. Primary alarm notification still comes from the Medley pump.
With their SPO2 module, Alaris also has limited physiological monitoring capabilities. This has significant potential for improving patient safety. Depending on the area in which the pumps are used and what equipment (and parameters) you may already have will determine the imprtance of this capability. This is of less value in an ICU, but of greater value in lower acuity areas that don’t already have monitors.
With this new version of their system, Alaris adds patient context to their pump and CQI database, adds surveillance, and alarms.
Their WLAN link is 802.11 b, using an Alaris developed component radio.
Hospira Wireless Pump
Hospira launched their “smart pump,” made up of wireless pump, patient safety app, and associated server, 18 months ago. Like all the other smart pumps, the customer’s formulary is stored in the pump. The MedNet application suite is scheduled to release mid year. Integration with Cerner is expected to release several weeks before a Bridge Medical interface. Hopira refers to these vendors as BPOCs, Bedside Point Of Care vendors.
Patient ID and associated medication orders are controlled by the BPOC. The user scans barcodes for the patient, pump, med and user, and then pump settings for the ordered med are pushed into the pump. The barcode scanner is connected to the BPOC via whatever client device is used by the BPOC. I would imagine Cerner uses a PDA with built in scanner, but a COW (computer on wheels) or tablet could be used.
Interestingly, patient context is never established in the pump. All the heavy lifting is done by the BPOC. What Hospira has developed is the wireless connectivity, formulary management app, server, QA database of anonymous data, and integration with the BPOC.
Patient safety features include checking pump settings against the formulary, ensuring the right drug is administered to the right patient (via all that barcode scanning), and that pump delivery settings accurately reflect the order. There is no alarm notification beyond local alarms on the pump itself.
Their WLAN link is 802.11 b, using an Alaris developed component radio.
See Hospira’s investor presentation that covers wireless here. You can read their MedNet fact sheet here.
