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The Medical Device "Plug-and-Play" (MD PnP) Interoperability Program is promoting innovation in patient safety and clinical care by leading the adoption of secure patient-centric integration of medical devices and IT systems in clinical environments.


Device Clock Synchronization


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MD PnP Program
65 Landsdowne St., Suite 200
Cambridge, MA 02139

Julian M. Goldman, MD
Program Director

Drayton Freeman
Program Assistant

"A man with a watch knows what time it is.
A man with two watches is never sure." - Segal's Law

Medical Device Clock Errors 

Unlike your cell phone or computer, most medical devices do not set their clocks using a network time reference. Like an old-fashioned VCR, the clocks are typically set manually twice a year for daylight savings time, or when the medical devices are serviced.

The absence of automatic clock-setting capabilities in most devices—and the lack of time synchronization among the wide array of different medical devices used in a typical hospital—can result in inaccurate time-stamps of clinical data recorded in the electronic medical record (EMR). These inaccuracies also complicate the synchronization of data from multiple devices when analyzing adverse events.

There is no widely adopted standard for medical device time management and no implementation guidelines are available. Therefore, we are studying this problem and potential solutions.

Research Studies

Two studies are in progress – one to study the extent of the problem by documenting medical device clock errors in hospitals, and the second study to assess the personnel workload/cost required to manually perform DST clock-changes. These studies are being funded by NIH/NIBIB and DoD/TATRC.

Survey on Medical Device Clock Synchronization Issues

We have developed a survey that was distributed to the healthcare technology management field. 

Contact us for more information on the project or to participate in the study.

HHS released Meaningful Use Stage 2 requirements on August 23, 2012

In this Final Rule, HHS reasserted the use of accurate time and date stamping of EHR data:

(g) “Synchronized clocks. The date and time recorded utilize a system clock that has been synchronized following (RFC 1305) Network TimeProtocol, (incorporated by reference in § 170.299) or (RFC 5905) Network Time Protocol Version 4, (incorporated by reference in § 170.299).”

For convenience, we compiled several of the 45 CFR 170 references to synchronized clocks in this document.