WHITE PAPER

The Benefits of
Medical Device
Integration
How does it enhance patient care ?
How does it help IT and biomedical
engineering services ?
Yannick Michel, Organisation and IT Systems Director, Nouvelles Cliniques Nantaises (Groupe Confluent)
Stéphane Kirche, Head of Biomedical Engineering in Nord-Saône Loire Bresse Morvan
Nelly Mazet-Lacombe, Health Executive, Bagnoles-sur-Cèze Hospital
SNITEM, French Trade Association of Medical Devices
Jean-Baptiste Michon, Product Marketing Manager, Biomedical Interoperability Expert, Enovacom
Tim Gee, Influencer, Director and Founder of Medical Connectivity Consulting, USA.
 Editorial
No matter how old we are or what our life or surroundings are like, the
health sector concerns all of us. From paediatrics to geriatrics, me-
dicine examines all of our ailments, chronic diseases or reoccurring
aches and pains. Potential patients or ‘healthy sick people’, doctors’
appointments are part of our lives and public health measures help
us push back the limits of ageing even further. Over the last 60 years,
our life expectancy has increased by 14 years on average. A benefit
which doesn’t come without drawbacks as it is progressively changing
the prevalence of reasons for unhealthiness and mortality. As of now,
chronic diseases account for 70% of deaths.

Many different things have contributed to this evolution. To name a

few: the quality of treatment, living conditions, medical advances and
new technology which has developed phenomenally over the last de-
cade. The health sector in particular has seen numerous applications
growing. Telemedicine and connected devices have greatly changed
medical practices and the relationship between practitioners and their
patients. Another ensuing revolution: the arrival of patient version 2.0.
With digital technology and the development of e-health, patients are
becoming more and more a demanding and active participant in their
own health.

In light of these new needs, adapted and efficient IT systems must be

implemented for healthcare workers and patients. However, whene-
ver we talk about exchanging information, data transfer is never far
behind. If Big Data is sparking a debate today it is because, apart from
just confidentiality, collecting medical data requires specific technical
and human handling in healthcare facilities. With this white paper, we
will see how necessary it is to manage patient data from start to fi-
nish – especially in the biomedical field. Therefore, before integrating
connected devices into our daily lives, let’s first of all concentrate on
the patient’s journey throughout the hospital.
Enjoy,

J ean - Baptis te Michon,

Product Marketing Manager
Biomedical Interoperability Expert, Enovacom

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 Summary
P.5 S HARING PATIENT DATA IN HEALTHCARE FACILITIES TODAY
1. Computerising healthcare facilities and the lack of
standardisation
2. Beyond software, connecting non-generalised medical
devices
3. Team involvement

P.9 THE ROLE OF MEDICAL DEVICES IN DATA SHARING

1. The connected medical device market
2. Assessment: from the connected devices to the hospital’s
electronic patient records
3. Non-connected medical devices, non-exploited data

P.11 THE IMPACT OF CONNECTING MEDICAL DEVICES

1. Different connected systems
2. Interoperability versus Connectivity
3. The role of the IHE and the Connectathon
4. Regulations: certifying healthcare facilities

P.14 THE BENEFITS OF CONNECTING BIOMEDICAL EQUIPMENT

1. The 4 highlights of biomedical interoperability 
2. Advantages for physicians 
3. Technology to benefit the patient

P.17 TO BENEFIT THE PATIENT, THE ESTABLISHMENTS AND THE TEAMS – CASE STU-
DIES
1. Bagnols-sur Cèze Hospital
2. Saint-Paul Fort-de-France Clinic (Martinique) 

P.19 DISCOVER ENOVACOM

1. Enovacom at the heart of healthcare data 
2. Solution: ENOVACOM Patient Connect, biomedical
interoperability platform
3. Biomedical interoperability, or how to connect biomedical
equipment easily
4. Expected benefits of ENOVACOM Patient Connect

P.21 CONCLUSION

P.22 SOURCES

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 Introduction

TODAYS CONNECTED HOSPITAL ENABLING

COMPREHENSIVE PATIENT DATA

T
echnology is continually striving and therefore the amount of electronic
information available is progressing rapidly. The health sector is no excep-
tion with the so-called "big data boom": by 2020 the amount of healthcare
data (1) should increase 50 fold with the age of electronic health. An
increase largely brought on by our medical prac­tices and the patients
themselves, thanks to IT enabled electronic patient records and now
connected medical devices. Having rich healthcare datasets requires – IT and associated
technology must therefore be reinvented to find new ways of analysing and exploiting the
content as these large volumes of data are a genuine challenge to manage, exchange and
secure. The connections between medical applications or biomedical devices are far from
standardised – the data is produced, but not made use
of. Today, we’re seeing a real need to be able to utilise
data from biomedical devices in hospitals – which is E-health
constantly on the rise – to guarantee an optimised care increasingly
continuum. appears to be
the solution
for overcoming
difficulties in
Now let us take a look into the impact of a medical
our healthcare
device connected hospital. We will review how patient
system.
data is shared currently, how vital signs are trans-
cribed and then look at the transition to automated collection and examine the types of
benefits you would expect to realise.

(Sources p.22)

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 SHARING PATIENT DATA IN
HEALTHCARE FACILITIES
TODAY

1. Computerising healthcare facilities and the lack

of standardisation
These days, a consensus is emerging about the possi-
bilities opened up by Information and Communication
Technology (ICT), which is growing in the health sector.
It enables the information to be used so it can be stored,
converted, managed, transmitted and analysed. In
the medical field, information technology made its
appearance in the 1980s to make sharing information
easier – as important for each individual
patient’s treatment as the way the health
system is run overall. The first step was to
computerise the entire administrative and “Medical data processing is at the heart of the
financial parts, then to go deeper into the
process by implementing a decision-ma-
company’s IT strategy in different forms:
king and analytical-accounting IT system • The ability to put a patient file together completely
(PMSI). Then, at the end of the 1990s came
the component dedicated to computeri- electronically from start to finish
sing the production of treatments (patient
health records, speciality files, PACS, RIS,
• Ensuring the data is always correct
etc.) • Ensuring that the systems are both internally and
These different functions are managed externally interoperable so they can communicate with
by various different software vendors. If doctors, hospitals and patients.
we take the French example, in 2011 the
first repository on the French healthcare The care continuum concept must be considered above
market was built by software vendors and all else in order to make the data accessible”.
integrators: the Base RELIMS. By referring Yannick Michel, Organisation and IT Systems Director, Nouvelles Cliniques
to the latest figures, we can see more than Nantaises (Groupe Confluent)
200 vendors, 22% of which offer a single
software for a specific medical activity.
Just as much software for the hospital
teams to manage.

An assessment is emerging from this industrial lands-
cape: many different variants of norms, protocols or
exchange formats coexist. For Computerised Patient
Records (CPRs) alone, 27 different applications have
been identified on average. Knowing that apart from
the CPRs, physicians have to manage speciality files by
department at the same time: maternity, surgery, emer-
gency... (4). Normally, these business applications aren’t
able to communicate with each other and automatically
receive data without needing to adapt it.
To overcome these initial difficulties, software solutions
exist to enable business application interoperability
(5) – which certain IT teams already use. Nearly 40%
of healthcare facilities now have this type of central
application.(6)

(Sources p.22)

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 SHARING PATIENT DATA
IN HEALTHCARE FACILITIES
TODAY

Initially, to enable different software to commu-

nicate, peer-to-peer software connection was
made a priority: for example, a maternity file
could send data directly to the patient record
if (and only if) each software vendor used and
included the same formats and norms. But
with the enormous increase of software being
used in healthcare facilities, this solution is no
longer thought to be durable: the supervision
is complex and lacks stability depending on
how new software versions evolve. As a result,
more global interoperability solutions called
integration engines, or EAIs, have emerged and
tend to be standardised these days.

DIFFICULTIES TO REMEMBER

Incomplete electronic patient records

D ifferent vendors, different interfaces:
difficult for physicians to manage multiple
functionalities from different vendors

“For me, computerising health systems is

only done from an administrative point
of view. The existing tools respect the
regulations and certifications more than
they respect the eventual user”.
Yannick Michel, Organisation and IT Systems Director, Nouvelles
Cliniques Nantaises (Groupe Confluent)

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 SHARING PATIENT DATA
IN HEALTHCARE FACILITIES
TODAY
2. Beyond software, connecting non-
generalised medical devices
Medical and IT staff face these real problems:
systems are heterogeneous in and out of the
facilities, and the healthcare data is spread out
into silos which means that sharing medical
information doesn’t always go entirely smoothly.
A new difficulty is also the lack of coordination
needed to make different business applications
communicate. There are other sources of medi-
cal data – namely biomedical devices – which
are all too often not connected to healthcare
records. Physicians have to input the information
again which brings about all sorts of risks: data
monitoring, input errors, being aware of patients’
identities (identity vigilance).
“As soon as human intervention is needed
to collect and consolidate data, the ‘zero
default’ can exist. However, relying on
connected biomedical devices to exchange
data electronically, for example, clearly
aims at treating and improving this
issue.”
Yannick Michel, Organisation and IT Systems Director,
Nouvelles Cliniques Nantaises (Groupe Confluent)
DIFFICULTIES TO REMEMBER
I nputting information
Risk of error
Identity vigilance
(Sources p.22)
7 WHITE
IDENTITY VIGILANCE AND DATA SHARING
Identity vigilance is surveillance and error-
risk management system linked to patient
identification – a key principle when we
speak about sharing medical documents or
patient data. How often identity mistakes are
made is difficult to evaluate and not very well
known. However, some research has been
done in the U.S and France, in the Aquitaine
region, for example.
If we go over these elements, patient
identification problems in the U.S have
been recorded in more than 100 in-depth
analyses of adverse events which happened
between January 2000 and March 2003 by
the ‘Department of Veterans Affairs” (7).
According to the definition suggested in 2013
by the National Authority for Health (HAS), an
adverse event is, “an event or circumstance
linked to treatment which led or could have
led to a patient breach and hopefully wouldn’t
happen again.”
In France, the immediate causes of mistaken
identity linked to professionals which occur-
red in 37 healthcare facilities in Aquitaine
were analysed between 2008 and 2010.
14.4% of these mistakes were linked to data
entry. Therefore, when healthcare facilities
are computerised, patient identity must be
managed and guaranteed by the different
systems used and processes in place.
PAPER WWW.ENOVACOM.COM
 SHARING PATIENT DATA IN
HEALTHCARE FACILITIES
TODAY

3. Team involvement
Computerising care units often causes problems. Even “Physicians are
today, many doctors and carers have expressed their
reservations about its real contribution to daily work. overloaded with
Aside from technical failings, they wonder whether it
really is easy to use or helps organise treatment. The administrative work
number of criticisms is never-ending: it’s imposed more
than wanted, the work is overloaded due to the informa-
that they often view
tion being automatically processed, it’s complicated to as pointless, enforced
use, etc.
and time-consuming
and which takes over
Indeed, 50% (9) of the time staff would be spent mana-
ging patient information or paperwork in one way or
another. We can see that making patient medical data
processing easier is clearly a priority.
their ‘real work’ with
patients.”
Jean-Baptiste Michon, Product Marketing
Manager, Biomedical Interoperability Expert,
Enovacom

“Technology must speed patient

care up. It must enable the
physicians to focus on carrying
out treatment and caring for
patients by getting rid of pointless
tasks as much as possible –
anything that wastes their time.”
Yannick Michel, Organisation and IT Systems Director,
Nouvelles Cliniques Nantaises (Groupe Confluent)

(Sources p.22)

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 THE ROLE OF MEDICAL DEVICES
IN DATA SHARING

1. The connected medical device market

When we talk about medical devices, we include any
tool, device, equipment, software, material or other
item, used by itself or with others, including software
developed specifically to be used to :

diagnose, prevent, check, treat or alleviate an illness,

 iagnose, check, treat or alleviate an injury or disa-

d
bility,
t o study or to replace or change the anatomy or a phy-
siological process, to deal with child birth, and whose
main impact on the human body can’t be achieved by
pharmacological or immunological means, nor by
metabolism, but whose function can be assisted by
such means.
The term ‘medical device’ (MD) covers anything from
defibrillators, hospital beds, syringes, blood glucose
meters, insulin pumps, monitors, pacemakers. In 2015,
1100 (10) medical device manufacturers in France were
surveyed. In 2011, the French biomedical device market
was estimated at 21.3 billion Euros (11).
2. Assessment: from the connected devices
to the hospital’s electronic patient records
We have been able to evaluate the last studies
of the American Association dedicated to the
promotion of IT Health HIMSS (12) on the topic,
and there’s no question about the assessment:
only a third of healthcare facilities analysed in
the United States have developed interfaces
between biomedical devices and electronic
medical records (EMR). The table below highlights
the most common connections depending on the
type of biomedical device: defibrillator, monitor,
ventilator, etc.

Rate of medical devices connected to electronic medical records

Device Number Deployed Percent Interfaced with EMR

Physiologic Monitor 798 24,30%

Fetal Monitor 590 19,00%

Electrocardiograph 796 15,10%

Ventilators 750 9,30%

Cardiac Output Monitor 474 7,50%

Interactive Infusion Pump 406 6,90%

Vital Signs Monitors 779 6,80%

Infusion Pump 527 3,40%

Infant Incubator 566 2,70%

Defibrillator 815 1,60%

(Sources p.22)

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 THE ROLE OF MEDICAL
EQUIPMENT IN DATA SHARING

3. Non-connected medical devices, “The problem with medical

non-exploited data devices’ interoperability is seen
with a large portion of vendors,
manufacturers and systems
The impact of connected medical devices on the healthcare
market and organisation is limited in so far as their connec- which govern this sector. In
tivity is not ensured. Even though on average 6 devices could this industry, we have to cope
be connected to the electronic medical records (EMRs), only 3 with several manufacturers.
of them were in these hospitals (13). It’s difficult to standardise and
harmonise the terminology
This implies that a large part of the medical data these devices
are handling and measuring is either put into the compute- to create interoperability
rised records manually, or simply isn’t there because it isn’t semantics.”
integrated automatically. Tim Gee, Influencer, Director and Founder of
Medical Connectivity Consulting, USA.
The integration needs will also depend on the healthcare
departments and the devices they want to connect. When
a measurement is taken occasionally, like blood pressure,
the data is integrated more easily: it is only collected once or
twice a day. When a patient is being treated over a longer period, in the
recovery or resuscitation room for example, the data is collected much
more frequently. Manually putting the data into the electronic records is
therefore more of a constraint: it will be harder for the physicians to access
the sets of data in real time.

The problem is twofold: both in the lack of

biomedical devices’ interoperability with
each other and the diversity of solutions for
electronic records in hospitals.

The real revolution will be setting up biomedical

devices’ interoperability. By connecting healthcare “Today it’s becoming necessary to
devices, teams will be able to give and take data connect biomedical devices to make
more efficiently. Thus, medical professionals’ work
will be made easier and patient care improved. physicians’ work easier and aid
More broadly speaking, tomorrow’s medicine decision-making: collecting, tracking,
will see connected medical devices on every level making available, storing and finally
(in healthcare facilities or at patients’ homes) to archiving the data.”
ensure they comply better and lead to better treat-
ment of different pathologies. Stéphane Kirche, Head of Biomedical Engineering in
Nord-Saône Loire Bresse Morvan

(Sources p.22)

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 THE IMPACT OF
CONNECTING
MEDICAL DEVICES

1. Different connection systems “It is necessary to implement

all of the technical conditions
For a biomedical device to transfer data to a speciality file, it’s to make sure the solutions
necessary to connect them to integrate the vital data. Today,
function optimally to guarantee
several systems are available.
that the biomedical devices
CONNECTING DIRECTLY are interoperable with the
The material is adapted to data transfer via a proprietary commu- HIS environment – that it is
nication protocol – a specific language or one based on standards. easy for non-IT professionals
However, setting up such a system can prove costly, long and difficult
to pick up and requires the
– indeed, the more different the manufacturers and devices are, the
more interfaces there are – which requires a lot of extra expense for it IT workers to work together
to be developed. Nevertheless, using a peer-to-peer solution enables with the biomedical teams. The
the data to be integrated into the devices. tool that comes out must be
collaborative.”
VIA A BIOMEDICAL INTEROPERABILITY PLATFORM
The objective is to connect the devices (monitor, ventilator, ECG, Stéphane Kirche, Head of Biomedical
Engineering in Nord-Saône Loire Bresse
etc.) to the medical applications (patient records, for example) by Morvan
relying on a communal software solution used by all of the biome-
dical devices and business applications (regardless of the vendor).
It is capable of collecting, transmitting and integrating all of the
device’s data. This is the most economic system: it is compatible
with the diversity of the establishment’s IT system and is based
on the functionalities, the technical nature of the devices, and will
enable interoperability.

VIA A CONNECTING SYSTEM

THROUGH BACK UP MATERIAL
“The digital technology revolution and This is a link-up system to ensure
subsequent exchanges of data and information that biomedical devices are connec-
means we have to reconsider how to proceed. [...] ted – an IT system which requires
Faced with the increasing number of exchanges, buying and using extra material. Be
it’s becoming necessary to make not just the IT warned, this extra material costs
more and it can be difficult to make
systems interoperable with each other, but also it compatible with the devices’ usual
with the devices.” functionalities. That said, it does
SNITEM - French Trade Association of Medical Devices allow you to connect different types
of devices together.

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 THE IMPACT OF
CONNECTING
MEDICAL DEVICES

2. Interoperability versus connectivity
The need to connect devices is evolving. To make automatic
data integration from devices possible, the first step is
connecting these devices to the network. This connectivity
is not enough in itself and is just the first step of really
integrating into healthcare records.
We are also able to see the evolution of the different
degrees of possible integration:
3. The role of the IHE and the Connectathon
Setting up exchanges between systems applica-
tions means that a communal language needs
to be adopted, used and shared by the different
participants. That’s where the strategic issue lies:
normalisation and standardisation. In the E-health
field, being able to exchange data is fundamental
as it makes sure that patient care is coordinated
correctly.

For this reason, several institutions and

associations are working to promote the
Level 6 interoperability of health IT systems by
Composability Conceptual Interoperability adapting international norms and stan-
dards to case use in the health sector. For
example, the IHE (15) produces integra-
Increasing Capability for Interoperation
Modeling/ Level 5
Abstraction Dynamic Interoperability tion profiles which assemble and oblige
international norms and standards to
Level 4 produce an implementable specification.
Interoperability
Pragmatic Interoperability This answers a clearly defined need to
share or exchange healthcare data.
Level 0

Level 3
Semantic Interoperability Every year, professionals’ integration
Simulation/
Implementation work is validated at an event called
Level 2 Connectathon (16), an interoperability
Syntactic Interoperability marathon. During the event, manufac-
turers interface their systems to check
Level 1 they have applied standards according
Integretability to specifications given in technical
Technical Interoperability
frameworks.
Level 0
Network/ No Interoperability Specifically regarding integration
Connectivity profiles which answer medical devices’
communication needs, we already
Source : (14) intend to speak about the DEC (Device
Connectivity means devices communicating – then making Enterprise Communication) or ACM
it possible to transport or receive data. However, this system (Alarm Communication Management)
is more focussed on collecting information than integrating it. profiles to name but a few.

Interoperability, it is not just possible to receive and trans- Here we see the evolution of institutions
mit the data but also to integrate it into different healthcare and software vendors which move
systems. forward together to make the interope-
rability of different existing and future
Interoperability makes devices collaborative and allows systems easier.
their users to see them as a real tool they can rely on.

(Sources p.22)

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 THE IMPACT OF
CONNECTING
MEDICAL DEVICES

4. Regulations: certifying healthcare facilities

E-health workers all agree that interoperability is paramount. In
Europe, like in the United States, a series of regulatory provisions is
already used to oversee collecting healthcare data: regulation, label-
ling and certification depending on the respective devices.

Benefiting from a validated and functional interoperable system

enables healthcare facilities to gain easier access to existing certi-
fication defined by the National Authority for Health (HAS) in France.

Their main purpose is:

 o manage the quality and risks in healthcare teams’ real life daily
T
situations

 truly quality ongoing approach thanks to the definition of priori-

A
ties corresponding to real issues in establishments

To respect rules about identity vigilance

CERTIFICATION is an external evaluation

procedure done independently from the
facility and its governing body. Healthcare
professionals appointed by the HAS carry
out certification visits using a manual. This
repository enables the healthcare facility’s
overall state of operations to be assessed.

Implemented by the HAS, the certification

procedure takes place every 4 years. Its aim
is to give an independent assessment of the
quality of the facility’s services (17).

(Sources p.22)

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 THE BENEFITS OF
CONNECTING BIOMEDICAL
EQUIPMENT
By connecting healthcare devices, teams
can give and take data more efficiently
which in turn makes healthcare professio-
nals’ work easier and improves patient care,
particularly when dealing with different
people simultaneously.
“For me, connecting medical
devices plays a leading part in
healthcare facilities. Quickly
consulting healthcare data
accuracy, enables teams to make
decisions fast and effectively.
Result: improved treatment.”
Tim Gee, Influencer, Director and Founder of
Medical Connectivity Consulting, USA
The interoperability of biomedical devices
fulfils biomedical engineers’ needs just as
much as the Director of IT’s and physicians’
objectives. The proof: the many benefits
which come from this solution.
“Connecting biomedical devices
is advantageous in many ways:
medical information is brought
together into one package. Patient
treatment is much faster and more
accurate. The healthcare team can
save 20 to 30 minutes a day and
making medical decisions is faster
and more complete.”
Nelly Mazet-Lacombe, Health Executive, Bagnoles-
sur-Cèze Hospital
14
1. The 4 highlights of biomedical interoperability
1
 uaranteed patient care
G
• Reduced risk of manual input errors
• Physicians’ medical treatment optimised
• Reliable patient identification
• Data in the patient records and speciality files is
complete
• Information immediately accessible
 ealthcare IT system urbanisation
H
2 • Interfacing with all types of biomedical devices
• Patient data integrated into the speciality files,
DPIs, business applications
• Ability to follow every event on one central
interface
 ost optimisation
C
3
• Optimisation of IT management costs
• Control of IT facilities, no extra equipment
• Team productivity improved
 aving time
S
4
• Optimising exchanges between different
interfaces
BENEFITS FOR THE WHOLE HOSPITAL
Nurses : more time to dedicate to patient care
I T teams: computerised patient records received
more easily
 iomedical engineers : biomedical device facilities
B
managed better
Doctors : better traceability makes medical
decisions easier
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 THE BENEFITS OF
CONNECTING BIOMEDICAL
EQUIPMENT

2. Advantages for the physicians

The healthcare teams aim to treat patients coherently
and intelligently, to take care of them, to listen to them
and to save lives. But there are many healthcare facilities
where the medical staff has to fulfil demands which
sometimes contradict each other, to know management
techniques, which always require them to do more
work better with fewer and fewer means. An increasing
workload, lack of time, restrictive timetables. Listening to
the sick person is replaced with trying to make practices
more efficient – all of this at the cost of their wellbeing,
health and self-esteem.
Setting up a Computerised Patient Record (CPR) connec-
ted to biomedical devices – interoperable with other
business applications – gives so many advantages and
avoids tasks from stacking up which are often conside-
red tedious. Processes such as having to put vital signs
into the nurses' chart, repeating pointless examinations,
and manually inputting vital signs, can be removed.
Even if the fact that the medical devices and CPRs are
interoperable, it doesn’t solve all of the nurses’ problems
but it does make their job a lot easier :

THE IMPACT OF TECHNOLOGY ON PHYSICIANS’ WORK

70% 1 nurse
in 2
of physicians are notice medical
convinced that errors due to
patient care could biomedical devices
be improved if data
was processed in healthcare
facilities not
99% automatically (20) 3 challenges
for physicians while
coordinating On average,

3h30
properly(22)
treating a patient(21) :
of nurses interact • Lack of resources
with medical • Accessing patient a day of doctors’
equipment while data and/or nurses’
caring for patients(19) time is dedicated
• Locating the patient
during his hospital to documenting
visit patient records (23)

(Sources p.22)

“Connecting biomedical devices must enable data to be collected so that

the physicians have the right information in the right place at the right
time for the right patient.”
Stéphane Kirche, Head of Biomedical Engineering in Nord-Saône Loire Bresse Morvan

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 THE BENEFITS OF
CONNECTING BIOMEDICAL
EQUIPMENT

3.Technology to benefit the patient

Increasing the use of CPRs and medical devices in hospital departments clearly
improves treatment, healthcare, and guarantees how patients are identified.

“Integrating external elements into the

establishment (personal connected devices)
and integrating all of the clinic’s data (‘smart
building’ concept) will be a major asset in
the long run for helping patients during their
care continuum and not just as part of their
hospital visit. Connecting biomedical devices
to CPRs limits the risk of errors and improves
how reliable the information is.”
Yannick Michel, Organisation and IT Systems Director, Nouvelles Cliniques Nantaises (Groupe Confluent)

“Technology, software and connected

biomedical devices must have one objective:
helping to diagnose, supporting the physicians
with their daily work and assisting exchanges
with the patient – let’s not forget that the patient
must remain at the centre of the treatment and
the doctors’ focus.”
Nelly Mazet-Lacombe, Health Executive, Bagnoles-sur-Cèze Hospital

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 TO BENEFIT THE PATIENTS, THE
ESTABLISHMENTS AND THE TEAMS
– CASE STUDIES

1. Bagnols-sur Cèze Hospital

The Bagnols-sur Cèze Hospital has many projects KEY FIGURES
and invests hugely in new technology. The hospital’s
approach focuses on constantly striving to optimise
Bagnols-sur-Cèze Hospital
patient care and treatment quality.
• 16 000 hospital visits
Connected ECG : A clear time saver
• 1000 births
The project’s main objective was to optimise nurses’
time by preventing them from having to manually
• 26 000 A&E patients
enter information. This objective was clearly
achieved: as of now, physicians can find the ECG in • 5700 operations
patient records in just a few clicks. Patient care and
the team’s reactivity, especially in the emergency • 117 000 external consultations
department, have been greatly improved, “over 1000
patients have already benefited from this new solu- • 850 workers
tion” IT manager of Bagnols-sur Cèze hospital tells us.
• 100 physicians

“From now on, computerised patient records are becoming the

central component in managing healthcare data efficiently.”
Philippe Barbot, IT manager of Bagnols-sur Cèze hospital

Strengthening Biomedical IT connections

This approach has also helped bring the biomedical and IT teams together. “For a year, I’ve been part of the
medical equipment commission which validates the workers’ requests and necessary investments”, Philippe
Barbot adds.The links between the biomedical and IT departments have given a strategical benefit. “They have
enabled us to take our purchasing strategy in a new direction in a coordinated way by favouring the bio-
medical equipment manufacturers which see interoperability as an important factor”, explains Emmanuel
Laporte, biomedical technician at the hospital.

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 TO BENEFIT THE PATIENTS, THE
ESTABLISHMENTS AND THE TEAMS
– CASE STUDIES

2. Saint Paul de Fort-de-France clinic (Martinique)

The Saint Paul Fort-de-France clinic (Martinique) is an MCO (Medicine, Surgery and Obstetrics) and SSR facility
(After Care and Rehabilitation). Today it is capable of integrating and making use of vital signs recorded from
mothers to-be and new-borns.

Computerised Patient Records throughout

Martinique
KEY FIGURES
First of all, the Saint Paul clinic has participated in Saint Paul Clinic
the regional Computerised Patient Records project,
coordinated by the Martinique Health Cooperation • 100 beds including 30 out-patient and 15
Group. The key step in patient care, namely from
treatment to the operating theatre, is completely
maternity beds
computerised today. “The point of this project
was to centralise the patient information on a • 15 000 patients (2015) including
regional level, particularly for critical medical 10 000 patients in medicine and surgery
activities”, Dr Nabil Mansour tells us. Following its
success, the establishment has gone on to install
new technology in the maternity ward.
• 75% of operations performed in the out-patient
ward
Integrating and using vital parameters
from biomedical devices

Every year, the establishment delivers more than

900 babies – its obstetrics ward has 3 delivery
rooms and 2 labour units. Integrating vital signs
from patients and new-borns was therefore
crucial in completing the perinatal file and thus
having all of the patients’ information. It is easier
to monitor the data and for nurses to use it,
therefore improving the patient’s journey.
Automatically updating patient records. The GCS SIS in
Martinique chose software capable of getting monitor
readings and integrating them into the perinatal IDO.
“It can manage data produced by any biomedical
device, especially the Philips electronic foetal monitors
installed in the maternity wards – which really
interests us”, Dr Mansour remarks. In practice, the
midwives simply have to authenticate themselves and
connect the monitoring device to the patient. The system
then supplies the records with the mother’s contraction,
pulse, blood pressure and saturation readings, as
well as the foetal heart beat readings; all of this done
automatically.

A system made to interface any sort of biomedical

device

All of the gathered information can be routinely integrated

into the patients’ partogram which synthesises the mother’s
progress during her delivery. “This system is a real step
forward for our maternity wards”, Dr Mansour concludes.

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 DISCOVER
ENOVACOM
1. Enovacom at the heart of healthcare data OUR VALUES

100% Healthcare software vendor, Enovacom was created in 2002 Understanding

to make exchanging and sharing patient data easier and more How to ensure optimal
secure. Today, more than 1500 healthcare facilities trust it to deal communication between all
with their daily challenges. healthcare system workers.

Enovacom is originally a software suite enabling data between all

of the workers in the healthcare system to be interoperable and
secure. Its 4 areas of expertise are:
Trust
How to guarantee everyones
Securing, accessing and exchanging healthcare data private life is respected by relying
on technology.
 xchanging, transforming and integrating healthcare data
E
between all systems and workers
Planning
Managing and integrating electronic invoices from providers How to make use of this vast
amount of data to enhance
Building and managing data repositories patient care.

2. ENOVACOM Patient Connect, biomedical interoperability platform

ENOVACOM Patient Connect is the first interoperability platform for biomedical devices in France. It
automatically gathers patients’ vital signs from computerised health records or speciality files.

Benefit from the

first interoperable
platform for
biomedical devices
focussed on the
patient.

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 DISCOVER
ENOVACOM

3. Biomedical interoperability, or how to easily We must guarantee patient information by

connect biomedical equipment
In just two clicks, the physician validates the patients
identity and associates it with the biomedical device;
the vital signs which come from biomedical devices
(blood pressure reader, monitor, etc.) are then automa-
tically collected to be integrated into the health records
(CPRs, resuscitation files, etc.). Risking input errors and
wasting physicians time is over.
relying on functional systems and processes. It
is inconceivable to transmit vital signs without
guaranteeing patient identity and the hospital
visit matching with this data. Every manual input
element must be present:
The physicians username
The equipment username

ENOVACOM Patient Connect guarantees reliable
identification and association between the patient
and the equipment, without needing extra material.
It’s a real system of surveillance and risk and error
management linked to identifying patients, getting rid
of any identity-vigilance problem.
The patients reliable and unique identification
The transmitted information and vital signs
Only when all these elements are present can the
reliability of the data be guaranteed and enable the
information to be automatically integrated into the
patient records.

By relying on the biomedical interoperability

platform ENOVACOM Patient Connect, there is no
chance for error, the information ends up in the
right place at the right time.

4 . Expected benefits of ENOVACOM Patient Connect :

1 Help with 2 Complete transfer 3 Remote care
decision making of information follow-up –
- recording and relative to the accessing the
checking data in patients’ care expertise in
real time continuum between and out of the
and in the healthcare establishment
facilities made easier

4 Care Continuum 5 Complete 6 Follow up and

improved through computerised patient traceability of the
real time access to and treatment devices’ usage
secured data records - easier to
exchange information

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 Conclusion
Today, the care continuum no longer stops at the hospital: it’s organised
around inclusive and continued patient care, as close to their home as
possible. The ageing population, the rise of chronic diseases and the
optimal management of healthcare spending are all partly responsible
for this change.

Ultra connected rooms, intelligent beds, medical robotics, computerised

records, and remote surveillance of home care. Technology is now
helping these extreme changes. A further 73 million connected
healthcare devices are planned for installation in 2017(24).
The digital revolution with the arrival of E-health also redefines
sharing and exchanging patient information. The connected health
centre is undergoing rapid growth. With this momentum, it is now
essential to provide medical staff with innovative and effective tools
which answer new uses and needs. With this revolution, one word
should be remembered: interoperability – this normative concept
which allows different systems to communicate with each other.
In hospitals, software now communicates thanks to the use of
interoperability platforms. Today, the devices to consider are
biomedical ones: by relying on this technology and its ability to
transmit data, doctors will have all the information they need readily
available. Exchanging and integrating vital signs will be made easier.
The advantages? Making decisions will be more reactive, monitoring
information more accurate and above all, the possibility to focus on
the care we give.
Going beyond the hospital walls is the next step: with the development
of telemedicine and the mass arrival of connected medical devices at
home, called IoMT (Internet of Medical Things), the patient becomes a
participant in his own health. New information will be produced: for
them to become accessible, interoperability must once again be the
corner stone of these secured exchanges.
Let’s make understanding and sharing healthcare data easier to
help enable a connected hospital ... today.

(Sources p.23)

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 Sources
P.4 
(1) - EMC - Etude Digital Universe “The Digital Universe of
Opportunities: Rich Data and the Increasing Value of the
Internet of Things” - 2014
(2) - IoMT : Internet of Medical Things :medical devices and
applications that link the HIS through the internet
(3) - Atlas 2015 des SIH (Systèmes d’information hospitaliers -
Hospital Information Systems Directory)
P.5
(4) - Atlas SIH 2016.
(5) - Interoperability is the ability of a product or a system,
which interfaces are known - to work with other products or
existing systems or systems to come without any restriction
of access or deployment.
(6) - TIcSanté 2016 Study
P.7
(7) - “Control of the risk of misidentification in hospitals” by
Jean-Luc Quenon - Coordinating Committee for Clinical
Evaluation and Quality in Aquitaine. Xavier Arnozan hospi-
tal, 33604 Pessac
(8) - www.ccecqa.asso.fr/sites/ccecqa.aquisante.priv/files/
fiches-projets/OutilsGDR-PJ-Securite-Soins-Erreur-
sIdentite.pdf
P.8
(9) - Hospital Management – National Observatory of Employ-
ment and Professions of the FPH. Prospective study of the
professions of the FPH.
P.9
(10) - Studies PIPAME 2011 et SNITEM 2015
(11) - www.lantronix.com/wp-content/uploads/pdf/Medi-
cal-Devices-Landscape_Lantonix_HIMMS_WP.pdf
(12) - HIMSS, (Healthcare Information and Management
Systems Society) is a US associationestablisehd in 1961
which objective is to help improving the healthcare sec-
tor in relying on new technologies and IT in general.
P.10
(13) - Gary & Mary West health Institute Harrys Poll January
2015 Study
22 WHITE
P.12
(14) - https://en.wikipedia.org/wiki/Conceptual_interopera-
bility
(15) - Integrating the Healthcare Enterprise International is
an organisation that gather diverses e-health players
around the precise definition of standard profiles for
the digitalisation, the share and exchange of healthcare
data.
(16) - http://connectathon.ihe-europe.net/node/19
P.13
(17) - HAS
(18) - www.has-sante.fr/portail/upload/docs/application/
pdf/2014-03/manuel_v2010_janvier2014.pdf
P.15
(19) - Gary & Mary West health Institute Harrys Poll January
2015 : www.westhealth.org/wp-content/uploads/2015/03/
Nurses-Survey-Issue-Brief.pdf - Study
(20) - http://www.slideshare.net/JustinBikram/the-pa-
tient-journey-patient-and-provider-perspectives-uk
(21) - http://www.slideshare.net/JustinBikram/the-pa-
tient-journey-patient-and-provider-perspectives-uk
(22) - www.westhealth.org/wp-content uploads/2015/03/
Nurses-Survey-Issue-Brief.pdf
(23) - http://engage.nuance.fr/Les-defis-de-la-documen-
tation-medicale?cid=701d0000002eFmyAAE&ls=we-
bsite&rs=nuance.fr/stante&offer=medical%20
information&ot=study
P.21
(24) - Study Grand View Research http://www.grandviewre
search.com/industry-analysis/internet-of-things-iot-health-
care-market
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