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Author: Tim Gee

ED Diverts Not Helped by Recent Data

The latest CDC report on Ambulatory Health Care Data shows a 3 million increase in ED visits in 2002 over the previous year.  There were a total of 110 million ED visits in 2002.  Wheew! [via ACEP] On a lighter note, the ACEP has two handy brochures to help explain to your ED patients about overcrowding and long waits.  They blame downstream bottlenecks that cause them to have to board patients.  There are even dark suggestions to the reader that they could be there overnight or even a couple of...

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Hospital WLAN To Be Impacted by Acquisition

Cisco makes their play, buying Airespace.  It seems they picked some great technology.  The addition of Airespace will bring a different kind of WLAN solution to hospitals.  Airespace technology is client agnostic, and provides the same level of rich management tools regardless of the client radio.  This is critical for medical devices with embedded radios.  Oh, and Airespace provides much more value for the buck compared to Cisco's WLAN solution. Now let's hope that Cisco doesn't mess things up creating customer lock-in (via high switching costs) with a bunch of proprietary technology. Cisco Deal Jolts WLAN Users. Cisco Systems' acquisition of Airespace should bring Cisco up to speed in the wireless LAN management market. [eWEEK...

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What is Flexible Monitoring?

Many patient flow bottlenecks result from the rigid deployment of medical devices, especially patient monitors.  Its been reported in the literature that as much as 17% of ICU patients are there for monitoring, do not require the 1:1 or 1:2 nurse to patient ratio, and could be safely cared for in a lower acuity unit — if monitoring were available.  A key concept is the ability to place patients in the lowest cost care setting with the most appropriate level of care.  This frees up more specialized beds like the ICU for patients requiring the high level of care provided there.  One take on flexible monitoring is available here, presented by Jim Welch, CTO of Welch Allyn at the Fall 2004 Oregon HIMSS chapter meeting. (Be patient, its a pretty big file, and their server is slooow.) Most hospitals are organized with fixed units with predefined capabilities.  Along with rigid staffing levels and a specific suite of equipment, many times bolted to the wall, these units have very specific meds protocols, policies and...

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Cisco May Buy Airespace

Cisco has been a follower in the WLAN space for some time.  Something or other to do with not cannibalizing their LAN infrastructure business…  Regardless, their wait and see approach has given birth to a number of start-ups who have fielded some excellent equipment that is not proprietary, strong in security, RF and roaming, and significantly less expensive than Cisco.  True to form it seems, Cisco will be making an acquisition to catch up with the competition. I've been saying it for months and months: It's been crystal clear to me that Cisco did not have an internal WLAN switch strategy, and has its biggest problems in dealing with issues that switches can solve, which is policy-based VLAN assignment for WLAN users across network segments. News.com reports that a deal may be in the work for Cisco to buy Airespace, which is the leading marketshare vendor among the startup switch makers with seven percent of the market. I've thought Airespace was a 100-percent Cisco target, and am just surprised its taken this long to hear about a deal firming up. Cisco's intelligence is in the access point, which means that hand-offs are coordinated at the AP level, making VLAN roaming and other related issues pushed out to the edge or handled by Ethernet switches, which doesn't work very well for mobile users. Airespace handles the logical part of this in...

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Delphi Medical Targets Wireless Patient Monitors

Delphi Medical Introduces Clinical Communication In pursuit of a diversification strategy, Delphi, the auto parts company, created Delphi Medical Systems. Delphi Medical Systems’ coming out party was at Medical Design & Manufacturing East (MD&M) in New York City in June, 2004. They’re going after OEM business and indirect distribution sales into alternate care markets. Their target markets are vital signs monitors, IV pumps, respiratory, and dialysis. What caught my eye was their offering of wireless connectivity, asset tracking, and remote monitoring, control and alarms. This is rocket science stuff; only a few bleeding edge start-ups are doing these things. (Radianse, Sensitron, ) Here’s their track record to date: February 2004, while under the radar, signed $80 million contract mfg deal with Sunrise Medical December 2004, acquires medical device mfgr Peak Medical for $44 million (revenue of $72 million) December 2004, licenses vital signs technology from Zoe Medical (worldwide rights to manufacture, market, distribute and sell hospital and alternate site vital signs patient monitors) December 2004, snagged a $35 million mfg contract from Ophthonix for vision-testing equipment January 2005, inked co-development deal with Caretools for PDA-based charting and vital signs monitor/IV pump alarm management and control This most recent news shows Delphi Medical aiming for a mature replacement market (monitors and pumps) with innovative and (so far) unique features. The agreement provides exclusive worldwide rights for Delphi Medical Systems to...

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Tablet-Based Patient Management Solution Provider Secures Funding, Expands Senior Management Team (01/05/05) WiFiMed Inc., provider of a tablet-based solution to collect and manage patient medical information, today announced the closing of a $1 million Series A round of funding, the kick-off of a Series B round, and the appointment of Mark Bloomberg, MD, MBA, as chief medical officer, and Anthony DaSilva as executive vice president of sales and marketing. The funding is supporting the launch of Tablet MD(TM), an integrated, tablet-based solution to manage the physician/patient interaction. Designed to meet physician demands for mobility, affordability, and ease of use, Tablet MD helps manage medical information during the patient visit and improves practice procedures and communications. [BCBS HealthIssues.com] This is a great example of the continued entrepreneur/VC fascination with automating the physician.  Could they pick a tougher market segment?  The situation is marked by a disconnectedness.  Except for places like Kaiser, Mayo, Scott & White, etc., physicians work for themselves, not the hospital.  Consequently hospitals have very limited authority over their physicians with privileges.  Teaching hospital staff are a little more controllable, but not much.  And where are the benefits of automation?  If its a big win for the physician, will physicians pay the cost – not just for the app and hardware, but for the systems integration on the hospital side? And if its a big win for the hospital,...

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Campaign to Save 100,000 Lives

The IHI (Institute for Healthcare Improvement) has announced a campaign to save 100,000 lives, by enrolling hospitals to implement six proven practices to prevent avoidable deaths. #1:  Deploy rapid response teams (RRTs). Problem: Between 0.5 and 0.6 percent of patients suffer a cardiac arrest or shock while hospitalized, and only 17 percent of them survive to discharge. Most patients who arrest have signs beforehand; the potential for survival is higher in settings with monitoring; however, more critically ill patients are being treated outside of critical care units. Recommendation: Institute a rapid response team that anyone can call for any patient when they are concerned that the patient is deteriorating. Case study: Baptist Memorial Hospital in Memphis had a 28 percent decrease in codes for cardiac arrest after using RRTs and more codes occurred in ICUs. [FCG Healthcare Industry News Summary] The survival rate of inpatients who arrest is a pretty sobering statistic.  And while RRTs may be worth while, the resulting improvement in survivability is nothing to write home about.  It seems that the best approach is to identify those patients before they arrest.  The technology to cost effectively accomplish this is available, and has the side benefit of improving patient flow.  This delivers improved patient outcomes (beyond patients who arrest) and improved financial performance for the...

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Hospira Gains 510k Clearance for Two Wireless Pumps In their November 10, 2004 10-Q SEC filing, Hospira notes that they have received 510k clearance for two products, the wireless networked version of Hospira MedNet for Plum A+ and Hospira MedNet software for their patient-controlled analgesia pumps.  Both are expected to launch in the first quarter of 2005.  I'm expecting wireless products from all three big pump companies by the end of this year.  I'll be investigating this in detail in the coming...

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Future of RFID Tags Evaluated. According to an article in the Cincinnati Business Courier today, the RFID tags tested at Cardinal Health’s warehouses in New York and Boston failed to meet the ‘reads-per-second’ rate that the manufacturer promised. The accuracy of the reads was in the 96% to 98% range. The technology is being used to help combat counterfeit drugs by improving the tracking of drugs. Columbus, Ohio-based Cardinal Health is one of the nation’s largest prescription drug distributors. The company expects RFID systems to yield long-term benefits, but offered that technical problems in the early stages need to be fixed before the technology can be utilized in the drug industry. The FDA wants the technology deployed in the drug supply chain by 2007. [The Medical Informatics Weblog] I'm no fan of barcodes at the bedside.  There are many things that must be done right (orientation and indelible ink, to name two) to ensure that barcodes scan reliably.  Stories abound of nurses having to scan barcodes several times to get a reading, in seemingly optimal situations. And that doesn't include scenarios like cutting the ID band off the patient's wrist and taking it to the reader because the barcode reader's cord is too short. But the above idicates that more than cost may be holding RFID back from broad...

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Computer Entry a Leading Cause of Medication Errors in U.S. Health Systems — Percentage of Reported Errors Steadily Increased from 1999 to 2003. The United States Pharmacopeia (USP) reported today that despite the perception that technology is the panacea that will improve patient safety and reduce medication errors, nearly 20 percent of hospital and health system medication errors reported to USP’s MEDMARX SM program in 2003 involved computerization or automation. However, facilities that have implemented computerized prescriber order entry (CPOE) reported fewer harmful errors. According to the 2003 data, automated dispensing devices (ADDs) were implicated in almost 9,000 medication error events with 1.3 percent of those errors leading to patient harm. [The Informatics Review] Just another indication (reinforced repeatedly at <a href=”http://histalk.blog-city.com/”>HISTALK</a>) that automation is no silver bullet for improving...

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