Success Story: St. Luke’s Healthcare System

jeanne-venella

Driving medical device standardization and interoperability is among the most challenging and critical ongoing conversations in healthcare.

Whether greater connectivity means enabling a hospital or health network to capture best-of-breed solutions or simply connecting departments and devices across locations, the more they can communicate, the more efficiently things can run. That coordination drives workflow, patient throughput, and allows for intelligent data gathering that fuels the greater efficiencies driven by analytics. In the field of EMR and EHR, a variety of manufacturers are working to help enable the depth and smoothness of those digital conversations, including the Milford, CT-headquartered Bernoulli, which bills itself as a specialist in real-time connected healthcare.

Of course, it’s people who lay the groundwork for the coordinated integration of those devices. Jeanne Venella is a former ER nurse and the Chief Nursing Officer at Bernoulli. Together with Jonathan Krieger, Director of Project Implementations for Bernoulli, she travels to client sites to help assess how the technology can change their current workflow, and helps educate staff during the transition.

In April, the two helped the nonprofit, Lehigh, PA-based St. Luke’s University Health System connect device data feeds from multiple departments at six different hospitals during a multi-site installation of Epic Systems electronic health records software. All the sites went online at the same moment, and thanks to the device integration at the back end, everything connected seamlessly, “unrecognizable in the blip of change that they made,” Krieger said.

Integrating feeds from hundreds of devices and 300 beds’ worth of patients in departments with needs as different as gastroenterology, surgery, interventional radiology, obstetrics, intensive care, and catheterization requires coordination. On the hardware side, Bernoulli uses a four-port IDM-3400, which collects serial data from various devices, translates it to the HL7 standard, and transmits it to Epic via a main gateway. The plug-and-play manager is auto-discoverable, and can begin streaming data immediately upon connection.

“Read any publication and interoperability is the topic of the day, every day,” Krieger said. “With our hardware and connection to that software, we’re able to recognize what’s plugged into the device manager. It saves so much time on the clinician side. Each one of those serial devices has a cable or adapter that’s designed to connect with our device. The data just starts collecting and sending.”

Even when dealing with equipment from a variety of manufacturers within the same space, Venella said the Bernoulli software can acquire and transmit data within about 30 seconds of access. That ease of access helps speed the process of communication not only among devices, but among staff, too. There’s no drop-down menu to select from, or other software hurdle that appears on the clinician side of things, she said.

“It’s just plug in, and within 30 seconds the data is flowing.”

“That is a huge time-saver and makes the whole tech side of it simple,” Krieger said; “the clinicians don’t really have to interface with it at all.”

Even with technology that can provide a seamless connection among devices on the back end, the work that Venella and Krieger do on the end-user side of the equation extends from workflow to documentation. A significant part of the installation involved connecting with clinicians to determine “what they want to do and what they want to document, especially in the anesthesia areas,” Venella said.

“Before Epic, a lot of hospitals were on paper,” she said. “You have anesthesiologists having to document things on paper; our hardware and software frees them up to work. [Now] all the measurements are coming in on the chart, and it allows them to concentrate more on the patient.”

Similarly, in critical care units, digital data streams decrease the risk of transcription errors, freeing nurses from observing and recording vital sign information to a patient chart. Electronically “validating and not redundantly charting” such information decreases risk of errors while giving caretakers more time to observe the patient “instead of doing more of those tasks that are now physically automated,” Venella said.

The installations integrate so smoothly in part because Bernoulli works to maintain relationships with EMR and EHR vendors, like Epic, as well as with device manufacturers, to push interoperability and integration. Although Epic accounts for “about 60 percent of the world of EHR,” Venella said, Bernoulli works with a library of about 2,500 devices, from other EHR and charting systems to individual manufacturers’ technology products.

“We have a lot of standing relationships with a lot of the device manufacturers that they’ll even come to us,” Krieger said. “Covidien, for some of their new monitors, would want to certify with us. We work closely with Draeger; they’re rolling out the Perseus anesthesia machine.”

The result of that work is that an installation like that at St. Luke’s has helped hospital staff on both the back and front ends of the system to perform their duties more efficiently, Krieger said.

“The feedback has been wonderful,” he said. “If you asked any of the end-user clinicians, they would never want to go back. We work with the IT department; we work with the biomed department in connecting the devices.

“On the technical side, the CE’s have been just focused for years on the devices, the upkeep, and maintenance,” he said. “Now you’re integrating biomed and the IT world. We help them work through that and bring everybody together.”