The Healthcare and Enterprise Wireless Experience

A Healthcare Private Wireless Network - CBRS Frequency

For over thirty plus years I have been involved in the wireless space from the embedded, design, and deployment side. In 1999 802.11b got approved and the Wi-Fi Alliance was then formed in 2000. With interoperability assured among vendors the Wi-Fi revolution was off to the races. One vertical market that really benefited was healthcare. Early on around 2001, computers on wheels started to emerge as well the BCMA application driving wireless enabled infusion pumps. Fast forward to 2023. You now have the healthcare wireless ecosystem under a wide variety of usage models and devices not like any other vertical market that uses Wi-Fi. This wireless ecosystem often encompasses many of computers on wheels, hundreds of wireless enabled infusion pumps, now instead of WMTS, Wi-Fi based telemetry and patient monitoring, wireless enabled voice over IP, wireless automation delivery robots, wireless medication delivery units, wireless EEG, and more. In discussions most recently we have learned that Wi-Fi as we know in now in some large healthcare systems is failing. While the RF and initial network design may have been correct there is a wide numbers of reasons while it may not holding up. It simply may be a capacity issue and the variety of applications added on year after year with different usage requirements. In other words, things are at a tipping point. Adding more access points will not solve the situation; as this will only compound it. It is my opinion that Wi-Fi as we know it in the healthcare enterprise has reached potentially it’s capacity in large systems. Some CIO(s) as now are considering to de-couple voice and data away from the Wi-Fi enabled medical network and implement their own private network. This is not the same as a DAS but a private independent network that they can manage. They are now considering to build a second network adjacent to WiFi technically called a Private Wireless Network based on the CBRS frequency spectrum. Essentially this new design is moving as much clinical and operational voice and data away from the Wi-Fi enabled medical network to their own private cellular network. This is different from a DAS in that the hospital completely operates the private cellular network without any traffic leaving their network. The use cases for this in a hospital are endless and only just now being explored. The benefits include but are not limited to: 1. Real mobility inside and between buildings 2. Secure Network Access 3. High fidelity voice 4. Easy implementation of IoT 5. Public Cellular Network capability 6. Scalability to 5G. It seems to be right time for healthcare to consider their own private network that they own and can manage. The market is evolving in 2023

Immunoprofile - A Novel and New Way of "At Home Testing"

Most recently I have used the at home test model from www.immunoprofile.com. It provided me a unique and complete personal profile of my overall status of Diphtheria, H. Influenza B, Hepatitus A&B, Measles, Mumps, Pertussi, Poli, Tetanus, Chicken Pox, and Rubella. It is easy to use, saves costs versus single lab tests, and now presents to me a complete model to control my own overall health. It is HAS and FSA eligible and tests are valid in all fifty states.

Nordic Semi Wireless Quarter Issue 4 2022

As always, a jam packed article of the advances in the wireless domain.

Download WQ_Issue_4_2022

Personal Heart Monitors

Personal Heart Monitors – Wall Street Journal

An interesting article came out on October 10, 2022.� The article was written by a physician that addressed the issue of anxiety related to personal heart monitoring devices.� Reference “My watch says I off, what do I do, October 03,� Journal other author. As indicated in this article, “none of these devices can detect the electrical indicators of a heart attack which has much greater morbidity and mortality than atrial fibrillation.”�“Lay people could easily misinterpret the advertising of these device manufactures”. The overall outcome of this article was “to have regular check ups and alerting your provider when new symptoms arise. “This approach is evidence based and cost effective, per the author.

It is important to focus on a holistic approach to managing your health.� This means that any personal health monitoring device needs to be multi-parameter.� It should correlate all this information in a way so that the individual has the information at hand.

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Challenges of the non-IOT connected AED (Automated External Defibrillator) - AVIVE Life AED - FDA Approval Granted - The Challenges Solved

In the current AED space it seems that there has been no innovation of real time device connectivity for the AED device check up or ongoing and audited provided required maintenance. The engineering design of the entire industry since its inception from our perspective is with the AED non-connected. It is a stand alone use model. We currently look at this use model in 2019 as a legacy "walk around" approach for AED maintenance. Every single AED simply needs to be touched to ensure everything is correct. This needs to change! The reality is that any AED has to be available and working in the presence of a sudden cardiac event..and it has to be accessible. While first responders may have an AED or there may be one on site, there is often not the time to find one when starting CPR. The golden window of time for response is under twelve minutes. So in reality, the problem to solve is accessibility. Todays's cost of IOT connectivity is at a price point that we can ensure the health and integrity of every AED in a mobile environment and in a fixed location. Why is this important? The ability of the AED to deliver the shock to patient is dependent upon many variables. - You have to know where it is and be able retrieve it in a timely matter. - The battery needs to be fully charged and ready. - The gel pads of the electrodes need to be fresh and not dried out. - All software and firmware need to be current in the device to the latest refresh. What are the risks if you cannot accomplish this? - The AED cannot be retrieved in the window of time that will save the patient. - The battery is not charged fully, thus a shock cannot be delivered. - Gel pads of the electrodes are dried out, thus useless to deliver a shock. - Application software or firmware, is not current, thus potentially compromising the patient. AEDs need to function at the five nines of reliability: 99.999. The next generation of AEDS should leverage all current IoT connectivity of 4G, LTE-M1, NB-IoT, and coming 5G. What would be the value of this IoT connectivity? - An application that could show by GPS and/or in-building location of each and every available AED. - Remote check of the battery health of the AED - Validation and verification of the quality of the electrode gel. - OTA (over the air), updates of software and firmware. While fire extinguishers are checked and tags are signed and dated, there is to date no consistent approach to the validation and verification of AEDs in the field. It is a manual process. In my travels both domestically and internationally, I have seen where AEDS are not there or are taken out of service with notes (out for service). Today's IoT connectivity technology will allow the next generation of AEDs to be tracked, allow the location of each one to be known, allow vital checks of the battery health of a delivery of a shock, ensure electrode gel quality is correct for the delivery of a shock, and allow for software and firmware updates as needed for each AED. This can also provide a quality audit trail of the device for both the manufacturer and the enterprise where this is deployed.

I wrote this a few years back in 2019 when I considered what a "connected" AED may want to look like?

This was based upon my understanding and experience of the technical integration, the actual use model, the business requirements, and deployment cost models.  If this type of connectivity is available to other vertical markets; then it should absolutely be available for literally life saving technology such as defibrillation!  

AVIVE LIFE has developed what I consider the first "Defibrillation Connected Ecosystem".  The AVIVE LIFE team took out a "clean sheet of paper", and did not reinvent the defibrillation process, but focused on cost, access, the user interface, and "connectivity"  It is the first AED to have all the connectivity pieces, Wi-Fi, BLE, Cellular, and GPS built in that I know of.  The team at AVIVE LIFE headed by Sameer Jafri, Rory Beyer, and Moseley Andrews has made this a reality. They are a executive team that are passionate, humble, and focused on one goal - "saving lives"?  I also think they are the youngest executive team to ever achieve a FDA approval.

AVIVE Solutions has received FDA approval October 31, 2022.  

https://avive.life

This is a game changer in the AED space.

Congratulations for a job well done!

 

 

 

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Novel Antibody Testing Company - Market Introduction

A couple of years ago I was introduced to a company and found the technology fascinating. The company created a cutting-edge medical diagnostic home testing product and service. The company www.immunoprofile.com has launched with access to buy an antibody test panel.

This is the first at home CLIA approved serology test panel to measure IgG antibody levels across multiple vaccine preventable diseases to determine protection levels. This private at home test requires only a finger prick of blood which provides a qualitative result with an easy to read and understand numerical output for the eleven listed infectious diseases.

• Diphtheria
• Hepatitis A
• Hepatitis B
• H.Influenzae B
• Measles
• Mumps
• Pertussis (Whooping Cough)
• Polio
• Rubella (German Measles)
• Tetanus (Lockjaw)
• Varicella Zoster (Chicken Pox)

There are multiple value propositions:

-It is CLIA approved. (The Clinical Laboratory Improvement Amendments of 1988 (CLIA) regulations include federal standards applicable to all U.S. facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease.)

- You can do this at home, without having to go to a lab to give multiple vials of blood.

- Instead of one test result, you can get eleven test results, which dramatically lowers the cost.

-HSA / FSA eligible

- Provides peace of mind knowing your antibody status

I took the test a month ago as part of a pre-launch. It was easy, straightforward, mailed everything (all mailers and supplies are included). A few weeks later I was notified that my lab results are ready and I logged into the secure web portal and downloaded my PDF test results. I showed this to my family practice physician and they asked me if it would be OK to include the test results in my electronic medical record.

An interesting observation was a few months ago, I was asked do you wanted the shingles shot by my family physician. At that time, I really had no way to know my protection level against Varicella Zoster (Chicken Pox). Perhaps if I had this test earlier, I may not have needed that shingles shot.

Bottom line, this is a game changer for traditional antibody testing as we know it.

Download ImmunoProfile Infectious Disease Antibody Test Panel Overview

Global Logic

Integra Systems, Inc. has worked with www.globallogic.com over the past year plus to help provide subject mobile wireless subject matter expertise matter for one of their clients. We worked with a cross-functional team spanning continents. The professionalism of their engineering team and project management is world-class.

Validation and Verification of Wireless Design

Validation and Verification of Wireless Design

During 2022 Integra Systems has worked with a global digital engineering firm that is renowned in superior engineering skills and Agile delivery. This opportunity has allowed us to provide a unique wireless design pathway to both the enterprise and a smart mobility platform. This design was also validated and verified using the services of. https://www.keysight.com/us/en/products/network-test/protocol-load-test/ixload.html.

DataLogic Wireless Charging Healthcare

Data Logic https://www.datalogic.com/eng/retail-transportation-logistics-healthcare/mobile-computers/memor-20-pd-869.html is a company that cut it's teeth at the forefront of automatic data capture and process automation markets. You will find their products everywhere.

Their mobile computing platforms such as the Memor 20 provides the full power of a rugged PDA Android powered solution in the palm of your hands.

Noticed is the aspect of inductive wireless charging that works with any compatible available inductive charging.

From the healthcare vertical and other enterprise verticals this has many benefits.

- It eliminates cleaning of the physical contacts between the mobile device and the charger which is a requirement in healthcare.
- Cleaning solutions over time can also cause damage to charging ports over time.
- Physical charging ports can simply wear out over time by repeated charging. This then requires the expensive replacement of the mobile device as the physical charging ports are built into the device.

Nordic Semi Wireless Quarter

Have been a advocate of Nordic BLE SOC(s) for several years. Now they have also ventured into Wi-Fi SOC(s)

Download NS_WQ_Issue_3_2022