An architecture is presented which provides clinical information systems with access to vital sign information from medical devices. Middleware components encapsulate details of communicating with devices whilst adoption of de facto and international standards maximises interoperability with client software. An application in routine clinical use is described.
Clinical information systems (CIS) are increasingly being used throughout healthcare organisations to collect, interpret and display clinical data from critical care environments. Such systems are sued primarily for the management of patients but can also be applied to clinical audit and to the collection of data for research purposes. They offer many benefits to patients, nursing staff and clinicians, including accurate collection of data from monitoring devices avoiding human transcription errors or bias, greatly reduced burden of clerical work and online analysis of data for clinical decision support.
Standards are beginning to emerge for the collection of data from medical devices (e.g., the medical information bus) and for the exchange of physiological signals between hospital information systems (HIS) (e.g. HL-7). However, in practice, vendors of medical devices still tend to adopt proprietary and often unpublished formats for exchanging data and many small or legacy clinical information systems, particularly those at point of care, will not support applicable standards.
In this communication, we present an architecture based on middleware components which will help solve practical difficulties with acquiring slowly varying (of the order of 1Hz) parametric information (heart rate, blood pressure, infused volume, etc.,) from medical devices. This approach will: 1) assist the interoperability of information systems and medical devices until emerging standards become universally adopted and 2) simplify and encourage the development of tools for data collection used for clinical audit and research purposes. The implementation of one such component is described.
Sims AJ, Pay DA, Watson BG. An architecture for the automatic acquisition of vital signs by clinical information systems. IEEE Transactions of Information Technology in Biomedicine, Vol 4. No. 1, March 2000.
Dr. Andrew J. Sims, Freeman Unit, Newcastle upon Tyne. Tel: +44 (0)191-223-1370.
Regional Medical Physics Department, Newcastle General Hospital, Newcastle upon Tyne, NE4 6BE, UK.
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