Nurses at Ephraim McDowell Health's two hospitals in central Kentucky until recently had to copy raw data from monitoring devices into each patient's electronic health record. “The nurse would be trying to monitor the patient on the vital-sign monitor as well as doing documentation in the EHR system,” said Becky Blevins, project manager for information systems at Danville-based Ephraim McDowell.
That began to change in 2012 when the system retained a software developer to translate electronic data from the vital-sign and other monitors directly into the EHR. The shift sharply reduced human transcription errors. Now, it is “like the cellphone,” said Dr. Anjum Bux, an anesthesiologist with Ephraim McDowell. “You don't know how you lived without it.”
But the process is still incomplete. “Right now, we're doing a paper record of the anesthetic in the OR,” Bux said. The hope is to have the EHR grabbing the data during an operation within 12 to 18 months.
Concerns about the lack of interoperability between competing EHR systems are rising to the top of the health information technology agenda in Washington. HHS' Office of the National Coordinator for Health IT issued a report last month blasting both vendors and providers for blocking the exchange of data between rival EHRs and rival healthcare systems.
But that report ignored similar problems that prevent clinical-monitoring devices such as ventilators and electrocardiograms from communicating with EHRs. They create data that in theory should pass to the patient's record. But it often doesn't happen. Instead, nurses must manually transcribe the data, introducing another arena for hospital error.
That disconnect has created new opportunities for vendors selling software solutions to link up the non-communicative systems. Vendors also say linking devices to EHRs will allow clinicians to monitor data automatically, controlling drug dosages from afar and providing a record for analyzing and adjusting a patient's care plan. It can “(take) out any chance of user-entered error,” said Jeff McGeath, vice president of software solutions for Iatric Systems, which provides one such product.
Connecting monitoring devices and EHRs is likely to become a growth business over the next decade. Technology research firm Gartner predicts a 35.5% compound annual growth rate for devices that can communicate through the “Internet of things” between 2013, when sales totaled $19.9 billion, and 2020.
The first target is ensuring device data flow into the EHR. Roughly 18% of hospitals have purchased medical-device integration software, McGeath said.
Even the more sophisticated healthcare systems in the country are facing device-EHR integration problems. Geisinger Health System in Danville, Pa., for instance, has integrated its dialysis and anesthesia units and plans to integrate data from its intensive-care unit into its full EHR beginning this summer. But total integration between its inpatient-unit devices and patient EHRs won't happen until 2018.