Reader Charles F. posits the question above in a recent comment on the post Current State of Medical Device Connectivity. I’ve reproduced his comment in its entirety:
Frequently missing from the device connectivity dialog is the all important question “ok, you’re connected, so what?” If the point is simply to dump device data into a database the point is being entirely missed.
Patient-attached devices are of value if ! and only if they can get their information to someone who cares…WHEN they care. Designing otherwise is to contribute to information overload and the long list of
things clinicians ignore until it’s too late. So, to improve device connectivity is just moving the problem around. What’s needed is a comprehensive approach to device data management that provides clinicians with the ability to recognize worrisome trends across multiple parameters and systems and be notified of those trends BEFORE the “mis-adventure” occurs. This, of course, begs the question of how device data management is to occur. As device suppliers increasingly get into the software business there is somehow an assumption on their part that their limited view of the patient’s condition must be a highly valuable perspective worthy of waking up the nearest attending physician. How long will THAT last? Device connectivity is a huge step forward but only in the context of systems capable of evaluating the data in real time and making prospective inferences….and then figuring out who should know.
“So what,” indeed. The connectivity market requirement that is most embraced by both vendors and users is dumping device data into some sort of software — be it for data analysis and reporting in a diagnostic system, or documentation for paperless charting. This capability is driven by growth of the paperless charting market. Medical device data acquisition is a critical requirement for successful EMR adoption, and
a considerable challenge all on its own. This is important, but to Charles’ point, of little value from a patient care and safety perspective.
Medical device connectivity has been rolling through the industry for 20 years, and has finally hit a wall at the point of care. The point of care brings together a plethora of medical devices (and no one vendor makes pumps, vents, and patient monitors); many clinicians, caregivers, and diagnosticians; and patient data aggregated from many sources presented in a clinical information system. There are no single vendor solutions here. Dumping data into the electronic medical record (EMR) is at least something relatively straight forward and within the control of a single vendor. Hospitals, who have to deal with a large installed base of legacy devices (that frequently average 5 or more years in age), networked in a myriad of private subnets or supporting device specific proprietary serial interfaces (both protocols and pin-outs), and usually a few newer networked devices (all incompatible, of course) face a significant need to move beyond point solutions dressed up as expensive upgrades and find an enterprise solution.
Applications like patient centric alerts and medical device alarm management must deal with complex workflows, multiple vendors, and numerous users. It is so natural for a device vendor to see the world as though defined by their own product centric market. Traditional clinical information systems vendors view market requirements from a broader user’s perspective, but despair at dealing with a multitude of device vendors and new regulatory hurdles (i.e., the FDA). Hospital leadership, having been burned before on complex systems integration, is not likely to rush to buy into the first point of care solution that comes along. There’s not even a name for this new area; point of care automation really doesn’t express the breadth and complexity (nor the promise) of this new frontier. Any suggestions?
The good news is that there are clear benefits to the kind of point of care integration and workflow support that Charles alludes to; things like reduced length of stay (LOS), improved patient safety, and reduced medical errors will drive this market segment to broad adoption. The eventual market leaders in this new segment will surprise us all, and represents a great opportunity for newcomers to grab a big piece of this market and existing players to retool their business models to meet this new combination of requirements. There is no doubt that early innovator hospitals are currently looking for solutions, and that select vendors are working on solutions. Navigating the next several years until the market has matured will be a challenge for buyers and sellers alike.