Patient Flow Vendor Tele-Tracking Announces Wireless Client
Last week, Tele-Tracking released (or should I say announced?) a wireless version of their Bed Board. Called bedboardmobile, it is intended to run on a wireless handheld device. I'll be curious to see the user interface. It's all about a very tight workflow when you have such minimal screen real estate. Patient placement coordinators and nurse managers are the target users.
Reasons Why Improving Hospital Patient Flow is Hard
Tim at HIS-Talk has a great post up today (what a hard workin’ guy) with thoughts about health care quality and technology adoption. Washington Monthly ran an article about how the quality of care at the VA is better than in U.S. hospitals in general. While admitting that he’s, “like most Americans, … scandalously uninformed, yet highly opinionated,” he has some excellent points that highlight challenges facing hospitals today.
Do “low quality” hospitals not believe the standards matter, or are they simply indefensibly negligent in not using universally accepted medical knowledge? Unfortunately, I think it’s the latter. Physicians practice pretty much like they were taught in medical school. I’ve seen convincing studies that older docs practice much further away from currently accepted norms than younger ones. Not because of age, but because of the time passed since their training.
Senior management insight, passion and will are critical to an effective organization. Without their support and involvement quality initiatives or initiatives of any kind will languish.
We cannot fix healthcare’s problems by mandating hospital quality. The assumption that hospitals will enforce the standards “down” to their doctors is absurd. Physicians work for themselves, in most cases. They make their money in the office, not in the hospital. They pay scant attention to the passive, untrained ex-nurses who often push paper in hospital “quality” departments, and they have little fear of having their privileges revoked. No one with any real influence hounds them about treating patients outside accepted guidelines. Rarely have I seen docs demand higher quality from hospitals, chastise poorly performing peers, or volunteer to lead the charge. They were trained work solo under whatever conditions prevail. Organizational quality doesn’t interest them much, unless it impacts them personally.
And I don’t want to make physicians the bad guys here either; this is as much a structural problem as anything. But doctors can impact patient flow significantly. Making rounds less than once a day and late orders (especially discharge orders) can greatly impact LOS and resulting bed capacity.
The VA has advantages over private hospitals. Their salaried practitioners don’t benefit personally from overutilization. I’m guessing they have fewer specialists treating observable but meaningless phenomena, prideful in making an obscure lab value go up or down even while the patient is deteriorating overall… They run hospitals, clinics, pharmacies, and nursing homes, all under common leadership and with easily mandated processes and information-sharing. They can enforce rules and mandate computer usage by physicians, even firing those who won’t comply. In terms of technology, they already have the benefits that NHII would give the rest of us…
What about VA’s use of technology? They have advantages there, too: 100% utilization by a captive audience, money to custom-build a system around their own processes, a universal medical record, and a single leadership structure to advance an agenda across all caregivers and sites. By controlling clinicians, they can control the quality indicators. They also had motivation to change, since they were being threatened with dissolution if they didn’t get their act together. Give them credit — the technology only helped them accomplish what they did, it wasn’t itself the solution. Plug it into a bad hospital and you’d still have a bad hospital.
The above are all reasons why running a hospital is tough. The good news is that there are many outstanding facilities that have overcome these structural challenges.
Read the whole thing.
Delphi Medical Targets OEM Wireless Patient Monitors
Talked with Paul Kowalksi (Business Development for Vital Signs) at Delphi Medical today to get clairification on their strategy and direction.
Delphi Medical is pursuing an OEM strategy (like their parent) to bring wirelessly connected medical devices (pumps, VSMs, vents) to the home and alternate care markets. The overall solution also includes a wireless PDA and central station for managing devices, alarms and patient data. They're also looking at Bluetooth enabled cell phones to connect to devices.
They've looked at the hospital market (where I think they could leapfrog established vendor's technology) but thought it too penetrated (GE, Philips and Welch Allyn were mentioned). Maybe they'll meet an OEM customer who needs a solution to support the Universal Bed concept in hospitals.
GE Has Great '04, Patient Monitoring Not Mentioned
GE issued a press release today announcing record 18% revenue and earnings growth in the fourth quarter of 2004. GE Healthcare contributed double digit growth. Jeff was ecstatic saying, “We've got great businesses positioned in the right markets with very strong teams driving powerful initiatives”. Here's what they said about the Healthcare division:
- Increased total orders 25% over fourth quarter 2003 to $4.4 billion, driven by 9% growth in services, 15% growth in ultrasound and $0.8 billion in Biosciences.
- Received strong orders for new products, including the Volume CT (computed tomography) scanner, the 3T MR (magnetic resonance) scanner, and the Vivid I(TM) portable ultrasound.
- Signed a $200 million-plus agreement in the U.K. with Fujitsu Services Ltd., to provide Picture Archiving and Communication System (PACS) technology that will enable the conversion of hospitals and clinics to a new digital system for storing, retrieving and displaying patients' medical images.
- Launched HDMR, the world's first high-definition magnetic resonance (MR) system, which provides unprecedented image clarity for patients such as Parkinson's sufferers.
- Received FDA approval for InSightec's ExAblate 2000, which combines GE's MR imaging with focused ultrasound to provide non-invasive treatment of uterine fibroids (GE is an equity shareholder in InSightec).
- Launched LOGIQBook XP, a 10-lb., full-featured, easy-to-use ultrasound system with advanced connectivity that enables clinicians to scan patients virtually anywhere — even in trauma and surgical settings.
Overall, GE Healthcare showed 2004 revenues of $2.286 billion, a 34% increase over 2003. I would imagine much of this is a result of the acquisition of Amersham. Diagnostic imaging is doing very well indeed. It's a good thing too, since word on the street is that they've lost significant market share (mostly to Philips) in patient monitoring. When and how GE Healthcare plans to consolidate their many acquisitions into a lean mean GE machine remains to be seen. I will investigate at HIMSS and let you know.
ED Diverts Not Helped by Recent Data
The latest CDC report on Ambulatory Health Care Data shows a 3 million increase in ED visits in 2002 over the previous year. There were a total of 110 million ED visits in 2002. Wheew! [via ACEP]
On a lighter note, the ACEP has two handy brochures to help explain to your ED patients about overcrowding and long waits. They blame downstream bottlenecks that cause them to have to board patients. There are even dark suggestions to the reader that they could be there overnight or even a couple of days!
