Philips-WiFi-phone

The mantle of “best nurse-carried point of care computing device” has yet to be claimed. The eventual winner will probably be either be an UMPC like the OQO or a wireless phone with a nice big display. Each platform has their own advantages, and the eventual winner in any event will be complemented by COWs (computers on wheels) for tasks requiring a real keyboard display and user interface.

On the heels of pre-release info on the OQO 02, a new Philips wireless VoIP phone has surfaced on the FCC's Office of Engineering and Technology's electronic filing web site. From Engadget's write up:

The VP 6500 and VP 6000 are similar in many ways, as they sport a
2.2-inch screen with 65,000 colors and a QCIF+ 176 x 220 display, and a
rotating 240-degree VGA cam. From what we can tell, the VP 6500 also
comes with a TV out mode, letting you connect your handset to a TV via
a component cable (although we don't know how good of a picture quality
you'll get when viewed on your sexy new flat-screen display). Further,
your calls should go through those common encryption protocols WEP, WAP
and WPA2 without a problem.

Wireless phones have the advantages of being small, long battery life, and everyone knows how to use them. What's been missing is a nice big display to show contextual data related to medical device alarms – ECG wave forms and the like. This phone has a nice big display. You can see more photos here and here (both PFD files).

The disadvantage of wireless phones is writing a client application to handle the alarm notification, task lists and other handheld applications. Wireless phones are CPU constrained, have little more than a couple function keys, and require a development effort for each phone vendor that is to be supported.

What seems to be missing from this phone is the ability to withstand repeated 3 foot drops onto linoleum covered concrete, water resistance, and the ability to stand up to harsh disinfectants – all basic acute care requirements. The photos show poor fit and finish, but then this is a pre-release product.

Oh, and the video camera is a problem too, what with HIPAA and all. I'm sure some vendor has fantasies of telemedicine and remote video consultations, but fantasies they will remain for the foreseeable future. Nurse carried alarm notification will be common practice long before caregivers are waving cameras at patients for physician consults. (Not to mention the fact that physicians won't want to use them unless they're reimbursed for the consult – I'm sure CMS will jump right on that!)

Speaking of physicians – someone asked me the other day about point of care devices for physicians. Blah! Physicians get way too much attention in the acute care market. The vast majority of physicians don't even work for hospitals and most have privileges at more than one hospital – most hospitals lack the influence (or will) to drive physician work flow changes. Exceptions are physician owned hospitals like Kaiser, Mayo, Group Health, Cleveland Clinic, the government with “yes sir!” military doctors and those that practice at the VA, and the small but growing number of hospitalists – actual employees of the hospital. The bottom line is few hospitals can drive near universal adoption of physician focused IT, witness the poor adoption of CPOE. The penetration and adoption of a common point of care device and related physician application in a hospital is likewise minuscule.

The real point of care market is the person who delivers your direct care, coordinates the care everyone provides, and (hopefully) catches the mistakes your physician makes before it's too late. That person would be your nurse. They work for the hospital, and as an employee have little choice but to use the stuff that's bought for them. These are the folks that make or break hospital bed turnover and patient flow, patient safety, outcomes and operating costs. It is their passion and commitment that will cause them to gladly adopt any new technology that will really help them do their jobs. And if you employ hospitalists at your hospital, give them a version of what the nurses have.

UPDATE: Okay, maybe I was a bit harsh on physicians and physician applications. Such applications have their place, but I still maintain there are bigger (and easier) fish to fry at the point of care.