From teaching millions of people a better way to tie their shoes, to sharing ways to live longer, the global set of conferences known as TED has branded themselves as presenting “Ideas Worth Spreading.”
In 2012, our very own Craig Rusin was invited to experienced the excitement of a TEDx event when he spoke about Real-Time Clinical Decision Support. Thanks to Medical Informatics’ innovative breakthroughs in the healthcare technology field, we have one again been invited participate in a cutting edge TED event.
We’re going to be a part of The Hive at TEDMED 2015!
Medical Informatics will be in Palm Springs, California from Wednesday, November 18 through Friday, November 20 to collaborate with 19 of the most innovative startups in the health and medical industries.
The Hive is part of the annual TEDMED conference and allows startups to showcase innovation, highlight inspiring entrepreneurs, and brainstorm on ways to create a healthier tomorrow.
To provide additional information to those of you following Medical Informatics journey towards ending alarm fatigue and saving lives with virtual patient monitoring and predictive medicine, we have put together a Pre TEDMED 2015 interview. We hope the following responses give your further insight into this exciting event.
Why is TEDMED a Big Deal?
“It’s TEDMED! The people that participate are the thought leaders and innovators in healthcare. I am excited to meet them and share ideas. This will be a wonderful opportunity to network and discover how we can save more lives,” says Craig Rusin
“When you bring together a group of born innovators and give them two day to collaborate, great ideas are possible,” Rusin added.
What Do You Hope to Learn?
“I want to learn from other innovators where they have struggled and succeeded in introducing new ideas into healthcare. I feel the barriers to innovation in healthcare are often non-obvious and require creativity and perseverance to overcome,” answered Medical Informatics’ CEO, Emma Fauss.
What Do You Hope To Contribute?
“I want to share our vision of what predictive medicine can be and show how this type of innovative work is breaking through old paradigms of traditional healthcare IT.” says Fauss
Follow the Journey
We are honored to be recognized as one of the most innovative companies in the healthcare industry and look forward to helping The Hive generate breakthrough ideas.
“I think that the best way to find information is self-discovery. It’s how I discovered programming, ended up going into computer science at Rice University, and is why I became a programmer for Medical Informatics Corp. After all, if you aren’t passionate about what you do, what are you actually accomplishing,” said Morgan.
The Early Years
Morgan grew up in Denver and attended Regis Jesuit High School where he was the Co-Editor In Chief of the school paper. His passion for programing and Indesign helped him create the school’s journalism website. In addition to making websites and programming in his free time, Morgan also led the FIRST Robotics team all the way to the regional finals during his senior year.
The computer science program at Rice University was challenging and rewarding for him. He really liked the classes that dove deeper into the hardware, like computer systems and multicore programming.
Morgan has also been running the Soundworm, an art project that streams live audio from all around campus to a steel sculpture by Rice Universities’ library. A unique project he acquired through helping out with the Ethernest, Rice’s student hackerspace.
His Role at MIC
Morgan Jones is a software developer at MIC. His first project was developing a bot that made generating documentation from our Github issues much easier. Recently, he helped to author and develop the Open Waveform Format, an open-source binary file format for transferring device waveforms. Right now, he’s working on a Sickbay software development kit that will make it easier for people to talk to Sickbay in their applications.
What he likes about MIC
“The engineering team is very small, but amazingly good at what they do. They know how to make the right engineering decisions to solve specific problems that hospitals need solutions to,” Morgan responded.
What he hopes to accomplish
Morgan really enjoy developing real time systems. Coming in, he hoped that he’d be able to contribute meaningfully to the Sickbay Clinical Platform. Hospitals need to focus on using software founded on solid engineering decisions and he is proud to be a member of this innovative team that is creating solutions.
Common alarm management techniques to date have included efforts to drastically decrease the number of nuisance and unnecessary alarms present in hospitals by customizing alarm thresholds to the applicable patients and organizing professional teams to develop correct policies and procedures to deal with alarm organization.
While the former is the ideal option for decreasing the amount of blaring alarms, very few systems exist that are able to capture the sheer amount of data running off of monitors in order to evaluate which alarms are unnecessary. Furthermore, interoperability errors can occur from systems that attempt to capture the data without being capable of integration. Certain simple methods exist to reduce problems relating to monitor performance, such as checking alarm batteries regularly to ensure that no alarms are functioning badly or irregularly, changing parameters on alarms and monitors so that a “one size fits all” issue doesn’t cause alarms to go off for patients who have nothing wrong (customizing alarms for patients ensures that alarms only go off when a patient truly is in need of help and not just when a common alarm threshold set for all patients has been reached, thereby decreasing the number of alarms), changing electrodes daily, and monitoring only those patients with a clear need for it.
However, most hospitals have continued to merely change or decrease the amount of alarms present, which only means that they end up dealing with the same concerns later on (akin to only treating the symptoms of the issue instead of the root cause). A greater problem exists, though. While, for some hospitals, such actions may actually reduce their alarm problems, for other medical environments, a more complex solution may be needed. Medical Informatics and some medical device companies are starting to produce the solutions necessary to tackle these challenges head-on, but a need still exists to have alarm management techniques peer-reviewed and validated across other hospitals. As few guidelines and measurements exist to aid health centers in their transition from chattering alarms to actionable and intelligent alarms (for example, as alarm management is still viewed as a relatively new problem, medical environments still struggle with where they ought to be placing their focus, whether it be on reducing the total number of alarms, time spent in alarm flood, average alarms per bed per day,etc), hospitals and other infirmaries must make it a priority to share their results with others so beneficial techniques can become a standard across the health space.
Unlike common vendors advocating for devices that do little to manage alarms, the Medical Informatics product, First Byte, aims to provide a complete alarm management package to dispense aid to hospitals struggling to determine what alarms to tackle first. Through a comprehensive three-step process, the First Byte servers collect 60 days worth of data and then determine which signals to manage first, how many/which alarms can be classified as nuisance alarms, and the best steps to take based on patient population distribution and characteristics through the Baseline Analysis Report.
Since 2003, the Joint Commission has advocated for improved clinical alarm systems, consistently ranking it sixth among its most important National Patient Safety Goals. In fact, despite being retired from the list in 2005 and incorporated as a standard, issues concerning alarm safety only continued to grow until alarm management was added back as a priority to the the list in 2014. The Emergency Care Research Institute, a nonprofit organization that serves to research the best solutions to patient care, has ranked alarm hazards as its top patient safety concern since 2013.
Specific Cases of Inefficient Alarm Management
Disturbing reports from the Boston Globe and other publications have made light of multiple deaths resulting from alarm fatigue and inefficient alarm management. In one of the most publicized incidents occurring in 2010, a cardiac patient at Massachusetts General Hospital passed away after his heart rate fell and a series of beeping alarms carried out over a period of 20 minutes were ignored by nurses. When Medicare and Medicaid professionals investigated further, they found that a crisis alarm at the patient’s bedside had been turned off unknowingly. However, while ten nurses nearby denied hearing any alarms sounding off, investigators attributed the lack of awareness about the nearby alarms and medical tickertape reporting the patient’s vitals to alarm fatigue.
Furthermore, a year later, the Pennsylvania Patient Safety Authority found that over a 6 year period tracking 187 patients who died while being physiologically monitored, 35 died from issues involving human error. After a dismal incident in 2012, in which the parents of a 17-yr-old girl who had died following her tonsillectomy because a heavy painkiller had dangerously slowed her breathing without nurses taking note received a $6 million dollar malpractice settlement, the responsible Pennsylvania surgery center decided that nobody could have the authority to mute any more alarms. Yet, while this action may have given the bereaved parents some satisfaction, it actually did nothing to solve the problem on hand: alarm fatigue, the condition in which nurses become desensitized to or overwhelmed by the barrage of alarms they’re subjected to everyday.
Alarm Safety Becomes a Top Concern for Hospitals
Since then, a host of recent studies has helped to bring clinical alarm safety to the forefront of hospitals’ concern. In January 2014, the Boston Medical Center conducted a six-week study in which they drastically reduced the number of warning alarms by tailoring the alarms to fit patient needs and, in some cases, changing the status to “crisis” alarms, which require immediate action. In doing so, the number of alarms dropped by around 89%, decreasing from 12,546 alarms per day to 1,424 alarms daily.
Additionally, the Children’s Hospital of Pennsylvania conducted a novel study in 2014 in which they used a video-based approach to monitor various patient alarms and the length and suitability of nurse responses instead of shadowing nurses to judge the effects of alarm fatigue. Through 210 hours of observation reviewed by multiple researchers, an analysis of 4, 962 alarms found that 99% of alarms in ward patients’ rooms and 86.7% of alarms in heart and lung failure patients’ rooms was classified as false (didn’t warrant a clinical intervention from nurses).
Written by our Summer Intern, Riti:
A year ago, in a building far far away (literally, now that MIC has switched locations), I had the pleasure of interning for a summer with some of the greatest people I (now) know. And, in the course of those three months, I was exposed to the very intriguing world of high-stakes healthcare through several excursions to TCH, various research projects involving hospice care and nurse turnover rates, and exhausting hours spent with Excel and Quickbooks.
I don’t think there was ever really a question of whether or not I would come back because I indubitably have too much left to learn (also, I missed the MIC family too much). It’s also incredibly exciting because quite a bit has changed since I left, so I’m getting back up to speed on new product developments and interactions with other major hospitals/institutions. Since, with the invaluable help of Craig and Emma, I’ve decided to major in chemical engineering, I’m getting introduced to Matlab and several crucial programming languages, along with continuing research into medical conditions and alarm management.
With the recent attention MIC has been getting for its work with alarm management and predictive algorithms, the atmosphere around here has definitely become decidedly fast-paced and exhilarating, and I couldn’t be happier to be right in the middle of it. Here’s to a thrilling summer ahead!