PanGo Merges with InnerWireless
The RFID market in health care has been going through some significant changes, many of which were evident at HIMSS 2007. The latest evidence of evolving business models is the merger announced today between InnerWireless and PanGo (press release).
While styled as a merger, PanGo will be absorbed by InnerWireless with only half of PanGo's 30 employees remaining in their Massachusetts engineering facility. PanGo co-founder Micheal Campbell will serve as InnerWireless' Senior VP for location services, and is the only PanGo exec mentioned as staying with the combined firm. PanGo's investors got just one seat on InnerWireless' 8 member board of directors. Ed Cantwell remains InnerWireless president, CEO and chaiman.
Wireless Patient Monitor Design Concept
I saw the following design concept on Gizmodo today. Intended for use by first responders, the product is made up of (starting upper left and going clockwise) the Paramedic's pad, capsule, electronic band-aid, and personal tag. This page describes each component in detail.
Remember, this is a design concept, not the blueprint for an actual product. The designer, Saravanan Nagasundaram, based his design on research done by Philips and Siemens on molecular diagnostics and miniaturization. Technology used include, “Capillary electro-phoresis (where liquids are decomposed into their component parts in electric
field),bio chips, molecular diagnostics, which will do the analysis
and the data transferred using wireless-lan, blue tooth and infra-red
signals.”
Petty cool.
Free EMR Suppored by Google Ads
I can't tell you how many visitors have come to my site based on a few posts I wrote about the VA putting Vista Office into the public domain – gobs of them.
Early this afternoon I noteced Google search terms like “Google EMR business model” in my server logs. It wasn't long before I came across this (from FierceHealthIT):
giant Google to distribute Google text ads within its EMR, a step which
may mark the first time that an EMR vendor has financed its offering
this way. The Google ads will be generated based on keywords drawn from
patient clinical data. Because it's agreed to let the ads into its
Web-based EMR, vendor Practice Fusion will be able to offer the EMR to
physicians for free. It had previously sold its software-as-a-service
product on a subscription basis. The new EMR should be fully rolled out
within four months.
Vendor Practice Fusion has shifted their business model from a paid subscription to an ad based model. There has apparently been some hand wringing about privacy – Google software looks at the web page to decide which ads to put up – you can be sure that's the first thing the vendor nailed down in contemplating this move. Since this is all in software over the Internet, physician users will have to trust both Google and Practice Fusion to privacy is really maintained. But I'll bet doctors can put up with a lot for a free EMR. On the other hand, should there be security breaches I doubt Practice Fusion will be given much slack from their customers. From a Government HealthIT story:
Ryan Howard, chief executive officer of Practice Fusion. The company
will also provide the EHR through a standard for-pay model, he said,
but focus groups have indicated a greater potential acceptance of the
free EHR.
“In this case the physician is the standard consumer
for the ads,” Howard said. “When they realize this will allow them to
offset the $50,000 per seat it could cost them with traditional EHRs,
physicians tell us this will be no big deal.”
Ah, the times they are a changin'. I can just see future academic papers being written on the impact of pharma ads delivered with the physician's EMR; I can also imagine pharma is anxious to put those ads up on pages with patients whose diagnosis matches their latest blockbuster drug.
Be sure to check out Practice Fusion's CEO blog here.
UPDATE: Reader Vince Kuraitis points us to an interesting article on Practice Fusion's “deal” with Google from journalist Neil Versel (who has plenty of objectivity in my book). It seems Practice Fusion is using Google's AdSense program to generate the ads on their web delivered EMR app.
“It was much better than anticipated,” says Ryan Howard, founder and chief executive of Practice Fusion, of the initial response to an offer made last week in conjunction with a first-of-its-kind arrangement with Google’s online advertising service.
A
Google spokesman says that this is not the long-anticipated major entry
into healthcare for the Mountain View, Calif.-based Internet search
giant. “This shouldn’t be interpreted as a product move on Google’s
part,” says Brandon McCormick. “This is not any more [of a business
relationship] than we would make for any other mid-size company. What
they do is give us keywords that we match advertising to.”
Perhaps Howard is guilty of a bit overspinning – not that I blame him. Practice Fusion's whole strategy is to create buzz and awareness about their product's attractive price.
Google's been up to something substantial in health care for more than a year – I've been getting hits from Google domains for 18 months, and not search bots but real users moving from page to page. In fact the Google spokesman distances themselves from Practice Fusion a second time in the story by saying, “Practice Fusion’s participation in our AdSense program is not exclusive
and should not be read as an indication of any product plans by Google.”
Can't wait for the other shoe to drop.
Network Management Improves for Medical Devices
In health care delivery, the network is a medical device. Okay, not always, but when devices like patient monitors or infusion pumps are connected to a network that carries data critical to patient surveillance or alarm notification, the network is part of the regulated medical device. Now the FDA has been kind enough to mostly look the other way regarding wired and wireless local area networks. The FDA would be well within their legal jurisdiction to tell network vendors to follow the Quality System Regulation (QSR) and get premarket approvals for their products in applications that are regulated medical devices. To date (with a few minor exceptions) the FDA has been content to let people who really know what they’re doing (i.e., medical device vendors) manage networks as off-the-shelf technology incorporated into their regulated devices. Device vendors follow the QSR so vendors like Microsoft and Cisco don’t have to.
As networked medical devices and the resulting distributed systems of devices, servers and clients become more complex, the need to actively monitor and manage those networks becomes increasingly important. In days past, vendors could create their own proprietary island of information, and by creating a tightly controlled and isolated system they could reduce performance variables (especially pesky external variables) to the point where a system that is certified upon installation will pretty much run reliably on its own – until some major component, like a network switch or something, fails – which becomes a simple break/fix task.
Hospital IT has been breaking down islands of information, forcing them into enterprise solutions, for as long as I’ve been in the industry – over 20 years. That day is dawning for medical devices. Virtually every patient monitoring and infusion pump vendor has a gateway server product that converts their proprietary protocols to HL7 so they can export patient identifiable clinical data to EMRs and such. But many of these vendors still rely on private networks, their own VLAN, or some other inconvenient and obtrusive method for isolating their system from the customer’s enterprise infrastructure. Now most of these vendors will tell you that that’s the way it has to be, and will mumble “FDA” or some other such higher power to justify their position. Draeger’s OneNet was the first patient monitoring system designed to run across the customer’s enterprise infrastructure – and even supports the customer’s choice of wireless network cards. This radical departure was not made without special tools to ensure safety and efficacy – in this case the Packeteer Quality of Service network appliance.
With all this in mind, a recent deal between NextNine and Apparent Networks caught my eye.
Networks have become the lifeline of all IP communication systems and business applications. With the integration of NextNine Service
Automation and the Apparent Networks AppCritical™ Technical Support Edition, support organizations can proactively maximize system availability by accurately identifying performance issues in their IP networks and resolving them quickly and effectively in an automated fashion. Designed specifically for remotely assessing and troubleshooting converged networks, AppCritical™ provides end-to-end visibility into any live network and identifies and outlines all conditions and faults that will impact network quality.
NextNine’s intuitive Virtual Support Engineer™ checks the equipment on-site, correlates this information with network data and rapidly resolves the identified problem, all without the need for field visits or customer assistance.
NextNine Service Automation Ecosystem Edition automates support processes that allow vendors and support providers across the service ecosystem to deliver efficient, superior, scalable services while lowering costs. NextNine’s innovative, proprietary Virtual Support Engineer™ can either be deployed at the customer’s support organization for 24X7 proactive support or downloade on demand to resolve issues when required. The company’s products have been deployed by global leaders such as GE Healthcare, Allscripts,
Openwave, Comverse, and airwide solutions.
Apparent Networks’ AppCritical™ Technical Support Edition provides network-dependent vendors the ability to instantly pinpoint problems on their customers’ networks and discover why their applications are not working properly. With its focused and intuitive remote network troubleshooting capabilities, AppCritical™ provides unobtrusive access to customers’ networks beyond their firewalls. Its ability to instantly identify whether the application problem rests within the network or not enables an accurate and targeted approach to problem resolution, therefore saving time and money and boosting customer confidence. Its ease of use encourages broad
levels of adoption within the support organization and the unequaled depth of knowledge present within AppCritical’s expert systems ensures non-network experts are able to confidently troubleshoot and resolve problems.
The press release mentions GE Healthcare, Allscripts, Comverse, Openwave and airwide solutions as users.
Network design and management is a lot like managing RF in a hospital – there is no magic “one way” that one follows when throwing up a network or deploying wireless devices – this is complicated stuff, and diligent proactive planning and management, plus better tools are needed. Putting life critical applications on enterprise networks is not always the best choice – redundancy has advantages – but having the option to run on enterprise networks is important to the market. Since they have released NetOne, Draeger has won a number of high profile sales against Philips in Europe. Draeger has little market share in the US and has not greatly impacted “private network” vendors here. But vendors like Spacelabs and Welch Allyn are making similar, if not quite so dramatic, moves as Draeger.
Pictured right is Welch Allyn’s new nurse-carried alarm notification product, introducted at HIMSS07 (pending FDA approval). I’ve much more to say about this later, but for now note that upon release (later this year) it will run on an Aruba WLAN – and a follow-on version will run on Cisco infrastructure.
This Site is Back Up
Last Friday morning, sometime after 3:30am, my hosting service moved this site to a different DNS (domain name servers that associate URLs with IP addresses). They fumbled the transfer, resulting in none of the other DNS on the Internet pointing to the correct IP address for this site. The correct information finally propagated across DNS some time Saturday.
I use 1and1 hosting, and until this have been pretty pleased with their service. They have been reliable even though not particularly accessible or responsive. Of course, as reliability falls, the importance of responsiveness increases – I'll let you know how things go…
