Is Bedside Medical Device Integration in scope?

As part of Clinical & Systems Transformation project design work, some teams raised questions about whether Bedside Medical Device Integration would be included in scope. This refers to clinical data being electronically transferred from medical devices, such as ventilators, hemodynamic monitors and infusion pumps, into the patient’s record within the clinical information system.

The decision

We have now confirmed that Bedside Medical Device Integration is not in scope for CST; it exceeds our current scope and goals, but we will get there in time. The Project Board members emphasized a strong desire to do BMDI in the future and it is part of our planned journey towards a completely integrated electronic environment to support patient care. This is part of achieving HIMSS Level 6 and 7 (see below).

Our CEOs (Carl Roy, Mary Ackenhusen, and Dianne Doyle) reiterated that our priority is to focus on the huge task in front of us – to successfully establish new standardized clinical best practices, implement a shared clinical information system and achieve HIMSS Level 5 (see summary below). That’s a big job! Once we do that successfully and adjust to the changes, we can make further improvements like Bedside Medical Device Integration. We want to acknowledge the impact this decision will have in some areas that would benefit from device integration. Our commitment is to work with you to minimize impacts and we welcome you to contact us if you would like more information.

How was this decision reached and who was involved?

Bedside Medical Device Integration is relatively new and unproven in healthcare, especially in Canada, and there are many pros and cons to consider before undertaking BMDI. The technology is complex and not standardized, which makes it costly and difficult to implement. It has been the cause of failed EHR implementations because it puts a huge burden on the network, which can slow down system response times. The added complexity of BMDI creates real risk to CST’s timelines and overall likelihood of success.

Over the past few months, multiple options have been thoroughly explored and, as part of this process, we consulted:

– Key clinical and organizational leaders across the three Health Organizations
– Subject matter experts involved in the design teams
– Biomedical technicians; and
– Leaders from other sites in North America, who are using Cerner.

To reach a conclusion, these options were taken through the established CST governance process, including the Project Board, where our CEOs ultimately made the final decision.

What happens now?

CST Clinical Leaders will connect with the design teams, made up of multi-disciplinary professionals from across the three Health Organizations, to review any relevant workflows with this decision in mind.

Summary of HIMSS Levels

HIMSS Level 5 functionality includes: electronic nursing and allied health documentation; computerized provider order entry (CPOE); and closed loop medication management.

HIMSS Level 6 and 7 functionality includes: more comprehensive documentation that allows for more in-depth analytics; more advanced clinical decision support; more integrated radiology PACS and biomedical device integration; and advanced data warehouse integration.

For more information

Please email us at info@CSTproject.ca or contact a member of our clinical leadership team, listed below:

Dr. Bruce Long, CST Chief Medical Information Officer, VCH/PHC – Bruce.Long@vch.ca
Dr. Kellé Payne, CST Executive Director and Transformation Lead, VCH (Joint) – Kelle.Payne@vch.ca
Donna Stanton, CST Executive Director and Transformation Lead, VCH (Joint) – Donna.Stanton@vch.ca