This lack of interoperability can lead to serious errors. It also means that clinicians waste time chasing false alarms set off by individual gadgets. For example, today’s telemetry monitors track heart rhythms, while other gadgets monitor heart rate and levels of blood oxygen. Sudden changes in activity and movement can cause sudden heart-rhythm fluctuations, triggering urgent warnings. But such alarms could be eliminated if an integrated system also checked heart rate and oxygen levels; if these were unchanged, no heart-attack warning would be necessary.
David Osborn, manager of international standards at Philips Healthcare, says that while the new standards will help, “the document put together so far is a high-level framework. The devil is in the details, and the details haven’t been written yet.” However, he adds, “harm is occurring to patients more often than we’d like to admit, and this can be a step toward a solution, if we can get beyond the framework.”
Szolovits says that the eventual goal is an integrated clinical environment, in which all devices are interconnected, in plug-and-play fashion, for better management. Currently, devices made by different manufacturers operate on their own, and, in general, they cannot communicate with one another. Several medical associations, including the American Medical Association, have called for interoperability.
“Even at leading modern hospitals, I have seen pulmonary technicians run around the foot of a patient’s bed to transfer ventilator settings from a device on one side of the bed to a computer system on the other,” says Szolovits. “Not only is such a process laughable to watch, but it increases the risk of errors, corrupts data, and possibly even puts patients at risk.”