Traditionally when developing clinical research or analytical algorithms and you were in search of raw clinical data parameters to minesuch as cardiac output or SPO2, you might try to interface that data via HL7 from the EMR, (if indeed that clinical interface was in place to begin with). In HL7 version 2.3, that would be a man-readable ASCII string with the proper transmission nomenclature. The best resolution one could hope for would be data received every five minutes, and of only the clinical parameters that can be exported via HL7.
Waveforms cannot be communicated well using HL7 due to latency, and thus research, or released algorithms that measure heart rate variability, (HRV), or other parameters such as ST segment amplitude/slope, and the ECG/pleth/respiration waveforms themselves, requires a dynamic data transfer method. Many of the latest clinical decision support algorithms use HRV to detect sepsis onset, as in the case of the HeRO algorithm, and as well in the CleMetric patient degradation algorithms. Heart-rate variability requires the ECG waveform in order to isolate, and denote the R wave and measure the delta between subsequent QRS complexes.
In order to have a direct interface to every clinical parameter, including waveforms, there’s really only one product on the market that has the ability to sit on either a Philips or GE patient monitoring network, and streams real-time data over a network. That product is Excel-Medical’s BedMaster product. This software runs virtually or on a physical network and extrapolates every parameter including waveforms and drops into a SQL database. From there it can be mined dynamically to feed real-time or retrospective research or clinical decision support algorithms.
This data can then be mined by virtually and analytical software package and lends itself to not only decision support tools, but also the development of larger data sets to include peripheral device information from ventilators or infusion pumps, and even more distal information via HL7 , lab, and financial interfaces. Excel Medical has a partnership with IBM Watson Health to provide streaming analytics data to IBM InfoSphere Streams to encompass structured and unstructured data. One of their installations, Emory Healthcare in Atlanta, has created the “ICU of the Future” utilizing this granular clinical data that provides for persistent data storage and real-time analytics support.