FCC Seeks Comment (Again) on MBANs
Some semi recent news on Medical Body Area Networks (MBANs) from GE Research and the FCC. It starts with GE’s September 1, 2009 press release (pdf), where they announced:
…an intiative aimed to develop wireless medical monitoring systems, or body sensor networks (BSN), which would replace the traditional tangle of bedside caables used to capture a patient’s vital signs. GE’s vision for the systems would enable wireless monitoring from anywhere in the hospital — or even remotely at home.
For the past couple years, GE’s been pushing for the allocation of spectrum for MBANs. The press release notes that, “The FCC recently issued a notice of proposed rulemaking (NPRM), acting upon GE Healthcare’s petition to establish a new, vendor-neutral dedicated radio frequency band for low-power, short-range, wireless patient monitoring devices. This petition requested creation of a new Medical Body Area Network Service (MBANS), to support wireless sensors that monitor a patient’s health state, linked together in body sensor networks.”
Here’s David Davenport talking about their wireless sensor initiative:
Apparently, GE’s going after the cable replacement business for traditional multi parameter patient monitors. LifeSync has had a product replacing ECG cables (by far the most predominate type of cables in clinical use) for several years. LifeSync also controls the Besson patent (licensed to them exclusively by Motorola) that applies to wireless sensor based physiological monitoring.The FCC Notice of Proposed Rulemaking referenced is from June 29, 2009. Another “article” written by a law firm apparently engaged by GE was published March 20, 2009 and outlines:
Proposed Frequency Band: ”identified the 2360-2400 MHz band as the preferred frequency band based on engineering studies showing that MBANS devices can successfully coexist with incumbent operators and users.” I would love to see that coexistence data. In a conversation with David Davenport of GE Global Research that, he told me that spectrum just outside 2.4 GHz was desired because it would enable the use of off the shelf 2.4 GHz components, with only minimal modifications.
Medical Device System Network Install Issues
Last week there was an interesting discussion on the Biomed Listserv about network installation for patient monitoring systems. Emphasis highlighting key issues and best practices are mine. The discussion started with a question from Scott Skinner:
I’m curious if anyone has been successful using their own vendors to pull cables for monitoring installations. With the monitoring OEM we work with, they simply get a local subcontractor to do the cable pulls.
So this would involve breaking future monitoring packages up into two quotes: one for the actual technology itself (and associated installation and implementation), and then one for just the cable pull work. The latter would get bid out, and the OEM could compete against other vendors.
Of course, the OEM can just take the profit they would have made on the cable pull and add that to the cost of the equipment bid. One would need to find a way to watch that carefully.
Which lead to a critical observation from Craig Muehling:
We have started pulling our own cable for monitoring installations. I have one happening now and I’m not exactly pleased how it’s working out. I won’t mention and names, [vendor name removed] but they make their equipment charges per drop whether you have any drops or not.
I would still like our [networking] vendor to do the networking, ie: install and configure switches and physically plug patch cables into the switches. Seems easy, but the way they [the patient monitoring vendor] charge it’s really not much less than if they did the whole job. I think from now on, we will have to take on the entire networking job.
I have learned a lesson from this last installation and will scrutinize the quotes closer from now on, but with their charging structure
(supposedly) there’s not a lot of options. Either we do the entire job, or they make lots and lots of money for relatively little work.
Here’s how they do it at the Mayo Clinic, from Steve May:
We have our own low voltage and high voltage contractors for all in-house cable pulling, to include data pulls and all project related work, so cable pulling and wiring costs are never part of an installation package, but an infrastructure cost which we earmark as Capital expenditures and plan/budget annually. Bids & labor costs are renewed by Purchasing every 2 years and our preferred contractors are all able to bid on both project services & time & material services.
Market Trends Series: Wireless Connectivity
Fresh back from the MDC Conference in Boston last week – great inaugural event and a perfect venue at Harvard Medical School. Thanks to Tim and the conference organizers — I personally heard many very positive comments from a number of attendees.
As the healthcare market continues to evolve, so do solutions related to medical device connectivity. I would like to invite you to join me in a dialog over the next several weeks – perhaps even on an ongoing basis – that will explore the trends that are affecting the market of medical device connectivity. The idea is to have an open and interactive discussion on where the technology is today, where it needs to go, and what is driving the market. Remember that this is just my viewpoint as I see things based on my experiences. Perhaps your experiences and perspective are similar or maybe they are completely different.
So, let’s begin. The first trend I’d like to talk about is wireless medical devices and the impact on connectivity. We all know that more and more medical devices are becoming wireless and therefore more mobile, for example more and more smart IV pumps (smart pumps) are being implemented every day. One key aspect of wireless technology is the fact that wireless enables devices to become untethered, and therefore a mobile use case is enabled. Wireless medical devices such as smart IV pumps and patient monitors add to the list of connectivity challenges because, from a pure connectivity perspective, they have basically eliminated one problem (the use of a serial data cable) and often create others. Once a medical device is no longer connected to something that facilitates data integration (like a bedside terminal server for example), then part of the connectivity and integration problem often shifts onto the manufacturer of the medical device.
Variable Acuity Nursing Benefits Proven Again
I’ve not seen many stories on what is referred to as “universal beds,” “variable acuity units,” or as in this story, “universal patient floor.” The idea behind all these terms is a radically different approach to care delivery. Conventional care delivery is divided into specialized areas through which patients are moved, based on their type of illness, acuity, and whether they’re getting better or worse.
The vast majority of hospitals are organized like this, where their resources are divided based on (rarely met) assumptions about patient volumes. The alternative approach is to admit patients to their “on service” unit (orthopedics, oncology, med/surg, etc.) and rather than tranfering them to a higher acuity unit if their condition deteriorates, medical equipment (usually patient monitors) and staff are brought to the patient. Bringing the equipment and clinical expertise to the patients, rather than the reverse, has numerous benefits.
In addition to improving patient flow throughout the hospital and reducing patient safety errors, the universal floor has allowed staff members to spend more time with patients, making for a more comfortable patient stay.
Hat tip to StatCom’s Going with the Patient Flow e-newsletter, a great source for patient flow related stories.
Medical Device Connectivity Conference Wrap-up
The first ever Medical Device Connectivity Conference and Exposition was held September 10 and 11, 2009. The event was at the Joseph B. Martin Conference Center at Harvard Medical School in Boston (what a swanky place!).
The program focused on regulatory changes (the FDA’s proposed MDDS rule and the new IEC 80001) and industry standards (IHE PCD, HL7, 11073, ICE, 802.11x, etc.) and patient safety. The second day had separate tracks for:
- Trends in connectivity infrastructure, like networking, converging hospital IT and Biomed departments, and wireless sensors;
- A survey of predominate medical device connectivity applications — EMR documentation, infusion pumps, operating room integration; and
- A clinical track looking at why people make and buy connectivity, to improve patient safety and improve outcomes.
There were over 200 attendees at the conference, split about 60/40, manufacturers and health care providers. Among the providers, there was a preponderance of clinical engineers, then came IT folks, and finally clinicians. Manufacturers were mostly senior level product management and engineering people.
There were 9 sponsors for the event: Capsule, Cardiopulmonary Corp., Cerner, Cisco, Fluke Network, Hill-Rom, Medical Connectivity Consulting, Nuvon, and Philips.
I’m proud to note the following supporting organizations, with which many speakers and attendees are affiliated: AAMI, ACCE, ACCE Healthcare Technology Foundation, Mass Technology Leadership Council, the Medical Device Group, and RFID in Healthcare Foundation.
The nature of the conference business is that the first year’s always the hardest. The biggest challenge is that, because your conference did not exist last year, no one has budgeted money to sponsor or attend the first year. Under that handicap, we did quite well — which is a testament to both the organizer’s acumen (TCBI) and market interest in the topic.
Next year — yes, there will be another event next year — will be bigger and better. Thanks to everyone who participated for helping create a great event. Any comments, observations, critiques and suggestions are welcome — just leave a comment.
