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Smart Device Integration
Improved Documentation Accuracy in Anesthesia
DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.
The views and opinions expressed are those of BD
Documentation Causes 16% of
Injectable Medication Errors
1 IMSP high alert medication list, IMS data
2 Weigner et al, 1994
The views and opinions expressed are those of BD
Case Study #1:
Unintentional Misdocumentation
Example: Rocuronium Administration Data Inaccuracies
Situation:
Challenge:
Desired Solution:
•
Hospital was meticulous in assessing muscle relaxant use.
•
Received daily report of all cases with the use of drugs like
Rocuronium, as well as monitoring used.
•
Hospital was certain a drug like Rocuronium was given, but
nothing was logged in Epic.
•
Believed if this was happening with one drug, it was happening
with many more.
•
Ability to see an injected drug was logged in Epic and billed.
The views and opinions expressed are those of BD
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Case Study #2:
Unintentional Misdocumentation
Example: Retrospective Charting During Emergencies
Situation:
Challenge:
Desired Solution:
•
Despite implementing an AIMS, difficult to defend
anesthesiologists’ actions during adverse events.
•
Caused by incomplete retrospective charting that occurs
during emergencies.
•
Inappropriate for clinicians to divert their attention from the
patient to charting while emergency is occurring.
•
Effective solution to assure the reliable and accurate
documentation of intravenous medications for use during
emergency situations.
The views and opinions expressed are those of BD
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Case Study #3:
Patient Safety Risk Identification
Example: Prophylactic Perioperative Antibiotic Dosing
•
Higher than expected surgical site infections (SSIs) despite
anesthesia records suggesting strong compliance with
intraoperative intravenous antibiotics.
•
The Infection Control Committee felt this was due to failures
to give perioperative antibiotics at the appropriate time.
•
In some cases, the Committee felt a different antibiotic would
have decreased the likelihood of the SSI.
•
A more reliable and accurate method of capturing intravenous
antibiotic dosing.
•
Decision support that recommends the most appropriate
antibiotic regimen at the time of pre-incision administration.
Situation:
Challenge:
Desired Solution:
The views and opinions expressed are those of BD
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Overarching Documentation Challenges
Medication administration data entry is largely a
manual and tedious process within the Anesthesia
workflow
• Data inconsistencies between medications administered and documented
• Retrospective documentation during emergencies
• Limited narcotic auditing and decision support solutions
• Complex legacy HIT systems with limited integration capabilities
The views and opinions expressed are those of BD
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The Solution
• A new class of device is being brought to market for automating the electronic
capture of IV injectable drug data.
• These devices are similar to infusion pumps:
– They provide integration with hospital IT systems,
– Offer improved clinical workflows and
– Real-time patient safety checks for IV drug delivery.
• At the same time, they are sufficiently different from infusion pumps to warrant an
independent device classification.
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The views and opinions expressed are those of BD
The BD Intelliport™ System
A medication management solution for IV bolus injections that may help manage the
risk of medication errors and improve documentation accuracy.
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The views and opinions expressed are those of BD
Aligned with APSF Recommendations
APSF Recommendations:
“Every anesthetizing location should have a
mechanism to:
1. Identify medications before drawing up or
administering them (bar code reader) and
a mechanism to
2. Provide feedback, decision support, and
3. Documentation (automated information
system).”
BD Intelliport™ System Features:
 Identifies source container drug name and
concentration via barcode scanning
 Automatically identifies drug name and
concentration
 Audibly announces drug and concentration
 Performs real-time, patient-specific allergy
checking with audible alerts
 Captures real-time drug identification and dose
measurement data
 Captures time given
 Wirelessly sends medication administration data
directly into the patient’s EMR
The views and opinions expressed are those of BD
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Designed for Standards-Based
Interoperability
• BD Intelliport™ Gateway was architected from the bottom-up to support
Integrating the Healthcare Enterprise’s (IHE) PCD-01 Profile
• Utilizes common HL7 messaging structures for inbound and outbound
interfaces
• Integration has been, or is in the process of being, developed with the following
IT partners:
The views and opinions expressed are those of BD
Inbound & Outbound Data Exchange
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The views and opinions expressed are those of BD
Improved Documentation Accuracy
via Smart Device Integration
Documentation
Challenges:
BD Intelliport™ System:
Documentation data
inaccuracies
Retrospective
documentation during
emergencies
Limited decision support
solutions
Automatic documentation that
• reduces manual documentation efforts,
• improves documentation accuracy and
• eases charge capture by wirelessly sending information
on drug, dose, time, and route of administration directly
into the patient’s EMR.
Automated med administration data collection that
• can help support assessment of some National Quality
Hospital Measures, such as Surgical Care Improvement
Project (SCIP).
Controlled substance reporting that
• aids anesthetists and pharmacists with med
reconciliation.
The views and opinions expressed are those of BD
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Thank you
The views and opinions expressed are those of BD
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