Low Cost Remote Monitoring Gateways Get Closer
The New York Times has an interesting story about a new product category: portable Wi-Fi hot-spots.
Whenever you wanted Internet access, [...] you'd [use] a little box. Plug it into a power outlet
— or even your car's cigarette lighter — and boom, you and everyone
within 200 feet could get onto the Internet at high speed, without
wires.
Actually, such boxes exist. They come from companies
like Kyocera, Junxion [pictured at right] and Top Global, and they're every bit as awesome
as they sound. (Unfortunately, the category is so new that it has no
agreed-upon name. “Portable hot spot” is descriptive but unwieldy.
“Cellular gateway” is a bit cryptic. Kyocera's term, “mobile router,”
may be as good as any.)
To work, you buy a wireless data card from your cellular carrier that provides the actual Internet connection. At 2.5G and 3G speeds, these networks offer plenty of performance for home-located remote monitoring applications. Carriers currently charge $60 to $80 for wireless data cards, and the mobile routers themselves run from $200 to $600 each. Here's basically how they work:
must first be activated in a Windows laptop). Then you connect the
router to your computer using an Ethernet cable (included). You type
the box's numeric address into your Web browser, and presto: you're
viewing its configuration page. Here's where you indicate which brand
of PC card you have (Novatel, Sierra Wireless
or whatever), turn on password protection, and fiddle with pages and
pages of network and security settings, if you're into that sort of
thing.
The Junxion box even lets you put up your own splash screen that users could see when they connect to the access point (AP). Way cool.
More Pre-IPO Press for Verichip
Another story, this time in Forbes, works to paint a picture for prospective buyers, investors and “chipees” about the benefits of Verichip's sign of the beast implantable RFID tag.
microchip about the size of a grain of rice embedded in their arms.
The chip — similar to those now used to identify thousands of pets
nationwide — allows EMS and ER crews to gain quick access to
patients' medical e-files should they be unable to provide
them.
Out of a population of almost 300 million, their adoption rate is pretty low, especially if you figure a 200 bed hospital sees 6,000 to 7,000 discharges and around 20,000 emergency room visits per year. To their credit they hit the tinfoil hat crowd's objections head on:
While the technology sounds like a win-win for everyone, it does
have its critics — namely privacy advocates who worry the embedded
chip could lead to a “Big Brother” state where computers
track an individual's every move.
But [David] Ellis [corporate
director for Planning and Future Studies at the Detroit Medical
Center, and as co-founder of the Michigan Electronic Medical Record
Initiative] believes those fears are unfounded.
“First of all, the chips are voluntary, and we believe that
they should always remain that way,” he said. “This
technology is also very easily removed if anyone later changes
their mind about having one.”
He also noted that scanners can only read the chips from
distances less than a few feet. “You can't be tracked by
satellite,” Ellis said.
Finally, “all that can be read on the chip is that ID
number,” he added. “So it requires that someone not only
be able to read that ID number but also have access to the database
that matches the ID number with the actual patient name and
details.”
Sadly, I could be easily refuted each of David's points (network effect, choke points, national patient identifier) and I don't even have a tinfoil hat. But don't count Verichip out; their ability to win proponents like David, John Hamalka, and Tommy Thompson (who still hasn't fulfilled his promise to get chipped) is amazing – so is their ability to get hospitals to sign on and get readers.
Symbol Touts Nurse Call Wireless VoIP Phone Integration
At HIMSS, Symbol announced a pilot project with Glenbrook Hospital in Chicago. The pilot was done in a 30 bed unit, with a maximum of 5 nurses per shift. Technology deployed included Symbol VoIP NetVision phones, a Symbol 802.11b WLAN integrated with a GE/Dukane ProCare 6000 nurse call system, and Nortel Meridian PBX switch with voice gateway. McKesson appears to be the systems integrator. No mention on what middleware was used for the integration.
Symbol has always had great products – wireless networks, barcode readers, hand held computers, the foundation and peripherals that make up solutions. It seems that now they are positioned as a point of care systems solution provider. Here's some text from their web site:
Wow, you'd think they were describing a medical device… oh wait, they are.
POC Communications – What Is It?
The categories used on this site (see the left hand column) to organize posts by topic has been pretty stable for several months now. But after HIMSS, I've got to add one that deals with workflow automation at the point of care (POC).
The point of care is a very challenging work environment, with many different systems and devices competing for a caregiver's attention. Revolving around the caregiver and patient are the following:
- Nurse call systems provide communications between the patient and central station. Of course the objective is to provide communications directly between patient and the caregiver assigned to that patient. Problems with traditional nurse call systems include today's trend to private rooms can isolate patients, and lean nurse to patient ratios that let nurses spend less time at the central station.
- Overhead pages interrupt everyone on the unit with a request from one individual to another – inefficient and disruptive.
- Phones are usually limited to the central station. There are two problems with phones: the caregiver that's needed is rarely standing next to it when it rings, and the person the caregiver is calling (attending and consulting physicians, respiratory therapist and other roving techs, case manager, and social worker) is rarely standing by their phone – the result is lots of phone tag.
- Medical devices are increasingly found in general care units providing surveillance, delivering therapy, or both. Telemetry and patient monitoring systems have central stations so alarms are generated at the device and at the nursing station and/or central monitoring room – problems include missed alarms at the central station or the high operating costs of a “war room.” Infusion pumps and ventilators don't have central stations, so caregivers must rely on local alarms on the device. The safe use of all medical devices is challenged by locating devices in patient rooms where they can be sequestered behind closed doors and manipulated (reset, alarms canceled, etc.) by irritated patients or family. All medical devices suffer from alarm fatigue generated in caregivers who must respond to alarms (many of which are false positive) and filter different alarm schemes that vary by device and manufacturer.
- Vital signs capture is really a different animal. Rather than providing continuous surveillance or therapy delivery, vital signs monitors take spot readings from patients at intervals ordered by physicians. Using manual methods to get accurate vitals information into the chart in a timely manner are the challenges.
- POC information systems from the usual suspects (Cerner, McK, et. al.) generate work lists for caregivers and can help with shift change.
- Meds administration systems are also appearing on nursing units in greater numbers. Whether as part of an infusion pump solution or intended for caregiver administered meds, these systems are intended to improve patient safety.
Many of the above product categories have related systems and gadgets that serve as data entry, look up or communications devices. If a hospital were to adopt all of today's point of care systems, caregivers would need both a tool belt and a bandoleer to carry the phones and multiple PDAs. Neither caregivers nor hospitals are going to go for this duplication of POC systems in any big way – you would think this is obvious, but given what I saw at HIMSS, and products that are in development, many vendors don't think much past the use of their own products. Single vendor solutions are nonexistant at the point of care. All of this makes for a messy situation where market needs compete with established vendor strategies.
Starting now, posts dealing with point of care products and issues will be available in the POC Communications category in the left hand nav bar.
