By Sarianne Gruber
Twitter: @subtleimpact
How much impact could medical device interoperability have on improving safety? A West Health IDEA series hosted care experts to address this question in an open forum titled “Missed Connections, Costly Medicine: Frontline Views on Interoperability and Improved Patient Care”. The West Health Institute, a bi-coastal, nonprofit medical research organization, sponsored the live webcast from the Newseum in Washington, DC on Thursday morning, March 12. West Health’s Chief Executive, Nick Valeriani, opened the session calling for the need to have “medical devices to talk to each other”. He explained how the bane of interoperability falls on the shoulders of nurses tasked with extraneous work like transcribing data from different systems, and takes time away from their first priority- patient care. Complaints have been made that hospital monitors and devices sounding so many signals and unsynchronized alerts have become a nuisance rather than an aid. Many nurses suffer from alarm fatigue and feel unduly emotionally burdened. A compromised staff cannot perform at critical times, and as a result patient safety is compromised. Today medical errors account for between 210,000 and 440,000 preventable deaths. The third leading cause of death.
Compelled by improving safety and the toll non-interoperable devices have on frontline hospital workers, West Health initiated an online National Nurses Survey in January 2015. Harris Poll conducted the survey to 526 nurses on how they interact with technology, their challenges and how these challenges could be lessened. Key results presented were:
- 50% of nurses had witnessed a medical error because of lack of device coordination.
- Three in five medical errors could be significantly reduced if medical devices were connected in such a way that they shared data with each other automatically.
- 48% estimated that as many as one in four medical errors and adverse events might be prevented in a system where all hospital devices seamless shared information in an automatic, coordinated and connected fashion.
.
How can health consumers, device manufactures, hospitals and research organizations change medical device interoperability and improve patient safety? Moderating the speaker session was Sarah Kliff, Senior Editor of Vox.com. The panel included: a patient advocate, Lenore Alexander of Leah’s Legacy, who lost her 11 year old daughter to medical error; a patient safety director, Patricia H. Folcarelli, RN PhD, from Beth Israel Deaconess Medical Center; regulatory for digital health, Bakul Patel, Associate Director at the Food and Drug Administration; and West Health Institute’s Chief Medical and Science Officer, Joseph Smith MD, PhD. Here are some highlights of the opinions expressed:
As healthcare consumers, we are not aware of medical interoperability so we don’t make it an issue, explained Ms. Alexander. However, if Verizon cell phone carriers couldn’t exchange calls with ATT carriers, we would make a fuss. She sees this an administrative issue and not a vendor issue, and we should not incentivize device manufactures, nor have hospitals wait until devices are outdated. Learn more about Ms. Alexander’s work at Leah’s Legacy.
Patricia Folcarelli said at her hospital, “We have a goal to eliminate all cases of preventable harm”. She mentioned that there are a lot medical device cases where a dose of medication is miss-programmed into a pump, a delayed recognition occurs or the monitoring system is not talking to the pumps. She stated that with electronic health records, coding of documented complications and billing data, there is a greater awareness about the costs for treating patients with complications. In a highly transparent system, where patients and families are engaged and know what’s happening, is really the only way that the healthcare system will get better. Consumers will have to demand more because they have paying a lot more for a defective product, and it has to be a major movement to get us to an ultra-safe system.
West Health’s Dr. Joseph Smith made some poignant comments and a need for a call to action. Where can we make a difference? We have overwhelmed providers, over deployment of technology and a market failure where “vendors have no incentive”. What would it take to get it done? Perhaps open standard guidelines to vendors, financial incentives for those who do this quickly, or will consumers have to demand to have ultra-safe systems
From the regulatory side, Mr. Patel stated FDA goals support patient safety and public health, and interoperability has been a long time interest. He sees the benefit of learning from other industries to move forward. In the past, the agency has put out calls for standards to advance goals for patient safety. He is hoping there will be new requirements collectively imposed from the medical device market and healthcare that will work in tandem with health IT and providers.