Medical Devices Meet Electronic Records
August 2005
Two years ago, Riverdale Family Practice went live with electronic medical records software from Amicore Inc., Andover, Mass. Early this year, the six-physician practice integrated the application with a portable electrocardiograph-a medical device that measures a heart's electronic signals-from Quinton Cardiology Systems Inc., Bothell, Wash.
The EKG device is plugged into a port on a physician's Tablet PC. Cardiac data can be viewed on-screen and then downloaded "straight into the patient chart," says Frank Maselli, M.D., managing partner. "I can print it out, look at it on screen, whatever I want."
Bronx, N.Y.-based Riverdale also purchased from Quinton a spirometer-which measures lung function-and integrated it with the EKG device and electronic medical records system. The practice previously referred patients elsewhere for the $110 tests; it now conducts them in-house three to five times a week.
The electronic record/medical device integration has delivered clinical and financial benefits, but it's also brought home how the lack of such integration is holding Riverdale back, Maselli says.
The practice still must scan or manually enter information from other medical devices into its electronic records system, a task that's time-consuming, expensive and risky in terms of patient safety. Maselli is trying to get Amicore to integrate with the practice's CBC, or complete blood count, machine. Right now, blood count results are printed and scanned into the electronic record.
"One of the problems with electronic records is that scanning is very cumbersome," Maselli says. "The less scanning you have to do, the better."
Integration has been an ongoing concern as health care organizations make strides toward automation. Many integration efforts have focused on tying in large applications-such as laboratory and hospital information systems-with electronic records that are designed to be a receptacle for clinical, administrative and financial data.
There has been less attention-and less time and resources-devoted to linking electronic records to medical devices, the literal fingers on the pulse of the care delivery process.
Old practice, new adherents
Integration of medical devices with clinical information systems isn't a new idea. San Diego-based Sharp HealthCare nearly two decades ago integrated heart monitors with electronic records software from CliniComp International. At the time, Sharp HealthCare was a developmental partner with San Diego-based CliniComp.
What's new is the growing number of medical devices that are becoming computerized enough to support integration with electronic records, says William Spooner, senior vice president and CIO at Sharp HealthCare.
The delivery system, for example, has started a project to integrate glucometers, devices that measure blood sugar for diabetics-with the CliniComp software, automatically capturing data and storing it in the patient record. "That offers huge advantages in terms of accuracy and timeliness," Spooner says.
As the possibilities for electronic record/medical device integration increase, however, roadblocks arise. While there is an emerging awareness among some providers of the value of such integration, not every provider shares the same level of enthusiasm, says Peggy Congin, R.N., a nursing informatics consultant with Beacon Partners Inc., Weymouth, Mass.
"Medical device integration may be very important to a gastrointestinal specialist, but a cardiologist may not have any use for it," Congin says.
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