Abstract 218

"Infostat" is a PC-based bedside workstation developed to computerize clinical information management for ECMO treatment. Typical of many critical care situations, ECMO treatment is very data-intensive. People spend hours/day physically acquiring electronic patient data (machines, monitors, labs, infusions, pharmacy), writing results onto huge flowsheets, lab charts hung on the wall and drug sections of charts. The resulting information overload leads to mistakes and oversights. Computerization seems an obvious solution.

Virtually all bedside machines are internally computerized; usually communicating via RS232 ports. Industry standards don't exist for RS232 ports, most require optional programmable interfaces that add to the unit cost and the bulk/cable problem caused by many machines at the bedside. Eventually (years), the new IEEE 1073.x communication standards will solve the problem, but until then, millions of legacy machines must retrofitted or replaced. Few vendors have developed software to link with open-database or graphics software. Temporal programming is required. Each bedside machine needs a different interface program and query strategy.

InfoStat allows automatic information upload from RS232 monitoring or treatment machines by retrofitting a low-end PC computer with a floppy disc and a multiport cable and card (Keithley). The Infostat system is written to run on any Windows 95/Office97 120 MHz 486PC, with 16+ MB RAM. Data from each patient machine are stored to hard drive in an Access97 database and updated every minute using a synchronized query strategy. Machine data are continuously displayed on a single screen digital mimic of the faceplate arrangement of the linked monitors and ventilators. Condition-specific patient clinical data are entered on a series of six, usability-designed data entry screens; minimal typing by caregivers is required. ErrorChecked reports, formatted as data tables or colored graphic displays with a user-definable time axis, can be delivered to the monitor or printer using "easy" point and click dialog boxes. InfoStat has drivers for: CD1300 in-line blood gas monitors, InfantStar & VIP Bird ventilators, Mennen physiologic monitor, Nellcor O2 saturation and Datex CO2 monitors and Transonics flowmeter. The system was tested in ∼500 hours of bedside clinical trials in Shands Hospital's NICU (16 patients). System performance is exemplary for machines that produce decent data. Most nurses and respiratory therapists find the report formats intuitive and usable.

We hypothesize that this user friendly computer system can decrease bedside time and effort spent in creating large hand written patient databases. Timely graphic reports will help caregivers spot and correct developing problems early. In complex care environments, early response to emerging complications can save many hospital days, complication costs and sometimes brain cells and lives.

Funded by: Shands Hospital & UF Div of Sponsored Research