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.

kgovro@sphere3consulting.com

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.

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.

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 info@sphere3consulting.com

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.

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…..how 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 technology.....as 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......

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 “1^st 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.