NEPHRO 7 - Das Informationssystem für die Dialyse und die Innere Medizin/Nephrologie


Automated data documentation of dialysis treatments Consider the use of the online connectivity and documentation system nephroCOM if you need to optimise the workflow and processes in your renal department. The nephroCOM system offers the perfect tools for this purpose. The nephroCOM ConnectivityBox allows the connection of dialysis machines, scales and blood pressure screens to the network, while the nephroCOM software modules provide overviews of measurements and treatment data from the connected devices. Since all data will be saved automatically in a database on the server, it can be used directly on all network clients for tracing the treatments. The data are also available for medical documentation and for quality assurance, as well as for billing, stock keeping, controlling and statistics. In addition, all relevant data can also be transferred into hospital information systems. And last but not least, the ongoing documentation offers a current overview of all treatments and progresses in the various dialysis rooms, intensive care units, satellite centres or home dialysis units for the medical staff – provided the devices are connected through nephroCOM. Visualising and managing treatment data For displaying, recording and editing the transmitted treatment data, vital parameters, events, applied drugs and used material the module nephroCOM provides convenient application software. The applications are easy to use and adjusted to the specific requirements of the staff and consultants. They can also easily be configured for special demands. The application program nephroPROTOCOL records and visualises the transferred treatment data from the medical devices. Additionally it allows for manual entries, for example if not all dialysis devices have an integrated blood pressure screen, or if medication and treatments during an incident need to be documented. For manual record keeping at the patient’s bed also a small tablet PC can be used, giving you access to the data through a wireless LAN connection. The application program nephroSTATUSVIEWER works like a panel. It gives an overview of all running treatments in the different rooms of the department, the intensive care wards or the satellite centres. The nephroSTATUSVIEWER displays the progress of the treatments with data, such as the weight before and after a treatment, the according measurements of blood pressure and pulse, the device parameters, such as ultra filtration, blood flow, TMP and the device alarms. In facilities where a lot of patients are treated at the same time you can limit the display to certain rooms or patient groups. However, this application cannot be used for a real-time monitoring of the patient, since the data from the medical devices is transferred in collected data packages at preset intervals for reasons of data security as well as to reduce the data traffic on the network. If MedVision’s renal information system NEPHRO 7 is installed the recorded data can be accessed automatically for billing, quality assurance and stock keeping in the accordant application programs. The NEPHRO 7 application program nephroDESKTOP makes use of the optional integration of nephroCOM. As the data is continuously transferred to NEPHRO 7 during an ongoing treatment it can be put in relation to all other patient data at any time, such as prior treatments, lab data or other patient’s medical records. Blood pressure and weight developments, monitoring of given drugs, e.g. EPO and iron therapy, put in correlation to lab results, are only a few examples of how to use nephroDESKTOP. In order to provide a maximum of relevant data, the application can display up to four tables in one window, sorted by topics. For example charts or tables with former treatment results, diagnoses, lab tables and graphs etc. can be arranged as overviews in a window and each can be accessed by just one click. But nephroDESKTOP not only displays the data; it allows modifications of the treatment prescription or drug dosage and similar entries or changes at the same time. All changes and entries become directly available for the consultants and nurses. This opens up new possibilities of treatment monitoring for the doctor in charge during his ward round or in the doctor’s room. The nephroCOM hardware and software components The central hardware component of the nephroCOM system is the ConnectivityBox. Dialysis devices and scales from any manufacturer can be connected with the ConnectivityBox, as long as they are equipped with a serial interface and interface descriptions for the development of drivers are published. If a device already has a LAN interface, it can of course also be hooked to the network through a direct link. Additionally it is possible to connect devices for measuring blood volume or devices for automatic profiling of the UF rate and Na+ saturation. The ConnectivityBox combines many advantages: It assures that all treatment data is connected to the patient’s ID without mistakes, it buffers and collects the data from the medical devices, combines the data into packages and verifies, encrypts and transmits the packages to the server at preset intervals. This leads to less network traffic and more security, ensuring that even a home dialysis unit can be connected via public DSL with encryption without risks. The box is much more than just a simple interface converter, linking the medical devices to the Ethernet and converting serial data into computer readable information. Despite its small size the ConnectivityBox contains a computer with processor, RAM and a Linux operating system as well as an integrated chip-card reader, which can read the smart cards with the patient’s identification data. Another huge advantage of the box is the storage capacity, which is big enough to store several treatment procedures in case of a network or server breakdown. No data will get lost and, as soon as server and network are available again, all saved data will automatically be transmitted to the database. With the help of various mounting systems, the ConnectivityBox can be mounted to the devices, to a separate rail or to the wall. In addition to the mentioned main programs nephroCOM provides a number of additional applications. One of them is a server application which receives, consolidates and saves data transmitted by the ConnectivityBox into the nephroCOM database. An application for burning the patient smart cards with the patient’s ID and printing them with the patient’s name and picture is also part of the package. And finally each type of device requires special driver software, since no standard has been established for the data transmission of medical devices. More time for the patient Optimising of the workflow and processes is the first goal of the automated treatment documentation with nephroCOM. The second goal is saving time for both treating doctors and medical staff, time which can be used for an improved care for the patient. How much time can be saved? This question is not easily answered, as it varies from renal centre to renal centre and from installation to installation. So far we know of one prospectively designed study made at a renal centre, which is using the monitoring system of a dialysis device manufacturer in connection with the renal information system NEPHRO 7. The study indentified seven processes which could be optimised through the automatic data collection from the machines and devices. This optimisation resulted in approximately 21 minutes of time savings for the nursing staff per patient and treatment. On the one hand, the results of the study can only be ascribed partially to the connection through nephroCOM, for example since 1.5 minutes of the 21 minutes saved in total are due to transferring treatment parameters online to the dialysis device. This is not possible with nephroCOM for reasons of the manufacturers’ product liability. On the other hand, time savings due to the new possibilities of treatment monitoring coupled with the data from the patient’s file could not be taken into account, since monitoring systems only transfer the data to NEPHRO 7 after the end of the treatment procedure, which means usually at a time when the patient has already left the renal centre. With all due reservation towards the results of such a study, the time saving results due to the pre- and post-dialytic weight measurements, the integrated blood pressure measuring and the omission of the manual record keeping can easily be verified. Also, the time savings due to the automatic transfer of the data for billing, quality assurance, stock keeping and controlling are obvious. Even if the amount of time saved differs from renal centre to renal centre, all users so far attest to one thing; connecting the devices through nephroCOM and NEPHRO 7 is also an economically sound investment.

Automated data documentation of dialysis treatments

Consider the use of the online connectivity and documentation system nephroCOM if you need to optimise the workflow and processes in your renal department. The nephroCOM system offers the perfect tools for this purpose.
The nephroCOM ConnectivityBox allows the connection of dialysis machines, scales and blood pressure screens to the network, while the nephroCOM software modules provide overviews of measurements and treatment data from the connected devices.
Since all data will be saved automatically in a database on the server, it can be used directly on all network clients for tracing the treatments. The data are also available for medical documentation and for quality assurance, as well as for billing, stock keeping, controlling and statistics. In addition, all relevant data can also be transferred into hospital information systems.
And last but not least, the ongoing documentation offers a current overview of all treatments and progresses in the various dialysis rooms, intensive care units, satellite centres or home dialysis units for the medical staff – provided the devices are connected through nephroCOM.

Visualising and managing treatment data

For displaying, recording and editing the transmitted treatment data, vital parameters, events, applied drugs and used material the module nephroCOM provides convenient application software. The applications are easy to use and adjusted to the specific requirements of the staff and consultants. They can also easily be configured for special demands.

The application program nephroPROTOCOL records and visualises the transferred treatment data from the medical devices. Additionally it allows for manual entries, for example if not all dialysis devices have an integrated blood pressure screen, or if medication and treatments during an incident need to be documented. For manual record keeping at the patient’s bed also a small tablet PC can be used, giving you access to the data through a wireless LAN connection.

The application program nephroSTATUSVIEWER works like a panel. It gives an overview of all running treatments in the different rooms of the department, the intensive care wards or the satellite centres. The nephroSTATUSVIEWER displays the progress of the treatments with data, such as the weight before and after a treatment, the according measurements of blood pressure and pulse, the device parameters, such as ultra filtration, blood flow, TMP and the device alarms. In facilities where a lot of patients are treated at the same time you can limit the display to certain rooms or patient groups. However, this application cannot be used for a real-time monitoring of the patient, since the data from the medical devices is transferred in collected data packages at preset intervals for reasons of data security as well as to reduce the data traffic on the network.

If MedVision’s renal information system NEPHRO 7 is installed the recorded data can be accessed automatically for billing, quality assurance and stock keeping in the accordant application programs.

The NEPHRO 7 application program nephroDESKTOP makes use of the optional integration of nephroCOM. As the data is continuously transferred to NEPHRO 7 during an ongoing treatment it can be put in relation to all other patient data at any time, such as prior treatments, lab data or other patient’s medical records. Blood pressure and weight developments, monitoring of given drugs, e.g. EPO and iron therapy, put in correlation to lab results, are only a few examples of how to use nephroDESKTOP. In order to provide a maximum of relevant data, the application can display up to four tables in one window, sorted by topics. For example charts or tables with former treatment results, diagnoses, lab tables and graphs etc. can be arranged as overviews in a window and each can be accessed by just one click. But nephroDESKTOP not only displays the data; it allows modifications of the treatment prescription or drug dosage and similar entries or changes at the same time. All changes and entries become directly available for the consultants and nurses. This opens up new possibilities of treatment monitoring for the doctor in charge during his ward round or in the doctor’s room.

The nephroCOM hardware and software components

The central hardware component of the nephroCOM system is the ConnectivityBox. Dialysis devices and scales from any manufacturer can be connected with the ConnectivityBox, as long as they are equipped with a serial interface and interface descriptions for the development of drivers are published. If a device already has a LAN interface, it can of course also be hooked to the network through a direct link. Additionally it is possible to connect devices for measuring blood volume or devices for automatic profiling of the UF rate and Na+ saturation.

The ConnectivityBox combines many advantages: It assures that all treatment data is connected to the patient’s ID without mistakes, it buffers and collects the data from the medical devices, combines the data into packages and verifies, encrypts and transmits the packages to the server at preset intervals. This leads to less network traffic and more security, ensuring that even a home dialysis unit can be connected via public DSL with encryption without risks.

The box is much more than just a simple interface converter, linking the medical devices to the Ethernet and converting serial data into computer readable information. Despite its small size the ConnectivityBox contains a computer with processor, RAM and a Linux operating system as well as an integrated chip-card reader, which can read the smart cards with the patient’s identification data.

Another huge advantage of the box is the storage capacity, which is big enough to store several treatment procedures in case of a network or server breakdown. No data will get lost and, as soon as server and network are available again, all saved data will automatically be transmitted to the database.

With the help of various mounting systems, the ConnectivityBox can be mounted to the devices, to a separate rail or to the wall.

In addition to the mentioned main programs nephroCOM provides a number of additional applications. One of them is a server application which receives, consolidates and saves data transmitted by the ConnectivityBox into the nephroCOM database. An application for burning the patient smart cards with the patient’s ID and printing them with the patient’s name and picture is also part of the package. And finally each type of device requires special driver software, since no standard has been established for the data transmission of medical devices.

More time for the patient

Optimising of the workflow and processes is the first goal of the automated treatment documentation with nephroCOM. The second goal is saving time for both treating doctors and medical staff, time which can be used for an improved care for the patient.
How much time can be saved? This question is not easily answered, as it varies from renal centre to renal centre and from installation to installation. So far we know of one prospectively designed study made at a renal centre, which is using the monitoring system of a dialysis device manufacturer in connection with the renal information system NEPHRO 7. The study indentified seven processes which could be optimised through the automatic data collection from the machines and devices. This optimisation resulted in approximately 21 minutes of time savings for the nursing staff per patient and treatment.

On the one hand, the results of the study can only be ascribed partially to the connection through nephroCOM, for example since 1.5 minutes of the 21 minutes saved in total are due to transferring treatment parameters online to the dialysis device. This is not possible with nephroCOM for reasons of the manufacturers’ product liability.
On the other hand, time savings due to the new possibilities of treatment monitoring coupled with the data from the patient’s file could not be taken into account, since monitoring systems only transfer the data to NEPHRO 7 after the end of the treatment procedure, which means usually at a time when the patient has already left the renal centre.
With all due reservation towards the results of such a study, the time saving results due to the pre- and post-dialytic weight measurements, the integrated blood pressure measuring and the omission of the manual record keeping can easily be verified. Also, the time savings due to the automatic transfer of the data for billing, quality assurance, stock keeping and controlling are obvious. Even if the amount of time saved differs from renal centre to renal centre, all users so far attest to one thing; connecting the devices through nephroCOM and NEPHRO 7 is also an economically sound investment.