Monday, May 24, 2010

Power to the Pager....

Buzz Buzz the PCT’s pager sounded as he was taking my mother's vitals. He stopped – looked at the pager – then smiled and said “I never seem to be in the right place at the right time.” He silenced the pager and went back to checking her vitals. Before he could finish the pager sounded again – frustrated this time he smiled wearily at my groggy mother and said “I am popular today”.

The trouble with pagers when used in a decentralized methodology is their limitations on actively interacting with patients and the call while mobile. The message is received and its plain simple information about the patient such as the room number, the call type, and whether or not this is the initial notification. In a straight nurse call to pager design – even though they are cost effective they are not very effective. That’s not to say this is a useless piece of technology, because if applied correctly it can be very effective.

The reason that pagers are purchased in mass quantities for hospitals is primarily the price. They offer low initial cost and low total cost of ownership. While I am all for creating low cost options for alert designs and see pagers as very applicable in specific situations there are limitations to these power packed little boxes. For those of you who talk with the CFO – “if designed correctly – pagers used in a workflow application can see a payback potential”

Designing workflow in a way that properly leverages the power of the pager is critical. The power of the pager is it can be non-intrusive if used correctly. The Caregiver needs to know that there is information attached to the page that is specifically for them. They need to know that the patient need has all ready been triaged and that they can quickly and efficiently answer that need. For example, a pager should be used on Normal Calls only if triaged through a central point (whether through the PBX or Unit Secretary or Others) However, pagers can be leveraged with other emergency call types – such as Code Blue.

One final tip on pagers – this is a freebie – NEVER use an external pager system to automate a Code Blue. A Code Blue should only be automated to an internal paging system such as WaveWare. The latency and delays are a patient safety issue and should be seen and addressed that way. If your hospital is currently using an external paging system your delays can be in excess of 10 minutes during peak times. If your hospital is using an external paging system then the CFO will be pleased to know that by replacing 90% of the pagers with an internal system there are HUGE potential savings.

So the moral of the story – use a pager if you would like but design it properly.

A Personal Note: Spending time with my mother in the hospital brought back a lot of the initial reasons I started Sphere3. Ironically, it was 1 year ago this month that we launched. Designing alarm automation often times we get caught up in the geek side. It’s cool that through the air we can make something ring or buzz – it’s interesting to examine process maps and charts, apply lean principles that help us assess the efficiency of the process.

However, when you sit with your mother in a patient room – watching her recover - helplessly knowing that the red button is the only methodology we have to engage the outside world – your eyes are opened to the other side of the map – the human side. The human side is where lean and process don’t always compute. As much as we would like to make the processes as straightforward as building a cheeseburger at McDonalds the fact is my mom wasn’t a cheese burger.

I want to thank the team at Columbia Regional Hospital in Columbia, Missouri. My mother received excellent care. It wasn’t just the care that she received – it was the non-clinical emotional care that we all received while in that hospital. It was the true demonstration of team work that I saw between team RN and her Care Assistant. The friendly and helpful volunteers, and overly helpful support staff. Thank you from the bottom of my heart.

Monday, May 10, 2010

There's an Ap for that....

Some of you that know me well – know that growing up some people had pictures of Rock Stars on their walls – not me I had a file cabinet and books by Jack Welch. (I am serious, I asked for a file cabinet when I was 12 so I would have some place to store my budgets and letters). In other words – my rock stars were CEOs, movie producers, innovative genius, and other leaders. So, being able to talk with a great CEO is always high on my list.

I had a great conversation with Rob Campbell the CEO of Voalte. Rob, as you might know, has worked with the likes of Steve Jobs and Bill Gates on a little program – not well known at all – PowerPoint among others. Just talking to him was incredible. He has an amazing business mind and a keen understanding of the healthcare marketplace – which is surprising since he didn’t come from the file and ranks of an EMR vendor, medical device manufacture, etc. He is really an outsider who has stepped in to help launch the first Healthcare iPhone “App” for medical device connectivity.

What do you really think about that – an iPhone in the healthcare environment? Since I have been through 4 (yes, really) in the last two years I am a bit skeptical. The device, while loaded with features, is fragile. Dropping at the right angle can shatter a screen (been there) – not to mention that scratching a screen can render the device useless (done that). In addition the battery life can be – let’s say challenging (got the t-shirt). I have worked with wireless internal communication devices in hospitals for more than 10 years. They are as abused as a rental car in a third world country. That’s why Cisco rushed to replace earlier models that weren’t suited for being crushed by a Stryker bed, Ascom has made their phone survive the swim that often occurs when a Caregiver helps a patient off the toilet, and Spectralink’s case can be dropped and kicked down the hall.

Now, before you throw your hands up and run screaming from the device think about the flexibilities of what they have just developed. The Apple iPhone is one of the most user friendly devices on the market. If you are using the wireless device to receive patient calls and the average patient call per hour is 1.5 then making the “answer” function easy is essential. I challenge you to try answering a Cisco phone. (Hint: there are more than 3 button pushes to answer and speak with a patient) I don't claim to have experienced the Volate Answer process, but from what I have seen it appears very straightfoward.

Stop for a moment and think about the flexibility of this concept. How many Nurses currently have a “Smart Phone”? How many are using the facebook, twitter, yelp, urban spoon, or other crazy ap? The device is like a piece of clay that can be molded to it’s environment.  Aside from that it's fun and easy use.  The smart phone can display pictures, it can use decision assistance medical programs, and that little thing – enter information into the EMR.

If I didn’t say I was enamored with the concept – I would not be truthful. We are talking about Apple here – Steve Jobs is the Walt Disney of cool gadgets.   If I didn’t love my iPhone why would I have spent the money to replace and repair it 4 times...or maybe 5.   The device is great – it offers a lot flexibility to the hospital workflow. Some may argue that it also provides a lot of challenges for a hospital when it comes to policy of what is appropriate use, but no more so than a PC.

I recommend checking out their new website

BTW - anyone who wants to indulge me the one CEO who has been on my list for years is Meg Whitman, former CEO of Ebay.