If the January issue of AAMI News didn’t whet your appetite to learn more about an important infusion pump project at Johns Hopkins, I hope this blog post will. A report –37 pages of text, plus appendices — captures the input provided by clinicians and other experts to the Johns Hopkins Applied Physics Lab (JHAPL) last year on how to improve large-volume infusion pumps to make them more user centric. The report should be required reading for anyone in the pump business, anyone who wants to understand why human factors matter with healthcare technology, or anyone who wants to better understand a systems approach to product design. Here’s a link to the report.
JHAPL received a nice grant from the Agency for Healthcare Research and Quality (AHRQ) to support this project. The end result is expected to be an open source user-centric pump interface. The next phase in the project is to develop that interface, based on the rich data gathered in phase one. The overall goal of course is to reduce medication errors.
The report is synthesized into four recurring themes:
- Systems integration: “Pumps need to be more tightly integrated into the larger health IT enterprise for … ordering, pharmacy supply and control, documentation, and adherence to safety controls.”
- Programming navigation: Programming navigation needs to be more intuitive and closely matched to workflow
- Program presentation: Presentation of information on the screen is difficult to see and read
- Control standardization: Standardization of basic controls across pump vendors is needed (e.g., run, stop, etc.)
The lead investigator for the project is Alan Ravitz, who has extensive experience as a systems engineer in fields outside of healthcare. He brings “systems engineering principles and best practices” to the project, which is evident in the report. The multidisciplinary team also includes human factors expert Pete Doyle, and a clinician, Dr. Julius Pham.
Of course, designing a new pump interface does not necessarily translate to new pumps getting into the market anytime soon. The regulatory burden and expense of essentially bringing a brand new pump to market is enormous. And the cost of buying 500 or 1,000 new pumps for a financially strapped healthcare delivery organization is daunting. On the bright side, though, imagine the billions of dollars saved in medication-related deaths if we all do our part: a new pump interface that greatly reduces complexity; investors and companies dedicated to introducing a new product that uses the new interface; stronger standards for the basic controls; an FDA commitment to make the regulatory approval process easier; and healthcare delivery organizations committed to systems integration and adherence to safety controls.
Many thanks are in order to AHRQ for funding the pump interface project, and to the team at JHAPL for doing its part to improve medication safety. It will be fun to see what unfolds in the next chapter of this project.