The Healthcare and Enterprise Wireless Experience

Motorola MC40 and BYOD HIMSS 2013

Definitely on the radar big time at HIMMS was the whole aspect of BYOD. I used to to work for the former company that is now www.motorola.com. While the personal i-Phone may be desired to be used for point of care...it certainly can, but there are limitations. For instance the WLAN radio embedded in it is an afterthought and not really desired for the enterprise, let alone providing for FIPS. This includes also consumer grade Android devices. If you desire to add capabililities for bar-code scanning you have and an additional "sled". Any consumer grade device is not IP-56 rated, so if you drop it on a hard floor or or splash it with water...well. Finally, for infection control purposes folks have to think about using their own personal devices.
http://www.motorola.com/Business/US-EN/Business+Product+and+Services/Mobile+Computers/Handheld+Computers/MC40

Smart Infusion Pumps Buyers Remorse from KLAS Report

I have briefly read the excerpt that KLAS wrote, (March 16, 2010) but these are my initial comments. First of all, I do not think the healthcare community should actually pay for a report, but then again this is their business model. Does the analyst have a technical or clinical background or depth of experience, you just have to ask this; and what is their frame of reference? 

The overall accepting of what is "termed" a smart pump seems to be based on many variables. I think truly the use of world "smart pump" has been overused.  First what is the overall functionality and user interface, wireless capability, and a back end HL7 interface to an agnostic EMR, is it automated to help the clinician, or does this add extra workload? Just like patient monitoring in some respects infusion therapy is being a little comoditized. The LVP has not changed much in many decades from the basic functionality, but there are  some cute user interfaces; at the end of the day, an LVP is an LVP.  Wireless capabilities are pretty much universal, i.e. 802.11a/b/g.  In reality all wireless plays in this sense is to download drug libraries and upload log files. This is transaction based and not quote life critical in nature and some infusion pumps simply hold this data in cache even in out of range of a wireless network. Wireless  simply replaces the legacy serial interface to upload drug libraries and download log files.  The author has been there and done that.

The key here is to make the clinician experience easier and better. Not throw technology out into the mainstream. Clinicians went to school to take care of patients, not technology. There should be some ability to create automation around the point of care to help them.  This does not or should not have to force the clinician having to use a bar code scanner always at each point of care interface  (however this does have a place), but maybe automate real time the connection between the patient, the clinician, and the actual medical device. (Think RFID), or some software connection in the background making the automation connection.  Then the clinician simply has to confirm this convergence on like say a Capsule Neuron www.capsuletech.com and it actually or could backfill any EMR. This means EPIC, Cerner, Siemens Soarian, you name it.  The key here is automation around the point of care that will reduce work load for the clinician, improve supply chain automation, improve efficiency, and decrease risk. That will save a lot of money in patient care and improve the patient experience, let alone making the better day for the clinician. In closing clinicians which are huge value assets to our healthcare systems went to school to take care of patients, not technology.

 

Medical Device Management at the Point of Care

While the recent www.himss.org was an eye opening experience in terms of the mobility experience; there were were was a  huge cross the chasm technology experience across the point of care, wireless LAN, and broadband. For one, www.capsuletech.com had the Neuron platform front center and for the first time showing active RFID. (This is important as it automates workflow, thus decreasing the technology need to understand at the clinical level)  Their booth was crazy, evident to the value proposition of the Neuron and the association/diassocation platform.  I then visited www.nuvon.com to look their IDM-MG 1000 under glass. (would not let you touch it). What intrigued me was the similiar like to Neuron from Capsule, but a handheld. I have issues with handhelds as previosly worked for Symbol Technologies many years ago. Clinicians do not have time to hunt and peck on buttons. How many clinicians today do you see carrying around handhelds?  That is a 90's time, they simply did not use them because they would not carry a toolbelt of handhelds for all different applications.  Looked very interesting as I noticed the bar code scanner input also, assume had some sort of 802.11a/b/g/n.  Does this detract or add to the overall workflow input? What if somebody puts this into their pocket and walks out the door, does it contain any confidential patient information?  When I started to ask these tough questions, I was met, well with you have to sign a NDA. Find this initial discussion interesting; well let all judge regarding this. I just walked away.  

 

Integra Systems Inc as a Healthcare Visionary for Point of Care Connectivity

Integra Systems, Inc. www.integrasystems.org is a forward looking visionary boutique firm firmly implanted in the wireless and medical device space that is based upon two decades of field integration experience. 

 
That will not stop us at nothing to advance the quality of the modern wireless healthcare delivery model.  We have been instrumental at driving this forward looking with vision over five years ago with Anyware Network Solutions, of which now is a part of www.gtri.com. Our original out of the box model was demonstrated with www.draeger.com and OneNet. This is our passion and mission of which is always pushing the envelope to take current technology offerings and to wrap them around perhaps non-proprietary solutions to move decision makers to the next level with the goal to save costs and manage risk.  From this mission as described it is coupled and tested to ensure that all caregivers have the best user experience for the patients and their families. This is as described also saves huge costs and decreases overall risk at the point of care and with medical devices on a wireless or wired network. Separate proprietary medical device networks are legacy. Go to www.linkendin.com for  our full profile. We have completed consulting and design work on a global basis with the leading medical device companies. (patient monitoring, infusion therapy, ventilation/anesthesia) whereby Integra Systems, Inc has been front and center in 2008 and 2009.  www.integrasystems.org  Download Edit Post - Healthcare Wireless and Device Connectivity TypePad Patents pending on RFID and wireless integration point of care devices of which are pending clinical trials will define the new avenue in the point of care space.  Just some messaging to put things into perspective will follow. We certainly can help in this perspective.  www.capsuletech.com of which we (David H. Hoglund) share a combined IP through a licensing agreement.

" The Pain in life Happens. It may last a minute, or an hour, or a day, or a year, but eventually  it will subside and something else will take it's place. If I quit, it lasts forever." Lance Armstrong. http://www.lssmn.org/

The message is:  "Just keep on a going"

What do you think is at present and forward looking; do you think that the days of proprietary medical device networks are over..why or why not?

Why should a hospital install a separate WMTS telemetry system, a separate stand alone patient monitoring network?  Why not converge them onto a single enterprise designed and managed WLAN?

How is the risk lowered by using enterprise tools for design and management?

Who is going to be responsible for the management of a life critical network if enterprise management tools cannot be used?

A goal here as described is to provide and enable the healthcare enterprise to provide the quality of healthcare wireless experience in a proactive fashion for 2009 and beyond that everybody needs.

Medical Device Connectivity and What is the Right Strategy?

It seems that these days everybody is jumping into the medical connectivity space; however there are a lot of issue to look at. This will simply explore a bit what needs to be front and center - that is the core business model.

Overall Design -First determine if the connectivity solution is patient centric. Second, how does this actually help the care giver, or does this just add more layers of "things to do" for the nurse at the bedside.  The reason I bring this up is when I was at Symbol Technologies (now Motorola), caregivers had initially a lot of push back on the use of hand-held scanners, but mostly surrounding PDA(s). Application specific PDA(s), seemed to wane and hunting and pecking on a tiny screen added a lot of frustration. Caregivers, simply want technology solutions that work. Several companies in this space have taken different approaches and are pursuing various business models. Not all of these make sense - let me know if you agree here?

Cerner - Cerner a software company by definition has chosen to enter the medical device connectivity space with CareAware and MDBus to add to their portfolio of other solutions to include iCommand, among other previous acquisitions as Bridge Medical.  Why move away from their core business?  It is going to take a tremendous amount of work and effort to keep these connectivity solutions going and supported. Meanwhile, I do not feel that hospitals want a medical device connectivity solution that is tied to a specific vendors EMR application. Most hospitals have multiple EMR solutions, so it is not quite clear how open other competitive EMR solutions will be playing with Cerner and MDBus.  Any contextual patient connectivity needs to be a part of the patients continuum of care.

Hill-Rom - Navicare Bed as a Hub. Driving efficiency at the Point of Care with Navicare Device Connectivity. It is not quite clear how this fits in with Hill-Roms core business which is hospital beds and nurse call. You have to ask yourself if making your hospital bed a medical device integration hub is the right approach?  What if you hospital does not have all Hill-Rom beds?  And what if your hospital decides to switch from Hill-Rom to Stryker beds?  it would appear that you would also have to re-assess your hospital's medical device connectivity strategy at the same time - which makes no practical sense to me. Finally, is this solution able to be patient centric and follow the patient throughout the continium of care?

How much more R&D money does Cerner and Hill-Rom want to throw at "medical device connectivity", when this is not centric to their core business?

Capsule Technologies - The business model that makes the most sense to me is vendor-neutral. A company like Capsule does not make medical devices, hospital beds, a nurse call system, or an EMR application. Medical device connectivity is their core focus and they have been at this for over 12 years. In this space, I believe experience counts for a lot. Capsule does not care what bed, monitor, or ventilator is in the room and can connect all of those to any EMR on the market.  This advantge for the hospital is that they can switch out any of their medical devices and even change EMR's - without having to redesign their MDC strategy.

Also regarding a patient centric approach for connectivity, their new Neuron platform will automate the association and disassociation of medical devices to the patient - which is really the right model for data identification. It also does not create extra workload for the caregiver. Finally, by moving away from room centric or bed centric, it provides a platform that is enterprise enabled for the patient's total continuum of care.

Let me know what you think?  Are their advantages to any of these business models that I am missing?  What models have you seen  - good or bad?

 

 

 

 
 

Capsule Tech builds out their technology expertise with McAlpine

www.capsuletech.com the leader in medical device connectivity adds industry veteran Brian McAlpine. 

Download final_capsule_mcalpine_announcement.docx

Brian McAlpine has the long marketplace leadership experience and proven success in medical device connectivity and Capsule will greatly benefit from not only his engineering excellence, but his overall holistic vision of both the point of care space as well as the entire healthcare enterprise ecosystem. Very few people can transcend both the device side, clinical side, and enterprise side at the same time.  Capsule as they move forward with their unique leadership in the medical device driver side of the business has the right person to take them to the next level in the growth of their company.

Draeger Medical and Trapeze WLAN Approval

A few years ago, actually about five years ago a small group of folks at Draeger to include at that time myself, decided to buck convention and come up the concept that eventually led to OneNet. Imagine that a shared wireless and wired network on an open architecture, shared with healthcare data and voice applications!  This did as Tim Gee said in www.medicalconnectivity.com it often takes resources and additional outside third party companies to get this done. But at that time and even now medical device companies do what they do very well, design and manufacture medical devices. They will continue to need to look to third party organizations that are in the network/wireless space day and day out. While it is true you can grow your own organic competence, an outside view always helps. Originally  OneNet was deployed with Cisco, now it is signed off with Aruba Networks and now with Trapeze.  I commend Draeger to driving this forward in a big way and not backing off. By now collectively they have three WLAN infrastructure vendors approved and they can offer a lot of flexibility to their customers.  The challenge for all the medical device companies will be keep up the zillion re-iterations of the WLAN technology model going forward.  Perhaps that is why other companies with the exception of Welch Allyn www.welchallyn.com and Draeger are not going down this path quickly. Then again, it is those innovative organizations that tend to change the dynamics of any market segment.  Now all the patient monitoring and infusion device companies have some sort of WIFI enabled patient monitor or infusion pump, however how to do this on a shared network is questionable. I do think that it is important to follow on from the white paper that Dr. Baker and I wrote on trying to set the design requirements for a life critical wireless enabled network.  As Tim had mentioned, that there must be an easier way?  Agree yes.  In my opinion the industry (medical device industry), needs to collectively come together to establish as a group what is the criteria for medical device on a wireless network.  This would included standarized testing methdologies and the requirements that must be met for software notifications/firmware releases/validation and verifications, risk analysis etc., from the WLAN infrastructure companies. This would put some of the burden on the infrastructure providers and ease testing and provide a quicker roll-out of wireless mobility solutions.  To drive costs of healthcare down, improvements in work flow, productivity, and risk need to be addressed, that is a given.  Allowing innovative products such as the first WIFI enabled telemetry transmitter (Draeger) www.draeger.com to hit the market are definitely the step in the right direction. Now the question is how can you shorten the life cycle of product development and get innovations out there on a continual basis in the hands of clinicians to improve the delivery of care?