New electronic barcode system increases workflow, empowers medical assistants
ORLANDO–At the 2008 HIMSS conference today, Michael Dempsey presented a pilot project of an electronic barcode system developed to collect medical data from medical devices at Brigham and Women’s Hospital (BWH) in Boston. The system provides for wireless, device-agnostic, networked edge devices that learn how to connect medical devices and clinical systems through the scan of 2D barcodes.

The system starts with the clinician, or medical assistant (MA), scanning his or her ID badge. The system figures out credentialing and training level. Then, the clinician or MA, scans the patient’s ID band, and the system figures out what services the patient needs. Finally, the system scans medical devices and figures out how to communicate to the devices and what it can do. The end result is the personal/electronic digital assistant (PDA/EDA) agent configures itself to complete the expected task and automatically establishes communications to the appropriate systems.

Dempsey, investigator at CIMIT, department of biomedical engineering and anesthesia at Massachusetts General Hospital in Boston, said they began the project to capture vital signs for detection of precursors of disease (especially hypertension) more quickly; extend the life of legacy medical devices; to create a more portable data to the various systems; to review trends across practices and locations with longitudinal data; and to create a clean point of demarcation between IT network and medical devices.

“You want to know that the data are reliable, and [which clinicians are] managing hypertension patients better than others,” Dempsey said.

For background, Dempsey said that there are approximately 60,000 medical devices currently in use at Partners, and the devices are spread across seven hospitals and span 20 years of “best of breed” technology.

Before beginning any new adjustments, he stressed that “it’s very important that the end-users are very comfortable with any changes that you make.”

He also listed the challenges of networking medical devices:
  • There is a huge delivery diversity of medical devices in use and their correct operation is critical to their safety and effectiveness;
  • The same device may be used in very different ways, and hence have different networking needs; and
  • The performance of the system is a function of both devices and the network—a “one size fits all” solution doesn’t necessarily work.
Dempsey also stressed the importance of creating a system that can be integrated with any number of products from any vendor. “We didn’t want to tie ourselves into only working with certain devices,” he added.

With the new system, designers need to remain conscious of the importance of workflow awareness. “The system enables and potentially empowers the medical assistants to undertake certain actions, and the information is immediately pushed off to the physician helps workflow,” according to Dempsey.

The current project started in September 2006, and the initial roll-out in three different practices took place in December 2006. The Phase One deployment in BWH Department of Medicine Ambulatory practices took place in May 2007. The system shake out took place from May through December 2007, and the transition to production scheduled for March 2008 actually occurred two weeks ago, Dempsey said.

He also reported that currently the system has been used in 15,000 patient encounters with multiple vitals; there are 52 PDAs in use; it is used in 18 practices; and is scheduled to be used in three more facilities this summer.

When questioned about the fluidity of integration with the various devices, he said that there are only about 20 to 30 different devices, most of which are fairly ubiquitous and easy to maneuver to write the software to make it compatible for each.

The project also is working to integrate with any EMR, as well as the various medical devices, Dempsey concluded.

BWH is part of the Partners Healthcare system, which logs about $3.5 billion in business a year, serving approximately 1.5 million patients and staffs about 53,000 employees. Additionally, Partners’ research portfolio intakes more than $1.8 million in business annually, and has approximately 2,300 investigators and 1,400 active clinical trials.