In taking it a step further from Nurse Call and VoIP phones, in the future we will have IT departments that provide nothing but connectivity and support to interfaced-services for facility systems, bio-medical systems, and clinical systems – a given. Is it possible that we are at the verge of an entire new operational department within the preview of a CIO that connects VoIP, bedside medical devices, chiller plants, security, virtually any element that creates an event and/or alert and we will not have a means to interconnect it all? Talk about IT being in the middle, if I may. Or, will there be some ‘eureka’ moment that some standards-based ideology actually takes place and works without the advent of additional and highly-skilled IT staff to manage additional and highly technical platforms? I wonder the time-frame what with industry infighting, posturing, infringement, and that whole concept of manufactures actually making some money along the way and I wonder the palatability of today’s IT leaders in taking the risks of attempting connectivity at an enterprise level now that so many expectations have been set on – well, almost nothing.

Reaching that goal has turned out to be another story.

I think the hospital customers have been literally caught in the middle (and are the biggest losers here). Middleware turf wars have not helped anyone.

The middleware providers have had a very hard time coming up with a sustainable business model, as no matter what they do, the “connectology” of it all (nod to Tim Gee) is hard to implement, and even harder to support. Thus, they have not been able to figure out a way to give customers what they need and make money at it.

As a result of business issues, folks like Emergin (and to some extent Ascom) have clung to an architecture that is not exactly open (to somehow give them the leg up and improve their respective bottom lines).

Philips’ acquisition of Emergin doesn’t help this cause out very much, as it takes what had been an inherently agnostic utility application (by design) and puts it under the control of an entity that has its own product interests at heart.

Over time standards are likely to prevail and fix a lot of this (and perhaps eliminate the need for middleware), but the sheer amount of legacy technology in healthcare only means that this will take a very long time to work itself out.

Very good article indeed, with some excellent points. I would also put up for consideration that a staff assignment client needs to encompass a broader cross section of clincial systems outside of nursecall.

Whilst nursecall is an essential system it forms one of many disparate systems within a healthcare environemnt. One needs to consider staff allocation in the broader context.

Additionally, the nursecall vendor needs to embrace the bi-directional functionality of the wireless device.

Whilst SIP / H323 will provide voice connectivity, it will not assist in the task assignment and monitor the workflow associated with the request.

Good article. I just wanted to inform you that we (Intego)deployed our SIP integration over a year ago with Cisco and are currently deploying our SIP integration with Avaya. Our first installation had over 1000 handsets and yes no middleware.

Charles Bell
Founder Intego