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 www.starlinghealth.com

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.

Leading....

I really enjoy watching soccer – though I am a relative newbie to the sport, over the past year I have learned a lot about the rules and strategy from my boys.  One of my favorite things to watch is when the players are driving the ball down the field towards the goal.  It’s amazing how they kick it to a seemingly empty space and out of nowhere one of their teammates will appear.  My oldest tells me this is called “leading”.   He explained “If you kick the ball directly to your teammate – where they are – then you will never make it where you want to go.”  What a powerful statement for everything we are doing…..

As I watched the MLS cup last night, and read through some information on a few middleware companies – I wondered – who is “leading” hospitals and who is merely kicking the ball directly to them. 

I will submit that if I am truly honest with you all – I think most are trying to figure out where to kick the ball.  Many of them know there is more that can be done than what they are doing currently, but can’t really seem to identify the open space so that their teammate can kick the ball into the goal. 

There are two things in that statement if you are paying attention.  The first is identifying the open space – the second is so their teammate can make the goal.   

They cannot identify the open space because they are too busy worrying if they have a “trail” someone trying to come up and steal the ball from behind them.  (If they are playing Chance Meyers – they should worry)   This watch your back mentality has stifled their ability to take a really good concept – middleware – and leverage it into a really powerful platform.   Old data models and proprietary mindsets are crippling that industry. 

The open space is not in your hardware or even some of your proprietary software….it’s the data, and your ability to understand it and to model it is at the root of the future. 

The second part of that statement is “so their teammate can make the goal”.  Have you noticed how few real teammates there are in health IT?  I think it would be interesting if Middleware could accept their role on the field.  They are the midfielder – the person enabling the end point device to make the goal.  The midfielder is an interesting position – probably the most interesting position on the team because they play both offense and defense.  They run more than anyone else and frankly their ability can decide the game.  The midfielder positions the ball – leads – to the open space so the forward can send it in.  The forward may get the glory of the goal – just like the end point device that the clinician’s use or patients touch is visible.  The midfielder enabled that goal.

Just some food for thought on a Monday morning -  compliments to the LA Galaxy on the win - thank you for beating the Dynamo.  

The 3rd Annual Medical Device Conference

I am really excited about the workshop S3 is presenting at the Medical Device Conference.  The presentation will take a look at how different types of industries measure effectiveness.  We are in process of touring, interviewing, observing, and documenting several interesting places to bring value to the MDC attendees. We will be looking at Shatto Milk Company, US Toy's 750,000 sq foot Distribution Center, a Call Center, a manufacturing facility, and more.  During the workshop we will use the case studies to determine how efficiency and effectiveness metrics were used to improve productivity, customer satisfaction, and more.   We will be applying the learning to developing useful metrics (IndicaresTM) for your hospital's patient communication platform.

I will be blogging about some of the experiences prior to the class so stay tuned to learn more.

Sign Up - this will be a lot of fun!

http://www.tcbi.org/files/agendas/MDC3_Agenda.pdf

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.

Symphony of Information

Have you ever heard a 9th grade band on their first few days of rehearsal? I lived it – well a much heavier, awkward, glasses wearing, hair out of control, version of myself. The interesting thing about 9th grade band is everyone has had their instruments for a while so most can make a noise that resembles music, but “musicality” is really lacking. What they teach you in that critical year is how to be “Symphonic” which means taking something that is very complex and diverse and pull it together harmoniously. For a percussionist (like myself) that means - just because you can play the loudest doesn’t mean you should and that following the conductor is not an optional activity.

As I was reviewing data this week (reams and reams of data) I began to notice a series of new patterns. Patterns, within themselves, are fascinating but they get interesting when variations occur. So in musical terms if you have 4 measures of quarter notes and then a measure of 8th notes and then a measure of 16th notes the original pattern varied to a pattern that builds intensity. Intensity builds excitement and excitement builds to the climax of the song. As geeky as this may sound the workflow data we review is often like a musical score to me – sometimes just out of sync.

I don’t know about you but when my mind gets stuck on patterns I have a hard time breaking free. My solution has always been to get in my car and turn the radio up to blaring sound to let my mind focus on the patterns in the music. After a few minutes identifying them, and figuring out the layering it is easier to refocus on something new.  This week was especially overwhelming as we discovered patterns outside of alarms that affect our data points AND that the information is readily available.

That’s when it hit me – the problem with the patterns that I was seeing for this particular hospitals report were that they are simply out of sync with the other dimensions of the unit. (Clear as Mud?) Think of it like a musical score – if the woodwinds are playing 3 measures behind the brass who is playing two measures ahead of the percussion it sounds like noise. However, if the conductor is able to see how the patterns line up and is able to pull everyone into sync then it’s an amazing symphony.

Music at it's base is a complex math equation - music at it's core is art and soul.  The key to making beautiful music is to be able to define where the math ends and the soul begins.  The same is true in clinical workflow design the numbers may speak the "truth" but the answer may lie in the "soul" of the work.  That's what we do - we help the hospital define the math so that the clinicians can better create the soul.

I know this is two months in a row of shameless plugs but we are creating a new dashboard that is unlike anything in the market today.  We have welcomed several new team members in to help us mold the product into something that can quickly help a hospital reduce falls, increase patient satisfaction, and increase safety. 

Workflow and Growth

I have found with a start up there are several rules – I think of them like the If / Then statements we use in developing our software.


The three that I have found to be critical are:

1. IF you don’t have enough Capital THEN you are hosed.

2. IF you don’t make the right relationships THEN you are hosed.

3. IF you don’t create replicatable processes where every move isn’t hinged on you THEN you are hosed.

The third item I noted is one of my favorites – hence the reason for writing the Sphere3 Workflow Tool aka our software program. I don’t like to do the same thing twice, and it kind of drives me nuts to watch someone else do repetitive processes. (Once I have figured out the puzzle you might as well garage sale it because it’s not like revisiting an old friend for me, it’s just dull.)   I think that’s why I like to look at workflow – while there are patterns there are also variables around those patterns keep things interesting.

I recently found a kindred spirit in this vein, Tony Marsico, CEO of PCTS. Tony stopped by our office on a recent trip to Kansas City to get the “Grand” tour. Tony has a graduate degree in documentation of complex processes and corporate training. (No, I didn’t make that up, and yes I did laugh when he told me.) Which makes him perfectly suited to run PCTS, a analytic software firm that provides business intelligence for hospitals via an RTLS system.   He is an investors dream with his ability to clearly document and communicate process back out to his team.

PCTS provides real time business intelligence for Operating Rooms and Emergency Departments with “air traffic control” like screens, mobile buttons, and integration to systems and medical records. The really interesting thing about their product is its ability to run workflow rules and associate them with other rules. (That’s an over simplified way of describing that) Breaking down processes to physical movements, allowing for interaction levels and not only the “time association stand point” such as “IF the RN is in the room for X period of Time THEN do XYZ” obtaining information from other systems to validate the entry and interaction with patient specific information. All of which I have seen in “Demo” mode.

As I have said before I usually don’t believe it until I see it and PCTS was gracious enough to take me on a site visit and let me watch their team in action at Cook’s Children’s Hospital. This was an asset tracking project, so not nearly as complex as the workflow in an Emergency Department or OR, but interesting and exciting. The team was incredible, and the processes appeared to provide real time value to staff.  Including the ability to better locate, identify, and collect recalled pumps and modules.

It’s important to note – while PCTS is dependent on RTLS they are NOT an RTLS company. However, they do provide RTLS products. Tony’s explanation made a lot of sense.   Analytics based on workflow using RTLS is not simple and the validity of the information is a direct correlation to the installation of the RTLS product.    His challenges, similar to many companies I have talked to, is who to hitch his wagon to. He is in need of companies who understand analytics, understand workflow, and understand the relationship to hardware. (That last point may sound “easy” but take it from the voice of experience it’s not)

My assessment – Tony Marsico is an Investors dream - he could "McDonalize" processes within a company.  He has also surrounded himself with good people - which I have found to be the key to building a successful people.  (Yes, that's my secret - I hire people smarter than me.)  He is driven, intelligent, and has an eye for creating better workflow inside his firm and outside.

Tony’s Most Recent Read: Inside the Tornado – which I read the following week and it was a really interesting read. (Note to audience: Just read the first couple of chapters and you will get the gist of the entire book)

Sphere3 celebrated our first birthday in May. Though there was no noted celebration there was a strange, we have arrived moment – meaning that the phone has been ringing a lot and business is definitely starting to move. That momentum has really increased my travel - which has noteably decreased the blog posts. Stay tuned there are good posts to come later this month: Chad West, CEO of Ascom Wireless and Todd Plesko, CEO of Extension

Who put the "I" in Innovation....

It seems anytime you put an "I" in front of a product it can represent a number of different things.  In healthcare it means innovation, interaction, intelligence, and integral.  The goal however is to make sure that it does not become irrelevant, inferior, or illogical. 

The I-phone has spurned a number of discussions because of it's innovative nature.  The product has been built on a platform that allows everyone to create their own "Aps" - in my world that means design their workflow in a way that works for their unit not generically designed to work in all applications. (just a quick warning that can be bad also)

The flexibility of the platform that is open to large and small organizations (and individuals) is the best way to drive new ways to solve problems.  Let's face it - it's not always the big guys with all the ideas.  It's also not always those of us who break out and build a business - more times than not it's the people who live in the situations everyday. Therefore, the intelligence in the product is built by the users, and the flexibility allows it to become an integral part of the workflow and daily life.  So integral often times we overlook product "issues" such as durability and compatibility with infrastructure.

The challenge will be how do we make sure a strong "I" shaped platform does not become irrelevant and illogical.   The best way to approach this is to make sure that it's the workflow that drives the innovation and not the innovation.  Cool - for Cool sake - is not so Cool.  This is not meaning you need to run out and hire a Sphere3esque firm to document and help design your wireless device workflow - it just means if you are not currently doing it - why not? What innovative value are you missing?

The I-Phone is driving people to design applications that can be used in the healthcare space - in my world that's for automation of alerts to a wireless device.   Amcom releasing software that will automate information to the Iphone is interesting, but as you saw in my previous post about Voalte that application for clinical alarms to the Iphone is still hard for me to accept.  Durability has to be in the decision process for a clinical device not just innovation.  Also as we drive more information to a single device are we really making the best decision?  It sounds logical - don't get me wrong - one device that can get alerts, call the on-call doc, use decision making software, access facebook, see information on a med record, etc sounds great but is it really the best choice?  (I am throwing that out there for interaction sake because honestly I am not sure - I see benefits but I also see a lot of limitations due to the critical nature of alarm automation)

The device has more application to those who work outside the hospital, like a doctor but then the question becomes what information does he need that requires integration to the hospital.....this I know, but I will let  you ask me to find out.

From a market perspective - it's only good news to have multiple competitors in the on coming tornado that will occur with smart phones. 

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. 

To Wash or Not to Wash....

Recently, I enjoyed a spirited conversation with Hill-Rom’s GM and Vice President, Mike Gallup. Mike is a former IBM consultant who has been tasked with creating an unstoppable force in the Hill-Rom HITS (Healthcare Information Technology Systems) Group. His goal is to systematically coordinate the design of applications, creation of partnerships, and integration of collaborative initiatives that will strategically confront the marketplace status quo.  He was gracious to share his thoughts and a new project that they are going to be launching soon.

Hill-Rom as written and developed a patent on hand washing that should cause the industry to sit up and take notice. Hospital infections are costly and many are preventable. Those two items are ear perking to people who focus on providing value to a hospital. Not to mention the pain and discomfort that they cause a patient, and potential additional infections throughout the hospital. The ability to decrease infection by a simple hand washing or sanitization is crucial. To put dollars to the thought, according to Hill-Rom MRSA infections can cost in excess of $200,000.

Hill-Rom approached the marketplace trying to identify a strategic partnership with an RTLS provider that could meet the system and software requirements developed in the patent. After much research they decided on Centrak. Centrak’s ability to get granular in the patient room allows for the proximity of the caregiver to the dispenser to be identified. It also detects the actual motion and interaction with the cleaner.

Sound a little like Star Trek? It’s not.

The concept is actually quite simple, but software and application is really brilliant. The motion sensor within the Centrak tag notices movement of the dispenser when it is touhed and the badges correlate the proximity of the caregiver. To “fool” it you would actually have to have a caregiver bump the dispenser on purpose and not clean their hands. This would seem to be a farfetched idea. I am not an expert on hand washing, by any means, but I would assume that a majority of the time that a caregiver didn’t wash their hands prior to interacting with a patient would be more out of forgetting, and not intentionally avoiding.

I see this as a brilliant tool. Since it’s a standalone system it could be tied into a number of different integration points to track the effectiveness, but also offer some proactive notifications to the caregiver or manager. While the application is not prime time at a facility today the system has made it through all of the Hill-Rom and Centrak’s internal testing. Mike’s projection is to have it live within the next three month.

Thanks again to Mike Gallup – www.hillrom.com I look forward to more spirited interactions about healthcare in the future.

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?

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

Keep it Simple Sweetie.....

I was recently asked why I related healthcare IT to a car in a previous post, and did I think that it made me sound less “techy” or intelligent?    Forgive me while I soap box a bit - One of the things that bothers me about healthcare IT is we use overly fancy words, acronyms, and phrases to describe something really simple. While I understand this is similar in many industries – for example, the dentist yesterday he used 15 different words to describe my sore tooth. It’s the second tooth from the back on the right side people! Bicuspus chomper regularus painfulugus!

It would be easier if we could all just translate a little. That’s why I try to use a lot of non-healthcare and non-IT analogies. Not because I don’t understand – because I do. I understand that to most people we work with the concept is more powerful then a detailed description of the program or Code. The result is more critical then the how.

To those of you who program – don’t get me wrong I understand that the details must be covered and if not then the concept can never occur.  To those of you who live in the concept – the details drive you nuts but without them your vision is just words.  Words accomplish very little.

With everything occuring in Healthcare IT - communicating between technical and non-technical people is critical to making things work right.

What do I know?  I am just a little gal from Missouri…..with a company that takes “Anything that rings, dings, or buzzes and we design the workflow to get it to a wireless gadget that a caregiver carries.”

Disruption is NOT Always in the Initial Splash

Disruptive Technology – at first glance it almost sounds negative. Disruption as a term means to throw into confusion or disorder. Disruptive Technology is disruptive to a process, disruptive to an industry, but most importantly disruptive to a mindset.

I sat in two conferences. One a group of well intentioned manufactures wanting to disrupt the space surrounding falls in hospitals and the other with a group who wants to disrupt current processes in healthcare by reducing workloads. Phrases like “Change is inevitable” and “If we don’t change then we will be left behind” resonated with me as I tried to collect my thoughts over the weekend. How does this add value to the hospital? How does a hospital make sure it’s not just one more PO on a piece of technology that could end up never being used because of its inability to fit into the life of the caregiver?

As we drove back to the office, my Analyst had a stroke of genius (which happens often) she said “You know that vital device we saw – that could save at least 30 minutes.” To which I replied “30 minutes a day doesn’t change much.” “Not a day! Every time they do that! Kourtney, that would allow us to decentralize at .…..” as she rattled on through several scenarios. (As a former caregiver, she is always excited to find ways to save time.) Then it really hit me – The disruption does not always lie in the immediate process sometimes it’s in the ripple effect.

Have you ever watched a pebble thrown in a pond or puddle? The initial splash is sometimes impressive but what’s truly impressive is to watch the rings as they multiply and span out over the water. Think through the ripples – there is an assumption that the time being gained is used for productive activities and that the productive activities free up another area.

As the ripple gets larger there are more related items that could fill that 30 minutes of time saved, and possibly more time can be gained in other areas. The direct connection back to “that” 30-minutes becomes looser as you move farther from the initial “splash”. In theory and on paper assumptions become strong cases to justify the actions/purchases of administration. I think we will see a lot of that in the coming year, and while skeptics might balk at simple associations – without the creativity of process design – no one would’ve found “that” 30 minutes and we would still be wasting it today.

Have you ever thought about that – let your mind wander through all of the things that one item changes? You have heard of 6 degrees of Kevin Bacon – what’s the 6 degrees of one innovation? How many rings does it make? That’s the true value.

My instruction “Blow it Up”! We work in an industry that is so ripe for innovation. There is a new era of change – not just change for the sake of change. We are not talking about technology that ends up in a recycle bin because its value was linked to “fancy” and not linked to improving the day of the caregiver. We are in an era where healthcare providers are demanding follow through on a promise and PROOF in the pudding.

Patient Satisfaction and Value

Patient Safety initiatives can readily be linked directly to value for the hospital. If a hospital reduces one fall there are savings of litigation, and non-reimbursable care. Patient Satisfaction can be a little more abstract when measuring results – not that you can’t get a score very readily from a Press Ganey Survey. What does that mean for dollars? How can we measure our effectiveness in these initiative? Adding new dimension to this is the HCAPS Surveys and how they will affect reimbursement for care.

Every business uses some sort of performance metrics. Often quantity of incoming requests (similar to incoming patients) and quantity of “credits” given for mistaken work (similar to non-reimbursable care) – not that these are exactly the same in all instances but they are similar and make the point that tracking specific information can be helpful when improving business practices.

Sphere3 believes that a stand-alone metric, while valuable information, is less effective as one that is cross-referenced with another. For example, if a hospital were to look at average response time balanced with the staff to patient ratio and correlated with total average call volume – you could use the information together and create a multi-faceted metric. Then take that metric and see if there is safety improvement and if there is also an improvement in patient satisfaction score.

Most importantly, what is the link it to dollars? Will the hospitals elective surgeries increase? Will the hospital have a consistently higher census? I understand there are some large assumptions when loosely linking these two data points but the point is if you had the power to easily look at information such as (1) your response times, (2) quantity of direct interactions with patients, (3) average wait time before exit, and (4) total call volume, would you be able to make specific linkages to improvement in patient satisfaction? Would you be able to take that information and link it to increase in electives and increase in revenues based on increase of paying heads in beds?

Our new Sphere3 Scorecard™ will make it easier for hospitals to get specific information on clinician response and interaction which can be compared to patient satisfaction.

Call us for a full presentation.