Bedside Monitoring Data Paper

Three general strategies are currently used to transfer bedside monitoring data into the hospital’s EHR. The first is the simplest: nurses observe data presented on the monitor screen and manually “key-in” the observations into an integrated EHR. As simple as this may be to implement, such manual data collection strategy is inefficient and does not collect representative data gathered by the bedside monitor. (Gardner, Clemmer, Evans, Mark, 2014)

The second strategy used by ICU information systems, such as CareVue (Philips Healthcare) or MetaVision (iMDSoft), is to acquire vital sign data directly from the bedside monitoring system’s network by using an HL7 feed. The information is automatically gathered by the ICU information system; nurses have the option of either accepting or modifying the data. In typical clinical settings, nurses perform the selection and transfer of bedside monitoring data from the ICU information system to the EHR about once an hour. These ICU information systems typically retain the high frequency bedside monitoring data and can achieve near-real-time computerized decision support. In many cases, the nurse’s notes are also entered into the ICU information system-generally once per shift-and some summary vital sign information may find its way into those notes. Physician progress notes are also entered into ICU information systems in a similar fashion. Unfortunately, data in the ICU

Most systems that automatically gather data with this strategy take a “median” of the vital sign data over a 15 min time interval to smooth the data (Warner et al 1968; Gardner et al. 1991; Vawdrey et al. 2007). This strategy provides real-time data for computations and computerized decision support for the hospital’s EHR and is the preferred strategy. (Gardner, Clemmer, Evans, Mark,