Development and Deployment of an Open, Modular, Near-Real-Time Patient Monitor Datastream Conduit Toolkit to Enable Healthcare Multimodal Data Fusion in a Live Emergency Department Setting for Experimental Bedside Clinical Informatics Research

Abstract

Healthcare providers rely on complex biomedical devices to assess, treat, and monitor patients. Ongoing research efforts are attempting to generate and implement better algorithms and mechanisms to ensure the early, accurate, automated, and clinically meaningful recognition of patterns and changes in patient health and pathology. Effecting such evolutionary advances in patient monitoring will likely require large collections of high-resolution physiologic parameter datasets from a broad spectrum of patients. As part of a research program to scientifically improve patient monitoring (with a focus on alarm fatigue mitigation), investigators developed the Medical Technology Interface-Open/Research toolkit with modular conduit components that provide the following capabilities: 1) access to select bedside monitor physiologic signals in real-world clinical settings for near-real-time acquisition, storage, and export of high-resolution patient datastreams in a portable format (.json); 2) establishment of a safe, parallel test environment at the bedside for experimental datastream analyses in a research framework. Deployment and interfacing of toolkit elements with off-the-shelf software solutions in a live emergency department setting enabled the construction of a bedside clinical informatics (BCI) research pipeline infrastructure that featured 1) indexing, search/query, and retrieval of datastreams for sophisticated analyses, experimental processing, and algorithm development; and 2) dataset visualization for expert adjudication of datastream interpretability, alarm clinical significance and severity, and experimental algorithm performance. In order to help institute a collaborative biomedical engineering research resource, this article shares details of the active ED BCI data pipeline and presents preliminary examples of ongoing multimodal data fusion applications.