The West Health Institute (WHI) presented a report before a recent hearing of the Energy and Commerce Subcommittee on Health in the U.S. House of Representatives. The report estimates that medical device interoperability could help save $36 billion a year in healthcare costs, as well as improve patient care and safety.
Device interoperability refers to the ability of medical devices to exchange information with each other and with patient data repositories such as electronic health records. The issue has been a particular point of discussion in recent years with the rise of “smart” and wireless technology. Security, privacy and accessibility have been major points of contention, as large, complex computer/data systems can be vulnerable to hacking, crashing and data loss.
The report identified areas of monetary waste due to lack of medical device interoperability such as:
- Adverse events from drug errors;
- Redundant testing resulting from inaccessible information; and
- Increased lengths of hospital stays due to delayed information transfer.
A lack of commonly adopted standards for interoperability has caused waste in device testing and development costs, as well as in the provider costs to integrate devices with electronic health records (EHRs).
Unlike the consumer market, which caters to a “plug and play” expectation from users who demand interoperability, reduced cost and ease of use, manufacturers of medical devices have lacked incentives to use open interfaces for interoperability.
“As a result, facilitating the exchange of data between and among medical devices and EHRs currently requires hospitals to invest significant resources in developing custom interfaces and paying for middleware solutions,” the study’s authors wrote. Medical device integration is estimated to cost hospitals $6,500 to $10,000 per bed, plus 15 percent of that in annual maintenance fees.
But the longer-term savings could be significant. Linking medical devices to electronic health records could save the United States $17.8 billion by reducing hospital stays; $12.3 billion from increased clinician productivity; $3 billion by lowering the cost of care; $2 billion by reducing adverse events; and $1.2 billion from wider adoption of interoperability standards, according to the report’s findings.
In addition, according to the report, only a third of hospitals that use six or more medical devices capable of being integrated with EHRs have them linked to electronic records.
The bulk of the savings to be gained from robust interoperability standards—93 percent—will go to healthcare providers, according to the report. Payers will see 6 percent of those savings, and patients the remaining 1 percent.
The report was presented by Joseph M. Smith, M.D., chief medical and science officer of WHI, as part of his testimony outlining regulatory and policy changes necessary to create integrated, interoperable systems to improve outcomes, lower costs and create higher-value healthcare focused on increasingly patient-centered solutions.
The report advised that “to realize the benefits, providers, payers, medical device manufacturers and the government will need to collaborate and partner to promote the development and adoption of seamlessly interoperable devices. Industry trends are already driving providers and payers to converge and share risk through care coordination, clinical integration and improved population health management. Stakeholder collaboration is expected to provide a strong platform for accelerating adoption of medical device interoperability and realizing its associated benefits.”
For example, in a modern U.S. hospital today, patients are treated with as many as a dozen medical devices in a typical intensive care unit, according to WHI, including defibrillators, electrocardiographs, vital-sign monitors, ventilators and infusion pumps. These devices often come from different manufacturers and are not connected, requiring a costly and complex IT infrastructure, not to mention the potential for miscommunication that could lead to adverse events.
“We see an enormous opportunity to use information technology and device innovation to bring about the much needed transformation in healthcare delivery,” said WHI’s Smith. “Today’s hospitals are filled with medical devices that are unable to share critical data, creating potential dangers to patients, as well as inefficiencies that put a tremendous financial burden on our healthcare system.”
“Medical devices need to share data based on standards, so they can better inform clinicians and help patients,” said Peter Pronovost, M.D., medical director for the Center for Innovation in Quality Patient Care at John Hopkins University in Baltimore, Md. “By doing so, we can both improve quality and reduce costs.”
WHI is an independent, non-profit medical research organization based in La Jolla, Calif.