Integrating Medical Device Data With EMRs Likely To Be Slow

While most healthcare organizations have their hands full integrating their various clinical databases, that leaves another set of problems untouched.  As things stand, EMR implementation efforts don’t generally involve connections to key medical devices.

Medical connectivity consultant Tim Gee sums it up nicely in a recent blog entry:

Medical device manufacturers in markets that have managed to resist creating connectivity solutions are facing increased pressure from providers adopting EMRs. I mean, what’s the use of automating the EMR if users have to write down numbers read from medical device displays and then manually type them into the EMR? That’s certainly not “automation.”

Gee then goes into a discussion underscoring just how big a challenge it will be for device manufacturers to close this gap. Broadly speaking, he says, devicemakers have to meet three criteria:

  • Be able to export data in a digital form.
  • Work with a centralized computer or server that aggregates data from your medical devices.
  • Offer HL7 interface that takes your device data, in your proprietary protocol, converts it to HL7 and sends it on to the EMR.

While these criteria may not sound too intimidating, there’s actually many, many unresolved issues as to how these solutions will play out for the medical device industry, he notes.  Device vendors will either have to do a great deal of custom work to meet standards or invest heavily in outsourced development.

Why do I bring all of this up?  Well, from the looks of Gee’s analysis, I’m guessing it will be quite some time before medical device makers universally offer plug-and-play data feeds into EMRs.

Though they may be under great pressure to integrate, devicemakers aren’t going to be able to do it overnight, particularly given that the EMR market itself continues to evolve rapidly.

While this isn’t great news, we might as well be realistic.  For the time being, I’d plan for manual data export from devices and hope for the best.

About the author

Anne Zieger

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

7 Comments

  • As someone who has been integrating Medical Device Data With EMRs for years, I can confirm that the process is slow. This is purely because most devices used to have proprietary data formats.

    Weeks get spent on reverse engineering these formats by deep study, continuous usage and polling.

    However a lot has changed in the past 2 years. For a start most manufacturers nowadays provide digital outputs as well as details of these formats are easily made available. Also many have standardized the outputs according to various standards.

    The bigger names in the industry are thankfully subscribing to the fact that their devices are a part of a bigger picture and not the only technology required in a medical practice.
    – Nrip

  • My pleasure. I’m not sure I understood the whole discussion (!), as I’m not a device expert, but it’s clear that people following EMR progress should know about the issues you’ve outlined. Please feel free to let me know if you’d like to compose an article on that topic for a more general HIT audience — we’d love to get your input!

  • This is why integration of devices has been so slow with a few exceptions like blood pressure cuffs. Although, anything more complex becomes an issue.

  • Katherine – It is difficult to tell if your comments are centered on device integration for clinic EHR’s or for hospital-based EMR’s. You state — “As things stand, EMR implementation efforts don’t generally involve connections to key medical devices.”

    For the hospital market, the exact opposite is true. With EMR vendors like Epic, device connectivity is often part of the initial implementation and devices like patient monitors, ventilators, and anesthesia devices are very often integrated using common connectivity middleware (i.e. an MDDS).

    I think it is a common misconception that medical devices can just “plug and play” with an EMR and the device data automatically flows into the EMR. If devices had standard protocols (some do) and if IHE profiles were commonly implemented (some are), then this would reduce some of the cost and complexity. But current standards do not some practical address issues such as data filtering, data caching on loss of connections, or association of the device to the right patient – to name just a few. All of these issues are addressed by connectivity middleware solutions.

    You reference Tim’s blog post which is written for device vendors considering connectivity. This is only one perspective because the hospital has their own perspective. Which Tim states as “Providers prefer to have an aggregator for medical device data and a single HL7 interface for clinical documentation, rather than individual medical devices talking to the EMR.” The aggregation is performed by an MDDS or middleware.

    For a broader view of device connectivity – here is a pretty good article – http://www.cmio.net/index.php?option=com_articles&article=21281&publication=56&view=portals.

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