Medical device connectivity for bedside readings, matched to the patient by bed

Bedside monitors already measure the values your nurses copy into the flowsheet. An edge agent on the unit takes each value from the device, and Kymolog charts it for the patient the EHR has in that bed.

Scope a one-unit device-to-EHR pilot How bed matching works

Bed matching · review queue · FHIR R4 or HL7 v2 · on premises or private cloud

Fig. 1. Three bays on a ward, with each device's trace drawn to its bed's row on the station flowsheet.

Bedside medical device integration on the unit's own network

A pulse oximeter at bed 12 reports oxygen saturation (SpO₂) of 91% at 08:02. The Kymolog™ edge agent sits on the ward's network, next to the devices. It collects the value straight from the device, whether the device writes to a serial port or posts its results over HTTPS. It codes the value as a Fast Healthcare Interoperability Resources (FHIR) R4 Observation, with a LOINC code and a UCUM unit.

The same agent reads blood pressure cuffs, thermometers, electrocardiogram (ECG) monitors and continuous glucose monitors (CGMs). Your clinical engineering team adds any other class, a patient monitor included, by configuration: a file listing what it measures and in which units.

Matched readings reach the chart in the seven EHRs we deliver to, over FHIR R4 or through your HL7 v2 interface engine. Where that engine needs a new route for the feed, we build it through Saga IT's integration services.

Matching a reading to the patient in that bed

The agent sends each reading with a device id and a time but no patient details. Kymolog looks up the bed that device is assigned to, then asks the EHR who occupied the bed at that minute. The EHR returns the encounter, and Kymolog takes the patient from it.

The EHR stays the source of truth for beds and patients, so a transfer charted there changes the next match. When the bed was empty at that minute, held two patients or the EHR did not answer, Kymolog holds the reading as preliminary until a nurse assigns it.

A device that travels with the patient, such as a transport monitor, is assigned to the patient directly. Kymolog files its readings through that assignment as the patient moves between beds.

Bed-based patient matching: bed, encounter, patientA pulse oximeter reports SpO₂ 96 % at 08:02 from device 2b8d; the reading names no patient. Device 2b8d is assigned to bed 4W-12. The EHR says encounter e-5531 was in bed 4W-12 at 08:02, and that encounter belongs to patient p-041, so the reading is linked to p-041. A timeline of bed 4W-12 from 06:00 to 10:00 shows patient p-038 in the bed until 07:05 and p-041 from 07:40; the reading at 08:02 falls in p-041’s stay. With no one in the bed at that time, or two, the reading is held in the review queue.READINGSpO₂ 96 %device 2b8d, 08:02;no patient on itBEDBed 4W-12where device2b8d is assignedENCOUNTERe-5531in bed 4W-12 at08:02, per the EHRPATIENTp-041linked tothe readingBED 4W-12, PER THE EHR06:0007:0008:0009:0010:00p-038, to 07:05p-041, from 07:40reading at 08:02No one in the bed at 08:02, or two: the reading waits in the review queue.
Bed-based patient matching: bed, encounter, patientA pulse oximeter reports SpO₂ 96 % at 08:02 from device 2b8d; the reading names no patient. Device 2b8d is assigned to bed 4W-12. The EHR says encounter e-5531 was in bed 4W-12 at 08:02, and that encounter belongs to patient p-041, so the reading is linked to p-041. A timeline of bed 4W-12 from 06:00 to 10:00 shows patient p-038 in the bed until 07:05 and p-041 from 07:40; the reading at 08:02 falls in p-041’s stay. With no one in the bed at that time, or two, the reading is held in the review queue.READINGSpO₂ 96 %device 2b8d, 08:02; no patient on itBEDBed 4W-12where device 2b8d is assignedENCOUNTERe-5531in bed 4W-12 at 08:02, per the EHRPATIENTp-041linked to the readingBED 4W-12, PER THE EHR06:0007:0008:0009:0010:00p-038p-041, from 07:40reading at 08:02No one in the bed at 08:02, or two:the reading waits in the review queue.
Figure 2 as a table
StepQuestionAnswer
ReadingWhat arrived?SpO₂ 96 % from device 2b8d at 08:02, with no patient
BedWhere is device 2b8d?Bed 4W-12
EncounterWho was in bed 4W-12 at 08:02?Encounter e-5531, from the EHR
PatientWhose encounter is it?p-041, linked to the reading
HeldNo one in the bed, or two?The reading waits in the review queue
Fig. 2. Matching by bed: the reading carries only its device and time. The device’s bed and the EHR’s record of who was in that bed at that minute give the encounter and the patient.

Nurses approve held readings from one queue

Readings from a device type set to review-required wait in the queue until a nurse acts on them. The nurse approves bed 12's SpO₂ of 91%, rejects a reading taken with the probe off the finger, or moves a misfiled reading to the right patient. Kymolog logs each action with the user and the time.

If your EHR supports SMART on FHIR, nurses can open the queue from inside the patient's chart. Launch from Epic works today, and each deployment decides whether to turn it on.

An unresolved view lists readings that matched no one, so they can be placed by hand. Readings the EHR refuses go to an error queue, where users with the retry permission send them again.

Each device type starts on review or on auto-send, and the setting can change once a unit trusts the feed. Who may approve, reject, approve in bulk or reassign is a permission per role.

Bring the device list for one unit and the name of your EHR. We take a reading from one of those devices into a test chart, matched to a test patient by bed.

Scope a one-unit device-to-EHR pilot

Device health for biomed and clinical engineering

A biomed technician registers each device once, assigns it to a bed and sets it to active, inactive or maintenance. Its health panel then shows battery, signal strength, connection type, uptime and the last check-in.

When a device stops reporting, the technician can reboot it, restart its services, pull its logs or push a new configuration from the same screen, without going to the bedside. Health readings are stored beside the clinical values, so a fault can be read against the readings around it.

Biomed is one of five roles Kymolog ships with, alongside Super Admin, Physician, Charge Nurse and Nurse. Each role has its own permissions, and your administrators can override them for one user.

Hosted on hospital servers or a private cloud

Kymolog installs on servers you own or in a private cloud account you control. The edge agents and the hub carry device ids and values but no patient details, so the device network holds no patient data. The patient is attached further in, at the FHIR store.

A device maker can also run Kymolog for you in its own cloud. Your patient data then travels to that cloud and is held there under your agreement with the maker. Either way, the install de-identifies readings before they leave for our cloud, whether for research storage or the data network.

Each agent proves its identity to the hub with a signed, single-use token before the hub accepts a reading. Kymolog's own connections are encrypted with TLS. For your security review, we answer questionnaires in SIG, HECVAT or your own format.

Read how the install is divided into trust zones.

Charting without transcription

A nurse reads 96% off the monitor, writes it down, opens the patient's flowsheet, finds the row for the time, types the value and signs the entry. The value is copied twice by hand on its way in. The chart keeps no record of which device took it.

With Kymolog, nobody transcribes the value. The agent takes it from the device and Kymolog matches it by bed. The nurse's part is one approval in the review queue, or nothing at all for auto-send device types. The flowsheet entry records the device that took the reading and the minute it was taken.

One reading charted by hand, and through a reviewed feedOne bedside reading, SpO₂ 96 %, reaches the chart two ways. By hand, a nurse reads the value off the monitor, writes it down, opens the patient’s flowsheet, finds the row for the time, types the value in and signs the entry: six steps, two of them copying the value by hand. With Kymolog, the edge agent takes the value as the device measures it, the reading is matched to the patient by bed, and a nurse approves it in the review queue; devices set to auto-send skip that step. The value reaches the chart with its device and time. By hand, every step repeats for every reading, every patient, every shift.SpO₂ 96 %at the monitorBY HAND, EVERY READING1Read the value off the monitor2Write it downcopied by hand3Open the patient’s flowsheet4Find the row for the time5Type the value incopied by hand6Sign the entryIn the chart, as typedWITH KYMOLOG1Edge agent takes the valueas the device measures itautomatic2Matched to the patientby bedautomatic3Nurse approves it inthe review queueone clickIn the chart, with device and timeDevices set to auto-send skip step 3.By hand, all six steps repeat for every reading, every patient, every shift.
One reading charted by hand, and through a reviewed feedOne bedside reading, SpO₂ 96 %, reaches the chart two ways. By hand, a nurse reads the value off the monitor, writes it down, opens the patient’s flowsheet, finds the row for the time, types the value in and signs the entry: six steps, two of them copying the value by hand. With Kymolog, the edge agent takes the value as the device measures it, the reading is matched to the patient by bed, and a nurse approves it in the review queue; devices set to auto-send skip that step. The value reaches the chart with its device and time. By hand, every step repeats for every reading, every patient, every shift.SpO₂ 96 %at the monitorBY HAND, EVERY READING1Read the value off the monitor2Write it downcopied by hand3Open the patient’s flowsheet4Find the row for the time5Type the value incopied by hand6Sign the entryIn the chart, as typedWITH KYMOLOG1Edge agent takes the valueas the device measures itautomatic2Matched to the patientby bedautomatic3Nurse approves it inthe review queueone clickIn the chart, with device and timeDevices set to auto-send skip step 3.By hand, all six steps repeat for everyreading, every patient, every shift.
Figure 3 as a table
StepBy handWith Kymolog
1Read the value off the monitorThe edge agent takes the value as the device measures it (automatic)
2Write it down (copied by hand)Matched to the patient by bed (automatic)
3Open the patient’s flowsheetA nurse approves it in the review queue; auto-send devices skip this
4Find the row for the time
5Type the value in (copied by hand)
6Sign the entry
ResultIn the chart, as typedIn the chart, with its device and time
Fig. 3. Charting by hand copies each value twice. With the device feed nobody retypes it, and the nurse reviews the reading instead of transcribing it.

Talk to us about a pilot unit

To compare medical device connectivity solutions on your own ward, start with a pilot. It puts one device class on one unit on review-required, so nurses approve each reading while you check the feed against their charting. It runs against your EHR test system first, then live. We reply within one business day with times to talk.

Scope a one-unit device-to-EHR pilot