Smart Pump/EMR Interoperability 2017
First Look at Interoperability Performance

1. BD Rolling Out Pump/EMR Interoperability Faster Than Any Other Vendor

Despite the FDA hurdles that all pump vendors encounter, over the last two years, BD has been the most proactive in driving customer adoption of interoperability, and their customers represent the vast majority of interoperable sites today. This higher adoption is due in part to the large market share and appeal of the multimodular Alaris platform. BD customers expected to have PCA interoperability, but to date, ICU Medical (Hospira) is the only vendor to have released it (one live organization). ICU Medical has seen increased interoperability adoption, though at a slower pace than BD. Plum A+ customers are hesitant to integrate with the pump since it is not ICU Medical’s go-forward platform. As a result, the question of interoperability often turns into a larger, slower decision of whether to migrate to a newer pump platform, either from ICU Medical or another vendor. Early feedback on interoperability with the Plum 360 is positive. Baxter, B. Braun, and Smiths Medical have not driven development or rolled out interoperability for their customers as quickly as BD and ICU Medical.

2. Early Feedback Shows That ICU Medical's Dual Lines Provide Flexibility for Workflows

Overall, ICU Medical (Hospira) customers report higher satisfaction with interoperability than BD customers. However, ICU Medical’s interoperable customer base is significantly smaller than BD’s. ICU Medical’s unique dual infusion lines, which allow for both concurrent and subsequent infusions, and cassette technology result in key workflow differences, such as improved workflows for intermittent infusions and the ability to autoprogram boluses. The dual-line design, however, does not help with the complexity of multi-ingredient infusions, an area in which BD has been more successful in helping customers adopt workflows. The concerns reported by BD users include the number of steps required for intermittent infusions as well as issues related more to the EMR, such as problems with disassociating pumps.

3. Epic's Reports Help Drive Optimal Workflows; Cerner Customers Hindered by Lack of Reports

In order to hold clinicians accountable and increase usage of optimal workflows, providers need actionable reports from their EMR. The reports from Cerner and Epic—the two main EMR vendors with whom interoperability has been established—could do more to help providers in this area. Epic’s reports provide actionable department, clinician, and infusion details that help increase usage, but not all users have this depth of reporting since more-complex reports must be built and developed in partnership with Epic over time. Most interviewed Cerner customers have no reports at all or have gone to great lengths to make their own. Additionally, when users encounter error codes in the Cerner Millennium EMR, they aren’t able to decipher the codes without help from IT and are thus more likely to resort to manual workarounds.

4. With Fewer Interoperable Customers, ICU Medical Provides Strong Partnering

With their efforts to drive interoperability, BD and ICU Medical (Hospira) stand in contrast to other smart pump vendors, who have taken a more reactive approach. In addition to driving this technology, BD and ICU Medical have also done well at providing the additional partnering that interoperable customers find themselves in need of. With fewer interoperable customers to support, ICU Medical in particular provides strong handholding, guidance, and responsiveness. Regardless of vendor, many providers want to know whether the ROI and safety benefits of interoperability justify the significant cost and change management required. The answer is that not a single organization KLAS has interviewed regrets adopting interoperability or has plans to remove it. BD and ICU Medical customers highly recommend the technology, noting that the benefits are worth the costs.

Writer
Elizabeth Pew

Designer
Natalie Jamison

Project Manager
Robert Ellis