HHS connects vital signs monitors to its EHR

Hamilton Health Sciences has gone live with a system that automatically feeds data from over 400 vital sign monitors into the electronic medical records of patients.

HHS, which comprises seven hospitals and over 1,100 beds, plans to soon add another 200 monitors to the system.

The hospital corporation created the integrated system in less than three months by using a software solution from Iatric Systems, of Boxford, Mass. It went live in January of this year.

Mark Farrow, vice president and CIO at HHS, explained that the Iatric system is a technological platform that’s capable of integrating any type of device with the hospital’s electronic health records, including smart pumps and ventilators, both wired and wireless.

The plan at HHS is to use the Iatric Systems platform to tie together many types of devices, so they feed data directly into the electronic records of patients.

“Whenever you can re-use a platform for other purposes, you’re ahead,” noting that financial pressures are forcing all hospitals to work smarter and to seek more bang for the buck when installing new systems.

The vital sign monitors that were recently integrated are located in the hospitals’ ICUs, CCUs and Neonatal Unit. Among other benefits, it means that nurses in these units no longer need to spend time scribbling notes onto scraps of paper and transcribing them into computer workstations.

Moreover, the flow of data between devices and the Meditech EHR system is two-way, with ADT data being pushed to the devices.

That reduces the need for clinicians to enter patient data into the monitors at the point of care, saving time and reducing the chance of error.

Significantly, the investment in the Iatric Systems solution has enabled a quantum leap in analytics usage and patient safety at HHS.

The platform in conjunction with Iatrics Visual Flowsheet, is capable of powering the hospital’s Hamilton Early Warning Score (HEWS), which uses real-time information from devices such as blood pressure cuffs and EMRs to predict which patients are at risk of a medical emergency. When this occurs, the appropriate clinicians can be alerted, enabling them to provide care before it is too late.

“You can predict, for example, a respiratory issue or a severe infection ahead of time,” said Farrow, adding that the HEWS solution makes use of predictive analytics.

“It’s not good enough to import your data four hours later, and to see that your patient is getting into trouble. And that, by the way, the patient had a cardiac arrest or ‘code blue’ which could have been prevented if the response team had been alerted.”

The HEWS team has produced an algorithm made up of seven different vital signs. The system scores patients on the wards, continuously and in real-time.

“It has translated into real-world improvements,” said Farrow. “We’ve seen a reduction in code blues and unplanned ICU admissions. It is now unusual to hear code blue called at the General site.”

Jeff McGeath, senior vice president of software solutions at Iatric Systems, noted that HHS has created a visual interface for HEWS that will allow members of the critical care response team (called the RACE team) to easily monitor the status of critical care patients.

He explained that analytics have evolved in recent times through three phases, and that HHS is now developing solutions for the third and most useful phase.

The first type of analytics is ‘descriptive’ and consists of simple reporting, he said. The second consists of predictive analytics – systems that can forecast what is likely to happen. And the third phase is prescriptive; it not only predicts but also makes recommendations. “It’s where you’re also prescribing a course of action,” said McGeath.

Farrow noted, “That’s what we’re trying to get to.”

The potential benefits of such systems are enormous, as they will enable caregivers to prepare for incidents before they occur, and to use ‘best evidence’ databases to take effective actions.

An additional facet of the Iatric Systems platform is its benefit to biomedical engineers and clinical informatics specialists. The integration of medical monitors and devices allows them to remotely diagnose and repair the hundreds of devices spread across the seven HHS sites.

Indeed, it was the need to maintain a fleet of monitors that spurred HHS to implement Iatric Systems in the first place.

That’s because last year, Philips Medical announced it would stop supporting the vital signs integration engine used at HHS at the end of 2014. To keep its monitors communicating with the EHR, Farrow and his team had to find a support solution.

They found it in the form of the Iatric Systems platform, and were able to connect the Philips monitors to the new solution in less than ninety days. Next, HHS is looking to add their SpaceLabs monitors and potentially Welch Allyn devices to the platform.

Other devices, such as smart pumps and ventilators, will also be connected. “We needed a solution that was multi-vendor, and multi-modality,” said Farrow. “And we found it.”

Interestingly, the Iatric Systems software server solution cost only about $60,000. That investment will form the cornerstone of a system that ties together all medical devices in the organization and integrates them with the hospital’s electronic medical records.

It is also a key element of the HEWS drive in analytics and patient safety.

And of course, it is enabling engineers and clinical informatics specialists to keep close tabs on the functioning of the devices and interfaces.

All in all, it’s performing a lot of work. As Farrow says, the ability to accomplish all of these tasks on one platform is having a significant impact on the hospital. “It’s a very big deal,” says Farrow.