An Industry in Flux

It strikes me that there are some fascinating industry changes occurring in the “middleware” space and more are on the horizon. Interestingly, its not aggressive competitive behavior - it’s shuffles, buyouts, ReOrgs, partnerships, major players leaving major organizations, and simply surprising business decisions.
Dramatic human capital changes as opposed to dramatic technology change.
But what does it all mean – is it that alarm notification tools are not doing the job they set out to do, is it that the alarm notification tools promised too much and delivered too little, or is it that creativity and design ability was not balanced with well researched deployment on the cause and effect of the disruptive technology.

My thought is well intentioned creative individuals saw an opportunity in the marketplace that allowed the perception of faster communications. (If you haven’t figured it out – I believe most people are well intentioned.) The crux is more than 10 years after Michael McNeals press to market with the game changing Emergin platform – the cluttered market space is starting to relax and mature into a “what’s next” mentality.

Major platform changes are needed to meet the demands of a healthcare ecosystem that has a broader expectation of what information needs to go to which person. The new mantra is not about “alarm notification” it is more about “information distribution” and “decision support”. “Notification” brings with it the thought of disruption while information distribution and decision support bring the picture of well balanced and focused approach to patient care.

The problem is alarm notification has not reached maturity before the next change. What I mean by that is we have started to move to a new thinking without truly looking at the data associated with the “old thinking”. We have no base line comparison to clearly identify how information distribution will affect the ability of the clinicians to serve better. The industry has no clear baseline of information to compare the emerging decision support capabilities of the patient communications platforms (aka Nurse Call) with the old way.

Technologists, ask yourself:

Are we making things more flashy, exciting, techy because we can or because it’s right?

I challenge Nurse Call providers – Middleware developers – and even you EMR players who get in the game to prove it.

Show us how a change to status quo solves….if it doesn’t make the patient’s and caregiver’s lives better in documentable, data backed ways – then don’t waste your development dollars.

My prediction – major change is coming – large players will be motivated to change their focus and new players will be motivated to create better platforms.

Command Centers

In a strange turn my blog has lead me to interviewing – ok so not really interviewing more having conversations with really interesting leaders in the healthcare medical device community. I want to be transparent – probably don’t need to say this because it’s apparent – I am not a journalist and 100% of what you read is my opinion.


Since the blog started last May, I have encountered all sorts of people. Some I like- Some I didn’t like so much. One that I have really enjoyed getting to know, during my contracted work with his organization which is now complete, has been Chris Heim, CEO of AmCom Software.

Chris is a genuine nice guy which permeates the corporate culture of his organization. He is genuine because he has never forgotten his roots.   He started in a garage - not in a band but building a shipping software platform that grew and grew and was eventually sold for multi-million dollars.   A lot of people would be pretentious after achieving that, not him.  He is down to earth and even willing to talk shop and understand the journey of little start up software company like mine.  Just because he’s a nice guy doesn’t mean he isn’t competitive – think of the way that Magic Johnson and Larry Bird competed – tactically, well practiced, engaged, and with a team spirit. That’s the competitive attitude of Amcom.

In 2007, Am Com Software, an operator/ call center company, saw an opportunity to enter a market space purchased a middleware company called Com-Tech. From the view of most middleware players Com-Tech was a simple “point to point” solution, one that wouldn’t rival the depth of Emergin, the flexibility of Connexall, and the integration to wireless power of Ascom. While the perception of the product is a challenge, the team behind it is building a well researched powerful offering.

Even at a high level view AmCom has a unique market opportunity. Their core product is operator or call center software, with a unique application that provides doctor on-call contact information. Since I have only seen in it a lab – the view is appears well organized and easily attainable. If you were to create a central call command center, then the operator software and middleware for alarms this could be a valuable pairing.

Communication from a patient perspective is any interaction dealing with their care, whether it is a with a licensed care provider, a volunteer bringing an extra pillow for their spouse, or even with the dietary group to order lunch. Communication from a caregivers perspective is any interaction from a patient, other caregivers, doctors or services provided that enable them to provide better care or services within the hospital. The faster triaged information can be provided the faster care can be administered.

Notice that I said triaged information. Information overload can hinder the effectiveness of the hospital’s performance. Sometimes I hear caregivers say, “we had pagers and/ or phones but we quit using them because they didn’t help”. Most of the time they “didn’t help” because the information was not provided in a usable fashion – in a central command center portions of the communications can be triaged and managed more efficiently than by pure automation. I’m a geek – I would like to say let the computer make all the decisions, but I have also been a patient, a patient advocate, and a parent –human interaction is more than just obtaining and triaging information.  It's about connecting - not just systems, people.

If you look at a central call command center from the view point of one communication point, it is really just a fancy phone booth. (not discounting it's importance, but couldn't we do more?)  The value of that command center is exponentially increased by leveraging it for additional abilities.   Even non-clinical - Think about the value of this application from a Mass Notification Emergency Communication standpoint! (see previous post on Seattle Grace)

It appears to me that the AmCom suite coupled with the Com-Tech software could be the “Killer App” in a command center design. Granted, I have only seen this application and their middleware piece in a lab environment. You all know my stance, I have to see it live to believe it would really work. (I do live in the Show Me State)

AmCom has a lot of "futures" planned and they have an impressive team of individuals who are working to build a really powerful very well integrated platform.  I look forward to watching them grow.