Session S24.1

An Open Source Toolkit for Managing Patient Monitoring Device Alarms Based on the IHE Alarm Communication Management Profile

MJB van Ettinger*, JA Lipton, KJ Fuchs, TB van Dam,
RJ Barendse, NHJJ van der Putten, SP Nelwan

Erasmus University
Rotterdam, Netherlands

The “Integrating the Healthcare Enterprise” (IHE) initiative organized by healthcare professionals and industry has defined an Alarm Communication Management (ACM) profile as part of the Patient Care Device (PCD) domain in order to communicate alarms from patient monitoring and therapeutic devices in a consistent way. The ACM profile may lead to interoperability between systems of different manufacturers and may result in allowing alarm messages to be communicated in a standardized way.
We have implemented an extensible, open source framework (C#, ASP.NET) based on the ACM 2008 standard and interfaced our patient monitoring equipment (Draeger Medical), and infusion pumps (Alaris) using several export interfaces (RSS, ESPA, XMPP, SMS, SNPP) available in the intensive care units of the Erasmus MC. The framework can be extended by plug ins for devices that generate alarms and those that display alarms. Alarms can be archived to a SQL server database. The open source framework is available on http://i-put.sourceforge.net.
The framework enables new applications which may improve the accuracy of the alarms. Patient monitoring and therapeutic devices at the bedside generate many audible and visual alarms which interrupt care as they require a clinician to review each alarm. Few of the alarms actually represent life threatening events; most result from (slightly) abnormal values or artifacts. These alarms are often presented on different screens, use different sounds and visual effects. Also, to change specific alarm settings, each device needs to be configured separately. Finally, devices do not exchange alarm information with other devices of the same patient, so each device will generate its own stream of alarms. Thus, a single physiological event may trigger different alarms (time, message and/or level) for each attached device. Using the ACM profile can lead to systems which improve the frequency and presentation, as well as the accuracy of these alarms.
In conclusion, the presented open source framework of the IHE PCD ACM profile provides a starting point for a centralized, uniformed approach to device alarm management.

(Abstract Control Number: 240)