Day Two at AACN/NTI
More interesting news dug up at the show today. Ventilator vendors don’t seem to get the whole connectivity thing yet. I think they’re spoiled by only having to serve up a serial interface to monitoring vendors in the ICU. Even a non invasive vent for use outside the ICU had no more than a serial port.
I went by the LifeSync booth today. They’ve gotten some adoption for their wireless ECG electrode system. They have a very interesting implementation that shows the basic requirements for wireless sensor based monitoring. You can see the electrode harness that provides reduced noise and false positive alarms, and the patient transceiver (on the right arm). This wireless rig connects over Bluetooth (1.1, class 2) with a monitor transceiver that is connected to the monitor. As I took his photo, one of the many female bystanders told him to smile. I cut his head off, to which he said, “I’m used to that.”
I saw some pretty cool examples of device and software integration today. At the Philips booth, I got two very interesting demos. First was an alarm management and notification demo (using Emergin again). There was a software client that managed caregiver-patient assignments (with 3 levels of escalation). Patient alarms were distributed to VoIP wireless phones from Cisco. And here’s the cool part, the handset displayed a 6 second ECG waveform (along with patient name, room number, and type of alarm). The caregiver can also accept or refuse an alarm, causing the system to escalate to the next caregiver. Later I saw a Philips/Baxter prototype integrating the Colleague infusion pump with a Philips MP 70 patient monitor. The integration supported establishing patient context and the 5 rights for meds administration, using the patient monitor as the workstation. All the resulting data is sent into the EMR. The Baxter pumps talk to their server, which talks to the Philips server. On the Philips side, the Portal feature is required, using a Citrix server. Philips plans to release some version of this as a future product. There are some very interesting comparisons and contrasts between the Emergin/Cisco/Philips alarm notification product (which is released) and the Philips/Baxter project.
With all the hoopla about WMTS, it is interesting to note that both GE and Philips use 802.11 FH (frequency hopping) for their wireless multi parameter patient monitors. I asked them both if they were going to switch to WMTS, and they both said no. You should know that 802.11 FH has been discontinued; Proxim discontinued their product last year, and Symbol’s last buy is this year. All the vendors using this technology have made “last time buys” from their vendors, and as one said, the question is how much of their last time buy inventory they’ll have to write off when they go to a new radio.
Could Handheld Products’ Dolphin 7900 beat out Symbol’s PDAs for clinical use? I heard one user that was getting 11 hours of continuous use out of their 7900 (that’s with WLAN and bar code use) vs. 2 hours from a Symbol device. Both devices are ruggedized and water resistant (conforming to IP54).
UPDATE: It seems that the alarm notification on the Cisco phone shown in the Philips booth is not released. They are going next to clinicals and shooting for a release before year end.
Patient Flow Unplugged: JCAHO Guidelines and the Flexible Unit
Cheryl Batchelor and I gave our NTI Sunrise Session presentation this morning to a crowd of 300 critical care nurses — an excellent turn-out for 7am in New Orleans. Most were managers, with a smattering of staff nurses, educators and students. Cheryl and I tag teamed; I addressed the JCAHO patient flow standard, ways to improve patient flow and introduced the variable acuity care model, while Cheryl described her specific experience at FirstHealth Moore Regional Hospital.
After the introductions I lead off with 3 questions to the group:
- How many of you are in ICUs that are at or near capacity most of the time. The vast majority raised their hands.
- How many have patients in your ICU that don't require 1:2 or 1:1 nurse/patient ratios, but can't be monitored elsewhere. I didn't even finish the question before hands started to go up, again a heavy majority.
- How many spend a substantial amount of time looking for rooms to discharge your patients, and fielding calls from the ED and other feeder units. Again, I got as far as “discharge” and the hands shot up — a bit fewer on this question than the first two.
If you (or your customers) answered yes to any of these questions, check out the presentation. You can download it here (right click and Save Target As… or Save Link Target As…). If you have any questions, or need some help with your patient flow issues, let me know.
