Hospitals like single vendor solutions - they want well integrated complete solutions that are well supported and easy to service (with one phone call). A number of vendors have done their best to deliver on this need. Sadly, in most cases the reality of this approach falls far short of the promise. Many broad based solutions are cobbled together through acquisitions (where it seems more money is invested in marketing then, you know, actually integrating the acquired products). Then there's the barrier of traditional market segmentation.
Historically, infusion pumps were made by dedicated pump vendors, most ventilators are made by dedicated vent vendors. There is no one vendor who makes patient monitors, infusion pumps, and vents. And don't even mention smaller markets like enteral feeding pumps, or wound suction devices, point of care diagnostics or portable dialysis systems - these are highly fragmented markets.
High-risk industries like aviation have been building integrated multi vendor systems with closed-loop interoperability for years, they're called airplanes. Up until recently, health care seemed to lack the safety imperative of aviation and resisted adopting the open systems interoperability that would allow clinicians to create "error-resistant" systems that would improve safety and patient outcomes. One of the leaders driving medical device interoperability is Julian Goldman MD, Program Leader, MD PnP Program, and President, Society
for Technology in Anesthesia.
Next week at the annual meeting of the American Society of Anesthesiologists (ASA) in Chicago, Julian will host a 2 hour session on medical device interoperability. From the session handout (Word doc):
reliance on sophisticated medical devices, each device is designed to stand
alone as an island. Anesthesiologists, stimulated by a technology-filled and
internet-connected world, have numerous creative ideas to leverage the
integration of health information and medical device systems to improve patient
safety and healthcare efficiency. However, due to the lack of medical device
connectivity or interoperability, it is difficult to integrate multiple
devices to support the widespread clinical use of medical device data to
produce complete and accurate electronic health records, reduce medical errors,
and reduce healthcare costs. This session provides an overview of recent
national activities in this area, addresses the clinical implications, and
includes an opportunity for attendees to provide examples of medical device
connectivity that could solve current clinical problems, improve safety or
efficiency, or enable innovative clinical systems of the future. For additional
information, please see the May 2006 ASA
In the grand landscape of medical devices, the operating room is one of the most integrated clinical areas in the hospital - right up there with the ICU. If the interoperability need is unmet here, you can imagine the state of affairs in the rest of the hospital or in physician offices.
I wish I was going to be in Chicago next week. Perhaps someone can send us an update of the session...
Pictured right is a view of the OR at Massachusetts General Hospital, Boston.