Healthcare Wireless and Device Connectivity

PAN (Personal Area Network Space)

Well Zigbee has ruled the mesh space here, as well as ANT for very low powered links. It looks the adoption of Bluetooth Low Energy (BLE), that this will change the game. Apple has recently announced the adoption of BLE in all of it's I-Phones forthcoming. Devices using Bluetooth low energy wireless technology are expected to consume a fraction of the power of Classic Bluetooth enabled products for Bluetooth communications. Low duty cycles will greatly extend battery life..up to a year on a coin cell battery. Bit rates are 200kbits/sec, versus 1-3 Mbits with Bluetooth V2.1. Set up time is also drastically improved <3ms versus <6s with Bluetooth V2.1. I do believe that this will change the landscape of medical device connectivity. Now your I-Phone or Android device can be used as a simple gateway to the cloud.

Search Engine Ranking for DAS - Integra Systems Ranks 1rst

My long time friend Eric who does my SEO (Search Engine Optimization), pointed out to me that if you type into Google...."Distributed Antenna Systems for Healthcare" Integra Systems, comes up first and dominates. The grayed areas are ads. We even come ahead of Graybar...and they probably had to pay to get there.

Integra Systems M to M Development Program

In the past two years we have developed solutions for a medical device company that wanted remote connectivity. The prototype was built in record time. We are now embarking upon the actual application development to M to M solutions for a variety of vertical markets. M to M stands for machine to machine from the non-intelligent device to cellular to the cloud. We also will providing complete end to end Android and I-Phone application development for these solutions as well as back end management for kitting and deployment. Stay tuned for further developments.

The Bandwidth Pipe Requirement it is real and coming fast

Had an interesting conversation with one of the smartest guys that I know in the cellular and optical industry. Apparently one of the larger (will leave out names..let you guess)networking companies is going down the path of supposedly integrating components of DAS into their WLAN infrastructure. At to this, it is analog. They evidently see that providing Gigbit Ethernet with 802.11ac and cellular capabilities is perfectly fine. I am sorry but this is like building a two lane road in the middle of Los Angeles when you actually need ten. In my previous blog I mentioned LTE and LTE Advanced. The question comes up how will you handle a hundred, (conservative number), smart phones downloading live video at 1 Gbit/sec, with 1Gigibit Ethernet? You won't..oh you say..just add another strand of Giga Ethernet. You will need so much Ethernet it is not funny. This is where the revolution is coming in optical...fiber. You need the back haul to provide the pipe. Imagine over one strand of fiber (use patented optical laser and WDM (wavelength division multiplexing), that can deliver 16 independent channels of traffic, with each channel capable of carrying GbE, SONET, up to OC-48, EPON, GPON, or CPRI up to 3.07Gbps.

Advanced LTE Changes the Game...again - The Need for Speed

There is definitely a battle going on, i.e. LTE Advanced versus 802.1ac. Going from outside on LTE then I want LTE inside the building. But think of the use model. I have the Motorola 4G Droid Razer and it is my world. Still have to use a desktop and laptop..but with 4G..unreal.

Even though I have WiFi on my Droid, I do not associate an AP..even in my house..how many others do? Now this is changing again (once people get used to this type of bandwidth...everywhere they want more.

Traditional LTE has Peak Download of 100Mbits/s with Peak Upload of 50 Mbits/s. Still WAY better than 3G. LTE Advanced now will provide Peak Download of 1 Gbits/sec and Peak Upload of 500Mbit/s. LTE Advanced is an enhancement to LTE. LTE Advanced is similar to the upgrade path from WCDMA to HSPA. Additional spectrum and multiplexing will allow higher data speeds while coordinated multi-point transmission will allow for more system capacity to help handle the enhanced data speeds

Fallacy of WMTS and WMTS on a DAS

I got an interesting call this week from a major healthcare system (not to be identified). Question was...are their Quality of Service Requirements or latency issues for WMTS? Well, no. However I probed further and found out what the real issue was.

Apparently one of the installed (not to be named..but lets' say real large companies) WMTS in 608-614Mhz was actually having delays of up to 4-8 seconds from the transmitter to central station waveform display. (Very clinically unacceptable), every few hours. My read is it probably had to do with "drop-out". (The companies (manufacturing this)...apparently threw up their hands!)

So how do you trouble shoot this?...send people out and use a spectrum analyzer and then step by step look through all aspects of the coaxial antenna system. How do I know this...because been there and done that years ago. The point of this, (if the companies..which we know about), actually used WiFi; it would at least be a different story. You could remotely troubleshoot, but also ensure enterprise grade Quality of Service...and the IEEE standards.

Now moving on the issue of WMTS on DAS. Well looking at my crystal ball and what I know, the big companies that we know all have skunk work projects to figure out probably to exchange the 608-614Mhz and 1.4GHz radio with WLAN (probably 802.11n..as silicon gets smaller and more efficient. So this is where it gets interesting. One company is promoting how great it is to combine WMTS with a DAS, (at 1.4GHz). Another quote is obtained from a competitive WMTS company (at 1.4GHz). Discrete WMTS at 1.4GHz Combining it with a DAS cost $900,000.00 (more)..yes more. Oh yes how would you like an antenna element spaced every 15 feet down the hallway!

Integra Systems, Inc. and HIMSS 2012

The principal of Integra Systems, Inc. has been attending HIMSS since 1997. Previous to 1997, the AHA since attending from 1983 gathered the most attention. It is interesting to see the change in the HIMSS attendees and companies. Definitely there is the move from software (Cerner dropped out...we all know), to a lot of very forward looking companies in the wireless and mobility space front and center. In fact I would strongly agree that 2012 is another break out year for the wireless, mobility, and smart phone application space. The big iron networking or what we consider as this era..well, think of the desktop..what is their messaging and value proposition? Integra Systems, Inc. is working with many companies during this week...it should be a 24x7 week as always. Stay tuned for more concentrated blogs leading up.

New Era of Low Cost Patient Monitoring - Is this the Future?

Two years ago Intega Systems, Inc. worked with a major medical device company essentially engineering a like device a.ka. 2Net from Qualcomm; however we did not have all the back-end connectivity, i.e. the secure database. Last year Integra Systems, Inc. worked with a start up to help figure out how to design and embed the ANT radio in a diagnostic device with a proprietary protocol for a demonstration prototype. Also, at the same time we worked with a another company, a multi-billion $ company to drive forward a "band-aid" like patient monitoring device through a FDA 510k approval testing and approval process. Well it seems that maybe all the points of light have come together. This company out of the UK is providing a low cost patient monitoring device (no need for a display), using the ANT radio, while now Qualcomm has the 2Net platform using ANT and CDMA. OK, why not the need for display...it is post acute and not real time. Understand the post acute market, i.e. not telemetry is more of a every eight hours, thus you are looking at trending. Trending in terms of R to R interval changes, temperature and respiration. Thus an algorithim can be used to show varibility and thus alerting via the enterprise to the cloud to yes, the I-Phone or Android device the care giver has. Adding a display in my opinion...adds a lot of cost. Maybe a perfect after discharge opportunity for those patients to be monitored post ICD or CABG to decrease the potential for re-admittance? What do you think?

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Medical Design for Regulatory Compliance

Designing products for regulatory compliance can eliminate surprises! How do you move through this maze? Today I had a great conference call with my old friend of many years, Bill Salzstein. Once we got caught up, we shared ironically same stories about how medical device companies tend to look at the 510(k) process. I can attest to this of what I went through this year,it is how you look at the whole risk mitigation piece in light of the reviewer that can have the ultimate impact on the timeliness of the approval process. Here is the excerpt article that Bill sent to me that is a good read.
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Integra Systems, Inc. Reference Wireless Design Medical Devices - 2005 and now 2011

2005, it was the year that we got involved with www.drager.com and saw the vision of enabling at that time 802.11b patient monitors onto an enterprise network. It is ironic that this this has become pretty much the standard for patient monitoring and infusion device companies (OK, now 802.11g and 802.11a). We wrote all the test plans, brought in an outside integrator, and finally when the rest of the team moved on, we drove it through the regulatory approval process.

Moving forward to 2008 and then 2009, we got contacted by www.smiths.com (In between 2005-2008), the author worked for www.johnsoncontrols.com (set up testing there also), and finally www.commscope.com. Smiths Medical (a division of www.smiths.com) had the MEDFUSION 4000 Syringe Pump that needed to be tested and validated from a wireless perspective, to include both quality of service and security. Integra Systems, Inc. wrote the entire test plan and individual protocols, we used an outside integrator to assist with testing and also consulted internal with regulatory for Q/A. Smiths Medical received the FDA 510k approval on the MEDFUSION 4000 Syringe Pump in 2011.

In 2009, www.soterawireless.com contacted Integra Systems. In a similar fashion, we wrote the test plans and protocols (2010), and they are now awaiting their regulatory approval on the ViSi product. Around this same time we saw the real value of using www.veriwave.com, now www.ixiacom.com for validation and verification testing as as well as post deployment testing. As a result we wrote a business plan surrounding this testing and post deployment testing for a non-profit organization. Several of the large patient monitoring companies are now using www.ixiacom.com for internal testing as well. It is my feeling that WaveDeply will become the "best of process standard" for risk mitigation deployment in light of IEC 80001.

In 2011, Integra Systems, Inc. was contacted by www.carefusion.com as they had a very unique patient monitoring product that needed regulatory approval. At first there was some internal hesitation to conduct any type of testing, but after understanding the process, things moved forward in a rapid fashion. This was a unique case whereby we handled everything from the start to the finish which included internal and external regulatory discussions. The premise of the aforementioned is that we have the depth of experience, vision and strategy that has executed real results. However, the best validation statement is simply from a customer.