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May 29 2012   7:48AM GMT

Medical device integration: Part 3 — Workflow matters



Posted by: Jenny Laurello
MDI, Medical device integration, Workflow

Guest post by: Susan Niemeier, RN, BSN, MHA, Capsule Tech, Inc.

Every industry seems to gravitate to the next shiny gadget, but often times little thought goes into the product’s usability. The health care industry is no exception as the latest mobile health application for the smartphone or tablet continues to grab headlines. While there are a number of technologies out there that operate on smartphones and tablets, how do they truly impact the daily workflow for nurses and clinicians? And more importantly, the patient? No matter how cool the new device or app is, it’s not going to be worth anything if the steps to use them are too cumbersome. The result is poor adoption. That’s why it is important that when designing, testing and implementing medical device integration (MDI), workflow is evaluated from both an IT and nursing perspective.

The “nurse’s tool belt” refers to all the devices a nurse has to carry with her to care for patients.  Although it varies by nurse and nursing unit, it may include a stethoscope, penlight, scissors, hemostats, bandages, IV supplies, call light tag, RFID tag, ID-badge and the list goes on. With a tablet or another mobile device, the nurse must add yet another item to her tool belt. This bulk and weight is very bothersome to a nurse. Tablets or mini PCs may be offered but a nurse only has two hands so a tablet is just something else the nurse has to carry, keep track of and keep charged.   And, a PC may not be easily accessible in cramped rooms.  All of these “cool” mobile devices require the nurse to have her hands on the device, not the patient.

Also, let’s not forget about the devices themselves and their association to the patient. Some solutions will require the nurse to confirm the association on a pop-up screen. Once again, this presents a dilemma. What happens if she has to care for her patient and that association is interrupted? Will the data be sent before that confirmation is done? What about mobile carts or a mini-PC?  Mobile carts are of course in use at hospitals today, but they don’t fit into the clinical workflow; they are difficult to wheel into an already overcrowded room and often require multiple “clicks” to get to the application for device integration.

PCs are of course another alternative for device integration and actually work quite well in environments such as the OR where devices are static and a PC is already mounted to the anesthesia cart.  However, they can present a challenge related to clinical workflow and overall IT management when used in other care areas for device integration. The following list of questions could help a hospital decide whether or not running the application on a PC is best for the care area under consideration:

  • Is the PC providing a visual display back to the clinician on the medical device status?
  • How many steps are required to get the data flowing?
  • Is it a touch screen and are those steps intuitive?
  • Since the PC isn’t medical grade, can it withstand the hospital environment?
  • How does the PC address value-added bedside applications such as validation and submission of vitals or observation and assessment?
  • How does it address future connectivity needs such as bi-directional communication and smart pump connectivity?
  • Can it cache data locally and since the PC isn’t owned by the connectivity provider, how will the hospital manage troubleshooting?

Regardless of the care area, the key is that the device connectivity solution should be a part of the environment in a hospital room.  Each care area may have different needs depending on the clinical workflow.  Some areas may benefit from a solution where all data is collected and stored until the nurse has time to confirm the patient. This allows the nurse to focus on patient care with the confidence of knowing that all of the data is being collected and automatically sent to the patient’s record, waiting for validation when the nurse has time to chart. Or, in the case of lower acuity areas — such as med-surg — there are even solutions that will enable collection, validation and submission of patients’ vitals right from the bedside. Such solutions deliver data in near real time for all of the care management staff to have access and to improve decision making for better patient care and outcomes.

No matter what solution is chosen, it is essential to put the nurses’ workflow needs first because doing so will also put patient care first.  Patient-centric MDI is important; however, the solution for achieving patient-centric MDI needs to fit the way the clinician works, and the way the hospital works.

The next installment of the Connected Consultants series will take the topic of MDI a step further. It will demonstrate how hospitals can build on successful MDI implementations to fulfill a larger enterprise vision and use patient data in a truly meaningful way.

For more information, please visit Capsule Tech, Inc.

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