Consumable

Many of you who have read my blog for a while would read that title and think – here she goes again talking about food…not this time.  This time I am talking about the consumable nature of mobile technology used in the healthcare environment.   This post will focus mainly on hand held devices – in alarm notification that’s code for wireless phones.   I have heard them called all sorts of creative things – “workflow enablement tools” “mobile caregiver communication platforms” – all of which boils down to…. a wireless phone.   

Don’t get me wrong I was selling these innovative pieces of technology…..before the birth of #2.  (who turns 9 this week) While I recognize that platforms have changed (WiFi etc) – has the end user functionality really improved?  When a color screen is an “improvement” worth changing out all the handsets it’s kind of a sad statement for these little plastic wonders.

 I have been working in the medical device alarm and alert area of Health IT for many years (you might think I started working in grade school based on the number). I have noticed, wireless phones are becoming disposables….like gloves or needles…. (the sales tactics are certainly with that mindset) One of my hospitals has been offered 3 upgrades to their handsets from their single vendor…..when that happened all of the handsets (phones) needed to be traded in.   I heard that some EMR companies are wrapping it into the sale of their product….which just makes me scratch my head….and frankly should make any investor scratch their head as well.  Is that revenue worth the effort (because it’s surely not the margins)…..is it just a move to be more sticky in the client…..is it worth it?

When my clients ask me about the workflow of these plastic wonders, I quote one of my favorite CMIO  “It’s like fine tuning a model T, my friend.”  Really it’s time for better evaluation of end points, and if your hospital is still buying, replacing or upgrading your wireless phones….it’s time to rethink your strategy, ask yourself: 

·         Why am I buying a device that is as disposable as gloves?

·         Do I supplement our current wireless phone with other devices such as Ipads, Itouch, or other tablets (for those of you who have been able to keep away from the I-monopoly…..) could I combine it for more impact?

·         In the ever shifting reimbursement world – is a little plastic phone worth our time?  What’s the value vs return – could I attain more value with a different strategy?

·         If I have a lot of these devices…ie I was ahead of the curve 9 years ago – how do I phase them out to new devices?

·         Should I be evaluating the BYOD strategy for my hospital?

The point here is – hospitals are tired of disposable expensive technology that gives them Model T level experience?  They need to identify vendors that have the same mindset – how do we move to a modern “workflow enablement tool”?

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....

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.