According to Brenda the implementation of ConnexALL was initiated to better align with their hospital’s patient and staff safety goals.  After installation they were able to consolidate much of the management and interaction of these three event driven systems into an automated and consolidated system using ConnexALL. Specific benefits included, improved reliability, managed group notification, reduction in manual interventions, automatic alarm escalation, increased mobility (no sitting at a workstation or watching a panel), quicker decision making, and a consolidated auditing capability.

WatchMate is used for wandering, patient elopement and infant abduction. The hospital’s security is based on the premise that it’s easier to contain (a potential security situation) than retrieve, and that it’s easier to catch someone in the act than is to try to find them after the fact. WatchMate provides notification to a user at a workstation. The hospital used  switchboard operators to monitor WatchMate, since they’re usually at their desks. They had to recognize the alarm, look up who to notify, and ensure that notification is made. Now, ConnexALL automatically receives alarms, notifies appropriate staff, ensures alarm delivery (including necessary automatic retry), and escalates alarm notification when necessary. (After some googling, it seems that GlobeStar integrated with WatchMate even though the product is no longer sold by the manufacturer, Xmark.)

(more…)

Shawn Sicard, CEO of PiiComm in Toronto, Canada lead the customer presentations with a discussion about putting togeter complete solutions.  PiiComm is a systems integrator targeting the health care vertical market, with a long term relationship with GlobeStar. As an event sponsor, PiiComm has an exhibit demonstrating many of the products they support. Sean highlighted the Motorola CA 50 wireless VoIP phone with built-in barcode scanner. Built orignally for Home Depot, the phone has found some interest in health care. The phone has push to talk (PTT), a 1D barcode scanner in a small size (4.37″x 1.81″ x 1″ and about 4 ounces). The CA 50 is rather like a large Vocera pendant, there is no phone keypad. The phones are configured based on user profiles and voice input and text based menus on the phone to place calls. He also talked about the new Motorola EWP 1000/2000 wireless VoIP smart phones. The Moto phones were prominent in the Vocera/Motorola announcement at HIMSS, and is only one of two wireless phones that meet all the basic hospital requirements — ruggedized, water resistant and impervious to hospital disinfectants. (The other phone is the also new Ascom DECT IP phone, the d62.)

Shawn described asset management, preventive maintenance, temperature monitoring, patient and staff safety and workflow and resource management as key applications supported by AeroScout. PiiCommis also an Ascom reseller. Shawn noted that going wireless, including wireless VoIP is hard; part of his company’s mission is to help with that transition. He positioned Ascom as a DECT wireless phone solution that doesn’t require Wi-Fi.

Patient Monitor Integration

After the break Stephen Rocha with St Vincent Heart Center of Indiana presented Patient Monitoring Integration.  Stephen described the corporate culture and noted that Siemens/Draeger are the predominate medical device vendors (Hospira too). They also have Dukane for nurse call, Hill-Rom beds and Siemens (the Chantry Networks acqusition?), Meru and InnerWireless provide wireless networking. ConnexALL is used as messaging middleware.

(more…)

The messaging middleware market is transitioning from middleware to an enterprise application. GlobeStar has been in the business just over 10 years. Unlike Emergin, who started in paging messaging,  GlobeStar got their start in the 1990s integrating Austco nurse call and Nortel’s Companion (the first wireless phone system in North America). Over the years, the company (and the market) have evolved from a single nurse call/phone integration to a platform supporting many different systems and devices both on the input and output sides — and incorporating workflow automation through rules, alert initiation, and escalation.

The conference kicked off with introductory presentations from David Tavares, CEO of GlobeStar; Dr Teresa Sustelo, President of Centro Hospitalar de Lisboa Central (a large multi hospital system); and Dr Miguel Correia, Regional  Secretary of  Health, Azores. During his opening remarks, Miguel Correia noted the broad applicability of improved messaging. He spoke to the extension of messaging systems to tracking and eventually orchestrating complext processes and tasks. This is a vital requirement in health care delivery.

GlobeStar’s technology has been applied outside health care too. They monitor automobile painting production lines and “man down” systems in mining. Miguel Correia mentioned that they’re using ConnexAll in CO2 monitoring at volcanos in the Azorres. Now they’re moving further into workflow automation.

Keynote Presentation

My keynote presentation theme was, “everything is connected” and contrasted this with provider’s tendency to only focus on the immediate problem — or what they think is the problem.

Putting the health care IT market aside, the point of care market is divided into 6 separate market segments: wireless phones, patient flow applications, medical device connectivity, messaging middleware, nurse call, and real time location systems (RTLS), not to be confused with indoor positioning system infrastructure vendors like Sonitor and CenTrak. For some time, buyer’s haven’t been able to buy a product from one of these segments without impacting one or more of the others. Connections to medical devices, and the nurse-to-patient assignment process are common points of contention.

(more…)

Software designed to support the application of clinical protocols has been in the works from various vendors. Patient monitoring examples include Philips Protocol Watch, soft-launched back in February 2007, and . These applications automate what are otherwise onerous manual calculations with data acquired from medical devices and integrated with data from other information systems. This is workflow automation of the most important kind, diagnosis and therapy delivery. These applications are typically regulated as Class II medical devices.

Last week I spoke with Philip Settimi, MD, vice president of global strategic marketing for Hospira. According to Settimi, “EndoTool replaces spreadsheets of physician preferences and worksheets full of manual calculations for managing patient glucose levels.” Such manual methods are obviously inefficient, but also susceptible to human error. This approach provides an effective tool to impose a controlled and centralized tool for managing tight glycemic control (TGC). Endo Tool comes with a specific protocol based on sophisticated algorithms to support glucose management. The key: taking all that complexity (the calcs) at the point of care and automating those 33 different non-linear equations.

(more…)

What started as a straight on asset management strategy has grown in scope.

“Any hospital administrator knows about the daily headaches caused by the logistical coordination of providing patient care. For each and every patient interaction, patient, clinician, staff, space, assets & supplies must come together at the same time. Agility’s visualization system is the one tool we’ve found that lets us visualize these interactions to predict and prevent bottlenecks before they occur,” said Jeffrey Burke, Vice President and Regional Chief Information Officer, Bon Secours Health System.

The RTLS (real time location system) market’s initial focus was asset management. The industry consensus at the time was that asset management was easy to understand and had an attractive ROI - most hospitals lease some of their equipment that ends up poorly utilized due to hoarding and misplacing equipment. An RTLS can significantly reduce the amount of equipment leased through increased visibility and thus, utilization. Sadly, the hospital market was not sufficiently compelled to adopt this application (regardless of the ROI) at the rate that entrepreneurs and venture capitalists expected.

The founders at Agility, being software guys from McKesson, started with software. After some initial experience in the market they decided to stick with software and resell whatever infrastructure best suited their customer’s application. And the applications the market pulled them to are the kinds of things Bon Secours is doing. (more…)

In what looks like a tussle between Cardinal’s traditional supply chain services business and the young upstart CTS (clinical technologies and services) the two groups have decided to go their own way. With the retirement of Cardinal chair and CEO, Kerry Clark, the two vice chairs, George Barrett for supply chain services and David Schlotterbeck for CTS, are going separate ways. Barrett will take Clark’s position and Schlotterbeck will head the $4 billion global company to be headquartered in San Diego.

The new business’ offerings will include product lines in the areas of infusion care, medical and supply dispensing, respiratory care, infection prevention, diagnostics and surgical procedures.

The press reports the spin off is intended to deliver more stockholder value than the current company.

Analysts said the spinoff would allow a slimmed-down Cardinal Health to focus on turning around its underperforming drug distribution business, while potentially attracting a higher stock valuation for the publicly traded stand-alone med-tech company.

“The clinical technology side is really the crown jewel,” said Jeff Jonas, portfolio manager at Gabelli Health and Wellness Trust Mutual Fund, which owns Cardinal shares. “So that would presumably get a much higher multiple in the market as a stand-alone company.”

Apparently, declining revenue growth in the supply chain business is holding down the full valuation of CTS. The spinoff’s stock price should reflect the full value of the higher margin medical device business.  (more…)

To Cisco’s credit they have since made many substantive changes to their traditional approach to vertical market marketing in response to the special requirements of health care. During the AAMI conference this week in San Jose, I had a chance to meet with Erik Petersen, the Global Healthcare Solutions & Technology Partnerships Manager, to talk about what Cisco’s been doing in health care.

Health care has strategic importance to Cisco. After their run in with the FDA - a rite of passage for health care vendors - Cisco’s commitment to the market was confirmed by no less than CEO John Chambers.

As a corporation that has experienced enviable growth, the company is grappling with the transition from a $40 billion company to one doing $60 billion. “Cisco wants to offer a strong proactive value proposition in health care,” said Petersen, “rather than just providing a piece of infrastructure that the customer has to deal with for an overall project.” To meet their growth objectives, the company is shifting from a horizontal market company to one focused on vertical markets and applications. To us in health care, this means responding to the unique requirements of our vertical market. (more…)

Obligatory chest thumping:

“This acquisition brings together two leaders in healthcare IT — Hospira has led the industry in barcoding medications and infusion technology; and St. Clair, through Sculptor, was the first hospital in the country to combine barcoding and RFID in a single mobile device for the real-time workflow needs of clinical staff,” said Richard Schaeffer, vice president and chief information officer, St. Clair Hospital.

Note the emphasis on workflow. Given the greater experience of Sculptor, this may end up being a better acquisition for Hospira than CareFusion was for Cardinal. (more…)

Today Chinese medical device manufacturer Mindray announced that they reached agreement with Datascope to acquire Datascope’s patient monitoring business (PMB). The acquisition will launch Mindray into the ranks of leading international medical device vendors and create the third-largest player in the global patient monitoring device industry.

Mindray is paying Datascope $202 million cash, plus Datascope retains approximately $38 million of receivables generated by the patient monitoring business for a total of $250 million (I’m not sure about that extra $10 million, but these are Mindray’s numbers). The Datascope PMB did $161.3 million in sales in 2007. Mindray expects around $30 million of run-rate synergies in manufacturing, SG&A and R&D within 3 years. Mindray has rights to the Datascope brand until 2015.

(more…)

Philips announced yesterday that they reached a merger agreement to acquire VisICU for $12 per share, $3 over the current share price. From HIStalk, “Visicu earned $9 million on sales of $36 million over the past year. In
the 20 months since its IPO, Visicu shares have dropped from nearly $25
to below $9. Its board has approved the acquisition and recommends that
its shareholders approve it.” VisICU also had $130 million in cash on their balance sheet at the time of the agreement. The value of Philips’ offer totals around $300 million.

The Philips’ press release describes their rationale for the purchase.

By integrating VISICU’s remote patient monitoring and clinical
decision support technology with Philips’ patient monitors, both
companies expect to accelerate growth by offering products that provide
more effective clinical decision support to hospital staff, while
allowing them to monitor far greater numbers of critically ill patients.

Sounds like an extension to the old “proprietary end-to-end solution” strategy. The VisICU service would seem a natural extension for their ICU monitoring business. Tighter integration could probably improve performance and usability. Whether that would translate into better patient outcomes is questionable.

Rumor has it that Philips has one more acquisition to announce before the end of the year.