Friday, October 26, 2012

Compiling and Comparing Data

I work at a lot of coffee shops.  It’s not that we don’t have an office but there is something about being in a space with music, coffee, and energy.    There are always people there meeting for business – to stop collaborate and listen.   I have done it dozens of times myself – reached out to people who have expertise in a specific area or have started a business and can give insight from a been there, done that perspective.   This blog is spattered with some of those stories.

My one regret is how I have managed all the information that I have gathered in the last few years.  I take really crazy notes mostly with doodles and pictures.  When people say a picture speaks a thousand words- they are right (plus it’s easier to remember a picture).  The team jokes I have an addiction to spiral notebooks, there are about 50 in my office full of “valuable” information.   While I have gotten better about giving the algorithms to Kristal to be properly documented for evaluation, testing, and roadmapping  – there is a lot of information that is not that square – not a number, not an equation, more anecdotal but still important.   Those feelings that are just as important as a data point. 

I once had a friend describe working for a startup and watching the CEO of that company change in the years of its build.  The story itself was not uncommon to many I have heard before, but for some reason his words describing his perception of the emotional state of the CEO were.  Perception of the event or process – feelings – are as important as hard data.

We are working on ways to capture those thoughts of caregivers and nurses so that the square data can be compared to squiggly line data – thoughts, impressions, and ideas.  Active comparison to perception vs the reality of a situation will help to create more accurate benchmarks….just because you can be staffed to have a 10 second response time….is it necessary?  That was a hard question for me – my gut says YES of course if we can and we should but reality is there is always a cost associated with the movement.  I almost hate to say it but in this dynamically changing industry…. Is that worth the cost….

The balance between delivering the hospital leadership perception of service excellence and delivering an “Always” can be two different things. 
The “Always” can be more accurately attained if you understand the reality of the perception of the patient – if you create an expectation and meet it.  The “Always” cannot be obtained when we set unreasonable expectations with our patients, or we fail to meet a basic level of expectation.

Best Coffee Shops in KC for Working....

Mildreds in The CrossRoads District
Roasterie in Brookside
Latte Land in Briar Cliff

Haven't found any I love out South so open to suggestions....

Tuesday, September 4, 2012

Nurse Call Selection Process

 I thought I would share some tips to anyone looking to upgrade their nurse call system or drive any change within their current platform (upgrade is a variable term which encompasses hardware and software)  Sphere3 has walked a number of hospitals through this process and are glad to be of service to any hospital looking to update.

Hospital Tips:

1)      Define the REASON for change first – it’s generally three things – new construction, remodel, or existing system is "old". Your hospital will have some SOPs attached to each one. If you are looking for definition around "old" we have tools you can use to define and structure your business case for update.
2)      Define the INITIATIVES you want to improve which will be enabled by the change. Strip away everything that does not align with those initiatives, and compare the systems.

3)       Define the WORKFLOW associated with improvement of these initiatives.  Don't think about the technologies - define what would be the best process to improve your initiatives.  I know this can be very chicken and the egg for some folks.   There are groups like Sphere3, Burwood and others that can provide you with a vendor agnostic view of what current technology CAN do which allows you to define HOW you want the system to work.    
4)      Pick Three Systems and review for alignment with your core workflow, and meet with representatives.  Provide them all with the same workflow and initiative information and allow them to present how their system will meet your needs.  Their presentation MUST show you how their product will perform the workflows you have described.

They will all have “Whiz Bang” features and will highlight them as something that you should use to make your decision.  The truth is  if “Whiz Bang features”(which can only be supplied by “one” vendor) become decision points then it really detracts from your ability to make a workflow decision.  Please note – talk paths, voice over IP, single sign on for multiple applications, SQL databases, etc these are not Whiz Bang – these are essential functionality statements.  Understanding each systems IT structure and potential limitations is really important.  We should never make a decision in a bubble – multiple parties use the system and multiple parties maintain the system.   Make a clear delineation between Whiz Bang and Functionality.  
5)      Reduce to 2 systems and set up site visits of ACTUAL working client sites – their factory tours are all cool and the experience is meant to be incredible. Whether you go to the “farm” or an “experience center” you will be wowed…..that’s the point. Though I will agree with the vendors – having the opportunity to see all of the flexibilities of the systems can be valuable.   Go visit at least one real client site….proof is in the live pudding. 
6)      Review the database for ease of reporting AND structure.  If they claim have ability to interface with other products such as middleware, RTLS, phones,  Aperum® etc ask for them to provide a site where the data has been validated. Then ask for a sample DE-identified file for review. I need to emphasize here – there are holes in the way certain systems record data – it’s important to understand what those are and how it will impact your ability to use their data to make decisions in the future.
7)      Get your prices and take time to understand what is in them (or hire someone to review them for you who will understand the gotchas.) I have found on several projects now that pricing can be challenging to review (even for me and I started working with nurse call in 1986….if you do the math that’s a funny statement.) I have seen simple parts lists with a price to a 300+ page document.  If they send you a 300+ page document – read it – wow is it revealing about what they will and will not guarantee. (Check the contract if they will not “guarantee the operation of their IT system” runaway)

When you strip away everything that is “fluff” in these proposals and get down to the brass tacks of will this do what you want, will the vendor be available to service you when you need (not when they can make time to get to your area), and is the hardware AND software high quality and reliable  --- then you know you are making a good decision based on your specific needs not on their competitive advantages.

I could write pages on this process – if you are making a change this is a major capital and operational investment that affects a hospitals HCAHPS scores (which leads to reimbursement etc) it's important to really do your homework.  The industry changes are really interesting right now so don’t get caught with a system that won’t be here in a year or a company that can’t support your needs. 
If you have questions feel free to email me or call us.

Friday, August 24, 2012

The Fire Sale

 If you have been listening in the last 2 weeks you know the nurse call industry is in a flutter….to say the least. A price war has ensued with what appeared to be slashing like I haven’t experienced prior. My phone has been ringing a lot…..a lot is kind of an understatement. I would think that it’s a competitive thing but in actuality it may be a fire sale which has caused a ripple effect throughout the industry.
A few months ago I wrote about GE being acquired by Ascom. Call me crazy but when a manufacture of telecom handsets purchases a nurse call system then cuts the price significantly does it signal more than just we want to take market share? To call their pricing strategy “creative” would also be an understatement.  I am not suggesting "trouble" by any means - I am suggesting a strategic change in approach to market AND possibility that a new nurse call - one which lines up closer to their UNITE product may be in the works.  Possibly there is a need to make some sales to secure the client and move them to a new platform when it's released.   
To remain competitive it appears that the other others are indeed re-evaluating their strategies – essentially relying on the value in their hardware to secure their place.   In my opinion (humble as it may be) Nurse Call has spent the last 3 years trying to prove their overreaching “workflow” value in the market place only to play the games of a contractor today.   I am not trying to pick on GE by any means - they are just making the biggest change.
So what does this mean? Is it a signal in the market place of the devaluation of nurse call? Remids me of the blog I wrote a few years ago about Electronic Life, Technology Life and Workflow Ability. (I wrote a little algorithm to help hospitals understand this by answering a few questions and scoring the results per unit – helps phase installs – if you are planning an upgrade - give us a call.)
I don't think it's a devaluation - I believe the shift has started in redefining Nurse Call to a more patient centric cloud based product.
Stay Tuned - I will post some tips for hospitals making the decision on new nurse call.

Sunday, August 5, 2012

Sphere3® announces partnership with Stryker

Sphere3®, the industry leader in medical device alarm and alert analytics, has partnered with Stryker to provide a next generation bed-related compliance and safety alarm management tool.  Stryker’s new iBed Wireless system uses state-of-the-art sensory and communication technology to provide real-time smart bed data about patient position and bed configuration to enable determination of bed compliance with hospital safety standards and safety risk conditions.  The iBed Wireless system also produces and alarms wirelessly for notification of potential patient falls.  Additionally, data about siderail position, bed exit, brake, bed height, and more will be visually displayed and combined with other medical alarm and alert data to provide better insight into the patient's safety and other aspects of their stay.

“We are excited to partner with Stryker beds.  It's powerful for our clients as they build a non-filtered view of the patients stay through their movement, request patterns, and physiological alarms.  Stryker beds produce data and combined with our analytics tool it's amazing to see the picture of the patient stay.”  CEO, Kourtney Govro.

Monday, July 30, 2012

Sphere3® Introduces Trackit!™

Mismanagement of Assets utilization can cost hospital’s millions each year.
Sphere3®, the industry leader in medical device alarm and alert analytics and hospital alignment of medical device strategy, has partnered with TriVestige Consulting to provide Trackit!™ consulting services for RTLS selection, asset management, utilization, and staff workload.

Trackit!™ employs the core principles Sphere3 has used to help hospitals leverage existing technology, plan for new, and identify how to manage the data associated with the purchase. This vendor agnostic approach to market provides greater insight for hospitals in both the selection and application of best of bread products, and best practices processes.

"Our partnership with TriVestige brings cross industry expertise to our growing client base. Our focus is making the patient stay better. Providing the things they need in a timely manner not only improves patient perception but enhances their ability to heal faster. There are great products out there in both the software and hardware - our job is to make the process easier for the hospital" CEO, Kourtney Govro

TriVestige consulting has depth of knowledge into best practices in the distribution and logistics industry. Their expertise is in process optimization, automation, software, and robotics. They provide better throughput results, reduce staff workload, and decrease spending, resulting in millions saved.

"TriVestige is focused on building solid content with replicable processes and enhanced delivery of existing services. We are excited to bring these proven techniques to the healthcare market."

Contact us

Saturday, July 21, 2012

The Future of Nurse Call

I grew up the daughter of an integrator – for those of you who don’t know what that is in the 1970s and 1980s an integrator was a person who made two hardware systems talk to each other.  The 1990s brought more integration via software and now the software controls the hardware and integration is becoming interfacing.   As with other “trades” my siblings and I were immersed in technology and projects from a young age.  While Dad did everything from sound to security, fire to paging, intercom to burglar – our specialty was always nurse call.

I believe an era is coming where there will be no nurse call as we know it.  The integrator will again be asked to shift their model as the hardware will become as simple as a light switch and the software will be interchangeable.  Kind of like a computer – they all run Microsoft Word.  

I had the opportunity to talk to Brian Yarnell, CEO of Starling Health.  Brian is one of the many “non-healthcare” folks to enter the space.  His background is in business intelligence for the retail industry.   His focus is creating a methodology to capture data to truly evaluate performance management by allowing patients the opportunity to direct their own care in any language they speak.  

Starling has developed a “Ap” (for lack of better terms because it runs on any tablet OS) that not only allows the patient to “have it their way” but allows the hospital to capture data about specific performance improvement.   With the simple touch of an icon the patient can request a number of items and the workflow can be transitionally tracked in the database.  Did I mention that it can automatically change to any language.  It’s a really patient centric tool for patient request.

For most standard nurse call systems decentralized modeling is a challenge (mostly because few hospitals look at the request quantities prior to design and implementation) so many hospitals have started to look at the war room model to better triage the need of the patient.   While it’s clearly not a “nurse call” product - it would not, by itself meet, most regulatory standards.  However, today with simple integration (the old school way) it could compliment a UL1069 listed system – making an inexpensive featureless system very feature rich.   There is even greater opportunity in the future through interfacing with a higher quality more software centric platform to really create amazing workflow.

Starling is certainly the most interesting product I have seen in a long time.  Brian’s vision will allow patient the opportunity to direct their own care in any language they speak.    Check out their website

The revolution of the IP based nurse call was challenging to many integration firms and another shift is on the horizon.   It used to be the major argument was who “owned” the assignment process - now it’s who is the “hub” – what if there were no “hub”.   Systems with strategies of open infrastructure – well written API will be the winner in the battle – those who don’t want to leave the old school proprietary mindset will be left behind.   You have to be flexible to integrate to innovation and accept the fact that your company may not be able to innovate everything.

Friday, June 29, 2012

Ascom Wireless Acquires GE Nurse Call

You may have remembered back during HIMSS – I made some comments  on the blog about GE’s nurse call and may have even said something along the “lack of vision” lines.  (which my mother said was shockingly not nice of me to say)  GE did have a strong lack of vision surrounding its nurse call product…if you remember GE purchased EST who had purchased the once competitive Dukane line.  As they divested the “Security” division of their product lines (EST) due to the lack luster performance the nurse call line was shuffled around and never could get past their market status of third place.

So here is what really blows my mind - GE potentially they had the perfect scenario… cool would it be to walk in and offer everything soup to nuts to make your hospital run. (If you are a dreamer thinker – why wouldn’t GE just have a hospital…why not?)   Even if the hospital didn’t want everything – how amazing would it have been to have access to every piece of a hospital – think of the flexibility and potential for innovation.  The potential intellectual capital was just squandered – to me this was purely an execution faux-paux on the part of GE.  They had all the pieces – they just couldn’t get them to move together.
I find the acquisition to be really interesting play for Ascom Wireless as well – while they have had reportedly good success with their nurse call line Internationally – I do wonder if the same model will apply in the US.   The company line is that the nurse call and wireless phone system will be “kept separate” as to not upset too many apple carts (since Ascom distributes both through nurse call manufactures, and independent integrators).  It would be silly to keep that mindset for long.

Ascom offers a nice middleware product called Unite – same thought process of all middleware it interfaces to different alarm generating technologies such as nurse call and distributes the information the assigned caregiver.   The acquisition gives them more control on the development side of the product – creating better workflows but it limits their vendor agnostic approach to market.   It’s perplexing why that they would tether themselves to another “end point” device – like they have done with their handsets – Yes, I know that Unite integrates with several handset devices BUT if you know middleware you know they integrate best to their own handset.
Areas where disruption may occur in the space – Distribution (who is selling it, not who is shipping it), IP consolidation, and IP development……further market consolidation.

Nurse Call is a really interesting technology....not interesting in a creative way - interesting in a how are we going to mold this old school technology, that's required by code, into a new highly relevant my new favorite CMIO would say - "Where is the Disruption?!"  It's hardware and software blended together and without one being high quality it will fail to meet the expectations of the hospital.   
My firm belief is that the hardware will continue to decrease in value and the software will continue to increase….but not just software the content of that software is the real value.     Watch the market - I think another Nurse Call company will make movement like this soon......

Monday, June 4, 2012

A Passion for Patients

I am often on planes – seems to be the blessing and curse of success - I have to admit, after working and being away from my family for several days, I usually just want to slip on my head phones and look out the window, but sometimes my seat mate just wants to chat. 

It was a Thursday, I missed #2’s baseball game the night before so I was a little grouchy, and I was eager to get home to spend time with my boys.  I had splurged $50 to upgrade to Airtran “1st class” which generally translates to a comfortable quiet trip home.  As I was praying the plane wouldn’t break, in walked my seat buddy – a 6’5  55+year old woman carrying a 10 month old baby.  There went quiet….though the conversation that followed was much more than I ever imagined.

We talked about the airplane – we talked about raising children – we talked about travel abroad - we talked about the Lord and then we talked about her adorable baby.   Soon I learned her name was “Mary” and it was her grandson who was only 4 months old when his mother, her youngest daughter, had passed away.  The story struck me, but more than that - staring into the face of the little boy on her lap - it broke my heart to imagine my boys growing up without me. 

Her daughter was a vibrant healthy young woman who became ill and deteriorated over several months.  She had several visits to the emergency room of their rural hospital with little answers.   Eventually, she was admitted to that hospital, Mary kept her children and her husband stayed with her as her advocate.  The baby became ill and Mary had to bring him to ER, when she arrived her son-in-law left his wife alone and met her to check in and see his son.  While he was gone, his wife pressed her call light – with no response she went to the bathroom alone then returned to her bed.  When he returned to the floor, he saw the call light on in the hallway outside her room.  He found his wife unresponsive.  In his confusion, he pressed the call button and began yelling for help – with no answer he ran to the nurses’ station.  The unit secretary ran to another patient’s room to find the nurse.   A few moments later – Mary heard a Code Blue call to her daughter’s room.  Leaving the baby with the ER nurse she flew to the floor, but nothing could be done.  Her daughter had died.
My mind immediately went to Regina and the E-patient movement. I shared about the Walking Gallery and my dear friend’s story of the loss of her husband.  How she had inspired me, and how the people in the gallery inspire me. 

She asked me what I did in healthcare – so I shared about Noah, and what we do at Sphere3.  She asked if I could get the data about her daughter’s incident. “I am not sure” I responded – seeing disappointment flush her face – I tried to explain that some technology does not support historical records – some technology does not save any records at all especially in small rural hospitals.  There are ways for me to get to data on a go forward basis, but many times it's a challenge to get to the retrospective data if it was not planned for when the initial technology was installed.  However, I would take a look if she ever wanted me too.
I wrote a while back about the drive to do more, to make a greater impact, to intercept the incidents, to save lives…..when patients are your driver – when people are your purpose - you do more.  You find yourself listening on an airplane - when you just wanted to look out the window.  You connect with people who inspire you and will drive you to go further.   

Are you doing this for the sake of profits?
Are you doing this for the sake of the patients? 
Are you inspiring a conversation in the HIT community or are you riding on the wave of government funded HIT? 

Don't ride the wave - find your inspiration and drive for change that matters.  

Wednesday, May 16, 2012

Be The Change Event in KC

A few times I have blogged about the need for all of us to be the change we wish to see in the world.  My Dad has instilled this belief structure in all of us with his micro loan program, and in the 8 schools he has built in the last few years.  My youngest brother took that belief structure and this year became the Director of Be The Change Volunteers - this year he is doing a school build project in Kenya this summer and Papua New Guinea. 

The Govro's have funded the soccer field in Kenya but Grant still needs to raise funds for the school projects.  (It would be a great soccer field but really pointless without the school :-)

So do you want to be a part of it?  Do you want to be the change?  Come and learn more on Monday May 21st from 6pm-8:15pm at the Leedy-Voulkos Art Gallery (it's by Jack Stack in Crossroads) this is a free event to drive awareness about BTCV but the goal is to raise money for these school projects!

Please RSVP to Stephanie -

If you just wan to give but can't come - that works too :-) BCTV can provide you with a tax receipt.

Monday, May 14, 2012


When you were in high school did you ever use the letters “TMI”?  (Back in the days before texting we just said acronyms)  Usually it was used after hearing way “too much information” about someone or something.   Lately, I have been saying TMI a lot - not about inappropriate or gross info but about information in general.  We are generating too much information about ourselves and why? To “better” communicate? It’s actually less about communication and more about documentation.    I watched a show on sharks this weekend – the scientist were implanting devices into sharks to track their movements in the ocean to try to identify where they had their babies so that they could protect the species.   We don’t even need an implanted device we just freely put it out there.  

Think about it……I will use myself as an example.
In the past week….I went past intersection cameras that records driving patterns.  I used Facebook so that everyone could know my “status” and I could see theirs.  I visited with my son’s doctor and updated his medical record because they hadn’t entered all his shots.  (*Wished I could’ve just done that myself – click and drag or something)   I hopped on Twitter while I watched the Sporting KC game because I like to see what the community of fans is saying about the plays, it helps me learn the game.  I hopped on twitter again to see what articles the people I follow suggest.   I used my Chopper Shopper Cards (grocery loyalty cards) mostly to get a discount but full well knowing that they are recording every purchase I make to better market to me. (I actually get irritated when a retailer markets products I would never need to me – I think you know what I buy at least market something generally related)  I hopped onto Linkedin.  I checked the calorie content with an ap on my phone and recorded my Pilate's exercise in another.  I checked out Pintrest to see if there was a recipe for oatmeal pancakes – realized it’s really not a search engine but a big magazine which is strangely addictive.  I booked two flights using my frequent flier number.  I used the “genius” built in my iTunes account to see if there was some new flavor of music that would “suit” me.  Turned on Pandora for my kids. Amazon sent me an email of some books that they thought would entice me to buy.  This morning I used my access control card to get into my building.

As different as these items are - they all create the same thing – data.  Data that paints a picture of who I am, what I do, when I do it, and what I am interested in.    Do you ever look at your digital footprint and think TMI – wow that’s just too much!  Or do you look at it and think – wow that is such a missed opportunity.   We have developed a culture that likes to document ourselves - which really makes me strangely confused as to why there is so much resistance to EMR - but maybe if it were more like facebook nurses and docs would like it more.    

Here is my point – if you think about all of the things I listed above – all of the ways we document ourselves or allow ourselves to be documented – the model of business has rapidly and radically changed and will continue to do so.    How are you equipping your company to accept my information?  Is your EMR really ready all of this – is it really future ready?    How are you enabling me – the buyer – the patient – to provide you with valuable data about location, interaction, activities, diet, and more.   Are you building a tool for the future or are you hoping you can adjust your current technology consume the masses of information coming?

Friday, March 30, 2012

Intego Acquired by CAS

Recently, I had the chance to chat with Charles Bell, Founder of Intego Nurse Call.  I always enjoy meeting fellow entrepreneurs - for those of you who don't know entrepreneurship is an incurable disease as much as it is a passion.

Listening to Charles, I am reminded of the raw creativity and passion that drives innovation and ultimately new jobs into our struggling economy.  Charles started his company in the early 1980s but has been in the industry since the early 1970s.  He regaled me with stories of old Zettler systems that he was able to wire and do innovative things with, but finally settled on the fact that he needed to build something all his own that would challenge the status quo.

The Intego mindset is simplicity - how can we provide a system let the RNs be with patients more?  How can we leverage what has to be there in the wall In a communication model that compliments ease of use? 

Charles speaks highly of what he calls the ROC - this model takes all the patients calls from nurse call and routes them directly to the centralized operator core.  Thus, removing the direct interaction from the caregiver and allowing her to prioritize her response using her skill set as a nurse to determine who/ what needs attention first.   The strategy is to utilize a low cost device - such as a pager - that can compile the messages the caregiver receives.

This model is one that I have been promoting for a while as well.  The data models that I have run support the idea that providing greater context to the alarm and alert message can be extremely valuable to the caregiver.  The challenge is the design model - the clinical aspects of the design must be setup by a RN with a technology background.   Someone who understands the information being recievded in the command center and how it can be distributed in a meaningful way. 

The theory is this - patient presses the big red button on their pillow speaker (aka the "paddle") the call goes to a centralized point in the hospital, such as the operator area (where external calls are received) then the operator triages them back to the floor.  (Look back to the blog I did on Chris Heim from AmCom) 

Since you are using a lay person to triage - its important to design a really simple decision tree process.  (Similar thought if you have your IT Help Desk triaging Nurse Call issues)  

What I have found looking at this model is often laziness kills it's effectiveness.  The operators may not use the available messages and only distribute a blank - assigned message - ie "PCT Needed".  If the team answering the calls are not driven to follow the process it becomes garbage in garbage out.  It is critical to manage the data associated with their effectiveness and following the process. 

The other side of this data is to identify if the caregivers are using a task list approach or varying their response based on type of need - you cannot run the data model or report on this model any more effectively than decentralized to phones if you are not following the process correctly.   

I also HIGHLY recommend coupling this with strategic automatic distribution of specific Emergency level call types AND allowing the caregiver to call back into the patients room via a call back feature on their wireless phone (or smart phone if available).

This strategy is complimented by Intego recently being acquitred by Critical Alert Systems. CAS is a relative new comer to the industry, as its a purpose built organization to compile specific technologies to drive full throttle into the industry. Charles will remain with Intego focused on driving new business and strategic relationships. 

Great conversation - thanks to Charles for taking the time to chat with me.

If you have a health IT business in the medical device space and want to be featured in the blog email me - our next feature is with Strykers Rich Mayoras - talking about their new wireless bed.

Tuesday, March 20, 2012

The Art of the Report

I always really enjoyed stories but a confession - and I hope Mrs. Karnes is not reading thi s- I rarely read an entire book.   Generally, the beginning was interesting and so was the end but everything else was just filler.  Most  of the time after I got to know the characters a bit – I would just make up my own story.   (That's why now I stick with non-fiction)

The challenge with reading for school was the book report….due at the end of the designated reading time.  As I have started working with my kids on their book reports the reason behind the reports is becoming clear.  It’s less about the “report” of the book and more about the function of the activity.
A book report had several purposes but mainly it helps a child move from basic reading skills to true understand of the authors intent.   It teaches you to look into the materials you are reading and disect important information.  You don’t start out in 1st grade being able to read a book and describe the message.   You must first start with pulling the phonograms (sounds) into words – the words into sentences – the sentences into paragraphs – the paragraphs into stories – the stories to interpreting the materials to find its meaning. 

This is the way I look at data – right now it’s pretty dispirit – it’s a lot like phonograms.  If you don’t know about phonograms – they are a single or small group of letters that makes a sound.  My favorite is “er” as in her.   As in that example, however, “er” is part of several words – such as deter – same ending phonic but when coupled together with “de” instead of “h” it’s a different word.  Data is kind of like that too – depending on how we look at it – what pieces we add together the different pieces of data can give us different words.  The phonic does not change but the word does.  Once we build those words we can begin to link them together into sentences and so on. 
All the pieces of information could be pulled together to tell an overlying story but today – in health IT  - as we look at data most are just trying to make the phonograms say a word.    Once we are able to get the words we will be able to pick out simple attributes such as  characters names, locations, time period, etc   Once we are able to move past those simple attributes - We can progress to inferred things such as attitudes.   For example, she cried when she found out her beloved dog died.  Nowhere in the sentence does it say she was sad but you can figure it out based on what you know about crying and what you know about the death of a beloved pet.  As you progress to high school you are asked to identify big picture items such as theme.  We apply knowledge filters every day to assumptions – what do we already know to be true and how does that influence what we are looking at to get to the next level.  We reference other materials - we talk to teachers who know.

Eventually, we will be able to take the attributes and the inferred understanding of situations then apply it into a bigger picture understanding of the story – what is the theme – what is the message – what is it saying about society in general.
So what?  My small group leader at church says that at the end of each Bible Study – meaning so what does this mean to me – how do I apply this towards real life today.

The data in the medical devices, the medical records, and other technologies are independent data sets – the parts and pieces within them are the phonograms which need to be pulled together into words and will tell us a story about the patient.  As we begin to compile that data – review it across a population – it will tell us more.  Think about research papers you wrote in college – did you reference only one book? The challlenge before us is the sheer quantity of data that will need to be analyzed to get to the final answers.  Note: Not impossible.....just a challenge. :-)

Tuesday, February 28, 2012


I liked how Colin Hung (@Colin_Hung) put it in his blog “white space dominates” at HIMSS12  - I was afraid maybe it was just me – was I working too much and not looking hard enough for the new and exciting.   So, I have waited an entire weekend before writing my final blog HIMSS12.  I went back and reread some of the blogs I posted after HIMSS11 including two of my favorites The Patient as a Consumer and The New Economy.   Ironically, not most heavily trafficked but a good glimpse into the way I see things.

I debated back and forth about what to post – I could blast a few people and companies for same-o-same-o booths, technology that is still behind the times, promising more than they can deliver, or when people said or did things that were “just business” but were frankly just wrong.    It seems like everyone was focused on refinement of existing ideas instead of pushing anything new.   The most disappointing comments I heard circled around “proprietary” databases and not sharing information.   I wish I would have had the gumption to say…… brrring brrring – that’s the 80’s calling and they want their proprietary database back.  Or quote my friend Epatient Dave "Give me my Darn Data" (this is a G rated blog so I changed the wording a bit)  I know that sounds a little childish as a response but after I got over being angry (which for me equated to tears) – I realized that companies that believe that it’s better to stifle innovation are going to get left behind at some point.  Proprietary databases are just pride lived out in our geekery.

The most exciting things were announcements from the government on ICD-10 and MU #2 – I read a great blog about this by @JohnSharp

“Big Data” we are generating more data than ever before – the EMR is just part of it – the tip of the clinically documented iceberg.   I was enamored by @ReginaHoliday ’s profound statement that her husband posted 6 different times on his facebook conditions that could have indicated he had kidney cancer.    We document our lives to 400 of our closest friends….if the data were analyzed what would it tell us?   I have a fb friend who's husband is manic depressive and you can tell distinctly when he is not taking his medication by her status updates.  The scary thing – that’s just a second subset of self-reported data.   How about the 5 medical devices that are hooked to you when you are in the hospital – how about fitbit – how about (you fill in the blank) etc.  I could more than 20 areas where data resides that “could” tell us something about an individual health.   I live in the acute care space because that’s where my data resides today – but the lines are blurring which is a good thing.   To me – this is really the most consuming part of my career.  Do you devour information in a manner that let’s you apply it into other learning? 

Before my head explodes – I want to share with you my favorite comment at the HIMSS show.  I was able to meet a Kevin from North Shore LIJHC.  He comes from outside of healthcare into a fast changing world – which he likened a lot to the other industries he has been in where technology and data changed the way we do things.  As we started talking about big data – medical device data – EMR reference data - my hands were waving as I got more and more excited…… He replied with a fantastic east coast mixed with Irish accent – “Kourtney, you are trying to win the Super Bowl when today all we need is a first down.” 

Folks, don’t let big data scare you.  We each have a subset of information that we are good at – that we know and understand better than anyone else.   Today – by the next HIMSS – we need a first down.  We need to gain 10 yards.   Sustainability will be driven by our ability to work with others.

Thursday, February 23, 2012

HIMSS Day #2

Shameless Plug -  I present today at  Booth #8310 at 11:00am – you can see a demo of Aperum and get some insights into how we work with hospitals to reveal data to improve HCAHPS #4. 

The only word I can use to describe day two….busy….running from meeting to meeting and trying to squeeze in seeing some new and cool technology.    It seems this year that everyone is saying the word “Data” and how much they care about it much more than years past.   As I listened to different people describe their products it was all about the analytics and improvement and their ability to provide more data.  It’s pretty mind blowing…however I was given the best quote of the conference at dinner last night from the CIO of North Shore LIJ Health System.  (If you stop by the booth #8310 – I will tell you)
So, instead of telling you about every booth I went to yesterday – I want to highlight the one that impressed me the most.  I have to admit, I was reluctant to go to the Versus booth, but a very persistent marketing person from their organization emailed several times.  RTLS is a competitive space with a lot of technology differences – while I am not 100% sold on the hardware side of Versus – their software blew me away.      The roundtable presenter was a hospital person talking about her experience – talking about actual documented savings.   Then their Sales team spent time one on one with me presenting the software and new analytics tool.  Loved it – drill down reports – well laid out – very impressive.  Versus # 5852 – ask for Susan.  Other vendors should take note of this professional group. 

I ended my day at The Walking Gallery - the best part of my day.  I was able to see my friend Regina Holiday.  She is so impressive - she just wants to make things better - she is not looking to gain anything for herself execpt the opportunity to share her story.  She is so focused on the patient - so focused on finding ways to encourage people like me.  If you haven't met her - don't have a jacket - contact her @reginaholiday 

I will challenge you all - the data is not yours.  I get it rules, HIPPA, proprietary......but the data is not yours to hold. It's not my data. Your technology is a tool to enable the care of an individual.  What is your motivation? 

Short and Sweet today – If you have a chance I present today –  Booth #8310 – you can see a demo of Aperum and get some insights into how we work with hospitals to reveal data to improve HCAHPS #4.

Tuesday, February 21, 2012

HIMSS 2012 Day 1

HIMSS is an ADD nightmare – moving shapes, lots of people, so much to take in and experience.  I get a little overwhelmed with the amount of information to absorb.    My day was spent in meetings with clients and colleagues understanding how different technologies could impact healthcare.   Looking into products, services, and software that Sphere3 clients would find of value.

My day started with a great meeting with a friend from Press Ganey – excited to go by their booth #552 tomorrow and take a look at their technology offering.  I am always impressed with people who know their offering well and know how it specifically impacts the hospital and patients. 

 I headed to the Cerner booth where I was able to enjoy a few moments with Clay Patterson.  We chatted about Health + Care (my favorite tag line at HIMSS because Cerner really means it),  the HIMSS show, and of course Sporting KC.   Then I enjoyed a presentation on Clarvia – Cerner’s latest acquisition.  I think is a great product.  It has that has the ability to apply data into the assignment models for the floor.  They focused on the dollars saved which don't get me wrong - is impressive and had great impact to the hospital bottom lineHowever, what I saw was a tool that would create a an incredible environment to ensure that patients are cared for in the most effective way by optimizing the hospitals ability to leverage available staff.   It was geeky and cool (my highest compliment)  It will play into their suite of products well.  If you get a chance stop by Cerner’s booth # 476 and ask to see a demo of Clarvia.

I walked over to see the new GE Teligence workflow station that will challenge the Rauland Staff Terminal and the HilRom Graphical Room Station.   Their workflow station matches the competition in the ability to provide automatic alerting at the press of a button but really lacks the visual appeal of the two other products.  Don’t get me wrong - just because it’s not pretty does not mean it’s not effective, but I have concerns with all of these types of stations.  Is there a true ability to improve care and reduce workload?   The fuzzy line between automation and documentation is not well reported.   The only think I will add about the GE is that I am a little surprised that a company that offers EMR and owns a nurse call company would not make some logical alignment between the two products….you have all the pieces and they could talk to each other…in a really meaningful way.  See it for yourself at Booth #2635

While walking over to the Centrak booth – I happened upon Tibco #3571 really interesting take on compiling data and utilizing a “collaboration tool” which is much like facebook to drive better understanding.    Tibco, was really interesting.

The final booth I visited was Isorona # 12414 – the booth is in the lower level by the interoperability show case.  It is a software based medical device data collection tool - I assume kind of like capsule.  It would have been nice to see more about the product and learn more about it while there at the booth.  The description I received was that it collects the data from multiple sets of data and distributes them to EMR and alarm/alert software.   

Tomorrow you will catch me checking out medical device connectivity tools and you may even find me at the Burwood booth – great people who I really enjoy – in booth #8310.  If you have suggestions on booths I should see and maybe blog about send me a twitter message or comment on the blog.   @Sphere3CEO

All in all this has been a great day - while I am not a big fan of Las Vegas – the venue is actually a lot more convenient than most of the other cities HIMSS has been in years prior.  There is a lot better access to coffee and easy walk to the convention center – it’s nice to get some fresh air. (just avoid the smokers and the people with the little papers…oh my gracious)  

Friday, February 10, 2012

HIMSS 2012

I am really looking forward to HIMSS this year - it's always a lot of fun to see everyone and catch up on the year.  For the first time Sphere3 will be not simply attending HIMSS - we will be displaying in two of our partners booths. 

This is our new video that has had over 100 views in the past 2 days.

The Burwood Group is a consulting firm out of Chicago that really has an incredible practice around healthcare technology.  I have had the pleasure to work with them on several projects in the past year and would highly recommend their services to any hospital.  Their clinicians are really well spoken people with a great depth of knowledge in technology and transition planning.   

I will be presenting at their booth on Thursday at 11am  you can register here

We will also have the pleasure of being a part of the Connexall Booth.  Connexall is an industry leader that has more than doubled their market size in the past year.  Their team is lead by John Elms and Mary Baum.  They are aligning the brand of Connexall US with transformational care by spending a great amount of time listening to hospitals across the United States.

As I did last year - I will be updating the blog throughout the conference sharing thoughts and learning.  Send me an email if you would like to see Aperum in person and we can coordinate a time to meet.

Monday, January 23, 2012

The Art of Location

Please turn left.....Please turn left.... The GPS lady repeated herself as I basically made a circle..... "When possible please make a legal U turn...." at this point I decided that my car was lost. How was this possible? She is supposed to know where I am at any point in time and direct me to go.... I think we have grown so accustomed to location accuracy that the idea of Lack of accuracy in hospital RTLS seems really strange.

The lawsuit that Centrak has filed against Ekahau is at the heart of location accuracy in a hospital. Products like Awarepoint and Ekahau are at a significant disadvantage to products like Centrak and Sonitor based on their ability to get bedside accuracy. Let's face it, if of you are including a RTLS system in your hospital you want to be able to do more than locate a pump in a room or cancel a call light. In the very least you want the ability to build into bedside location and accuracy. This enables the RTLS system to integrate to the EMR and provide meaningful integration of data associated with

The challenge is to identify where the ultimate accuracy needs to be - or what technology needs to hold it. Products like Capsuletech encapsulate it in their bedside interface. The neuron can easily forward it to the medical record. Products like Centrak are more independent and interface with multiple systems.

RTLS has been somewhat of a novelty "nice to have" product for healthcare. However, the increased need to be Lean and it's ability to support the legal processes has caused a real interest among hospitals. I will caution hospitals that the flash you see in a demonstration - moving dots on a page are really worthless without a quality reporting mechanism.

Leveraging the investment for real value comes from the ability to interpret the data associated with the movement, and utilize the information for meaningful automation of processes.