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Clinical Systems

Systems and software engineering contribute not only to advancing and improving the delivery of healthcare but also to doing it more safely than has been the case in the past.

Turning “To err is human, but to really screw up, you need a computer” on its head, the Institute of Medicine named To Err Is Human: Building a Safer Health Care System recommended that healthcare professionals focusing on patient safety should increase their understanding of how information technology could be applied to deliver safer care.

Much of the subsequent response to that challenge has focused on increasing the capabilities of enterprise hospital and clinical information systems – for example, implementing order-entry systems to check for drug allergies when writing prescriptions. But IT and patient care also come together at the bedside in the medical equipment and instrumentation systems used to deliver direct patient care – for example, smart infusion pumps that help ensure that the right dose of the right drug is administrated to the right patient.

Providing care to any one patient is likely to require multiple devices, particularly for the more acutely ill. The instrumentation at an intensive care bedside will minimally include a physiologic monitoring system to acquire, process, communicate, display blood pressure, oxygen saturation, cardiac output, respiration, and other key parameters. Other devices likely to be in use will include infusion pumps (smart or otherwise) and ventilator. Equipment that can be brought in as needed includes dialysis system and laboratory equipment such as automated blood chemistry analyzers. Some patient will need all of the above and perhaps more; others will present different needs.

Responding to the demands of the patient care environment requires hospital medical equipment inventories that are not only well-stocked but fairly dynamic as well.

To reach the goals, numerous advances in software engineering include the growth of the subdisciplines of requirements engineering (focused on the gathering, documentation, and analysis of user requirements), user-interface design (focused on the design and construction of intuitive and safe user interfaces), and usability engineering (focused on the study of ease of use and suitability for purpose). In addition to an improved software engineering paradigm, software engineers should focus more attention on the usability aspects of medical systems.