Saturday 8 February 2020

The Convergence of Technology in Healthcare

There are several burgeoning technologies that are converging as we speak and are about to greatly accentuate patient care as we know it. A few years ago while working for a large healthcare equipment manufacturer, I worked with a customer account which had a telemetry patient that had just been moved from the 2nd floor to the fifth floor. The patient experienced a run of V-Tach that devolved into V-Fib. The telemetry alarm algorithms caught it, and a code was called - unfortunately to the wrong room. By the time the code team made it to the correct room, valuable time was lost and the patient expired. As it happened, when the patient was moved, the appropriate information was given to the Electronic Medical Record system, but even with all of the interfaces that were then possible, the two systems didnt communicate, and thus something as rudimentary as reposting a three digit room number on the telemetry central station didnt occur, and perhaps cost someone their life.


Service Oriented Architecture (SOA) products such as the technologies being offered by Johnson Controls Inc. and Emergin Systems allow these disparate systems to communicate together in a manner which affords feature teaming and aggregation of capabilities across multiple systems. For instance, take the existing ADT (admit/discharge/transfer) system that contains patient room and demographic information, couple that with clinician staff information from the enterprise network Active Directory, then couple that with the existing nurse call and patient monitoring system, and you could route alarms to specific caregivers for specific patients based upon level of acuity of the alarm and level of response capability of caregiver. All of this from existing systems that have simply been enabled to talk to one another. This concept can be explored further here.

HL7 (Health Level 7) interfaces are now (as they were, in fact then) commonplace and an ADT (admit, discharge, transfer) interface could have easily updated the central station as the patient was moved. Moreover the patient could now be tracked with RFID or 802.11x based location vectoring systems. Interestingly the telemetry technology has been evolving towards digital spread spectrum (FHSS) devices operating in the FCC allocated WMTS bandwidth. This allows for technologies that have been created in one technology sector to be shared in others. A good example of this is Philips Medicals new DECT based telemetry system. After GE had purchased Vitalcomm a few years ago to assimilate their 608-614 Mhz FHSS telemetry technology into their product line, Philips needed a bold, forward-looking technology solution. They attained that by utilizing VOIP technology that was running in the 1.4 Ghz WMTS band. Now all they need is integrated RFID for a true RTLS solution that can aid in patient location.

Bandwidth has changed as well. Hospitals were once squeamish to carry life-critical binary patient information on their networks. Typically the patient monitoring, or real-time networks were completely separate. Some interesting new packet gating software allows for multiple use devices sharing the same network, such as Siemens One Net System. With all devices sharing the same wireless infrastructure, global IT architectural features can be established across the enterprise.

Break-out logistical technologies such as RFID, RTLS, and network integration, coupled with advanced interface and data dissimination technologies stand poised to bring us into the twenty-first century, albeit about six years late.

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