Adding connectivity to Medtronic's NIM device simplified hospital workflows, reduced manual tasks, and gave them business intelligence like they've never had before.

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Medtronic’s NIM nerve monitoring system helps surgeons avoid accidents that can diminish or even destroy nerve function. They approached Macadamian to create a seamless data integration with back-end EHR systems.


Launched in 2004, NIM has been updated over the years to become a very feature-rich product. In addition to real-time monitoring during operations, the unit produces historic reports that are added to patient charts after surgery. While operating room staff can copy reports from the NIM to their electronic health records (EHR) system using a USB memory stick or by printing and then scanning reports, neither approach is very elegant. Since the NIM is regulated patient equipment, the printer connected to it also has to be certified and sold exclusively by Medtronic. Paul Cox, Senior Principle Engineer at Medtronic approached Macadamian to address these challenges as he was already familiar with our reputation for solving tough healthcare workflow challenges.


A major update like the one Medtronic envisioned for the NIM is a bit like surgery itself: it takes methodical planning and a holistic engagement that starts with consultations and careful listening, and ends after the under-the-hood engineering work is done and, much like a patient, the software is stable and functioning fully again. The planning started with an on-site alignment workshop where Medtronic and Macadamian explored a range of options for integrating the NIM into back-end EHR systems. These included cloud-based solutions, Interface Engines, FHIR, and HL7.


Ultimately, a combination of FHIR integrated into the NIM units for patient record look-up and HL7 to do the actual data updates was chosen. The revised device will allow reports to be uploaded to a hospital’s EHR system over Bluetooth or Wi-Fi with a couple of button presses. And it will be future proof too, since FHIR is quickly becoming one of the most popular standards for health data exchange in the industry. Connected product capabilities paired with secure cloud integration will allow Medtronic to gather usage and diagnostic information, and even troubleshoot problems remotely as they are being used — opening the door to a new world of service and revenue opportunities. With the next-generation NIM rolling out to
operating rooms, doctors and support staff will have one less thing to be nervous about during delicate surgery.

Project Details

On-Site Workshop

Macadamian joined the Medtronic team onsite to conduct an alignment workshop, exploring a range of integration options.

EHR Integration

A combination of FHIR integrated into the NIM units for patient record lookup and HL7 to do the data updates.

Seamless Data Transfer

Data transferred from the NIM device to the Hospital EHR via Bluetooth or WiFi with a few button presses.

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Learn more about the partnership between Medtronic and Macadamian by downloading the full case study below.


"Cloud integration gives us business intelligence we’ve never had before, and that opens the door to all sorts of possibilities, from better product planning to novel revenue models."

- Paul Cox, Senior Principle Engineer, Medtronic

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