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ITHIN the typical healthcare organization, different software vendors’ clinical applications, ranging from electronic health record (EHR) to

e-prescribing to radiology imaging systems, present numerous health interoperability issues. In the same vein, medical devices, ranging from simple

monitors to complex ventilators, pose similar issues. Many devices transmit and receive data in proprietary ways, yet hospital IT staffers must get data from the devices into EHR systems—and get alerts dispatched to nurse and physician smartphones.

Searching for Seamless Integration As is the case when addressing software’s health

interoperability challenges, some facilities are using middleware to connect medical devices to back-end information systems. Mike Freeman, Biomedical Device Integration Manager

for Sentara—an 11-hospital system in Virginia with more than 1,000 beds and 18,000 devices, including fetal monitors, ventilators, and anesthesia machines—sees such middleware as the interoperability solution for getting information from medical devices into his Epic Systems, Inc. EHR. “For us, we can standardize on the integration but give the user flexibility of multiple endpoints,

which is crucial to them,” Freeman said. “To us, interoperability means we’ve got to support whatever we put out there. Standardizing on how we’re going to make things talk to each other—that’s probably the most important thing to us.”

Mobile Devices, Custom Apps, and

Interoperability Complications The market penetration of devices running the Apple

iOS operating system—the iPad, iPhone, and iPod touch— is increasing among physicians and nurses. Hospital IT staffers might cringe at the idea of adding an iOS EHR implementation to a long list of regulatory-spurred technology implementations, but those mobile devices can actually be used as an incentive to promote EHR use, said United Health Services CMIO Afzal ur Rehman, M.D. in a presentation at the Health Information and Management Systems Society’s HIMSS 2012 conference. “A lot of physicians said to me, ‘I always wanted a

reason to buy an iPhone, and this is it,’” Rehman said, in reference to his upstate New York health system’s iOS EHR rollout. An iPhone or iPad can consolidate several devices physicians or nurses might currently carry into one, increasing their satisfaction with the new medical records and unified communications systems they are learning to integrate into healthcare workflows.




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