Transcript Use Case 15
Use Case 15 Care Theme: Transitions of Care, Medical Device Integration Use Case: Ensuring Safe, Timely Patient Care With Medical Devices and Transition to Follow-up Care by a PCP Primary Goal: To demonstrate the ability to provide efficient and accurate ICU care, formally close the ICU event with the patient’s PCP, and show interoperability of patient data across MD offices and hospital. Medication is ordered and administered through the EHR. Medical device information triggers alerts about a patient’s status. Patient data is sent from the hospital to the PCP when the patient is discharged. Key Points: • When the patient is admitted to the ICU, all bedside patient care devices (physiologic monitor, programmable infusion pump, and “smart bed”) are linked to the hospital EHR, so that data is readily available to hospital staff. • Ordered medications are electronically filled and programmed into the infusion pump with the status updated in the EHR. • Patient care device alarms are electronically linked to hospital staff’s smart phones to speed alarm response and enhance patient safety. • Patient data moves seamlessly between hospital departments and PCP office, each of which uses a different EHR system. Meaningful Use Relevance: Coordination of Care as evidenced by movement of patient data between separate hospital departments and PCP. Device data is continuous added to the patients chart recording vitals signs. IHE Profiles & Actors Domain IT Infrastructure (ITI) Patient Care Coordination (PCC) Patient Care Device (PCD) Pharmacy Profile Vendors Actors PIX, PIXv3 XDS.b XDS.b XDS-MS Optum Insite ICA Care Exchange Hyland GE Manager, Consumer, Identity Source, Repository Registry Repository Content Creator, Content Consumer XDS-MS Allscripts Professional Content Consumer DEC, IPEC GE, iSirona, Carefusion, WelchAllyn, Covidien Device Obs. Consumer, Device Obs. Reporter PIV Cerner, Carefusion Infusion Order Programmer, Infusion Order Consumer ACM Amcom Alarm Reporter, Alarm Manager, Alarm Communicator HMW GE, Omnicell Prescription Placer, Medication Dispenser, Med. Admin Informer Care Theme: Transitions of Care, Medical Device Integration Use Case 15: Ensuring Safe, Timely Patient Care With Medical Devices and Transition to Follow-up Care by a PCP Clinical Workflow: 1 – ICU Monitoring Devices 4 – Rx Infusion Pump Administration 2 – Hospital EMR 5 – PulseOx Monitoring 3 – Rx Dispensing 6 – PulseOx Alarm 7 – PCP 1. A male patient has been admitted to the SICU following surgical repair from multiple gunshot wounds. The patient is currently being monitored in the SICU on a physiological monitor. 2. The hospital EMR is receiving information from the monitoring devices. The patient becomes hypotensive following the operation and is ordered to begin a vasopressor drip to maintain the blood pressure. An appropriate medication is ordered from the inpatient pharmacy. 3. The medication dispensing is completed with the medication being retrieved from the SICU department’s local dispensing unit and the order status was updated accordingly. 4. At the bedside, the medication is added to the patients care program. The infusion pump management is engaged to ensure that the vasopressor is administered correctly. Monitoring of the patient and vital signs continues. 5. The patient’s condition improves and is finally able to transfer to the Surgical Step-down unit. The patient remains on patient controlled analgesia (PCA) to treat his pain. Vital signs, including pulse oximetry are monitored on the floor. 6. The PCA is too high for the patient. As a result, he begins taking slow and shallow respirations. The PulseOx reading drops, triggering an alarm. The patient’s nurse is notified of the issue and the patient is administered oxygen through a nasal cannula and the PCA dose decreased. 7. The patient continues to recover from his operation and is well enough to go home. The patient is discharged from the hospital. The patient visits his PCP for follow-up from the incident. Visit the IHE Product Registry at: ihe.net/registry