MDI boosts quality, saves time

Stage 7 health system raises the bar

Some say that medical device integration, or MDI, provides a significantly higher level of quality data capture than manual data entry.

Count Kevin Jones, Assistant Director of Information Technology at Ohio State University’s Wexner Medical Center, among those. What’s more, he says, MDI reduces the time to data capture and adds a layer of patient safety.

Jones should know. In October 2011, Wexner integrated its $102 million EMR with 700 medical devices for a simultaneous "big-bang" implementation. The go-live event replaced nearly all the medical center’s clinical and financial applications with a single EMR.

Jones and his colleague, Lynn Kuehn, RN, Director of Clinical Applications at Wexner, detailed their experience with MDI at go-live and beyond during a HIMSS13 education session Monday.

“We’re building an 21-story ICD and oncology building in 2014,” Jones said. “We required scalability in our medical device integrator and needed a flexible system that would be a global toolset for all devices.”

As far as process workflow, Jones said the single MDI was the way to go. Devices at Wexner communicate via HL7 or web services. Device data either has a dedicated gateway from the vendor or a simple fan-less PC attached.

The MDI interface devices currently include patient monitors, ventilators, ECG machines, glucose monitors, hemodynamics, and multiple others. Jones emphasized that Wexner also recognized the potential of the ambulatory side for MDI expansion.

Six months after the go-live event, Jones formed a small team within the IT department to handle medical device data. It was a team of two – ‘nimble,’ according to Jones – a tech lead and a clinical engineer. “Those two are a very nice enhancement to an application suite,” he said.

In order to determine the efficacy of clinical device integration, Wexner initiated an internal study using 4 data quality measures: consistency, timeliness, correctness and labor savings.

Kuehn said the study examined all ICU patients for one week. The results were impressive: 95 percent of vital signs were captured at least once per hour; the vast majority of data was validated by clinicians within the first 15 minutes of posting data; only 4 percent waited more than 2 hours – although Kuehn did say that was unacceptable and needed to improve.

Wexner saw an 81 percent decrease in the time required to take a set of vital signs as a result of MDI. Kuehn said that meant 96 work hours were saved in over a week, or the equivalent of 2.4 FTEs over a one-year period.