CIMIT Strategic Initiative on Integrated Clinical Environments

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Strategic Initiative on
Integrated Clinical Environments (ICE)

A MULTI-INSTITUTIONAL COLLABORATION FOR TRANSFORMING
PATIENT-CENTERED CARE WITH TECHNOLOGIES THAT INTEGRATE CARE ENVIRONMENTS

The CIMIT Integrated Clinical Environments (ICE) Initiative seeks to improve healthcare, enhance outcomes, improve patient safety and reduce inefficiencies.

» ICE Program Overview & Fact Sheet (pdf)

A consortium-wide collaboration that draws on the collective expertise of its Boston-based consortium of premier teaching hospitals, universities and labs, the CIMIT ICE initiative aims to help clinicians be more informed as they make decisions at the point-of-care, while also making clinical systems more efficient and less error-prone. It leverages and adapts technology and systems engineering to improve the continuity of health care within and across care settings. It enables the more effective capture, transfer, use and display of information as patients move through clinical workflows and interact with healthcare systems and associated electronic medical records.

Projects within the initiative include working groups and collaborations that are focused on integrating clinical workflow redesign with innovative technologies, medical device interoperability, and clinical use simulation to enable the effective use of electronic medical records and provide improved decision support for clinicians at the point-of-care. The core of the work is translational research and development that adapts and applies enabling technologies to specific problems experienced by clinicians and allied caregivers – providing rapidly implementable solutions.

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Through ICE, CIMIT seeks to address today’s fragmented healthcare paradigm, which results in systems that are inefficient, error-prone, and subject to sub-optimal outcomes. The devices used for monitoring, collecting, analyzing and displaying device- and patient-generated data usually operate independently from each other and the electronic medical record, each using proprietary systems. Medical devices that deliver care, such as infusion pumps and ventilators, act autonomously to perform a specific set of functions, typically optimized for existing, conventional workflows.

Without an effort like ICE, systems will remain fragmented and inefficient. Standards and infrastructure need to be made widely available to support the development, validation and effective use of interoperable devices and systems. No one company or healthcare provider has the resources or infrastructure to optimize use of devices within an interoperable system, nor to ensure the safety and efficacy of the resulting clinical workflow, but all can benefit when these goals are achieved through a coordinated effort. Accordingly, CIMIT will convene the clinical, technical, regulatory and commercial expertise to demonstrate the potential, start building the necessary infrastructure and catalyze the action needed by stakeholders.

Projects
Delegates
Forum/Events

Projects
YEAR	PRINCIPAL INVESTIGATOR	INSTITUTION	PROJECT TITLE
2012	Lee Park, MD	Newton-Wellesley Hospital	Analyzing hospital readmissions to design interventions
2012	Naren Gupta, MBBS, PhD	VA Boston Healthcare System	An integrated clinical system to reduce stroke risk in patients with carotid disease
2012	Trudy Pang	Beth Israel Deaconess Medical Center	Development of a Stat EEG Prototype for Rapid Diagnosis of Non-convulsive Status Epilepticus for Community Hospital Settings
2012	Steven Horng	Beth Israel Deaconess Medical Center	Developing and Validating an Integrated Intelligent Sepsis Monitoring System
2012	L. Michael Fraai	Brigham and Women’s Hospital	Hospital Readmission Reduction Pilot
2012	Elissa Weitzman	Children's Hospital Boston	Improving Healthcare Transitions Using a Personally Controlled Health Record
2012	David Hooper	Massachusetts General Hospital	Integrating Clinical Systems to Identify MRSA-Colonized Patients in the Outpatient Setting with Rapid Detection Methods
2012	Wilton Levine	Massachusetts General Hospital	Blood Ordering and Transfusion Safety System
2012	Mark Ottensmeyer	Massachusetts General Hospital	Low Cost, Modular Enhancements for Mannequin-Based Medical Simulators
2012	Julian Goldman	Massachusetts General Hospital	Improving Continuity of Care for Veterans by Electronically Exchanging MGH, VA, and DoD Medical Record Data
2012	Timothy Bickmore	Northeastern	Optimizing Hospital Workflow and Quality through Patient Engagement
2012	Steven Simon	VA Boston Healthcare System	Interactive Medication Reconciliation by Secure Messaging
2011	Julian Goldman, MD	Massachusetts General Hospital	PCA Monitoring Safety Interlock to Decrease Adverse Clinical Events
2011	James Gray	Beth Israel Deaconess Medical Center	Using network analysis to improve the qualities of NICU care teams and their function
2011	David Judge, MD	Massachusetts General Hospital	Implementation of a Hypertension Remote Monitoring Toolkit in a Primary Care Team-Based Practice, Clinical Systems Innovation
2011	Joel Karlinsky	VA Boston Healthcare System	Interoperability of Portable X Ray Machines with Ventilators in Monitored Settings
2011	Frank Moss	Massachusetts Institute of Technology	Collaborative Virtual Rehabilitation Interface with Home Treatment Integration
2011	Joanne Nowak	Partners Hospice	Telehospice Pilot to Connect Patients at End of Life and their Families to Providers to Reduce Rehospitalization and Control Healthcare Costs
2011	Jussi Saukkonen, MD	Boston University	Development of an interactive, clinical algorithm-driven interoperable smart ventilator.
2011	Kim Wilson	Children's Hospital Boston	Using Mobile Electronic Protocols to Improve Newborn Survival in Developing Country Settings
2010	Meghan Dierks, MD	Beth Israel Deaconess Medical Center	Reshaping systems, processes and controls to optimize outcomes in sepsis
2010	Debra Weiner, MD, PhD	Children's Hospital Boston	Handheld simulation procedure training device
2009	Ronald Dixon, MD	Massachusetts General Hospital	Healthcare 360: A technology-enabled model for general medical care
2009	Ronald Dixon, MD	Massachusetts General Hospital	Primary Care Kiosks: Making Solutions Affordable and Scalable
2009	Ronald Newbower, PhD	Massachusetts General Hospital	Handwashing Compliance Reminder and Documentation
2008	Walter Dzik, MD	Massachusetts General Hospital	RFID for Prevention of Bedside Errors
2008	Julian Goldman, MD	Massachusetts General Hospital	Medical Device Mobile Plug-and-Play Platform (MD MP3) for Medication Safety
2008	Robert Insoft, MD	Brigham and Women’s Hospital	Improving the Care of Neonates During Inter-hospital Transport
2008	David Judge, MD	Massachusetts General Hospital	Designing the Ambulatory Practice of the Future Systems Integration Hub
2008	Bruce Levy, MD	Brigham and Women’s Hospital	Remotely Monitored Inhaler to Predict and Prevent Asthmas Attacks
2008	Adam Wolfberg, MD, MPH	Children’s Hospital Boston	The Safe Fetus Project: Develop a new non-invasive monitor of fetal health

» View all CIMIT-Funded Projects.

Delegates

Information will be posted soon.

Clinical Systems Innovation at the CIMIT Forum and Past Events
EVENT / DATE	SPEAKERS	DETAIL
Forum Feb. 16, 2010	Susan Edman-Levitan, PA: Executive Director, The John D. Stoeckle Center for Primary Care Innovation, Massachusetts General Hospital	Designing Solutions Through the Eyes of the Patient: Avoiding "End-User Failure"
The FDA Center for Devices and Radiological Health (CDRH) Workshop on Medical Device Interoperability Jan. 25-27, 2010	Charles P. Friedman, PhD., Chief Scientific Officer, Office of the National Coordinator for Health Information Technology Jeffrey Shuren, MD, JD, Acting Director, FDA/CDRH Donna-Bea Tillman, PhD, Director, Office of Device Evaluation, FDA/CDRH Doug Rosendale, D.O. F.A.C.O.S, Veterans Health Administration, Office of Health Information, Joint Interoperability Ventures	The Food and Drug Administration (FDA) Center for Devices and Radiological Health, in co-sponsorship with Continua Health Alliance and the Center for Integration of Medicine & Innovative Technology (CIMIT) held a public workshop entitled ‘‘Medical Device Interoperability: achieving safety and effectiveness.’’ The purpose of the workshop is to facilitate discussion among FDA, industry, academia, professional societies, clinical investigators and other interested parties on issues related to safe and effective interoperable medical devices. Final Agenda & Videos.
Forum Dec. 8, 2009	Jaques Reifman, PhD: Senior Research Scientist, DoD Biotechnology High-Performance Computing Software Applications Institute, TATRC, U.S. AMRMC, Ft. Detrick, Maryland Collin M. Stultz, MD, PhD: Principal Investigator, Research Laboratory of Electronics and W. M. Keck Associate Professor of Biomedical Engineering, MIT	• Predictive Models for Individualized Medicine: Tools to Manage Cognitive Performance, Diabetes, and Heat Stress • A Novel Non-invasive ECG-based Method for Predicting Adverse Cardiovascular Outcomes
Forum Sep. 15, 2009	Lamont M. Yoder, RN, MSN, MBA, NEA-BC, FACHE: Vice President & Chief Nursing Officer, OhioHealth, Inc., Dublin Methodist Hospital Barbara Blakeney, RN MS: MGH Julian Goldman, MD: Partners HealthCare Ronald Newbower, PhD: CIMIT Sue Schade: BWH	• Transformation via Technology: Run Until Apprehended • Panel Discussion
Forum: "Living Laboratories" Across the Continuum of Care: Innovative Spaces and Virtual Places May 26, 2009	Ronald Newbower, PhD: CTO and Strategic Director, CIMIT Operating Room of the Future Colleen Kigin, DPT, FAPTA: Chief of Staff, Government Affairs Liaison and Consortium, National, and International Relations, CIMIT Clare Tempany, MB BAO, BCH: Ferenc Jolesz Distinguished Chair in Radiology Research; Vice Chairman, Radiology Research; Director, Clinical Focused Ultrasound, Department of Radiology, BWH; Professor of Radiology, HMS David Judge, MD: Co-Program Leader, CSI, Ambulatory Practice of the Future, CIMIT; Instructor in Medicine, HMS; Assistant Medical Director, Bulfinch Medical Group, MGH Ronald Dixon, MD, MA: Associate Medical Director, MGH Beacon Hill Internal Medicine Associates; Director, Virtual Practice Project, MGH	• Introduction • Operating Room of the Future • Advanced Procedure Room • Ambulatory Practice of the Future • Virtual Primary Care
Forum May 12, 2009	Julian Goldman, MD, Medical Director of Biomedical Engineering, Partners HealthCare; Principal Anesthesiologist, MGH "Operating Room of the Future"; CIMIT Director of Interoperability; Founder, Medical Device "Plug-and-Play" Interoperability Program Andrew Reisner, MD, Emergency Physician, MGH; HMS, MIT, and US Army Telemedicine and Advanced Technology Research Center Peter Szolovits, PhD, Professor of Computer Science and Engineering, MIT Department of Electrical Engineering and Computer Science; Professor of Health Sciences and Technology, Harvard/MIT Division of Health Sciences and Technology; Head, Clinical Decision-Making Group, MIT Computer Science and Artificial Intelligence Laboratory	• Improving Patient Safety and Clinical Workflow: System Integration through Medical Device Interoperability • Panel Discussion
Forum: Health 2.0: Connecting, Enabling Healthy Behaviors and Taking Charge of Health Records Jan. 20, 2009	Kenneth Mandl, MD, MPH: Associate Professor, CHB / HMS, Harvard-MIT Health Sciences and Technology John Moore, MD: Research Assistant, New Media Medicine Group, MIT Media Lab Jay Parkinson, MD, MPH: Myca	• Personally Controlled Health Records: Tectonic Shifts in the Health Information Economy • Persuasive Interfaces for Medicine: Enabling Patients to Change Health-related Behaviors • Hello Health: A Social Network for Clinicians to Communicate with Patients and Clinicians
Forum Dec. 2, 2008	Keith McCandless: Social Invention Group Ronald Dixon, MD, MA: Associate Medical Director, MGH Beacon Hill Internal Medicine Associates; Director, Virtual Practice Project, Massachusetts General Hospital	• Unleashing Innovation on the Front Lines—Preventing MRSA Transmissions & Transforming Culture • Innovation “Now" in the Clinical Office Practice
Forum: Retail-based Healthcare Clinics Sept. 9, 2008	Peter Markell, Vice President, Finance, Partners HealthCare System, Inc. Ahmed Albaiti, CEO, Medullan, Inc.	• Retail Clinics -The View from an Academic Integrated Delivery System • Increasing Health Care Value via Technology: Enabled Simplification
Forum Jun. 24, 2008	Jeanine Wiener-Kronish, MD, MGH Douglas Raines, MD, MGH Emery Brown, MD, PhD, MGH Keith Miller, DPhil, MGH	Developments for the Future of Anesthesia and Critical Care
Forum: Planning for the Neonatal Intensive Care Unit Nov. 27, 2007	Stella Kourembanas, MD; CHB, HMS Anne Hansen, MD, MPH; CHB, HMS Jonathan Kemp, PhD; Cambridge Sound Mgmt	Technology Requirements in the NICU of the Future: A First Look at Sight and Sound • NICU of the Future Project, CHB: Current Challenges and Future Goals • NICU of the Future, Sound and Light • Noise in the Clinical Environment: Sources, Effects, Solutions
Forum: Assessing Health of Older Adults Nov. 6, 2007	Alan M. Jette, PT, PhD, FAPTA; BU, BUMC Jonathan Bean, MD, MS, MPH; Spaulding Cambridge Outpatient Center, HMS	• How Are You Really Doing? Innovations in Functional Outcomes Measurement in Rehabilitation • Three Big Risks for Older Adults: Walking, Climbing Stairs and Rising from a Chair: Evidence-based Rehabilitative Care for Older Adults
Forum: Improving Quality and Patient Safety Oct. 30, 2007	Ronald Newbower, PhD; CIMIT Gregg S. Meyer, MD, MSc; MGH/MGPO Jeffrey Cooper, PhD; MGH	• How to Protect Oneself From Injury by Human Error in a Hospital • An Untapped Role for Patients: Online Reconciliation of Meds and Monitoring Care Transitions • New Hazards of Medical Technology
Forum: Challenges and Opportunities in Office-Based Medicine Oct. 9, 2007	Keith Isaacson, MD; HMS, BWH, BWH Fred Shapiro, DO; HMS, BIDMC Beverly Philip, MD; HMS, BWH Lisa Warren, MD; MGH	• Office-based Gynecologic Procedures • Office-based Anesthesia • Technology Implications of Office-based Anesthesia Safety • Regional Anesthesia in the Office Based Setting

Clinical System Innovation News
ARTICLE TITLE	PUBLICATION	DATE
iPhone Apps for the Clinic	Gosh, that's neat! Blog	Feb. 16, 2010
LiveData Wins SBIR Phase II Grant To Develop Integrated Clinical"Plug And Play" Environment For Patient Safety System	Medical News Today	Oct. 9, 2009
The ICEMAN cometh, and it's plug-and-play	Healthcare IT News	Oct. 6, 2009
Five emerging sectors offer promise with new technologies	Mass High Tech	Jul. 31, 2009
Dr. Ronald Dixon Featured 'Healthcare Revolution' Expert: VIDEO: Making Primary Care The Primary Focus VIDEO: Fulfilling Healthcare’s Digital Promise VIDEO: Downloading Health: Why Don’t Doctors Use Text Messaging and Email? VIDEO: Tough Medicine: A Big Think Interview With Ron Dixon About Reinventing Healthcare	BigThink.com	Jul. 16, 2009
$150,000 Engineering Prize awarded to CollaboRhythm Team. CIMIT Prize competition recognizes student research using novel technologies to address major diagnostic and therapeutic challenges in primary healthcare.	CIMIT Press Release	Jun. 25, 2009
The doctor will see you now online - Why your next physician's visit may be just a click away	Boston Globe	Jun. 1, 2009
The Doctor Kiosk. An automated health-care interface aims to streamline preventative screening	Technology Review	Feb. 25, 2009
Health data kiosk replaces in-person doctor visits	Mass High Tech	Feb. 6, 2009
Medical devices lag in iPod age. Patients' safety is at risk, experts say	Boston Globe	Dec. 29, 2008
Model Contract Gives Momentum To Interoperability Movement	Anesthesiology News	Dec. 2008
"Plug and Play" Hospitals, Medical devices that exchange data could make hospitals safer.	MIT Tech Review	July 9, 2008
Doc: Plug-and-play med devices could save lives	Mass High Tech	Jan. 18, 2008
Scientific and Educational Exhibit: First-place tie winners from Massachusetts General Hospital/Harvard Medical School	American Society of Anesthesiologists	Jan. 8, 2008
How to Improve It? Ask Those Who Use It	New York Times	Mar. 25, 2007
Personalized Medical Monitors: John Guttag says using computers to automate some diagnostics could make medicine more personal	Technology Review	Mar. 12, 2007
ASA Panel on Medical Device Interoperability	Anesthesiology News	Feb. 1, 2007
Once a Tech Fantasy, Plug-and-Play OR Edges Closer to Reality	Anesthesiology News	Jan. 2007
OR of Future Reports Improved Throughput	OR Manager	Jan. 2006
BWH Achieves World First in Thoracic Surgery	BWH Pike Notes	Dev. 9, 2005
Automatic Detection and Notification of 'Wrong Patient-Wrong Location' Errors in the Operating Room	Surgical Innovation	Sept. 2005

ICE Initiative Elements

Workflow Optimization
Clinical Simulation
Interoperability
Enabling Technologies

ICE: Integrated Clinical Environments

CIMIT Programs contributing to the ICE Initiative:

» Clinical Systems Innovation
- Of The Futures
- Medical Device Plug-and-Play
» Simulation

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