St Louis Creates Ambulance Based ADT System
One of the challenges of mass casualty situations is the lack of an aggregate view of casualties. Hospitals have difficulty determining the number of victims they must prepare to receive, and without a disaster-wide view of patients it's hard to get properly triaged patients to the most appropriate facility in the right proportions. The St. Louis Area Regional Response System decided to create a system that would address these pre-hospital patient flow problems. Using $2.1 million in federal homeland security funds, and working with IBM and EMSystem, they created what is essentially an Admissions, Discharge and Transfer (ADT) system for emergency response.
A modern wireless network has replaced a 30-year-old radio system.
Paramedics at the scene of an emergency now use handheld devices to
record patients’ identification, conditions, vital signs, chief
injuries or illnesses, and the hospitals to which they are being
transported.
The information is embedded in a bar code on
a paper bracelet the patient wears and transmitted via a wireless
network to the admitting hospital, where it is used to create a medical
record for the patient. That gives hospital administrators, emergency
managers and other public safety officials a good sense of the nature
and scope of disasters and other emergencies.
Now all they need is to integrate RFID casualty tracking and wireless patient monitors, and they will be able to triage patients at the disaster site (or some other near by staging area) and dispatch them to the appropriate hospital – while passing patient demographics and clinical data to waiting Emergency Departments.
Pictured right is a mass casualty drill from the Center of Excellence in Disaster Managment and Humanitarian Assistance (for some reason, known as COE-DMHA).
IntelliDOT Signs Hospital Chain
Meds administration vendor IntelliDOT has announced (press release) that they have been selected by hospital chain Health Management Associates to provide its bar code
based handheld bedside medication administration system to 55 HMA hospitals over the
next three years.
IntelliDOT has an interesting value proposition: it's well designed so that it actually improves caregiver's workflow while improving meds administration safety. What a concept. Readers of this blog will recall that IntelliDOT uses its own proprietary bar coding scheme and wireless hand held reader (pictured right) as key components of their system. IntelliDOT also has a Laboratory Module in development.
Last May IntelliDOT raised $13 million in a Series C round (previous post here).
New Multi Function VeriChip Installation Announced
You must admit, the VeriChip marketing guys are the hardest working marketeers in the RFID space. Here's another bit of news: VeriChip, along with distributor and nurse call system vendor Austco Communications Systems, have installed an RFID system for infant protection, wander prevention, staff duress and asset protection. The deal, bought by Brampton Civic Hospital, in Brampton, Ontario, is valued at $750,000 (press release).
designed to support multiple applications for facilities of any scale.
Inter-connection to the Austco nurse call system will enable staff to
receive notification remotely of all events–whether from the VeriChip
systems or the nurse call system–via any text-enabled device,
including PDAs and wireless phones.
Brampton Civic Hospital is under construction and expected to open in the fall of 2007. When completed, the hospital have 608 beds and accommodate 90,000 emergency patient visits,
160,000 ambulatory care visits and 110,000 outpatient visits annually.
Pictured right is the HALO infant tag.
Philips HL7-Ready VM Line of Low Acuity Patient Monitors
A question came up on the Biomed Listserv the other day about Philips’ new VM line of low acuity patient monitors (press release). The initial comment noted that the new VM line looked pretty impressive (it does), is HL7 ready, and questioned whether Philips OEMs the monitors or makes them themselves (they are Philips designed and made at a Philips plant in China). Given the innovative nature of this new line of patient monitors, I thought you, my gentle readers, might find it of interest.
I got a download on the new Philips VM line at AAMI. To my knowledge, this is the first line of medical devices that directly outputs HL7 from the device. Previously, medical devices output a proprietary protocol over a wireless or wired network to a server that converts the data to HL7. The server in turn “talks” to the other side of the HL7 interface, your EMR. The server also aggregates data feeds from multiple devices into one interface to an EMR or some other information system.The HL7 standard has (too) many configuration options and a high degree of variability in how it is implemented from vendor to vendor. Consequently, the state of the art for HL7 interfaces is a table driven interface that supports variations like data element labels, field lengths, and the ability to enable or disable individual fields in the interface. Some interfaces also support multiple versions of HL7. A table driven interface provides the necessary (at least up to this point) variability to integrate with the widest variety of other vendor’s HL7 interfaces. The bottom line: to date, HL7 is not a “plug and play” interface.
According to the Philips engineers I talked to at AAMI, the VM line outputs a fixed HL7 data stream through the Ethernet port on the back of the monitor. From what I learned, there is no table driven configuration of the HL7 output. (The fact that low acuity patient monitors targeting patients that are at least somewhat ambulatory doesn’t have wireless connectivity is a topic for another time.)
In a perfect world, the host side of the HL7 interface (there are always two sides – the device and the host) can be configured to support the Philips VM implementation of HL7. Your world may be less than perfect – painful even if your host can’t configure to match Philips’ implementation of HL7.
The direct HL7-out from the device, static nature of the interface, and absence of any table configuration utility makes the Philips VM HL7 implementation radical. If anyone can pull this off, Philips can; as the largest patient monitoring vendor they swing a lot of weight. Also the HL7 standard has been around a long time and has perhaps matured to the point where a non-configurable interface will work. Time will tell.
I’m sure many on the list would be interested in hearing from biomeds who’ve implemented the HL7 interfaces on the VM monitors, as well as more info from someone at Philips.
Evolving HL7 to a truly plug and play interface is good thing – I would recommend monitoring vendors duplicate Philip’s HL7 implementation – there’s no good reason not to, and several good reasons to do it. A lot of the variability in standards like HL7 is simply vendors who insist on including some quirk that they have already implemented (and don’t want to spend the NRE to change), or have some misguided notion that their implementation of HL7 is “better” because it’s different.
If you’re buying VM patient monitors and expect to integrate them with some electronic charting application (and who isn’t within the life of a new patient monitor?) best make sure your host system will support the Philips VM implementation – before you buy.
UPDATE: Conversations with Philips at the 2008 HIMSS conference indicated that the HL7 interface on the VM line of patient monitors is configurable. It was not clear whether configurability was added since the introduction in 2006, or was there all along.
QuiteCare Systems Adopted By Assisted Living Facility
St.
Therese Homes of New Hope (Minn.) has implemented the QuiteCare remote monitoring system in its assisted living apartments to remotely monitor
resident activity. Here's how the press release described the system:
Pictured right is the QuiteCare wireless receiver (which I had to assemble out of 3 different files – why some folks seem to make it hard to spread the word about their products is beyond me).
