In the wake of the AAMI/FDA Interoperability Summit, it hit me how similar the problems of interoperability are to the problems of alarm fatigue and infusion systems safety — the subject of two other AAMI/FDA summits that I attended.
Initially I was surprised to think that such divergent issues had similar causes and will have similar solutions. That couldn’t possibly be right. The more I thought about it, though, the more that I realized that these issues (and many others) spring from common causes. If we can get the mechanisms in place to address these specific problems, we will be in a great position to address many other smaller (yet still significant) issues that healthcare technology faces. If we can solve these top issues, we can solve a lot more.
The first ah-ha moment that I had was that many times, the solutions to these problems are already out there; they just aren’t being used. The problem isn’t the lack of solutions; the problem is the lack of using the solutions that already exist.
At the interoperability conference, for example, often people would clamor for guidance on a topic that is already covered by ISO 80001. At the alarm summit, people would clamor for physiological monitors that are flexible to the patient’s needs –- when it turns out that the monitors they already have can be configured for the patient, but they are being left with their factory default settings. At the infusion summit, a theme was the under-utilization of properly configured drug libraries.
Maybe what interoperability needs is a better awareness that 80001 is out there. Maybe we need an 80001 “starter kit” of templates, best practices, success stories, and things to watch out for. Maybe what alarms need is a better awareness of how to configure the device for the unique patient conditions. Maybe we need devices that are easier to configure, as well as evidence-based guidelines for what settings are appropriate for what patient populations. As for infusion systems, the drug library feature is out there. What we lack is a consensus on what the library limits should be — despite repeated, heroic efforts by ASHP and others.
The problem isn’t a lack of invention. The problem is a failure to use these inventions to improve outcomes. It’s time to stop reinventing the wheel. Instead, we need to gather the wheels that others have already invented, assemble them into a cart, and find the right engine that will keep the cart moving in the right direction. We need to know why these tools aren’t being used to their fullest.
The second ah-ha moment came when I noticed that none of these three summit topics could be solved by a single group alone. At every summit there were representatives from vastly different corners of the healthcare industry. To solve the hard problems, we need collaboration from many stakeholders. We will need an unprecedented amount of cooperation among the stakeholders –- and oversight committees that are willing to take ownership of these issues. We need to step out of our comfort zone and engage with other groups that we haven’t talked to before –- and possibly never knew existed.
We also need to do a better job at getting the C-Suite and The Joint Commission involved. We absolutely need their engagement and support for any of these efforts to succeed.
The third ah-ha moment was the realization that we have some absolutely top-notch people in healthcare. Not only are these people world class, they are also very approachable. Many times I’ve found myself in a high-quality, passionate discussion with someone about a technical detail, thinking that I’ve found a kindred spirit, a peer that really understands me and the topic that I care about, only later to find out that he or she is either an award-winning surgeon, sits on an IOM panel, is a licensed pilot, had lunch last week with the surgeon general, or is known for having invented the scalpel.
I am, of course, exaggerating just a bit here, but more than once I’ve been in a conversation with someone and realized that for this particular topic, this person is THE thought leader. No one else knows more about the subject than the person right in front of me. No one is more passionate for the subject than the person right in front of me. No one has been beating the drum for change longer than that person.
There’s absolutely no one else in the world that is going to get these changes accomplished if it’s not this group of dedicated professionals. I want to help them in any way that I can. I don’t want to let them down.
I’m in the presence of the best of the best.
And that’s just awesome.
Baxter Healthcare Corporation