History of Medical Device Connectivity for CIS
With all the focus on medical device integration for EMRs and middleware vendors like Emergin, many of the hospital’s looking for solutions today know little about how connectivity has evolved. So, we were talking at Capsule the other day and here is a timeline we came up with. This surely isn’t a complete list, and we’re sure there are other significant efforts that should be included. We tried to keep it focused on successful implementations in a production environment of a system extracting data from a medical device into a clinical information system. So let us know what you think is missing!
1970’s and 1980’s
Early systems evolved from research work performed in some of the large university teaching hospitals. For more background – see this link. Eventually the market evolved from patient management systems (for example the HP Patient Data Management System or PDMS.) which were the first commercially available systems to provide any type of automated data capture between a medical device and a computerized system.
1992-94
Standalone or independent connectivity solutions — Early efforts started in 1992 with Hewlett-Packard’s CareVue (now Philips) using the HP CIS Gateway. Early ventilator interfaces were implemented with custom serial cabling pulled to each bedside to connect ventilators via serial home-run cables back to wiring closets. The HP CIS Gateway was the data consolidation point and an early version of HL7 (2.1) was used to interface to the CIS. Other vendors such as EMTEK, Clinicom, and CliniComp also developed similar capabilities in this timeframe. There were a handful of drivers written for only the most common mainstream ventilators. In the peri-operative market, most surgical/peri-operative CIS vendors leveraged the local PC platform for serial connections directly to a multiplexor card.
Patient monitoring-based solutions – In parallel to the standalone connectivity solutions, key patient monitoring vendors including HP, Marquette, SpaceLabs, and Siemens developed monitoring-centric connectivity. These early products were proprietary “plug-in” modules that connected the medical device serial ports to the patient monitor. In these deployments, the patient monitor became the central “hub” for data consolidation. Here is primary purpose of the interface was to display non-monitoring data such as ventilation parameters and waveforms in a correlated display along with the physiological monitoring data. Alarms are also processed via these types of connections and sent to the monitoring central station. However, these types of interfaces have somewhat diminished in value over time – mainly because ventilator devices now have very advanced graphical user interfaces (less of a clinical need to correlate device data on the monitoring display) and alarm management and directed notification systems (i.e. Emergin) are now mainstream products.
