Medical Device Interoperability: A ‘Wicked Problem’ of Our Time
A conversation with Julian M. Goldman, MD
Julian M. Goldman, MD, is medical director of biomedical engineering for Partners HealthCare System, a practicing anesthesiologist in the Massachusetts General Hospital and director of the Program on Medical Device Interoperability at MGH and CIMIT (Center for Integration of Medicine and Innovative Technology). He founded the Medical Device “Plug-and-Play” (MD PnP) Interoperability Program in 2004 to enable innovation in patient safety and clinical care by leading the adoption of patient-centric medical device integration. PSQH Editor Susan Carr recently talked with Dr. Goldman about his work at MD PnP and the current state of interoperability.
Nurse Leadership from Bedside to Boardroom
There is increasing recognition that nurses must be involved as leaders and decision-makers throughout healthcare, not just at the bedside or within the nursing community. Nurses are executive leaders in health systems and hospitals, of course, and also in professional associations, accrediting organizations, businesses, government, and universities. Within the nursing community, many feel that the skill set nurses need for modern-day practice also makes them valuable contributors throughout health systems, especially in leadership positions.
Automated Care Tools for Population Health Management
With various forms of value-based reimbursement starting to take hold, healthcare providers have become increasingly interested in new care delivery models centered on population health management (PHM).
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Moving Toward the Five Moments
Much has been written and discussed about the Five Moments for Hand Hygiene from the World Health Organization (WHO). Most healthcare workers agree that doing hand hygiene at those five events is important to improve patient care but not everyone agrees on the real-world implementation.
Interruptions Lead to Errors and Unfinished…Wait, What Was I Doing?
If you’re a health professional, it’s hard to get through a single hour of the day without being distracted or interrupted, even when performing critical tasks. For instance, nurses administering medications and pharmacists and technicians dispensing medications are distracted and interrupted as often as once every 2 minutes (Relihan et al., 2010; Silver, 2010)!
Electronic Physician Documentation
Not Just Another IT Project
As hospitals throughout the country sprint towards Meaningful Use, computerized physician order entry (CPOE), electronic medication reconciliation, ICD-9-generated diagnosis tables, nursing documentation, and bedside barcoding seem to be riding a tsunami incentivized by the American Recovery and Reinvestment Act of 2009 (ARRA).
Nurses and Social Media
Working on an article for this issue (pg. 32), I conducted a brief survey of 12 nurse executives, which included a question about social media. Their responses confirmed my sense that most healthcare professionals are interested but tentative in their use of social media.
Information, Communication, and Teamwork for Care Collaboration
Hospitals now face penalties if too many discharged patients are readmitted within 30 days. This Medicare stipulation in the Affordable Care Act comes in response to expert analysis that indicates lack of discharge planning and poor follow-up care can lead to unnecessary admissions and higher healthcare costs.
Health IT & Quality
We Know What to Do
Almost eight years ago Richard Hillestad and his colleagues from the Rand Corporation predicted that electronic medical record systems (EMRs) would generate cumulative efficiency and safety savings of $142 to $371 billion during a 15-year period, an average of $81 billion annually (Hillestad et al., 2005). These savings were based upon assumptions of a low-end 1.5% productivity improvement from information technology (experience of the retail industry) to a high-end 4% productivity improvement (half of telecom industry experience).