Friday, April 30, 2010

Translation Fascination Part 2

The brilliance behind the early device integration software pioneers was the building of the library. There is significant VALUE  in the library of integrations. Anyone can build a little black box with a rules engine. (Please don’t throw things at me Integration Software folks - it's only slightly sarcastic)

Many different models have been taken to gain the library. Some “skim” the information off without building a relationship. This is a dangerous model that – while it works – updates can be missed. Some charge a fee to device manufactures which may seem like a poor model and not “open” but actually is smart. It makes people put skin in the game to ensure that development completes fully. Some work hard in the industry to build mutually beneficial relationships seeing a Co-development relationship that has more value long term and being less focused on the short term capital needs.
So why are these relationships so crucial? Think about it the changes in the language that might affect the way things are processed. Imagine if someone from 1776 tried to translate for someone in 2010.  "OMG that is so wrong - lol."  It wouldn’t work so well. That’s why building relationships between Integration Software and Device Manufactures is really important.

Sounds logical – almost easy right? Wrong. There are many device producers that are closed nations – they don’t share enough about their language to allow for high level translation. 

So is "Interoperability" a dream?

Wednesday, April 28, 2010

Translation Fascination

I have blessed to travel to several countries. I am always excited to see the sites, experience the culture, and of course – eat the food. One thing I have learned is in the countries where I don’t speak the language (so anywhere that they don’t speak English or Spanish) I can do very little without a translator. Believe me hand signals and acting out the need can only get you so far and does not work well in restaurants….and I do love to eat.

If you think about interoperability engines – each is a translator that allows for multiple items to speak with each other. The more “integrated” a engine provider is to the device the higher the level of communication you can provide. For example, I studied Spanish in a Classroom for 6+ years but I didn’t learn Spanish until I immersed myself in the culture and language when I lived in Seville, Spain. The culture and the language enhance your ability to communicate. The same is true for device integration – the more immersed you are in the product, the stronger the relationship - the more ability it will have.

Stay Tuned for Part 2

Friday, April 23, 2010

Top 5 Nurse Call: 2& 3

2) Which has the best equipment warranty and lowest cost of ownership?

Nurse call no matter how you slice it is equipment. Equipment needs maintenance – physical maintenance. An electronic component breaks down.

As equipment, once it is in the wall it is challenging to replace due to back boxes, cable and other “installation” issues. The house we talked about previously if you decide you would like new Kitchen Cabinets and countertops once you change what is there it is really cost prohibitive (if not prohibitive, it’s a really bad investment choice) to change it 6 months later.

Therefore, the long term cost of ownership is important.

3) It’s broken – now what?

As Nurse Call Systems enter the realm of VOIP it is amazing that the support structure Du jour is “off site” or “call center” similar to the change from full service to self service at the gas station. As described above, a Nurse Call System is hardware that is controlled by software that interacts with other software and systems.

The item I do think is valuable is using the hospital help desk to assess the issue, but they need to be aware that diagnosing the issue is more than just dialing into a software platform and making an assessment. If a clinician calls in on a fully integrated system and says “my phone doesn’t work” then the person answering the call needs to know it’s probably not the “phone” that’s broken. That’s why we developed a “Help Desk” training program that assists a call center in diagnosing the problem in an integration.

It is necessary to have an available group to be on-site within a period of time. If your disaster plan or maintenance plan categorizes a Nurse Call System to only be down for a set period of time then you need to make sure a response on-site can be within that time.

Monday, April 19, 2010

Top 5 for Nurse Call: 1) Can it do the workflow we have designed for our hospital?

Pre-Determining how the system will function is the only way you can determine which system will fully meet your needs. This can be done internally but utilizing a 3rd part workflow designer. If you are a do it yourself kind of place figure out what you are doing currently and how it would need to change to be better. One of the biggest mistakes made is allowing an equipment vendor to design the vision for a patient call system. Yes, they have experience but they are also partial to the system they are providing.

To put it in perspective, one of the largest personal purchase decisions you will make is buying a house. When evaluating houses inevitably you will begin to picture yourself in that house – what you will be doing? If you visit the house and the listing agent (seller's rep) is there – they are going to direct your eye to all of the “great” features and downplay any of the features their house is lacking. For example, if the house is a split entry the selling agent is not going to point out to you that you will be climbing stairs every week with multiple trips to carry in groceries. They will be directing your attention to beautiful view of the Cul-De-Sac and how your kids will love playing there.

The same is true for Nurse Call (stay with me techy geeks) If you have all of the Nurse Call Vendors present and you do not know what is important to you – then they will tell you what is important to you based on their systems capabilities. This is called features based selling. It’s not wrong or deceptive. It’s them presenting their product in the best way possible. It’s only deceptive if you ask them if their system can do something and they tell you it can when it can’t. Or they sell you a “road-mapped” item as current.

Entering the house with your top 10 criteria is the best way to approach purchasing houses. Understanding why you are purchasing is crucial. Has your family expanded, therefore you need more room? Are you getting older (or plan to grow old in the house) and need fewer steps?  Carry this thought process into purchasing a nurse call system.

The best tactic for reviewing vendors is to provide them with pre-determined workflow prior to their presentation then let them explain how they would provide you with that workflow.  Verify they can meet the expectation.   At that point they can show you additional items you may find of interest based on their products specific capabilities. This IS valuable information because your core need is being met. Their additional “features” then become the icing on the cake.

Stay Tuned for #2 Evaluating equipment warranty and lowest cost of ownership?

Tuesday, April 13, 2010

Patient Communication & Technology Part One

People ask me all the time why Sphere3 addresses Nurse Call first when we look at Alarm Automation. Quite Simply - it is the hub of all patient interaction at a hospital. If you want to see immediate change then address the way caregivers are interacting with patients. Nurse Call is the only Patient controlled device in the room that is related to their care. (Yes, interactive TV people may disagree) It is a life line for patients to interact with people who know how to help no matter what the request.

This is a medical device that is required to be in every hospital for notification of patient need. However, if you are just using it for that type of interaction then you are not fully leveraging the investment. For example, if you can purchase a button that can be used for bed management as opposed to a bed management system then isn’t it leveraging that base platform more efficiently? The key word above is “required” but the key idea is how do you leverage a required piece of equipment for innovative workflow processes that are outside the basic scope. Nurse Call purist will disagree with this point by saying that adding extra workflow processes decreases safety. By not using the system for its intended use you actually increase risk that a peripheral function would disrupt a critical one. However, most platforms are designed so that you can’t disrupt a critical process unless it’s not implemented correctly.

Further, when evaluating the system it’s important to define how it will be used. I have found that a majority of the time the system is being evaluated on a few key features – not necessarily on how the system will be used. Don’t follow the Shiny Ball folks!

To put it in other words – a hospital knows they need a nurse call system for communication but rarely has its uses or additional workflows been pre-defined. Many rely on vendors to provide outlines and designs on how the system set up, but that’s how it is looked at as “system setup” not workflow. There may be some base anecdotal type information about wanting to “send it to a phone” but not a true plan.   Having a plan of how each aspect of the nurse call is to be used prior to making a purchase decision is crucial.

Important: System design is how the components and cabling are put into the hospital. Workflow design is how the caregivers use the system. Workflow design overlaps system design because there are specific component needs that enable the workflow.

Stay Tuned for the next post: Top 5 things a hospital should look at when evaluating a Nurse Call System