Connectivity-goddessesAs John Pantano of Radianse noted, "technology has come to health care." The exhibit floor was notable for the many RFID vendors, and even a connectivity systems integration firm, HCTSI. As is typical for a show with medical device vendors, Emergin was to be found in many booths - Philips, GE, and Cardinal to name a few. I like the fact that exhibit hours do not overlap educational sessions, so I didn't feel the conflict I usually feel at HIMSS or RSNA between checking out the vendor news and attending the sessions.

Agility Healthcare Solutions, an RTLS vendor, was my fist visit. They claim the largest hospital market share, measured in top-to-bottom full deployments (i.e., not pilot sites). This claim may be true, but from what I heard from their competitors the hospital market is taking off and the "top-o-the-heap" designation will likely switch. The Agility system uses a dual frequency tag (433 MHz and 307 kHz) and claims a 5 year batter life. Agility has an interesting pricing model where they install the infrastructure and provide tags for a monthly fee. This is great if you don't want to pop for a capital expenditure up front. This does tend to hid the true cost of the solution, and makes price comparisons difficult. Since HIMSS (this past February) Agility has released a new touch screen client that takes the RTLS application from power users like IT and materials management into the realm of diagnostic departments and patient care area users.

Passing the FLUKE Biomedical booth I thought I recognized an Ekahau tag. FLUKE has indeed OEM'd the Ekahau RTLS, and this was a "pre-introduction" of the FLUKE branded solution. Word was the contract with Ekahau was signed at 9pm the night before the AAMI conference opened - nothing like cutting it close.

The word at the Radianse booth was that they've just closed their sixth big whole-house RTLS deal last week. Their patient flow application has evolved considerably since HIMSS - they've got their first patient flow sale and will install in early fall. They have a new positioning algorithm in beta that's giving them meter resolution. It seems RFID tags are shrinking and Radianse showed a new smaller version of the existing tag that's small enough to fit on top a Philips patient monitoring module - available this fall.

In other RTLS buzz, ECRI has an RTLS report coming out in the fall - and not every RFID vendor will be receiving a passing grade. The report looks at 4 or 5 vendors as a first evaluation of this new technology. There was some grumbling that it was taking so long, but it seems unrealistic to expect a speedy analysis of any technology as new and complex as RTLS.

Draeger showed their new (as in not yet approved by the FDA - not for sale) Infinity TeleSmart telemetry system. I was blown away. What they really have is a patient worn monitor in telemetry drag. The unit is the size of a typical telemetry unit, with a very nice ECG waveform display, and local alarms. The arrhythmia analysis is done in the telemetry unit, so if the patient goes out of range of the central station, alarms are still generated and annunciated. Power management is pretty cool too. The unit sports a 24 hour batter life using an enclosed rechargeable battery. There is a bedside trickle charger to keep batter levels up, and a slick central station charger for use between patients. When you place the unit in the central station charger, it automatically discharges the patient from the central station. The central charger provides a 70% charge in one hour. The unit also uses Draeger's mono-lead, greatly reducing clutter. The OneNet part of the product name denotes that it runs on an 802.11 b/g wireless LAN, like their other patient monitors. Given the problems hospitals have been having with WMTS channel capacity, this could be a real advantage. Overall, the device struck me as miles ahead of the competition; something I would have expected Welch Allyn to come out with.

Ultrasound-based RTLS vendor Sonitor was exhibiting. They entered the hospital market through a science experiment at Brigham & Womens Hospital developed by a group from Harvard and MIT. Like many non-Wi-Fi competitors, their tags run about $20 and have a 5 year batter shelf-life. Because their system works on ultrasound, power consumption is high. Like Wi-Fi based RTLS they use a motion sensor to activate the tag. According to CEO Terry Aasen, the tags will get a 2 to 3 year batter life when deployed on an infusion pump.

Prosec Protection Systems have sold infant protection systems for 10 years. They claim over 400 hospital installations. They OEM their system from Verichip.

I ran into fell connectologists at the HCTSI booth. This new company does systems integration and medical device connectivity for hospitals. Many of their staff came from Quovadx. As a Capsule Tech reseller, they've completed a recent project for Clarian in Carmel (that's CAR-mel, and not car-MEL) Indiana. We talked about the medical device connectivity business and they noted that it seems many hospitals are waiting for wireless connectivity. The hassles of dealing with serial cables with proprietary pin-outs and multiple dedicated connectors is problematic for some hospitals. A wireless term server would be nice but expensive - the real solution will be network connectivity that's integrated into the medical device. Another sticking point were home health devices that depend on the patient to send data - doesn't happen. To date, most hospital connectivity experience is limited to single vendor integrated systems, like wireless patient monitors - where hospitals are shielded from the true cost and complexity of connectivity. Now most hospitals are looking to integrate medical devices into EMRs or departmental systems for the ICU, ED or OR. This type of connectivity takes hospitals (and vendors) into a new realm where needs assessment and vendor selection processes are not known. HCTSI notes that many hospitals express sticker shock when considering the cost of a multi vendor connectivity project. Finally, ROI was mentioned as a barrier to adoption. Until you've implemented an EMR with medical device connectivity, you don't know the pain and additional costs to be incurred by expecting clinicians to manually enter data from patient connected devices.

Philips showed some new products and features. Philips had an evening reception (great food) to introduce their new low acuity monitoring product line to the biomed community. The products range from a vital signs monitor (OEM'd from Collin), to a C1 baby monitor, up to the VM4, VM6 and VM8. The VM series are Philips devices manufactured at a Philips plant in China. The monitors sport 2 to 4 waveforms and all the usual parameter. The units include 96 hour trending and a 4 hour Li battery. The VM 4 through 8 has an Ethernet connector (no wireless) and a USB port for software upgrades. The VM units output HL7 over TCP/IP. This was most surprising. I'm not aware of any other medical device that outputs HL7 directly. Standards like HL7 are not plug and play, requiring configuration for every different information system and site. Unfortunately I couldn't find any technical folks at the reception that could enlighten me as to how each individual monitor is configured, or if they expect HIT systems to simply conform to their implementation of HL7. Moving the industry to a standard HL7 configuration would be a good thing, and if anyone has the clout to make it happen, it's Philips. Philips was also showing an interesting new positioning feature for their DECT-based WMTS wireless network. Since their system knows which access point (AP) a patient monitor is associated with, they have taken that data and used it to return a zone or area inwhich the device is located. They can also deploy APs at choke points to capture when devices leave an area. For missing devices, the system saves the last six known locations providing some digital cookie crumbs that can be used to backtrack and hopefully find a misplaced device. Philips is coy about locating patients (they don't claim that) but if the monitor has an ECG, it must be connected to the patient, right? They're also working on a "key finder" feature that would facilitate finding devices that exit through the laundry chute or trash.

DISCLAIMER: All of the above was gathered wandering around drinking wine during the opening reception. Any inconsistencies, errors, or omissions are completely my responsibility - but as a reader of this blog (whether from a hospital, vendor or elsewhere) me and all of your fellow readers are counting on you to provide corrections, additional information and alternative points of view. You can make your contribution via the comments link below, or via email.

UPDATE: I forgot that one of the things that Paul Coss told me about their new wireless capabilities was a site survey service that Philips now offers - something no hospital should be without prior to installing a Philips telemetry system.