Medical Device Networks Trouble Industry
Over the past few years, medical device networking has become increasingly problematic. There is a growing perception of declining service levels and network reliability. (I’ve not seen or heard about any quantitative data to back this up – let me know if you’ve got any – but these are substantive issues.) As medical devices, by way of connectivity and workflow automation, have been pulled into the sphere of the IT department risks to patient safety have increased.
These growing problems are a key factor in the creation of IEC 8001 – which will have a major impact on how hospital’s deploy and manage networked medical devices. The current situation provides a lot of the impetus behind a meeting this week at Villanova on wireless technology in health care. So what’s the big deal?
Private Medical Device Networks
In the good old days, all medical device systems operated on private networks that were designed, installed and supported by the medical device vendor. Vendors decided exactly how the would handle IP addressing (static or DHCP) and every other configuration option. This minimized vendor’s product development costs, shortened time to market, and made service and support easy (because the network was their sandbox). When they got the inevitable calls from customers that, “your system just brought down our network,” vendors could quickly and easily determine if that was the case – and just as importantly, quickly prove to hospital network administrators why their answer was correct.
Providers benefited from this approach in a number of ways. First, vendor system support was quick, efficient and reasonably priced. This approach also relieved hospitals of the need to assume responsibility for supporting life critical applications themselves.
Of course nothing’s perfect, and relying on private networks created a few problems of its own. As more medical devices evolved to become components in medical device systems connected by networks, these private networks proliferated. The IT department of a thousand bed hospital system on the east coast did a survey a couple years ago of their networked medical device systems, and “discovered” over 200 private networks. And unlike enterprise networks that must be kept up to date to ensure cross vendor interoperability and coexistence, private medical device networks are like time capsules. With the exception of occasional failures of a switch or router, medical device networks remain unchanged from the day they’re installed; the hospital mentioned earlier found numerous ThickNet and ThinNet Ethernet networks in their survey of medical device systems.
Over time, medical device vendors have given some ground by moving from physically separate private networks, to creating logically separate private networks through the use of network switches and routers.
Managing Patient Context for Bedside Medical Devices – Today’s Situation
Clinical users have been managing patient context in various ways with medical devices for many years. With some classes of medical devices, this is nothing new. So you might ask — what is the big deal here with patient context and what has changed that makes this topic relevant today?
As I stated in a previous post, managing patient context is all about the clinical workflow. My working definition of patient context for medical devices is the linking of any information produced by a medical device (including data parameters, alarms, control settings, waveforms, etc.) with a specific patient identifier.
From a patient safety perspective, the best way to establish patient context is to tag data leaving a medical device with a unique patient identifier. And ideally this should be performed at the patient’s bedside where devices can come and go. There is clinician workflow associated with managing patient context – and this is perhaps the most important aspect.
We live in a dynamic world where technologies, products, and user requirements are constantly evolving. Take wireless medical devices for example. Wireless has evolved over the past few years and adoption will increase for the foreseeable future. When connectivity is wireless, patient context becomes even more challenging. Another example is with the evolving requirements for automatically integrating device data in to an EMR. The EMR market is moving beyond relatively simple patient monitoring vital signs interfaces and is now looking to integrate all bedside device data including smart pumps.
If you look at what is quickly evolving at the point of care today, patient context is becoming more of a challenge for vendors that manufacture the medical devices and as a result, end users (clinicians) are being asked to perform the task of establishing patient context at the point of care. So let’s look at how patient context is currently managed (if at all) and the impact on workflow.
