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Technologies Hospital Leaders Should Watch

Courtesy of non-profit research house the ECRI Institute, here’s some of technologies that they believe hospital C-suite execs should be watching this year. This list was generated by ECRI’s in-house analysts, reports HealthLeaders. Not all of these are directly related to EMR/EHR technology, but we’ve included a few that might be of interest on the broader HIT level.

* Electronic Health Records: This is so obvious it hardly bears mentioning, but yes, EHRs are number one on the list. ECRI notes that execs should beware of possible patient harm in the effort to achieve Meaningful Use, as some HIT-related errors are emerging that can lead to serious care issues.

mHealth:  Mobile applications are becoming an increasingly commonplace part of health IT infrastructure, but managing them effectively isn’t as simple as download-install-use.  This is likely to be the year hospitals need to get it right.

Alarm Integration Technology:  Alarm fatigue has been and continues to be a major issue for clinicians, with some critical care docs experiencing 350 alarms  per patient per day.  Increasingly, alarm integration systems are being implemented which send alerts to phones or pages, leading to more controllable alerts and quieter environments.

Imaging and Surgery:  ORs are increasingly hosting full-scale angiography systems to help guide high-risk minimally invasive surgery, as well as guiding combined open and minimally invasive surgery and verifying successful surgical completion. These hybrid ORs are expensive but have arguably improved results.

* PET/MR:  The PET/MR scanner is beginning to emerge as a new mainstay in oncology, improving on the results delivered for years by the hybrid PET/CR. The PET/MR offers greater detail, helping physicians detect cancers and tumors.

I would have expected to see something on the data analytics technology front to appear this year, but it was absent from the list. I might also have expected to see cloud solutions turn up, but again, not this year.  What technologies would you add to this list?

March 29, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Making Devices Interoperable Offers $30B Savings Opportunity

Right now, it’s a hit and miss thing whether hospital medical devices can talk to each other or connect with the facility’s EMR. A lack of standards — and money for next-gen devices — has made such interoperability a very tough job. But getting the job done is worth the trouble, a new story in iHealthBeat suggests.

At present, patients in hospitals are treated with six to 12 medical devices in a typical intensive care unit, including defibrillators, electrocardiographs, vital sign monitors, ventilators and infusion pumps, typically from a mix of manufacturers, notes West Health Institute.  Because these devices aren’t inherently interoperable, hospitals spend big on IT infrastructure to connect them.

There’s plenty of reason to make them connect, however. A study by West Health has concluded that if the industry could improve medical device interoperability and adhere to interoperability standards,  it could shave $30 billion off of U.S. healthcare costs.  According to the report, the U.S. spends $36 billion each year on “addressable waste” resulting from a lack of medical device interoperability.  Savings the U.S. could realize breaks down as follows, iHealthBeat reports:

  • $17.8 billion from higher treatment capacity that would result from shorter hospital stays
  • $12.3 billion from increased clinician productivity
  • $3 billion from reducing the cost of providing care
  • $2 billion from reducing adverse events
  • $1.2 billion from wider adoption of interoperability standards

But getting to the point where interoperability is common could take a long time, according to West Health’s Joseph Smith, who recently testified on the Hill on this subject. Right now, only one-third of hospitals using six or more medical devices that can be integrated with EMRs have actually done the integration work, Smith told a House subcommittee.

What’s more, vendors will need to invest in R&D to turn out next-gen interoperable devices, a cost that will be at least partly absorbed rather than passed on to the buyer, Smith noted.

March 25, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Video Demo of Metro’s Point-of-Care Technologies at HIMSS13

One of my goals at HIMSS is to try and give those who can’t attend HIMSS a chance to get a taste of what the experience of visiting the HIMSS exhibit hall floor is like. I’d been doing some writing for Metro on their Point of Care blog recently, and so I took the chance at HIMSS to film Erik VanLaningham doing a demo of some of the Metro point-of-care hospital solutions. It’s a quick video that shows a nice look into BCMA and point of care technologies in action.

March 21, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

Remote Patient Monitoring Going Mainstream

This week I read a piece of news which suggests to me that we’re seeing a turning point in the use of remote monitoring technology to manage patients.  It looks like AT&T is taking a major public position in support of remote monitoring via the cloud, via a partnership with a  hot new startup that just raised funding, according to a report in mobihealthews.

According to the mobile health news publication, cloud-based patient monitoring company Intuitive Health just got a $3.4 million investment in what appears to be the company’s first public round of investment.

Intuitive, which completed a pilot with health system Texas Health Resources and AT&T last year, offers cloud-based remote monitoring software which can interface with any device.

The pilot involved monitoring CHF patients remotely for 90 days using wireless pulse oximeters, blood pressure cuffs and weight scales, plus tablets and apps feeding the data to the  patients’ EMR records. During the pilot, THR reduced hospital readmissions for chronic heart failure patients by 27 percent, mobihealthnews reports.

According to a press release from AT&T, Intuitive’s software has since become a key component in the telecom giant’s own SaaS patient monitoring product.

Remote monitoring has been a hot topic of discussion and an emerging approach for several years, but hasn’t found an established place in day-to-day care for most institutions.  With AT&T and Intuitive offering a device-agnostic model, however, I believe they will give a boost to the use of remote monitoring generally.

Personally, I’ve been cheering for remote monitoring to succeed for some time; after all, given how mobile-device-oriented people are anyway, it just makes sense to leverage those capabilities to improve their health.  I hope this represents a turning point for this type of technology and that we see news of more successful pilots this year.

January 31, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

iPad App Helps Patients Understand Inpatient Care Process

During an inpatient stay, patients have usually contact with a large number of professionals, including doctors, nurses, x-ray techs, phlebotomists and more.  Without help, however, patients often lose track of who’s delivering their care, forget to ask key questions and generally fail to understand the process of helping them get well.

At Boston Children’s Hospital, they’re hoping to solve the problem with a new iPad app that guides patients through their care process and makes it easy for them to communicate with clinicians. The app, MyPassport, pulls data from the hospital’s Epic and Power Chart apps and displays it in a way which helps patients stay on top of their care process.  It also prepares them for discharge and arms them with home care instructions.

The idea for MyPassport came from a paper booklet which the hospital assembled manually, adding pictures and titles for every care team member as well as pages for lab test results and summaries.  The paper book, which also offered a place for patients to write questions for their providers and information about discharge, was helpful to patients, but took a lot of effort to maintain.

The notion of transforming the paper booklet into an iPad app was spearheaded by urologist Hiep Nguyen, MD, who won a Boston Children’s FastTrack Innovation in Technology award from the hospital’s Innovation Acceleration program to create it.

Not only does the app make it easier for patients to ask questions of clinicians — or in this case, parents of patients — through an instant message-like utility, it also displays lab values in a simple format understandable by caregivers/parents. MyPassport also offers a list of goals a given patient should meet to be ready to go home.

I don’t know about you, readers, but I think this is an excellent idea. Helping patients and caregivers understand and coordinate the process of care, know their clinicians and plan for discharge is a really great use of iPad technology. While the app is undergoing a small pilot now, expect to see MyPassport or other apps like it turn up elsewhere soon. Good show, folks.

January 14, 2013 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Health IT Stands Out In Health Technology Hazards List

The ECRI Institute has just released its annual list of top 10 health technology hazards, and this year, two of the hazards are health IT related. This probably isn’t a surprise to anyone who reads this blog, but it’s still worth noting, as it’s easy to get embroiled in abstract IT discussions and forget concrete patient risks, wouldn’t you agree?

For context, here’s ECRI’s list for 2013 in its entirety:

1.  Alarm hazards
2.  Medication administration errors using infusion pumps
3.  Unnecessary radiation exposures and radiation burns
during diagnostic radiology procedures
4.  Patient/data mismatches in EHRs and other health IT
(HIT) systems
5.  Interoperability failures with medical devices and health
IT systems
6.  Air embolism hazards
7.  Inattention to the needs of pediatric patients when using “adult”
techniques
8.  Inadequate reprocessing of endoscopic devices and surgical
instruments
9.  Caregiver distractions from smartphones and
other mobile devices
10. Surgical fires

As you can see, two of the top five are EMR-related, and perhaps more importantly, are risks that don’t get discussed that often in health IT watering holes such as this publication.  But it’s hard to argue that patient/data mismatches could pose severe risks up to including death, as could interoperability problems between medical devices and healtlh IT systems.

While ECRI doesn’t, I’d also count number nine, mobile device distractions, as I’m betting much of the distraction clinicians face comes from clinical communication, not idle chatter.  And while I don’t know how ECRI ranks its choices, I’d bet it actually belongs higher on the list.

I’m not going to sound like much of a prophet when I predict that health IT  problems will take over more slots on the list over time.  For example, when infusion pumps are linked with EMRs, interchange of data will almost certainly become a life or death issue.

In the mean time, dealing with mobile device distraction may be the lowest hanging fruit of the bunch. I don’t know how to do it, but if a vendor comes up with a solution that elegantly streamlines doctor communication on mobile devices, it’s likely to be a big hit.

November 30, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Providers Behind The Eight Ball On HIEs

ONCHIT is demanding them. Patients are beginning to understand them. But poor ol’ beleaguered HIEs still aren’t getting the attention they deserve, it seems.

A new survey by patient care organization ECRI Institute, done with strategic partner s2a, has concluded that while they understand the importance of HIEs, only 54 percent of providers have formally assessed their HIE and interoperability needs. (See the study here.)

Given the speed at which Meaningful Use data exchange requirements are barreling down on providers, that seems like a pretty low number to me.  After all, the final rule for MU Stage 2 requires providers to at least be able to electronically transmit a Summary care record using a certified EMR system or HIE for 10 percent or more of care transitions and referrals.

It’s also a pretty low number given that 93 percent of hospitals surveyed agreed that interoperability of health systems was one of their top strategic priorities.  Provider CIOs are well aware that getting HIE connectivity in play is a long and difficult process, and while they can’t do everything at once, one would assume that most providers would have a team in place to at least begin the assessments by this point.

The ECRI analysts conclude that two major factors are holding providers back:

*  Working with non-employed physicians:  For the moment, hospitals are focused largely on interoperability with their employed physicians, who typically use the same EMR as the facility does. Working with non-employed physicians is a major challenge for many reasons, including that they typically aren’t using the same EMR as the hospital.  There’s also legal issues that come into play: for example, what happens is non-employeds end up sharing data intended for Hospital B with Hospital A?

* Medical device connectivity:  Meaningful Use is putting great pressure on hospitals to exchange information between medical devices and EMRs.  However, interoperability even between a blood pressure cuff and and EMR is no picnic.  ECRI found that 40 percent of respondents hadn’t established policies and procedures for EMR interoperability with medical devices.

Of course, the sheer work and expense involved in becoming an HIE participant is immense, as well. Given those expenses, time demands, and the issues in connecting with physicians, I have to believe that a fair number of hospitals won’t be ready when Meaningful Use Stage 2 requirements hit.

October 4, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

Smart Bed Technology Interview with Casey Pittock of BAM Labs


The following interview is with Casey Pittock, Vice President of Sales and Marketing at BAM Labs, Inc.

Tell us a little bit about yourself and BAM Labs:
I have been fortunate to serve in leadership roles with various companies over the past two decades including Telcare, Philips, and Lifeline that have shared the common mission of helping people improve their health and the health of those in their care through technology and services. BAM Labs smart bed technology is the most compelling solution I have seen to deliver improved care, because it is completely touch-free and can help anyone regardless of setting or age or chronic condition.

BAM Labs®, founded in 2006 by Apple veterans and based in Silicon Valley, is a leading innovator in Smart Bed technology. BAM Labs partners with market leaders to develop smart bed applications and solutions for distribution to Acute (hospitals), Post-Acute (skilled nursing and long term care), Senior Living (assisted living and independent living), Home Health, and Consumer Retail channels.

BAM Labs first commercial product, launched in 2011, is the BAM Labs Touch-free Life Care Smart Bed System which features an FDA registered under mattress sensor and HIPAA-compliant cloud monitoring platform that transforms any bed into a smart bed. The TLC Smart Bed System delivers relevant health information and trends to individuals and caregivers via any internet connected device to improve health.

Where did BAM Labs get the idea to use a mat under a mattress to collect heart rate, breathing rate, motion and presence?
In 2001, Rich Rifredi’s son was born 12 weeks premature. He spent 10 weeks in a neonatal intensive care unit and was monitored 24 hours a day 7 days a week. When it was time for him to leave the intensive care unit, he was sent home with an infant apnea monitor, a device with three wires that attached to him and sounded an alarm when his breathing or heart rate became too low or too high. Unfortunately, the device had many false alarms and Rich and his wife stopped using the device and slept in 4 hour shifts taking turns watching their son breathe. Rich told his friend and former Apple co-worker Steve Young about his frustration with existing wired health monitors and challenged Steve to come up with a better solution. It was a tough challenge. Steve talked with a lot of engineers who said he couldn’t build a touch free health monitor and get enough accuracy to be meaningful.

Fast forward to 2006. Steve and his good friend Jim Williams, legendary analog circuit designer and former MIT professor, discussed a project Jim worked on at MIT. Jim’s team wanted to build a highly sensitive scale. However, the movements of blood flow through the body made his measurements inaccurate. A light bulb went off in Steve’s head. Using a similar approach to Jim’s scale, Steve could measure the vibrations from blood flow and lung expansion to create a vital statistics sensor. Later that year, Steve and Rich formed BAM Labs (BAM is an acronym for Body and Motion) with the mission to provide touch free health monitoring that everyone can afford. Four years later with the help of a talented team and advice from world renowned experts in the medical and electronics field, BAM Labs completed development of a revolutionary health monitor and cloud monitoring platform that is effortless to use and a fraction of the cost of existing vital statistics monitors. And to prove the doubters wrong, Steve designed the BAM Labs TLC Smart Bed System to be completely touch-free to provide a bit of magic for the user experience.

Does the mat collect these measurements as accurate as other devices?
Yes, and we consider our solution to be superior to other touch-free solutions for accuracy, precision and ease of use. The accuracy question is important, and we would like to stress ease of use here as well. If the system is hard to use, needs to be attached or worn, compliance becomes an issue and accuracy becomes less relevant.

The BAM Labs Smart Bed System collects the information effortlessly. Our superior design provides better accuracy than common actigraphy devices worn on the body. Likewise, heart rate is captured at a level very close to an 8-lead ECG, as will be demonstrated in a soon to be published study. Several major research institutions are embarking on alternative telemetry monitoring device studies, and they have selected BAM Labs Smart Bed System as a solution to deliver better outcomes while reducing cost.

I read that your smart bed technology captures 3,000-10,000 biometric signals in a 24 hour period. How do you take all that data and turn it into actionable data for the healthcare provider?
There is a small network device connected to the sensor mat that plugs into a standard outlet. This network device does some processing of the biometric signals and filters the data to BAM’s cloud monitoring platform. The cloud servers then take the data and convert it to a user-friendly display format that can be viewed on any internet connected device, such as iPads, desktop PC’s, smartphone, and so on. Healthcare providers can review presence and motion in bed, heart and respiration rate trends to indicate overall health trending, early indications of sleep disorders, and position change scheduling as a tool for workflow management.

What are some of the stories and healthcare benefits you’ve seen from having so much data?
Perhaps the best story of the healthcare benefits of the TLC Smart Bed System is the two residential care facilities that have eliminated injury falls from bed and reported zero new pressure ulcer incidences. Prior to installing the TLC system in all the beds in the two facilities, they were experiencing several injury falls each month and continued pressure ulcer incidence. After implementing the TLC Smart Bed System, healthcare providers at the facilities were able to identify and react to bed exits proactively to eliminate falls. Likewise, the position change scheduling enabled staff to know when to perform turns, and more importantly, validate that the turns took place, thereby eliminating pressure ulcers. Falls and pressure ulcers are two of the biggest cost and care issues for Medicare. The CDC and CMS have published studies showing the cost of falls at $12 billion annually and the cost of pressure ulcers at $50 billion annually. These staggering costs can be significantly reduced by implementing the TLC Smart Bed System in Acute and Post-Acute healthcare facilities.

Which are the most common ways for providers to interact with the data from the smart bed? Do you connect the data you collect from the smart bed with an EHR?
Nursing staff tend to interact with the data from the smart bed via the BAM Labs mobile app on handheld iPads and iPhones while they are performing their duties. For example, the mobile app will remind staff to perform a position change on a patient at a specific time and require that they press a directional indicator on the touch screen to validate the position change.

Administrators at healthcare facilities tend to use the data reporting features via their iPad or desktop PC web browser. They can print reports to share with family members showing the high level of consistent care they are providing, or show health trend data that may indicate a change of condition in advance of an episode enabling them to initiate a higher level of care. Administrators also use the applications and reporting as a compliance tool to show regulators the level of care they are delivering.

The BAM platform uses an open architecture allowing for ease of integration into EHRs through an API.

Do you think there should be a standard for exchange of this data?
Yes, history has shown that industries that try to push proprietary protocols fail because the network effect relies on open, low-cost ways to communicate. It’s the value of the data, not how it gets transmitted that is important. For example, BAM Labs uses an open architecture and all data flows securely through the internet. This approach seems to work fine for a few notable industries: banking, military, government, universities, etc.

What lessons have you learned that could be applied to the oncoming wave of healthcare device data that will be hitting physicians from personal medical devices?
Make the information easy to digest at a glance. The user interface is critical. The healthcare device data should be presented in such a manner that physicians get answers, not a bunch of confusing data they have to interpret. Devices must be connected to services that process and distribute the data and share clear, relevant information for the physician. At BAM Labs, data is processed in the cloud, reformatted and distributed to a physician’s internet connected device of their choice, in a user-friendly interface for “at-a-glance” information.

Does BAM Labs plan to offer a consumer version of their product, or will you strictly focus on the enterprise smart bed market?
BAM Labs works with partners in the Acute, Post-Acute, Senior Living, Home Health, and Consumer markets. BAM’s vision is to place a smart bed under every body.

What do you see as the future of patient monitoring? What will this look like 10 years from now?
The bed is the ultimate platform for consistent health monitoring. And, there is no need for straps, headbands, wires, or accelerometers in the bed itself to capture powerful health information. Our BAM Labs TLC smart system is completely touch-free – all you need to do is sleep. In 10 years, every bed will have smart bed technology. Our kids will say, “you were in bed one-third of your life and did not get any health information?!”

October 3, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 5000 articles with John having written over 2000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 9.3 million times. John also recently launched two new companies: InfluentialNetworks.com and Physia.com, and is an advisor to docBeat. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit.

FCC Says Wireless Health Should Be “Routine” Within Five Years

This week, the FCC made an announcement which, I think, is likely to have far-reaching implications, including for providers, hospitals, wireless vendors and medical device makers. *So* much is going on in this announcement that I think I’ll have to parcel it out into a series, so stay tuned.

But let’s start with the basics. In the announcement, the FCC said that it plans to implement on the key recommendations made by an independent mHealth task force.

Perhaps the most dramatic news is that the FCC seems ready to push for making mHealth “a routine medical best practice” by 2017.  Despite doctors’ increasing reliance on mobile devices, that’s a tall order — or even a nearly impossible one depending on how comprehensive your definition of mHealth is.  Regardless, this looks like a watershed moment.

The agency has already taken several steps that advance wireless healthcare networking, including:

*  Medical Body Area Networks:  The FCC recently released an order allocating spectrum for Medical Body Area Networks, networks of small sensors attached to a patient that continuously report results.

*  Medical Micropower Networks:  Last year, the FCC adopted rules enabling a next generation of  wireless medical devices used to restore functioning to paralyzed limbs. The MMN is an ultra-low-power wideband network consisting of transmitters, which are implanted in the body to take the place of damaged nerves.

FDA/FCC Partnership:  Since 2010, the FCC has been working in partnership with the FDA to help bring communications-related medical devices quickly and safely to market.

But this is just the beginning, folks. As you’ll see over following installments, the FCC is taking on not only the broad policy goal of “mHealth by 2017″ but taking several steps that should help to lay the groundwork to make this happen.

Are they enough?  Let’s talk about it. I’ll get into what some of the proposals are, and how much impact they’re likely to have, in coming HospitalEMRandEHR.com articles.  So don’t turn that channel!

September 28, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.

A New Frontier In Medical Body Area Networks: Digital Pills

This item is a bit to the left of what we usually cover here, but I thought you might be as intrigued as I am, so here goes.  Techie site Mashable has just reported that the FDA has — for the first time ever — approved a digestible microchip that can be embedded in drugs.

The sensor is a tiny silicon chip laced with magnesium and copper; it generates a slight voltage which responds to digestive enzymes. The voltage signals a patch worn by the patient. Then, the patch transmits info wirelessly to a provider’s mobile device.

Right now, the sand-particle-sized chip is only approved for use in placebos, but maker Proteus Digital Health hopes to see approval for other drugs in the near future.

So, why bring this up on a site dedicated to hospital EMR discussion?

  • This is great news for hospitals, as it will eventually offer a far-less-invasive and labor-intensive method for tracking how patients are responding to drugs.
  • This  offers one more way of tracking patients wirelessly and sending data straight to an EMR.
  • The chip in question is the first step toward products like a sensor that would deliver an ECG to a smartphone (and by extension into an EMR)

My guess is that it will be years before this kind of solution is mature, but it’s neat to hear that it’s progressing. I believe it has a real future.

August 10, 2012 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies.