The value of medical device integration; a clinical perspective - PowerPoint PPT Presentation

The value of medical device integration; a clinical perspective ADRIAN HUTCHINSON CHIEF NURSING AND ALLIED HEALTH INFORMATION OFFICER ROYAL CHILDREN’S HOSPITAL MELBOURNE

2014 Parkville 1958 Parkville 1876 Carlton

History 30 th April 2016 - EPIC EMR – Big Bang Fully integrated EMR ◦ Results ◦ Prescribing ◦ Orders / Results ◦ Emergency Department ◦ Intensive care / NICU ◦ Clinical documentation ◦ Oncology ◦ Theatre / Recovery ◦ Portals ◦ Medical Device Integration

Philosophy of build Patient safety National standards Legislation Reduce variation

National standards – Holy Grail Deteriorating patient Observations (VICTOR) / Anaesthetic charts Medical Emergency Team / Rapid review

In 2014/15 there were more MET calls (n=33,690) than ICU admissions (33,356 Victoria Admitted Episodes Dataset ) MET / Deteriorating patient call occurs every 15.9 minutes in Victorian hospitals with an ICU (n=41) (Vic) * ANZICS CORE data

RCH MET Calls July 2017 YTD

Deteriorating patient at RCH Services Provided ◦ Outreach (PICU team – all discharged patients + new referrals) ◦ Rapid Review process (ward team) ◦ MET team (PICU team) Adjuncts in the EMR ◦ VICTOR chart ◦ Active alerts ◦ MET modification ◦ Device integration Observation frequency

What informed our approach for MDI? Existing devices - device drivers – any device Philosophy of build – Patient Safety / National Standards / Reduce variation in care Network configuration of RCH / flexibility of implementation Knowledge transfer of vendor

Vendor Medical Device Integration Solution - Capsule (now Qualcomm Life) Enterprise wide licence Project timeline - 6 months

What have we implemented? Fixed / Mobile Bedside monitoring 270+ ++++ Capacity Anaesthetic devices Ventilators – PICU / NICU

Any medical device / device gateway What is required? Wireless network / cabled network Axon / Vital signs monitor DMM / cables – identifies the mobile device Gateway / Boot-P Server for each device type / Test server Server/s Technical - Biomedical department EMR

How does it work? Variable ID from device send to Capsule’s Server Capsule’s server interprets ◦ what variable ◦ what device ◦ what patient ◦ Sends information via an interface to EMR ◦ Devices built in EMR to accept variable being sent / EMR is not required to get benefit

Why did we implement a medical device integration solution? Improve efficiency of documentation Improve outcomes for deteriorating patient through EMR Research opportunities

Data

More data

Victor Chart / Thresholds

Clinical benefits of medical device integration Improved data accuracy Clinical alerts in EMR Audit and review Research

Research potential / projects “Multi - feed” and analytics – huge potential Neonatal thresholds Sending of clinical alerts to notify of deterioration NIRS Validation (Near Infrared Spectrometry)

Project Model ward – high acuity Monitor connectivity - 6 beds AUM handover PEWS scoring – triggers Send to nurse / AUM / MET team

Future Multi-feed – data extraction Capsule IQ - analytics Home devices

Questions ?