I was listening today to the CE-IT Webinar on CE and HIT from the 2014 AAMI conference in Philadelphia. Much of the session reviewed what has happened over the last five years and it got me thinking about my experiences and what I’ve seen over the last ten years in medical device connectivity and remote monitoring. It’s been an interesting ride and yet I realize there are a few basic ideas that have resonated over the years. These basic ideas are:
- Specifying those requirements that are unique to my situation are where I have the most control in acquisition;
- There are other players in the market who may change the landscape of what is available to me; and,
- The government may require something which can constrain my options.
A while back I had the opportunity to chat with Todd Dunsirn, the CEO of True Process. True Process provides products and services to both hospitals and various manufacturers. The company is focused on the point of care market offering a medication administration solution and a medical device data system.
What was the genesis for starting True Process?
I started the company in 2004. I have an engineering background, and had several other companies doing IT consulting and then web development, and application development. Then I had a friend contact me to develop a bar-code point-of-care simulation so that sales reps that were selling infusion pumps could demonstrate the five rights process with the pump. So, of course he said, “Hey can you do this? It’s gotta be done in three months.” And keep in mind, I had never heard of bar-code point-of-care [chuckle] prior to this, so I’d really never thought about infusion pumps.Read More
The previous post in this series suggested a set of characteristics to define the messaging middleware market and described the typical product architecture for these systems. In this post, we’ll look at ways the market may be segmented and how the market is adopting these systems.
Market segmentation is the dividing of a broader market into subsets of potential buyers who have common market requirements who then become the target for your product, sales and marketing. Using my favorite market adoption model, Geoffrey Moore’s Crossing the Chasm, this is the bowling alley strategy. Software developers in the messaging middleware market are currently pursuing a variety of market segments or bowling alleys.Read More
What do secure communications, care team coordination, patient engagement various workflow automation solutions and alarm notification have in common? They’re all examples of messaging middleware solutions found in health care. Which begs the question, what the heck is messaging middleware? This label is a term of art that was first coined by Emergin in the early to mid 2000s. As the name of a product category, it’s descriptive of the underlying technical functions of the product, but has nothing to with how the products are actually used – which can vary considerably.
All of this said, the term messaging middleware is terrible because it’s too generic and the term middleware usually doesn’t mean anything to people outside of IT. A survey of the market shows that many companies are avoiding messaging middleware and using words that describe their product in terms of their target market segment – secure messaging and alarm notification as two examples. In this series of blog posts, the terms messaging middleware, secure messaging, and messaging applications are used pretty much interchangeably.
What Is Messaging Middleware?
Messaging middleware provides integration with and transport for data or communications between users, applications and medical devices. The data streams between these entities are mediated by software to orchestrate secure message flow, message payload and can even generate new messages based on the content of data streams. These systems also provide closed-loop communications where the transmission, reception, reading and response of a message is tracked, with messages resent or redirected (i.e., escalated) in response to a variety of possible delivery failures. All of this communications is recorded and logged in a database to provide management information and big data analytics opportunities. Messages sent to or from users typically entail some sort of mobile device, a wireless voice over IP handset or smartphone running a client app. Such systems also have web based clients that can be accessed on PCs for users to both send and receive messages. These systems can include a number of common features:Read More
The recent recall (links below) for McKesson’s Anesthesia Care system raises interesting questions about potential information system failure modes as well as what system/software functions cross the imaginary line between unregulated EHRs and regulated medical devices.
First the facts. The FDA announced McKesson’s voluntary recall of its Anesthesia Care system in several on-line (here, here and here) postings. This trio of postings is interesting because the first links only to the second, the second does not link to either of the other two. The third also does not link to the other two, and was not part of any of the announcements, but it is the most complete.
The statement of the reason for the recall is that, “There was an occurrence where the patient case data did not match the patient data when the case was recalled in the anesthesia care record (ACR) in that it included data from another case.” It was further noted that, “Use of this affected product may cause serious adverse health consequences, including death.” In the third link the FDA identifies the product as,Read More
The HIMSS conference is so big, with so many different kinds of attendees and exhibitors that it’s almost impossible to have one big theme for any given year. Yet the question of theme for any given HIMSS is something we all talk about. The themes one perceives are at least partially defined by our own interests and area of focus. Consequently, the #HIMSS14 themes for me were:
- The shifting product and value proposition focus of many of the vendors I track,
- The tension between spot solutions and enterprise solutions, and
- The big buzz word of the show, population health.
Two of the market segments that I track with big shifts in value proposition were medical device data systems (MDDS) and messaging middleware. We’ll talk about specific shifts in a moment, but I think it worthwhile to consider why this change in value propositions has occurred. One obvious factor among MDDS vendors is acquisitions. Capsule Tech (registration required), Accent on Integration and iSirona have all been acquired. Acquisitions are major events when everything about a company is reevaluated in an effort to wring greater value from the acquired company. The other factor I think is the growing adoption of MDDS for clinical documentation into EMRs may have caused sales growth to temper a bit, causing vendors to look beyond clinical documentation and explore for ways to add value and differentiate. Let’s look at some examples.Read More