Luis Melendez, assistant director of biomedical engineering for Partners HealthCare, a hospital system that includes Massachusetts General Hospital and Brigham and Women’s Hospital, is in the midst of a major project to implement an electronic medical record (EMR) system. In this issue of AAMI News, he discusses the project and shares his thoughts on how biomeds can get involved in healthcare IT projects and have an impact.

AAMI News: Could you tell us about the EMR project at Massachusetts General and Brigham and Women’s Hospital?

Luis Melendez: I’m working on a large EMR implementation project called Acute Care Documentation (ACD). Our pilot test begins in November 2010 with three care units: two intensive care units (ICU) and one general floor at each campus (roughly 150 beds total). If all goes well, we will scale up to all 1700 beds. The system is specifically for inpatient care. The institutions would like us to connect all inpatient care medical devices to ACD.

This project anticipates high value from comprehensive device connectivity. But, as our team assessed currently available connectivity capabilities, we had to explain that even though both hospitals have modern medical equipment, much of it isn’t able to connect to EMRs. People are accustomed to modern technology simply connecting (e.g., computers, printers, and cell phones).

AN: How does the world of medical device connectivity need to improve in order for EMR and other initiatives to be successful?

LM: Today’s EMR implementation must provide the functionality users are looking for, enhance the quality of documentation, improve patient safety, support future connectivity needs, and minimize to-be-encountered challenges.

Users want medical device data automatically populating the patient’s record, but not at increased cost in added work and complexity. As with many large hospitals, Brigham and Women’s Hospital and Massachusetts General Hospital both have diverse medical device inventories. For ease of use and increased reliability, we must minimize connectivity permutations.

From the user’s perspective, until we can achieve the overarching requirement of connecting all devices, we are providing a simple, consistent message on what can and can’t be connected.

AN: What role is the biomed department playing in this implementation, and what challenges do biomed departments face in connecting medical devices to EMR systems?

LM: Partners biomed is responsible for developing system architecture and implementing medical device connectivity for Partners HealthCare. Our immediate challenges are that there are few established solutions, and the medical device connectivity industry is evolving rapidly.

Working with Julian Goldman, MD — a practicing anesthesiologist at Massachusetts General, medical director of Partners biomedical engineering, and director of interoperability for the Center for Integration of Medicine and Innovative Technology (CIMIT) — we’re developing short and long-term connectivity strategies and presenting it to hospital leadership. Our roadmap will help the organizations have a clearer picture of how we’ll meet our near-term needs, educated industry about our requirements, align with changes in industry, and bring greater capabilities to our implementation in the long run."

AN: You have taught physicians and others in the anesthesia departments how to use medical technology. What advice would you give to biomeds about training others?

LM: Figure out how to make a topic pertinent to the individual’s job and responsibilities and you’ll pique their curiosity and make them want to learn.

Regarding how to teach about technology, it’s important to understand underlying principles. Knowing how signals are generated, processed, and presented to the user strips away layers of complexity. Understanding the science built into a device helps you explain conditions that cause problems in simple terms to users. Lastly, and no less important, learn their vocabulary. The ability to speak with people accurately and confidently — in their terms — goes a long way in establishing credibility.

AN: What do you like to do in your spare time?

LM: Besides keeping up with my wife and kids, I like to climb mountains. Beyond the beauty and physical challenge, my attraction to mountain climbing is similar to what attracts me to biomedical engineering; it’s technical and requires diverse skills. Also, self-sufficiency is important but teamwork is crucial. You just can’t do it alone.

AAMI News: December 2009, Vol. 44, No. 11