National Nurses Week starts on May 6 and culminates on May 12—the 190th birthday of Florence Nightingale. Nightingale is best remembered as “the lady with the lamp,” the ministering angel of the Crimean War. Beyond that she was also a writer and a statistician. She defined the nature of modern nursing as a profession by founding the world’s first secular school of nursing in 1860. Her work in the Crimean War and at the school charted the twofold course — the American Nurses Association describes it as “an art and a science” — that nurses still follow.
In the 150+ years since, nursing has continued to be both art and science, both personal and objective. At times, the personal side has been nearly overwhelmed by the objective demands of high patient loads, stringent regulatory and documentation requirements, and medicine and technology that Nightingale could not have even dreamed of. At the same time, today’s nurses have expertise and information that were impossible in Nightingale’s day. We’re proud that device integration, which is what we do, plays an important part in freeing nurses from routine work and empowering them with accurate and current data, so they can continue to focus on both the personal and objective sides of patient care.
Nursing has come a long way since 1860, but it’s still an art and a science. I believe Florence Nightingale would recognize that, and she’d approve.
iSirona is pleased to announce that Duke University Health System will be using iSirona’s software solution to deliver patient data from medical devices to its EMR. A major academic health system, Duke University is ranked the #9 hospital in the nation by U.S. News & World Report.
“We are committed to acquiring technology options that can further augment our implementation of a state-of-the-art, seamless electronic health record throughout Duke University Health System,” says Kay Lytle, director of clinical IT strategy for DUHS. “This technology will give us additional capabilities to support our delivery of optimal patient care for our patients.”
Device connectivity is a hot topic right now: KLAS recognizes it as a key market segment and ECRI ranks it as hospital technology priority #1 for 2012.
Generally, when people talk about medical device integration, they talk about its value in strategic initiatives such as Meaningful Use and health information exchange. They also talk about its value in freeing nurses from much of the work of documentation, so they can spend more time on direct patient care. But device connectivity has another vital function, in eliminating the errors that come from handwritten notes and hand-keyed data.
This month Linda Kloss, in Health Data Management, wrote a highly relevant article on information integrity. She defines information integrity as the trustworthiness and dependability of information and goes on to say that “information integrity is a foundational building block…and it’s arguably the most underdeveloped block.”
That’s not just a theoretical claim. One study of the quality of conventional, hand-transcribed data found errors in about 15% of all patient records. If the data going into the system does not have integrity, then the best healthcare information system in the world can’t do any better than rapidly transmitting, storing and indexing bad data.
In this light, it’s clear that device integration is essential because the data chain can only be as strong as its weakest link. In too many hospitals, that weak link is at the very front end, where nurses hand-copy patient data onto paper and then hand-key it into the EMR. This problem is not new, but it appears to be growing. As Kloss puts it, “Data quality issues certainly preceded the change in medium from paper to computer, but research…suggests that they are growing rather than diminishing.” Device connectivity can remove the errors of hand-keyed data and substantially raise the integrity of your information. We have a white paper on this topic: Flawed Data Chain, Faulty EMR: How to Build a Solid Footing for Patient Data. I invite you to read it and, as always, we would like to hear your comments and experiences.
“Healthcare IT today…is much more than an EMR. It is the information ecosystem that supports every patient encounter.” — Carlos Nunez, MD, Chief Medical Officer of CareFusion, San Diego, CA
This year’s HIMSS threw a spotlight on how quickly the healthcare information ecosystem is evolving. Shahid Shah provided, in the March 27 Healthcare IT News, an insightful summary and analysis of the implications. He advises an approach based on multiple systems instead of monolithic applications: as the scope and complexity of the ecosystem grows, there is not going to be any one system or application that can do everything. As the hospital’s information ecosystem becomes ever-more capable (and complex!), he writes that “more orchestration across services and apps will be necessary, not larger apps.” His summary recommendation is to not look for a single app that can do it all. Rather, “become expert at data integration and connecting multiple software systems.”
Where will device integration fit in this rapidly evolving landscape? More to the point, when is the right time to introduce it? In brief, the answer is that you should implement connectivity now if you have don’t have it already. The first reason is that device integration goes at the front end, where clinical data enters the ecosystem. The only alternative is hand-keying, but that inevitably introduces errors, which then become permanent parts of the record. Besides eliminating hand-keying errors, device integration is necessary for Meaningful Use and other HIT initiatives, which is part of the reason that ECRI put device integration at #1 in its report on Hospital Technology Issues for 2012. On top of all that, a device integration implementation pays off quickly, with immediate improvements in efficiency and productivity on the hospital floor.
Shah’s message, above, leads to one more recommendation. If you’re ready for device integration, look for a system that will be easy to integrate with your medical devices, EMR and ADT systems, and the workflow of your hospital floor. If your connectivity solution “plays well” with others, then you’ll have a head start on building an integrated, connected information ecosystem.
Vinod Khosla, a successful Silicon Valley venture capital investor, recently stirred things up a bit in his TechCrunch piece titled, “Do We Need Doctors Or Algorithms?” In the post, Khosla describes how computers—drawing on vast amounts of medical data—may come to take on more and more of the decision-making tasks traditionally handled by doctors. He refers to these computer systems as Dr. Algorithm, or Dr. A for short.
“Dr A. will get better and better and will go from providing ‘bionic assistance’ to second opinions to assisting doctors to providing first opinions… and who knows what will happen beyond that?”
It’s an intriguing vision. Dr. A could have access to a patient’s entire history of symptoms, illnesses, and test results as well as millions of other data points. Already, as Khosla points out, IBM’s Watson computer is being applied to medical diagnoses. And, increasingly, patient data is becoming available more and more for computer analysis. “Kaiser Permanente already has 10 million real-time medical records with details of 30,000,000 e-visits last year,” says Khosla.
Will this digitization of data herald the end of Dr. H, the human doctor? Let’s look at other areas where computers are doing tasks that were once done by highly trained, specialized humans. There are on-board computers for airplane flight; materials structure and analysis systems; and modeling software for studying proteins and biochemical reactions. It’s important to note these systems haven’t replaced pilots, engineers or research scientists: rather, they have made them more powerful.
Khosla comes to a similar conclusion about the future of Dr. H. “We consider doctors some of the most learned people in our society. We should aim to use their time and knowledge in the most efficient manner possible.”
What we’re really talking about is the birth of the data-enabled doctor. Of course, it will take time to get there. And it will no doubt take incredible amounts of data integration. Patient data needs to make its way into systems where Dr. A and Dr. H—working together—can actually use it. That’s where iSirona comes in, and that’s the vision that drives our company forward.
I recently read a blog post on the shortage of women in healthcare IT. Women are underrepresented in most IT fields, but we were still surprised at how few women we saw at HIMSS12 this year. At iSirona, we place a high value on hiring and promoting women—that’s why we have several women in leadership roles, including Jena Milan, Polly Mulford and Mary Carr.
Jena Milan, our vice president of product management, leverages her 17 years of experience in product management, sales and marketing to help us design products that work—really work—for our customers. Polly Mulford, our vice president of account management, is our go-to client advocate, helping us nurture and maintain relationships with clients. And, we recently promoted Mary Carr to chief nursing officer. Mary’s been working in healthcare settings for 15 years and brings a wealth of knowledge on clinical workflow analysis, process improvement and healthcare information technology design.
If you’re interested in other women to watch in health IT, we recommend Katie Matlack’s article: The Top 5 Women in Health IT You Should Know.
A recent TechCrunch article titled, “Why It’s Good News HealthIT Is So Bad,” elicited a fair amount of comments as you might imagine. Of interest to me was author Dave Chase’s commentary on IT decision making processes in health systems:
”I was at a well recognized hospital implementing their patient accounting system and we needed to decide the unique patient identifier scheme. It’s an important decision, but they were in year seven of debating what the new scheme should be! It may seem like an absurd example, but it’s indicative of how interminable and almost crazy the decision processes can be in a health system.”
As Chase points out, decision making is difficult when the stakes—such as cost and time needed for implementation— are high. Here’s the good news: vendors today offer solutions that don’t cause sticker shock, and that don’t necessarily take six months to roll out.
We’re proud to be in that category. Our software is flexible; it works with any CIS and any device. Our software is easy to install; many of our installs take less than four weeks. And finally, because our software runs on hospitals’ existing hardware, costs stay low—the lowest in the industry. This makes IT decision making for our healthcare-provider customers easy.
Or, as Chase puts it, “The reward for healthcare providers in rationalizing their decision processes is they will no longer have to settle for rigid software that is difficult to implement.”
We’re proud to announce DeviceConX 4.0, the latest version of our connectivity software. This latest version includes an enterprise architecture and management console that gives IT and biomed professionals a centralized view for system management, maintenance and connectivity status.
Web-based and incredibly user friendly, this system-level view simplifies device connectivity management. It also generates alerts. In the event that one of the systems or devices goes offline, 4.0 sends a notification message to the appropriate IT or biomed professional. Why? So clinicians don’t have to, says iSirona Chief Nursing Officer Mary Carr, RN:
“Today’s nurses are overloaded as is; they shouldn’t also have to troubleshoot connectivity issues. By proactively notifying biomed and IT, the management console allows clinicians to do what they do best: provide quality patient care.”
We’ll be showing off DeviceConX 4.0 at HIMSS12—both at our main booth (#12414) and the Interoperability Showcase. Stop by to learn more!
Don’t miss us at booth #12414. Not only will you see the latest version of our software connecting devices; you’ll also become eligible for our daily drawing. We’re giving away a Kindle Fire each day!
To stay informed, text BUZZ to 53203, follow us on twitter, or keep your eye on this blog. If you’re ready to learn (and if you’re feeling lucky), we’ll see you in Las Vegas!
The key to a great device integration product is its technology. Similarly, the key to a great device connectivity company—or any company, really—is its team. I can’t tell you how proud I am that the iSirona team has unrivalled depth in every aspect of healthcare information technology. That’s what successfully brought us all the way from our initial vision to having so many successful customer deployments.
To that end, I’m thrilled that Mary Carr has accepted our invitation to become iSirona’s Chief Nursing Officer!
A modern hospital is a complex organization, and device integration has to meet requirements on a lot of different levels. One of those levels is the nursing floor, and even the most powerful and sophisticated connectivity technology has no value unless it meets the real-world needs of working nurses. In large part, our products have been so successful because of Mary’s understanding of how nurses work.
Mary’s contributions have been invaluable. She has worked for iSirona for several years, and our customers rave about her capabilities and knowledge. I believe she is just getting going; that’s why we created the CNO position. If you’ve already met her, you’ll understand how much she brings to that position. If you haven’t, I invite you to introduce yourself; you can reach her at mary.carr@isirona.com.
National Nurses Week starts on May 6 and culminates on May 12—the 190th birthday of Florence Nightingale. Nightingale is best remembered as “the lady with the lamp,” the ministering angel of the Crimean War. Beyond that she was also a writer and a statistician. She defined the nature of modern nursing as a profession by founding the world’s first secular school of nursing in 1860. Her work in the Crimean War and at the school charted the twofold course — the American Nurses Association describes it as “an art and a science” — that nurses still follow.
