Electronic Records
MHI automates vital sign collection in ICU, integrates with EHR
October 30, 2019
A renowned Quebec cardiac hospital has implemented an automated, electronic solution to collect vital signs data from ventilators in its intensive care unit. It’s another step towards Montreal Heart Institute’s vision of a “Digital Hospital,” says Leila El-Fehri, biomedical engineer with MHI.
Middleware from Marseille-based Enovacom helps automate the transcription of data from MHI’s Maquet Servo-I mobile ventilators into the hospital’s electronic health record and onto the nurses’ handheld tablets.
This saves time over writing the information down and re-entering it into the patients’ electronic health records and other hospital systems. It also prevents transcription errors.
The Enovacom Suite was designed from the caregiver’s perspective, says Jean Casini, Enovacom’s North American business development director.
“What do caregivers do on a daily basis? How do we integrate it seamlessly?” Casini says. “It has to be transparent to the users.”
Caregivers use the same applications that they have been using daily. As they make their rounds, the ventilators, connected to the hospital’s TCP/IP network, update the applications.
“The project has achieved several objectives,” says El-Fehri. Aside from eliminating transcription errors, the system allows regular logging of patient data, and allows clinicians to quickly find vital parameters to speed medical decision-making, she says.
It also frees up caregiver time so they can focus on patients, she says.
The amount of time saved adds up, as more medical machinery is connected. At the Bordeaux-area Hospital Centre de Libourne, France, whose ICU is similar in size to MHI’s 21-bed unit, as many as eight devices per bed are network-connected in this fashion, says Casini. It’s saving the hospital two hours per caregiver per day.
The next step: extend the automation to the rest of the hospital: Enovacom – which was acquired by French telecom giant Orange Business Services in 2018 – has middleware libraries for a wide range of patient devices, including ECGs, pumps, ventilators, anesthesia stations, dialysis equipment, oxymeters and more.
Choosing the hospital’s roadmap to more extensive automation is a matter for discussion, says Marius Tine, strategic advisor with Purkinje Inc. Services Informatiques, the Montreal-based integrator for the project.
“You can integrate pretty much all of the vital signs equipment,” says Tine. The integrator and the hospital must first determine which integrations will add the most value, and what the cost and risk management implications are.
MHI put together a team about 18 months ago with a mission to drive innovation in “a responsible and human way,” says Anne Nguyen, co-ordinator of the hospital’s Digital Hospital Initiative. The five-year vision for electronic health records revolves around real-time data collection and access, including telemedicine-based information from patients who aren’t on site.
A better hospital for a better care: MHI is focusing on “avant garde,” mobile-first technology, Nguyen says. The strategy is patient-centric and designed to combat the “digital fatigue” of learning new applications and technologies.
The Digital Hospital vision is supported by four pillars:
•Care focused on patients’ well-being. The initiative is to build technologies and processes around the patient experience. Technologies that are transparent to the user can help patients with treatment and compliance help make the patient part of the decision-making process.
•Changing the current healthcare system. Mobile technologies like smartphones, mobile apps and smart objects increase patient engagement and allow different healthcare professionals to co-ordinate follow-ups.
•Better prevent, predict and cure cardiovascular disease. The massive amounts of data collected through the network will be centralized and integrated with other clinical data picked up from the network.
•Strengthening at-home healthcare. Mobile technologies will create a holistic, rather than episodic, approach to patient care. Data collected in real-time from the patient can extend care beyond the hospital.
The hospital’s IP network is also to be fitted for navigation technology. The 60-year-old campus is undergoing a renovation and expansion, adding 15 percent in floor space, Nguyen says.
“There’s a lot going on right now,” Nguyen says. The site is becoming tricky to navigate, she said, particularly for older patients. The average age of an MHI patient is 67 years.
“When the patient is in MHI, it will be easier to get from Point A to Point B,” Nguyen says.