Healthcare News & Insights

IoT and medical device integration: How we get there

Since HIPAA, electronic health records (EHR) and electronic medical records (EMR) continue transforming the way patient medical data is recorded and stored. As Internet of Things (IoT) devices become more prevalent in health care, many of them still lack integration with EHR and EMR, creating gaps between the creation of those records and their housing in hospital networks. In this guest post, Eric Dusseux, MD, MSc, MBA, CEO of a robotics company focused on providing rehabilitation and mobility solutions to individuals with neurological and mobility challenges, explains what needs to be done to close these gaps and increase the accuracy of decisions and availability of patient records.

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Health systems must take the next step by integrating their medical devices and allowing them to both create medical records in real time and immediately feed those records into the health systems’ networks.

The data produced by medical devices for each patient is enriched with context and becomes useful information for healthcare practitioners. By providing their interpretation, these healthcare practitioners are then in a position to use this information to make significant differences for patients and their healthcare practitioner networks. It’s only this sequence of integration that allows the data to be integrated and actionable. Health care is a knowledge-based business, but data isn’t integrated enough and actionable knowledge is still poorly delivered.

Additionally, this integration with health systems’ cloud networks must be user-friendly and customizable, improve data quality and productivity, and comply with HIPAA. All of this must simultaneously occur at the patient, robot, hospital and network levels.

All of these headaches aren’t lost on medical device manufacturers, who in recent years have developed integration solutions to address them. To date, the problem is few available solutions address all those needs. It’s a long list of demands, but providers can’t compromise on solving any of these problems.

What do we need and why?

Integration: To better understand the need for integration, we can view the physical therapy space as just one example. As it stands, physical therapy is archaic in terms of data integration – it’s heavily patient progress-based, but lacks the connectivity to track and share patient results in real time. Even in technologically sophisticated physical therapy practices that have implemented robotics and EHR or EMR, patient activity and progress may be recorded electronically but data from medical devices still must be manually uploaded to the EHR or EMR by human therapists, rarely providing useful contextualization in real time. Integration can eliminate the need for manual entry by immediately uploading those records.

User-friendliness and customization: Some technology providers recognize these problems and are developing solutions to them, but many of them are inadequate and lack the customization required by today’s healthcare providers and networks. With individual U.S. hospital networks containing as many as 185 unique hospitals and many of those hospitals using their own information exchange standards, solutions can’t be one-size-fits-all.

Another barrier to implementation is the use of multiple information exchange standards – such as Direct or HL7 (with different versions) – within the same health systems. One health system may have 10 hospitals that all use different information exchange standards and processes, working in silos and preventing platform interoperability. In order for that health system to implement one information exchange solution, that solution must be customizable and flexible enough to accommodate all of the standards in play. Otherwise, each hospital must find its own technological solutions and partners, significantly fragmenting the marketplace and making it difficult for any one vendor to collect enough customer feedback to meaningfully refine their products in a standard manner.

Improved data quality and productivity: The most pressing need for IoT-integrated robotics is the need to improve data quality, which is important at every level from the patient to the health system. At the patient level, robots conduct neutral patient evaluations, which are by nature less biased than evaluations conducted by human caregivers and provide clearer pictures of patient progress. At the health system level, robotics and the IoT can collect data on therapy performance to improve practices.

It also enables the monitoring of the asset productivity of given equipment, enabling comparisons across time in the same department or across departments and facilities. Data can also provide insight to patient cost, which can help providers reduce unnecessary care and increase productivity. With integration that instantly uploads results, health systems always have the latest and most accurate data that can be enriched by context to produce information with which to make decisions.

HIPAA compliance: According to the U.S. Department of Health and Human Services (HHS), HIPAA required it to develop regulations protecting the privacy and security of certain health information, particularly when it’s stored or transferred electronically. As adoption of EHR and EMR continues, so do security risks and, in turn, HIPAA compliance becomes vital. Since HIPAA is the industry security standard, any solutions involving the recording or transfer of electronic records must enable users to comply with it.

What’s stopping us?

While many facilities have taken the first step by implementing robotic devices, many require integration to get the most out of their initial investment. This lack of adoption is due to both a misunderstanding of the technology’s benefits, and sometimes a reluctance to deeply leverage and invest in new technologies.

Historically, medical device manufacturers have been unable to develop patient-facing robots that check all of these boxes. As that changes and products become more all-encompassing, the next challenge becomes articulating these benefits to the healthcare industry and helping them understand how adopting robotics will improve patient care and their bottom lines in the long run.

While the healthcare industry’s information technology investment is steadily increasing, reaching $7.1 billion in 2017, it’s far from commensurate with the hospital industry’s profits or with its possession of many of the world’s leading scientific, technological and medical minds. The 2016 profit shared by 70% to 80% of only 4,800 community hospitals was over $76 billion, or about $16 million per hospital. That figure doesn’t include more than 1,400 additional hospitals, and the profit suggests that on average, there’s plenty of capital available for investment in a well-integrated information and decision making system.

In order for medical devices to be worthwhile for providers, they must integrate and that integration must accomplish a lot of different things in order to lead to actionable decisions, improve outcomes and access, and decrease costs. Producing the technology to perform all of these functions for health systems won’t be easy, but manufacturers are hard at work developing solutions to alleviate all of their customers’ major pain points, and make their practices more agile, cooperative and informed. Health systems know what their challenges are, so adoption should swiftly follow this technology’s availability.

Eric Dusseux, MD, MSc, MBA, is CEO of BIONIK Laboratories, a robotics company focused on providing rehabilitation and mobility solutions to individuals with neurological and mobility challenges.

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