The 2005 Medical Weblog Awards Are Open for Nominations
Michael Ostrovsky, MD of MedGadget is hosting another round of Medical Weblog Awards, which he started last year.
It's been another year filled with explosive growth, stirring
debate, and excellent writing — in a number of fields. Our categories
reflect this diversity. The categories for this year's awards will be:
– Best Medical Weblog
– Best New Medical Weblog (established in 2005)
– Best Literary Medical Weblog
– Best Clinical Sciences Weblog
– Best Health Policies/Ethics Weblog
– Best Medical Technologies/Informatics Weblog
Nominations are now accepted in the comment section of this post. Nominate your favorite medical weblog, even if it's your own. A blog can participate in more than one category.
Be
sure to nominate your favorite medical blog by December 30 (hint: the
Medical Connectivity blog was started in January 2005 – okay there was one test entry on December 27, 2005, is a medical
weblog and deals with medical technologies and informatics). When all
the nominations are in, voting will open January 3rd and run through
midnight on January 15, 2006. Awards will be annouced on January 25th.
Support your favorite blogs today!
New Study on Hospital RFID Adoption
Consulting firm BearingPoint has released a market study where they surveyed over 300 health care folks.
- Improvement to patient safety was cited as the top benefit for RFID by
nearly 70 percent of respondents, with improved patient flow and general
productivity ranking second, each cited by 48 percent of respondents as
“very important.” - 80 percent of C-level respondents described RFID technologies as
important or very important to their business strategies. - 30 percent of large organizations (those with annual IT budgets over
$100 million) have already deployed some RFID technology, compared to
just 13 percent of smaller organizations. - Less than 20 percent of respondents plan to spend more than $250,000 on
RFID in 2006 and 53 percent plan no spending at all. But nearly 74
percent anticipate investment in RFID by 2007 and nearly 39 percent
anticipate spending $250,000 or more on the technology in 2007 and 2008. - Large organizations plan to spend considerably more — between $1
million to $5 million on RFID in 2007-2008. - Cost is a chief barrier to adoption, with 57 percent saying a major
hurdle is lack of available funding and 46 percent citing the cost of
RFID tags and readers as a major issue. - 60 percent of respondents said they have delayed some RFID activities
while they wait for industry or government guidance on standards.
technology is already finding many uses in healthcare organizations,
including medical equipment tracking using real-time location systems;
patient safety systems such as for identification and medication
administration; patient flow management; access control and security;
supply chain systems; and smart shelving.
These findings appear consistent with other survey's showing asset
tracking as the leading RFID application currently adopted by
hospitals. I think the other applications mentioned are just noise. Nor
do I see RFID supplanting bar codes for patient identification or meds
admin. Select patient tracking to improve patient flow and patient
safety should eventually rank as a leading RFID application in
hospitals, right up there with asset tracking.
You can sign up for a webinar on the survey's findings here.
[Hat tip: FierceHealthcare]
FDA Approved Wireless Alarms
I've noted a recent flurry of search engine queries on “fda approved wireless
alarms.” The same topic was raised by a reader in a recent
email. So, given the subject's topical interest I thought I'd ramble a
bit.
First the short answer: the only FDA approved wireless alarm available
today is from Baxter with their Colleague CX smart pump. They have a
PDA that is included in their 510k as a means for primary alarm
notification. This means the wireless alarm notification capability was
validated and verified in accordance with the FDA's QSR (Quality System
regulation).
Now for the long answer. Patient care must be delivered in a way that
is consistent with the “intended use” of all medical devices (IV pumps,
patient monitors, vents, etc.) that are used in delivering care. This
means that staffing levels along with nursing unit policies and
procedures must be based on medical device capabilities that are
regulated and approved by the FDA. The “intended use” is a part of both
a products “directions for use” (DFU) and a part of the devices 510k
submission. Capabilities listed in the 510k are primary - this is the belt (my analogy will become clear in a minute).
Numerous products abound that “supplement” a device's primary capabilities – these secondary capabilities
are suspenders (more of my analogy). Any hospital that staffs or
delivers care based on secondary capabilities is exposed to
considerable risk because they are not using FDA regulated devices
consistent with their intended use and DFU. In the fashion world of FDA
regulated medical devices, primary alarm notification is the belt and
secondary alarm notification are the suspenders. From a risk management
point of view, hospitals can just wear belts or wear belts and
suspenders, but they cannot wear suspenders without a belt.
Pressures on operating costs, initiatives to improve patient safety and
staff productivity – even the trend to private rooms – all create
incentives to automate the point-of-care where devices connected to
patients generate alarms and caregivers must respond. The first major
dust up in this area was a few years ago with Data Critical. They came
up with a pager system that would generate a page upon an alarm
condition, sending the caregiver the patient, their room, the type
of alarm and even a snippet of waveform (so they could rule out common
false-positive alarms). Initially patient monitoring vendors offering
the Data Critical solution were “positioning” it as good as primary
alarm notification. Sadly, paging systems are open loop – there is
nothing that ensures
that a message was received and acted upon, and a number of sentinel
events ensued. Now monitoring vendors are much more
aggressive in making primary vs. secondary distinctions. Unregulated
vendors (wireless communications, software, data acquisition, and the
like) are not so proactive in making this distinction – the FDA can't
come in and close them down.
A clinical engineer from a major medical center sent me the following just last week:
the things some of us here are concerned about is that remote alarms are
considered secondary by FDA, when for all functional purposes they are very much
primary in clinical practice. Some of us have said that point blank to some of
the FDA folks, and they continue to dismiss it. Sooner or later there will be a
resultant “bad outcome” that makes its way above radar and into the popular
press, and then after the requisite crying and gnashing of teeth something will
be done about it.
It looks like he may be right.
There's a lot more on primary vs. secondary alarm notification here and here.
Also, try the term “alarm notification” in the Google search box on the
right hand of the page for many more entries – be sure to click the
“This site” button.
CodeBlue: Wireless Sensor Networks for Medical Care
CodeBlue
is a research program at Harvard that is exploring the application of
wireless sensor network technology to a range of medical applications.
Current applications include pre-hospital, in-hospital emergency care,
disaster response, and stroke patient rehabilitation. Lead by Professor
Matt Welsh, the team includes Boston Medical Center, Johns Hopkins Applied Physics Laboratory, 10Blade, Inc., and others.
The program has developed wearable pulse oximeter and ECG sensors based on Crossbow and Moteiv wireless sensor platforms. They've also designed their own wireless sensor platform called Pluto (pictured).
All of these sensors connect to the CodeBlue software infrastructure
designed to provide routing, naming, discover and security for wireless
sensors and gateways. The CodeBlue platform also includes Mote Track,
an RF based location tracking module – so that sensors connected to
patients (and thus the patients themselves) can be tracked through
indoor environments.
Very cool stuff.
What's a Blog?
I still hear this question frequently – and I'm not alone.
Blog is short from web log, an online diary or newsletter made up of a
series of posts or stories. You're reading a blog post right now.
The Wall Street Journal did a story last week about business blogs,
titled, “What the In-Crowd Knows.”
XBox 360 videogame console a week ahead of its debut. TV executives
keep tabs on which networks are ordering and canceling shows. Doctors
and others in health care can link to the latest news and commentary on
drug marketing. Reporters and media watchers turn to Jim Romenesko, who
runs a blog on the Poynter Institute's Web site.
There are three basic varieties of blogs: those that post links to
other sources, those that compile news and articles, and those that
provide a forum for opinions and commentary. Some do one of these
things or mix all three.
The story goes on to mention a couple of health care blogs, along with
examples of blogs from other industries. You can check out some of my
favorite health care blogs in the Blogroll located in the nav bar
on the right side of the screen. On my list, and noted in the WSJ, is
Matthew Holt's The Health Care Blog. There is also a weekly round up of
health care blogging, check out Grand Rounds – this weeks host is code blog: tales of a nurse.
