HIMSS 06 Wrap Up

Arnaud-Houette-Brian-McAlpine

Yesterday I was asked for some quick impressions of this year’s HIMSS. Now that I’ve had a bit of time to digest the event, here’s what I came up with. First, this show was much more of a business development/business alliance oriented show. Many vendors were openly partnering and had products in each other’s booths, brought together by their efforts to bring to market broader solutions that meet market requirements. These alliances frequently revolved around connectivity.

  • First Vocera came to market (a few years ago) on the strength of a health care targeted wireless communicator, and has done well. This year Ascom was the first established phone company to take that step with an almost full blown point of care system integrating wireless phones with nurse call, medical devices and more. Ascom now represents a competitor to both Emergin and their wireless phone competitors.
  • Two new wireless patient monitors were introduced at HIMSS using 802.11b (the GE Dash and Spacelabs SL2400). The adoption of ISM/Wi-Fi over WMTS for wireless patient monitoring is significant, and reinforces the trend away from that proprietary narrow band.
  • GE showed near real time fetal monitor surveillance (AirStrip OB) on smart phones – with a 510(k), no less! (check this photo)
  • PDAs and tablets lost much of their cache this year – there were lots of laptops and integrated computers on COWs (computers on wheels), AirStrip OB on smart phones, and while not an exhibitor, there was buzz about the OQO handheld computer. (check this photo)
  • Welch Allyn was the first major vital signs monitor vendor to release a wireless vital signs monitor for data integration into EMRs (the new Spot) – a couple years behind Stinger Medical. Also of note, Welch Allyn licensed Wellogic’s server software for their wireless vital signs monitor. Clinical servers are neither rocket science nor a trivial effort, what with role based access support, CCOW, RADIUS/LDAP integration, HL7, remote access (i.e., a web server), data storage and high availability. So far, not a single medical device vendor has launched a decent server – until now.
  • Integration middleware vendor Emergin was in over a dozen booths – most of the smart pump vendors, patient monitoring, nurse call and wireless phone vendors, and a few HIT vendors.
  • This was also a year for refining product strategies for patient flow application vendors – in particular, StatCom and Awarix have moved beyond (and in different directions from) bed management to help out more broadly with hospital care delivery.
  • On the imaging front, this was (if not the first) the largest presence of cardiovascular information systems (CVIS) shown at HIMSS. Agfa/Heartlab, Witt Biomedical, McKesson/Medcon, ScImage were all there – and maybe a couple I missed.
  • All the smart pump vendors (Cardinal/Alaris, Hospira, Baxter, B Braun) showed progress in moving past the first generation of wireless features.
  • RFID was hot hot hot at HIMSS this year. In apparent agreement with my post that RFID is not a product, many RFID vendors introduced software applications – mostly basic patient flow apps. RFID also presents an interesting issue for device vendors – for the slackers who don’t embed a Wi-Fi radio into their device, should they embed some kind of tag technology?
  • Finally on a related topic, wireless network infrastructure also got some buzz. GE formally introduced their deal with MobileAccess, InnerWireless repositioned themselves at the show (rolling out their RFID solution and dropping the “leaky coax” part of their solution), and lots of wireless LAN vendors – Cisco, Aruba, Trapeze, Symbol and Meru.

Whew. Pictured above right are two of the Godfathers of Connectivity: Arnaud Houette of Capsule Technologie, and Brian McAlpine with Emergin.

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Kingston General Hospital Goes Wireless

Canadian Healthcare Technology reports that Kingston General Hospital, Kingston Ontario, has implemented a, “fully integrated wireless communications solution.” Sounds sexy and exciting, doesn’t it? It seems they’ve deployed WiFi house-wide:

KGH is the first teaching hospital in Canada to integrate wireless applications with a point-of-care computer that accommodates intravenous infusion, patient monitoring and clinical best practice guidelines in a single platform through an advanced infusion pump system. This means additional support is available to ensure patient safety. These new infusion pumps provide the care team with the most up-to-date drug information through the wireless network while also communicating with other devices to alert caregivers when a problem arises.

Interestingly, no vendor names were mentioned in the writing of this article unless they’re Canadian. So the above vendor(s) shall remain cloaked in mystery. I will however guess the pump vendor above is Cardinal with the Alaris Medley smart pump – they’re the only vendor to offer a patient monitoring module with their pumps.

So, in addition to wireless medical devices, KGH as also deployed (or actually extended an existing deployment) voice over IP (VoIP) wireless phones. They also have, “wireless access to their medical records system,” and a “safety alerting system.” The former I assume is paperless charting with computers on wheels (COWs), the latter I can only guess is an integration between their VoIP phones and infusion pumps using Emergin middle ware (besides the fact that Alaris uses Emergin for this capability, they mention that they have the option of integrating their nurse call system with their VoIP phones, another Emergin capability).

TravelNet Technologies comes in for a mention and quote (along with Bell Canada who designed and installed the network) about their ability to offer patients and visitors Internet access through the WLAN. This is no great shakes as there are numerous network appliances that provide this network service – unless TravelNet is helping the hospital charge for Internet access, which takes all sorts of backend infrastructure.

All in all a pretty cool deployment, if scandalously shy of, you know, facts and details and stuff.

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Day One at AACN/NTI

New Orleans

It is hot and sultry here in New Orleans. Heard some great blues last night. But I really have been working. Here’s what I came across today. Hospira released their MedNet system — I’d tell you more, but the press release didn’t stay out too late last night.

Emergin was once again the vendor who was everywhere, but had no booth. They were in the Spacelabs, Alaris and Philips booths providing the software for alarm management and communications. As an aside, Philips introduced two new monitors at this show; I’ll go by tomorrow and check them out.

Welch Allyn introduced a new monitor, the Propaq LT. Here’s part of their 510k submission. More on this later.

B Braun wasn’t at HIMSS so I haven’t done a write up of their smart pump yet. They’ve wirelessly enabled their 100, 200 and (at this show) their 300 pumps. They will complete the line with the 400 by the end of this year. Here’s a story from 2002 on both Alaris and B Braun smart pumps — you will get a feel for how long they’ve been at this (since 2001) and how well they’ve delivered on their promises.

It’s almost time for dinner. Welch Allyn, the sponsor of our Sunrise Session tomorrow, is talking my co-presenter Cheryl Batchelor and I out tonight. The good news it’s a good creole restaurant, the bad news is I can’t wear shorts.

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Alaris Wireless Pump

Alaris currently has 200 Medley customers (with Guardrails, their smart pump/formulary/anonymous CQI database). At four of them, nurses enter the patient ID through a bubble keypad on the pump so they can pull pump data into their EMR via HL7.

This summer, Alaris will release the ability to establish patient context in the pump via barcodes — no more bubble button pushing. The care giver scans the patient, themselves and IV meds with a barcode reader attached to the pump. At some point I would expect Alaris to leverage Cardinal/Pyxis meds delivery in some kind of value-added bundle.

This release announced at HIMSS includes a patient identifiable database and client apps for surveillance and therapy viewing. In addition to indicating alarm conditions, therapy viewing shows the caregiver the volume administered and the status of the pump. Therapy views also help the pharmacy to minimize waste because they can see when meds have been discontinued, perhaps before the change is reflected through Order Entry.

In addition to remote alarms at the nursing unit, Alaris will have the ability to push alarms out to nurse worn devices. Using Emergin middleware, they can “talk” to Vocera pendants, pagers, and phones. Primary alarm notification still comes from the Medley pump.

With their SPO2 module, Alaris also has limited physiological monitoring capabilities. This has significant potential for improving patient safety. Depending on the area in which the pumps are used and what equipment (and parameters) you may already have will determine the imprtance of this capability. This is of less value in an ICU, but of greater value in lower acuity areas that don’t already have monitors.

With this new version of their system, Alaris adds patient context to their pump and CQI database, adds surveillance, and alarms.

Their WLAN link is 802.11 b, using an Alaris developed component radio.

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