Design of Interoperability-Coupled Safe Infusion Therapy in a Telemetry Setting

Abstract

Reliable wireless transmission of medical data is achievable in a modern telemetry setting and is put to good use. However, intercommunications among the different medical devices and initiation of controls to avoid unsafe incidents are generally not available. Interoperability among medical devices connected to a patient at a remote site is a challenging feature for practical realization that would increase safety. A new system is proposed to improve infusion therapy safety by implementing an interoperability feature coupled with a smart clinical decision support system. This system is designed to respond promptly to medication error alerts by the use of safety commands and interlocks. The design incorporates an innovative Intelligent Interoperability Supervisor (IIS) in the system which includes an infusion pump (or pumps) delivering drug therapy to a patient connected to relevant monitoring devices. A local decision support unit in IIS in the remote location analyzes the data transmitted by interface modules on the connected medical devices and verifies with preset patient-specific alarm criteria to detect presence of any crisis or to predict potential adverse episode. If the situation is assessed to be critical, IIS sends appropriate alert signals to a remote clinical care giver and control commands to the infusion pump to activate appropriate safety interlocks. Different critical situations of clinical cases are simulated in a conventional infusion therapy system (Configuration A), and in an IIS-implemented system (Configuration B). In Configuration A, there would be a significant delay between alarm occurrence and clinician intervention; such a time delay could lead to potential deterioration of patient condition. In Configuration B, clinically abnormal values are detected and the patient state is analyzed. If the situation demands, the system would promptly initiate the stop control command to the corresponding infusion pump ensuring safety and alerting the clinician to intervene quickly for better outcomes. Thus, the safety and efficacy of infusion pump therapy can be enhanced by incorporating proper interoperability functionality in the system design.