HIMSS 2005 National Nursing IT Innovation Award

The emergency nursing team at Christianna Care Health System received the above award for their implementation and utilization of PTCS' Amelior EDTracker emergency department information system.

In 2004, the emergency nursing team at Christiana Care, led by
Laskowski-Jones, managed the planning, implementation and execution of
the Amelior EDTracker automatic tracking system for their emergency
department. The system was implemented to improve patient flow by
automatically communicating the location and care status of patients in
real time. The implementation required training an emergency department
staff of over 200 people and integrating automatic tracking badges for
the 94,500 patient visits treated in their emergency department
annually.

Since implementing the system, the emergency
department has been able to track 100% of patients, decrease average
length of stay by 20-45 minutes and reduce patient walkouts by 24% due
to faster response times. During the first flu season using automatic
tracking, patient turnaround time decreased 5% despite an 8% increase
in patient volume.

 Sweet.

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The Health Wonk Review is UP

There's a new weekly compendium of blog posts dealing with health care. The Health Wonk Review focuses on health care policy and technology. Be sure to check out the inaugural review at Managed Care Matters.

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FDA Targets Postmarket Safety

FDA-logo

A broad international regulatory trend toward regulating medical devices after they are purchased and in use by the customer has been building for some time. Many other countries do not recognize the “veil of commerce” as a barrier to further regulation. So, in January the FDA announced their Medical Device Postmarket Transformation Initiative, the result of more than a year of planning and preparation. This new program will ensure effective monitoring of medical devices for continued safety after they are in use. The current approach has the following problems:

  • Adverse events are widely under-reported by users
  • Many reports contain inadequate information about the device used and possible causes
  • Identification of the specific device (after the fact) is problematic
    • Device use is typically no documented in patient records
    • Devices lack unique identifiers
    • Manufacturers continually produce modified versions of products
  • Devices are frequently used “off-label”

The new program has three key components: postmarket problem
identification, problem assessment, and public health response. Problem
identification will use the medical device reporting system and reports
from hospitals to gather information. Problem assessment will be done by teams of FDA staffers and
consultants who will analyze those data and determine the nature and
magnitude of each problem. Reponses will range from urgent alerts and media
outreach to enforcement actions.

The actual impact of this initiative on medical device vendors, vendors of products that “extend” medical devices (like secondary alarm systems), and users remains to be seen.

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Medical Device Commoditization Hits Health Care

Defibtech

This is a story about two guys who considered a then current automated external defibrillator (AED) and asked, “Why does this thing cost $4,000?” Founded seven years ago, Defibtech's been selling AEDs since 2003. With 30 employees and using state-of-the-art contract manufacturing and indirect distribution channels, revenues are approaching $30 million – with 3,000 units delivered in the last 6 months alone. They've been profitable for the past 3 years.

From the inception of the company, Defibtech's founders set themselves
up for a challenge: Create a rugged consumer product on the outside,
equipped with a medical device that is subject to the highest level of
FDA scrutiny on the inside. And they were driven to make it for less
than $1,500, about half the price that existing AEDs were selling for,
without sacrificing on quality.

Defibtech is a model for the successful medical device companies of the
future; ruthlessly wring out product cost and undersell established
competitors. Taking this commoditization a little further, do you really need $30,000 patient monitors in your ICU? Wouldn't monitors that cost a third (or less) meet the needs of the vast majority of your patients?

“When we first came out, we `Defibteched' people. We cut the cost of
the product in half without shortchanging them on any features,”
[president and co-founder Gintaras] Vaisnys said. “I would hate to have another company pop up and
`Defibtech' us. … I want to be the guy doing that to ourselves before
someone else does.”

Mature undifferentiated medical device markets (and that's most of them) combined with the availability of new
lower-cost technologies mean that some day soon you may be “Defibteched”, or you can “Defebtech” yourself before someone else does it for
you.

UPDATE: Fellow connectologist Brian writes:

I would have commented directly on your blog but I wanted to attach this article that speaks directly to the commoditization of undifferentiated products and markets.

I absolutely agree with you and this is exactly what I was thinking when I read this article about two years ago. I was at Siemens/Draeger at the time and it would be relatively easy to create a very low cost monitor using off-the-shelf hardware and software components. Even most of the algorithms you can license from the market leaders.

Here is an excerpt from the article. Know anyone who is entrepreneurial enough to challenge GE and Philips with a $3k ICU monitor? Talk about killing a cash-cow market for a big company …that might be kind of fun! Lots of opportunities and so little time ….

He's right of course. But does anything differentiate commodity products besides price? Certainly. Usability, serviceability and design can all be used to differentiate a product in any kiind of market, including a commoditized one. Here's the exceprt that Brain quotes:

Call it the age of the instant company. Commoditization — the process by which technology products become standardized and their prices are shoved relentlessly downward — has now driven the cost of the building blocks of tech so low that hardware expense has been all but eliminated from the equation of creating new products. Now entrepreneurs and innovators are discovering that they can use cheap standardized parts as basic ingredients, stir in their own flavor of distinctive software, and — voilà! — pop out a low-budget company that can swiftly attack a niche market or outmaneuver bigger, bloated rivals.

It does make the mind reel. Any readers with thoughts on this, feel free to give me a call.

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