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Care Theme: Maternal and Newborn Health
Delivery Event Requiring Newborn
Monitoring and Alarm Management in
NICU
Us Case 5
Interoperability Showcase
In collaboration with IHE
Use Case 2
Care Theme: Maternal and Newborn Health
Use Case 2: Delivery Event Requiring Newborn Monitoring and Alarm Management in NICU
Primary Goal: Demonstrate the ability to collect , track, and manage real-time intensive care patient information in an NICU setting.
Key Points:
• Information from upstream sources are available through the EMR and assist with patient care.
• Real-time data collection, monitoring, and management—including alarms—support care for high risk patients by making
timely information available and accessible through the EMR and alerts.
• Alarm management from both physiologic and medication monitoring systems trigger pre-defined priority-driven workflows to
inform and engage appropriate personnel.
• Single alarm manager capability eliminates the need for staff to carry multiple notification devices (e.g. multiple pagers, cell
phones, Cisco phones, etc)
Meaningful Use (MU) Relevance: Improving Quality, Safety, Efficiency.
Clinical Workflow:
1. The mother delivers the child at this facility. A labor and delivery summary (LDS) is completed and made available for the care team
of the newborn through the hospital’s EMR.
2. Due to complications, the newborn is transferred to the hospital’s NICU.
3. At the NICU, the newborn is placed on monitoring devices due to its medical condition:
• Medications are delivered through an infusion pump programmed with orders from the Neonatologist communicated through
the EMR system. The infusion pump is monitored by the NICU team and the alarm management system.
• Data collected by the warming bassinet and physiological monitors are communicated to the EMR, and monitored by the
NICU team and the alarm management systems.
4. The Neonatologist and Charge Nurse are engaged with appropriate communication devices when automated alarms are triggered
by physiologic and medication monitoring devices.
• The Charge Nurse receives information on a pager and responds by immediately adjust the medication flow on the infusion
pump.
• The Neonatologist receives information on a smartphone application and responds by evaluating the patient and forwarding
appropriate communications to the care team .
Care Theme: Newborn Health
Use Case 2: Delivery Event Requiring Newborn Monitoring and Alarm Management in NICU
Clinical Workflow:
1. L&D / EMR
2- NICU (graphic)
3- Physiologic Monitors
4. Medication Delivery
5- Alarm Management
1. Patient is admitted through the hospital’s Labor and Delivery unit, which uses an EHR system to record, track, and manage
information throughout the episode of care for mother and child.
2. Due to complications, the newborn is transferred to a the hospital’s NICU.
3. The newborn is placed on monitoring devices and a ventilator. The monitoring devices continually record vital signs.
4. Medication delivery is managed through the use of infusion pumps, which are programmed by orders from the neonatologist
communicated via the EMR.
5. Alarms produced by the physiologic and medication monitors, triggering appropriate workflows based on priority, informing and
engaging appropriate personnel.
Care Theme: Newborn Health
Use Case 2: Delivery, Public Health Reporting to State Vital Records Programs, Early Hearing
Detection and Intervention (EHDI) Programs, Quality Monitoring to Aid Early Pediatric Care
Domain
IT Infrastructure (ITI)
Patient Care
Coordination (PCC)
Profile
Vendors
Actors
PAM
GEHC
Pt Encounter Consumer, Pt Demographics Consumer, Pt
Encounter Supplier
PIX, PIXv3
Certify, Vangent, OZ
Manager, Consumer, Identity Source, Repository
XCA
Vangent, Aegis, Epic
Initiating Gateway, Responding Gateway, Registry
XCPD
Vangent, Aegis
Initiating Gateway, Responding Gateway
XDS-b
Certify, Vangent
Repository
XDS-SD
GMT
Content Creator
XPHR
Alert
Content Creator
AP*
GMT, Epic
Content Creator, Content Consumer
NDS
GE, GMT
Content Creator, Content Consumer
PPVS
Content Creator, Content Consumer
Device Obs. Consumer, Device Obs. Reporter
IPEC
GMT, Alert
Epic, Mindray, Nuvon, OZ,
CareFusion
Epic, CareFusion
PIV
Epic, CareFusion
Infusion Order Programmer, Infusion Order Consumer
ACM
Cerner, Nuvon, Vocera
Alarm Reporter, Alarm Manager, Alarm Communicator
DEC
Patient Care Device
(PCD)
Device Obs Consumer, Device Obs. Reporter