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 environment911 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."