Harvard-affiliate Beth Israel Deaconess Medical Center connects its cloud dashboard application to Open's SafetyPad software in Boston EMS ambulances to bridge the care gap.
Beth Israel
Deaconess Medical Center (BIDMC) in Boston has developed a cloud-based
electronic hospital management system using an application program interface
(API) called SafetyPad from fire and
EMS software vendor Open Inc.
to connect emergency department workers with prehospital data from Boston EMS
ambulances.
Open's API allows doctors at BIDMC, a
teaching hospital of Harvard Medical School, to see vital data collected in
ambulances on the hospital's Emergency Department (ED) Dashboard and import it
into patients' electronic health records (EHRs).
Medical personnel can view treatments,
patient history and medications as well as lab results such as those from
electrocardiograms.
"Our focus is on the prehospital-care
environment€”911 systems," Scott Streicher, director of operations for
Open, told
eWEEK. EMS operators in cities such as Chicago, Miami and
Washington, D.C., access SafetyPad in ambulances on
rugged
mobile devices.
Before using the SafetyPad application, first
responders would fax a trip sheet containing vital signs and medication
information for 150 to 180 patients a day, said Dr. Larry A. Nathanson,
emergency physician and director of emergency medical informatics at BIDMC.
Now these sheets are transmitted on tablets
in ambulances, Nathanson, who developed BIDMC's dashboard application, told
eWEEK.
Before connecting its ED Dashboard with
SafetyPad's software, prehospital structured data capture wasn't possible, said
Dr. John D. Halamka, CIO at BIDMC and dean of technology at Harvard
Medical School.
"What you want is a device where you can
capture the structured medications or problems or time stamps, but then have a
set of standards that can be used to take the content from that structured
electronic record and transfer it to an electronic health record where it is
viewable [and] analyzable," Halamka told
eWEEK.
"It is actually structured computable
data where decisions can be made," he added. "And it becomes a
medical legal document."
The data platform is a Web-secure,
standards-based data exchange, said Halamka.
BIDMC has spun off a private software company
called
Forerun to offer its ED
Dashboard platform commercially.
"A key challenge is to ensure that that
as we create a system of data exchange that the systems we employ are widely
integrated into commercial products so it becomes more plug and play instead of
plug and pray," said Halamka.
The ED Dashboard, which can be accessed on an
Apple iPad, is part of a private cloud at BIDMC, Halamka noted. BIDMC operates
three data centers with a petabyte of data in each, he said.
"We are running all of our systems out
of clusters of virtualized servers running at multiple geographic
locations," said Halamka.
The data exchange between the SafetyPad and
BIDMC platforms is encrypted and employs Secure Tokens, according to Nathanson.
"What we did at the outset was create a
framework for API requests to come into the system and to securely and safely
transfer data between our system and third parties like hospitals and health
providers," Josh Austin, director
of IT at Open, told
eWEEK.
"If it's Beth Israel Deaconess knocking
on the door of
SafetyPad servers, not
only are the transmissions encrypted bidirectionally, but there is confirmation
that it is a rightful request from an authorized location who has appropriate
credentials presented to SafetyPad before any data is transmitted,"
Halamka explained.
The SafetyPad platform uses a PHP-based
system and an API framework that transmits data to the hospital based on
representational state transfer (REST), or RESTful, API requests, said Austin.
Open's SafetyPad is "truly an
open-standards-based approach," said Halamka. He compared the SafetyPad
platform to the "ecosystems of secure transactions" developed by
Amazon and Facebook.
With the data captured in the ambulance on
tablets and stored in the cloud, patients might be able to avoid some
repetitive medical questions, according to Halamka.
"One of the things that drives us all
crazy is how many times when you have a medical event are you asked your
medications and allergies over and over?" he asked. "So not only does
it becomes a patient-satisfaction issue but also a data-integrity issue. You
want to make sure that the data is transmitted at each transition of care from
each caregiver in an accurate electronic fashion."
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