At the annual meeting of the ASA this morning, a group of providers announced RFP and purchase contract language for use by hospitals in an effort to hasten the availability of medical device interoperability. According to the founders, Massachusetts General Hospital, Partners Healthcare, Kasier Permanente, Johns Hopkins Medicine, and CIMIT (the MD PnP Program), hospitals,
“must lead a nationwide call to action for interoperability of medical devices and systems. One way that HDOs [Healthcare Delivery Organizations] can effect this change is by including medical device interoperability as an essential element in the procurement process and in vendor selection criteria.”
According to Julian Goldman, interoperability rocket scientist and anesthesiologist at Mass General, this announcement kicks off the beginning of an effort to build on Kaiser’s connectivity contract language (more here, here and here) and foster the adoption of similar language among providers world wide. The intent is to increase the glacial pace of industry standards based medical device connectivity adoption among medical device vendors.The program is called MD FIRE, Medical Device Free Interoperability Requirements for the Enterprise. According to Goldman,
“MD FIRE comprises a white paper and shared sample RFP and Contracting language requirements to promote the adoption of fully interoperable medical devices and systems in support of patient safety. The MD FIRE document was drafted by the CIMIT MD PnP Program Interoperability Contracting Requirements Working Group, that convened experts from The Massachusetts General Hospital, Partners HealthCare, Kaiser Permanente, and Johns Hopkinsin 2008.We are announcing the project in conjunction with the American Society of Anesthesiologists annual meeting in Orlando this weekend with an exhibit called, “Consumer” Empowerment: Hospitals Can Accelerate the Adoption of Medical Device Plug-and-Play Interoperability for Patient Safety with “MD FIRE.”
Medical device connectivity is the automation of workflow through the integration of medical devices and information systems. A potential capability enabled by medical device connectivity is device interoperability. This medical device interoperability means that the data from one medical device can affect the behavior of another device. This interaction is mediated by software running on general purpose computing platforms. As an aside, direct device-to-device interoperability is theoretically possible although writing such software on medical devices is considerably more expensive than implementing it on computers.The rationale for this initiative describes how interoperability will significantly improve health care.
Why is medical device interoperability necessary to improve patient safety? As an example, when taking an x-ray in the Intensive Care Unit, the ability to synchronize the x-ray with the patient’s breathing cycle has been demonstrated to improve image quality. Unfortunately, the capability of interconnecting and synchronizing these devices is not available today. Similarly, a safety interlock that would stop the flow of opioid pain medication from an infusion pump and call the nurse if a patient showed signs of respiratory distress could save lives. There are numerous other examples whereby medical device interoperability and medical system integration, if available, will improve patient safety.Standards-based medical device interoperability can provide real-time comprehensive population of the electronic medical record (EMR), and in the future will permit the creation of integrated error-resistant medical systems that will support advanced capabilities such as automated system readiness assessment; physiologic closed loop control of medication delivery, ventilation, and fluid delivery; decision support; safety interlocks; monitoring of device performance; plug-and-play modularity to support “hot swapping” of replacement devices and selection of “best of breed” components from competitive sources; and other innovations toimprove patient safety, treatment efficacy, and workflow efficiency.
The Contracting Requirements Working Group group does a great job of describing specifics. Here is the group’s “reality check” of where they see the market and what they hope to accomplish.
We HDOs wish to adopt interoperability standards for medical device interconnectivity. We also recognize that the necessary standards are not yet fully developed or widely implemented by medical equipment vendors. However, we believe that adoption of standards-compliant interoperable devices and systems will enable the development of innovative approaches to improve patient safety, healthcare quality, and provider efficiency for patient care; will improve the quality of medical devices; will increase the rate of adoption of new clinical technology and corresponding improvements in patient care; will release HDO resources now used to maintain customized interfaces; and will enable the acquisition and analysis of more complete and more accurate patient and device data, which will support individual, institutional, and national goals or improved healthcare quality and outcomes. Our goal is to document the clinical demand and to strongly encourage the development and adoption of medical device interoperability standards and related technologies.
What these providers say is true. The question is whether vendors will pick up the pace of connectivity adoption, or will instead continue to drag their feet.UPDATE: Reader Scot M. noted that I didn’t provide a direct link to the MD FIRE document. He’s right, so here it is. Enjoy.UPDATE: The ASA issues a press release urging leading institutions to “Get Connected for Patient Safety.”