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EHR smart pump integration: diminishing user error but raising specter of cyber security concerns

by Gus Iversen, Editor in Chief | May 14, 2015
Medical Devices
From the May 2015 issue of HealthCare Business News magazine

Best known for his roles in movies like Footloose and The Rookie, Dennis Quaid took the stage at the 2009 HIMSS annual meeting to play an altogether different kind of role: advocate for hospital patient safety. Two years earlier, when Quaid’s twin daughters were only ten days old, they were accidentally given one thousand times the prescribed amount of heparin, a blood thinning medication administered through an infusion pump.

The mistake was caught in time for the overdose to be counteracted with other medication, but the situation remains a high profile example of how serious an infusion pump accident can be. If the wrong button is pressed, or the wrong medication is dispensed, the results can be deadly.

To err is human, and in most professional settings, the impact of an error is relatively minor; reputations may be tarnished, money may be lost. The life-and-death burden that health care professionals deal with every day is part of why they deserve recognition for the exceptional work they do. It is also why automating medication administration through infusion pumps is emerging as a big area for process improvement, patient safety, and risk reduction among forward-thinking chief nursing officers (CNOs).

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“A survey asked 4,900 CNOs, ‘If you could only integrate one medical device with EHR this year, what would it be?’ ” says Jeff McGeath, VP of patient care device integration at Iatric Systems, a company that specializes in integrating health systems. “Of the respondents, 44 percent said smart pumps.”

Verifying ‘the five rights’ faster
In the old days, infusion pumps were little more than mechanical levers connecting medicine to a line which ran into the patient’s vein. While those basic systems can still be found in hospitals today, they are steadily being displaced by smart pumps; infusion pumps with software running on them. McGeath says most smart pumps follow a basic model: Clinicians at the bedside scan the patient’s wristband so the system knows who the patient is, then scan the medication so they know the drug. An automatic verification takes place – does this patient have an order for this drug at this concentration? A third scan of the pump itself creates a record of which specific piece of equipment was used for the transmission.

All told, that satisfies the five rights of medication administration: right patient, right drug, right dose, right route, and right time. Based on those three scans, a smart pump will either accept or deny the infusion. “You’ve got much more of a visual user interface on the pump where you can key in certain parameters and settings; you can integrate with your drug library and pharmacists can approve and manage the formulary,” says McGeath.

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