Connected devices: the clinical benefits

In order to deliver high-quality care and meet regulatory mandates, hospitals must collect increasingly detailed clinical data from patients, while at the same time reducing staff costs. In the near future, hospitals must also take responsibility for the data required to achieve measurably superior outcomes beyond their walls. Obtaining the data required to manage and coordinate care inside and outside the hospital without increasing staff numbers requires the ability to automatically retrieve information from a wide variety of medical devices. These devices come in many different forms and levels of complexity – from tongue depressors to artificial hearts. The number of medical devices that produce electronic data is growing as sensors are added to devices that have, traditionally, been purely mechanical in nature, such as the e-Knee prosthesis. While connected devices can be used to remotely monitor, control and configure devices, it is their patient monitoring function that adds the greatest value. Patient physiology data; drug administration data including dose, timing and rate; ventilator therapy data; and other information can be automatically recorded to help provide optimal patient care. When these devices are automatically connected to an Electronic Medical Record (EMR) the completeness, timeliness and accuracy of the data that becomes available is much greater than what could be manually charted by nurses. What is more, the potential quality and safety of patient care improves, while the time and cost required to collect and chart the data is reduced. The need for hospitals to connect their devices to an EMR is growing and Connected Medical Device (CMDs) will play an increasing role in this, particularly outside of the hospital, for the management of chronic conditions and prevention of hospital readmissions. Each CMD can save from 4 to 36 minutes of nursing time and prevents up to 24 data errors daily. In a typical hospital, they can also save over 100 hours of nursing time per day, giving nurses more time to spend with patients and improving the quality of care. By stopping over 800 data collection errors each day, hospitals can also offer greater efficiency and improved patient safety. The best practice for preventing hospital readmissions includes the use of connected devices in care facilities and patients’ homes. By making use of remote device data, patients can remain in the comfort of their own homes, and therefore avoid unnecessary hospital care. The medical device manufacturers will have a big role to play in the success of the technology as it is their responsibility to help translate device data into a format that can be read and understood by EMRs, and consequently the hospital staff that need to use it. Hospitals today use a vast number of common electronic devices, with IV pumps, physiologic monitors and vital signs monitors, making up 85% of the total. However, very few of these devices are currently connected to a hospital network. As indicated in Figure 1.1 Reliable statistics are not available for the use of electronic medical devices outside hospitals, but their number is expected to grow even more dramatically. The need for more accurate, timely and efficiently collected data will increase the use of CMDs in nursing homes, clinics and other healthcare facilities. The greatest growth is expected to be in patients’ homes and other locations outside of formal care environments, because potential improvements in data collection efficiency, cost and timeliness are greater outside of healthcare facilities (Fig. 2).2

 The benefits of connectivity

 Research has shown that nurses spend approximately 21⁄2 hours per shift on documentation activities, reducing the amount of time they spend on direct patient care. CMDs can automate a significant amount of nursing documentation which can help to increase the time that nurses devote to patient care, which can lead to improved patient outcomes. Clinical decision support (CDS) capabilities are the main source of value from EMR systems. Basic CDS includes things such as drug selection and dosing alerts, electronic order sets, and duplicate lab test alerts. Beyond these basics lies a world of value, much of which requires more detailed data, collected more frequently than most hospitals are able to afford. Emerging, high-value CDS applications include clinical surveillance systems that can review large volumes of clinical data and highlight patient risks when they occur, to guide real-time changes in care. CMDs can dramatically reduce the cost of data collection for these systems, making them a practical alternative for more hospitals. Another of the CDS capabilities made possible by CMDs is to receive global alerts for each type of device. For example, networking older IV pumps without safety alerts would allow hospitals to create their own real-time alerts based on current data, which could be sent to nurses in time to avoid dangerous and costly errors – making ‘smart pumps’ out of ‘dumb’ pumps. Potential candidates for this type of CDS include IV pumps, ventilators and cardiac monitors. Devices that connect to the network add analytical value. If all of a hospital’s smart pumps are connected to the network, then pump data can be aggregated to show trends in unsafe pump programming, which nurses need to be trained in, and helps to determine whether there are a greater number of errors at certain times of the day, for example.