Hospital Utilizes Smart Pump–EMR Integration to Support Patient Safety—and Bottom Line

Posted March 21, 2017

The next step in infusion therapy safety hinges on linking infusion pumps with the electronic medical record (EMR) so they can share information. This was the focus of a recent patient safety seminar hosted by the AAMI Foundation in partnership with the National Association of Clinical Nurse Specialists.

So-called “smart” infusion pumps include a number of built-in safety features, such as drug libraries and dose-error reduction systems, but a single wrong keystroke in programming the device can still result in a 10- or 100-fold overdose―and potentially tragic results. However, 75% of these programming errors could be averted with successful infusion device–EMR integration, according to an article published in the March/April issue of AAMI’s peer-reviewed journal BI&T.

“Not everything can be fixed by the safety that is provided in the drug library,” said Tina Suess, manager of medication safety integration for Lancaster General Health in southeast Pennsylvania, during the Foundation’s recent seminar. “For the most part, integration has the ability to help fix a lot of errors.”

Before integrating infusion pumps with the EMR, nurses at Lancaster General had to complete 17 steps to manually program a dopamine infusion, according to Suess. After integration, all elements of the intravenous (IV) order, such as drug name, concentration, dose/rate, volume to be infused, and patient weight, were auto-programmed into the pump, eliminating the “opportunities for a manual programming error.”

“The nurse still has a critical role in validating that the information transferred to the pump off of the physician order is indeed correct and starting the device,” Suess said. The integration has condensed the process to seven steps and reduced the amount of time needed to program infusion devices by nearly 25%.

Information from the pump documenting the events that occur and the volume of medication pumped then flows back into the EMR for the nurse to chart against.

“We are now taking a very complex PCA [patient-controlled analgesia] order containing the trigger, the lockouts, and basal rates and actually passing those to the … device and having that rich information about dose, number of attempts, and actual doses given all flowing back into the electronic medical record without the nurse having to manually search through the history on the PCA device and transcribing or inputting that information into Epic,” Suess said.

Implementing this technology has not only helped patient safety but also the bottom line, according to Suess. The accurate documentation of pump stop times allowed Lancaster General to assess a “medication administration fee” associated with IV infusions, resulting in a revenue bump for the hospital of about $2 million a year. Suess described that dynamic as “leveraging safety to fill in a gap in billing.”

“This is just another way that investing in a safety technology platform can help you fix other areas in your organization,” Suess continued.

The AAMI Foundation’s next free patient safety seminar will be held April 17 from 12:00 – 1:00 p.m. ET. It will focus on helping hospitals that are struggling to obtain baseline alarm data in the absence of middleware technology and will explain how to utilize evidence-based practices to reduce nuisance alarms. For more information or to register, please visit the AAMI Foundation’s website.