Us Case 5

Delivery Event Requiring Newborn Monitoring and Alarm Management in NICU

Care Theme: Maternal and Newborn Health

Use Case 2

Interoperability ShowcaseIn collaboration with IHE

Draft for HIMSS Team Review

Shippen

Primary Goal: Demonstrate the ability to collect , track, and manage real-time intensive care patient information in an NICU setting.

Key Points:• Information from upstream sources are available through the EMR and assist with patient care.• Real-time data collection, monitoring, and management—including alarms—support care for high risk patients by making

timely information available and accessible through the EMR and alerts. • Alarm management from both physiologic and medication monitoring systems trigger pre-defined priority-driven workflows to

inform and engage appropriate personnel.• Single alarm manager capability eliminates the need for staff to carry multiple notification devices (e.g. multiple pagers, cell

phones, Cisco phones, etc)  Meaningful Use (MU) Relevance: Improving Quality, Safety, Efficiency.  Clinical Workflow: 1. The mother delivers the child at this facility. A labor and delivery summary (LDS) is completed and made available for the care

team of the newborn through the hospital’s EMR. 2. Due to complications, the newborn is transferred to the hospital’s NICU. 3. At the NICU, the newborn is placed on monitoring devices due to its medical condition:

• Medications are delivered through an infusion pump programmed with orders from the Neonatologist communicated through the EMR system. The infusion pump is monitored by the NICU team and the alarm management system.

• Data collected by the warming bassinet and physiological monitors are communicated to the EMR, and monitored by the NICU team and the alarm management systems.

4. The Neonatologist and Charge Nurse are engaged with appropriate communication devices when automated alarms are triggered by physiologic and medication monitoring devices.

• The Charge Nurse receives information on a pager and responds by immediately adjust the medication flow on the infusion pump.

• The Neonatologist receives information on a smartphone application and responds by evaluating the patient and forwarding appropriate communications to the care team .

Care Theme: Maternal and Newborn HealthUse Case 2: Delivery Event Requiring Newborn Monitoring and Alarm Management in NICU

Care Theme: Newborn HealthUse Case 2: Delivery Event Requiring Newborn Monitoring and Alarm Management in NICU

1. L&D / EMR 2- NICU (graphic) 3- Physiologic Monitors 4. Medication Delivery 5- Alarm Management

Clinical Workflow:

1. Patient is admitted through the hospital’s Labor and Delivery unit, which uses an EHR system to record, track, and manage information throughout the episode of care for mother and child.

2. Due to complications, the newborn is transferred to a the hospital’s NICU. 3. The newborn is placed on monitoring devices and a ventilator. The monitoring devices continually record vital signs.4. Medication delivery is managed through the use of infusion pumps, which are programmed by orders from the neonatologist

communicated via the EMR.5. Alarms produced by the physiologic and medication monitors, triggering appropriate workflows based on priority, informing and

engaging appropriate personnel.

Domain Profile Vendors Actors

IT Infrastructure (ITI)

PAM GEHC Pt Encounter Consumer, Pt Demographics Consumer, Pt Encounter Supplier

PIX, PIXv3 Certify, Vangent, OZ Manager, Consumer, Identity Source, Repository

XCA Vangent, Aegis, Epic Initiating Gateway, Responding Gateway, Registry

XCPD Vangent, Aegis Initiating Gateway, Responding Gateway

XDS-b Certify, Vangent Repository

XDS-SD GMT Content Creator

Patient Care Coordination (PCC)

XPHR Alert Content Creator

AP* GMT, Epic Content Creator, Content Consumer

NDS GE, GMT Content Creator, Content Consumer

PPVS GMT, Alert Content Creator, Content Consumer

Patient Care Device (PCD)

DEC Epic, Mindray, Nuvon, OZ, CareFusion Device Obs. Consumer, Device Obs. Reporter

IPEC Epic, CareFusion Device Obs Consumer, Device Obs. Reporter

PIV Epic, CareFusion Infusion Order Programmer, Infusion Order Consumer

ACM Cerner, Nuvon, Vocera Alarm Reporter, Alarm Manager, Alarm Communicator

Care Theme: Newborn HealthUse Case 2: Delivery, Public Health Reporting to State Vital Records Programs, Early Hearing Detection and Intervention (EHDI) Programs, Quality Monitoring to Aid Early Pediatric Care