Medical Technology Still Requires Nurses to Translate Their Talk

With all their high-tech equipment these days, hospital rooms look more like Mission Control than a healing haven. But for all the help medical machines offer, sometimes they don’t play well with each other, and that requires nurses to run communication interference.

As reported by NPR earlier this month, the ideal techno situation is what engineers call “interoperability.” That means the buzzing, blinking ventilators, IV pumps, heart monitors and computers containing patient records communicate with and update each other as part of business as usual.

But a Harris Poll commissioned by the nonprofit Gary & Mary West Health Institute found that half of more than 500 nurses said they had witnessed a medical error caused by a lack of coordination among devices.

And they should know. Sometimes, they spend more time with machines than people. More than 2 in 3 said they spend at least an hour every shift dealing with devices. A majority reported spending significant time troubleshooting problems, recording data that wasn’t shared electronically and answering alarms.

“The electronic Babel at the patient’s bedside,” said the NPR story, “places a heavy burden on nurses and exacts a toll on patients.”

“The nurse ends up having to have a toolbelt on just to deliver care,” Linda Burnes Bolton, chief nursing officer at Cedars-Sinai Medical Center in Los Angeles, told NPR.

The burden on nurses can be lightened, said Nicholas Valeriani, CEO of West Health, with … better technology!

That requires medical device manufacturers to reach consensus on communication standards. Their products must be able to communicate not only with each other, but with electronic health record (EHR) systems.

What’s the likelihood of that happening any time soon, when so many providers are frustrated by different EHRs that aren’t compatible, threatening not only efficient office management, but patient safety when a person’s information slips between the cracks, or gets recorded different from what the provider intended?

What’s the likelihood of that happening when, as we reported recently, certain implant device manufacturers are resisting legislative demands to ID their wares, and feuding fed agencies let them?

Valeriani told NPR that carrots, not sticks, could entice manufacturers to establish communication standards. The FDA, for example, could accelerate review of compliant products so their manufacturers could get them to market faster.

Cedars-Sinai has been working with some suppliers to address the “I-can’t-talk-to-you” problem. The hospital was successful in getting its EHRs to connect to infusion pumps so that when a doctor prescribes medication it can be transmitted electronically to the pump. A nurse still is required to verify the meds before the infusion begins.

Good idea, but not an easy fix: vendors still must write special code to make the connections work.

Shouldn’t that be part of the deal, and not an option, like a moon roof and premium sound system on a car?

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