Still, sometimes one needs to “investigate” more specifically… While most hospital customer have call detail reporting (CDR) for their traditional telecom appartus, Vocera’s user and role based framework offers many additional dimensions to understanding what’s happening communications wise, or sometimes more importantly, what’s happened.

This past week, a clinical manager at one of our local customers needed such investigative work in regard to a specific employee over the course of a 6 month period. I’m not privy to the reasoning, but we were told that this was very important. Given the volume of calls at this particular facility, the canned IncomingCallDetail was going to be rather unwieldy to generate and sift through, and we needed a smarter (and more easily replicatable) means of running this type of report on particular users. Using Crystal Reports, and some MySQL query know-how, we now have easily bolted onto that customer’s report server the ability to easily choose a user, a data range and find out some important questions:

• Who called them?
• What was their status when the call came in?
  • Were they logged in?
  • Did they reject the call?
  • Did they block the call?

This was a pretty basic use case, but the larger point is that the Vocera Report Server’s extensible framework makes it easy to ask your own specific questions and easily deliver answers to them.

With so much smartphone attention shifting to Apple’s device centric IOS for the iPhone and iPad, and Google’s ever increasing Android ecosystem,  RIM wants customers to not see them as just a smartphone manufacturer or mobile email delivery mechanism, rather as a robust, secure, integration-friendly, and extensible platform for mobility throughout the healthcare enterprise. Strategically this makes sense: 1) focus on a core user community who already understands the value of unified, secure, and controlled delivery system 2) leverage the plumbing that’s often already in place and do more with it 3) let the rest of the world fight over disposable applications.

Consumerism is Creeping into the Healthcare Market
As interesting as the sessions were, the verdict is still out on whether RIM can keep Apple, Google, Microsoft and HP at bay, even in a niche like healthcare where they already have a beach head with core messaging. RIM has always delivered great solutions (and good devices, albeit bland at times), but the consumer market has been tough for them. And consumerism has indeed taken a hold in hospitals. RIM is challenged to be both Control and Kaos at the same time because like it or not Physicians and Nurses (and IT people too) are consumers.

As marketers around world know, sex sells (even if it will sometimes kill you). But it’s a slippery slope. On one hand the devices that Apple and Google’s hardware partners are delivering are innovative, compelling, and sexy; yet RIM’s competitors are challenged to build the enterprise management and security that RIM has carefully baked for many years.

I caught up with tour in Boston.  I walked away with the following questions swimming in my head…

• With increasing encroachment of iPhones and iPads into the enterprise, given a choice, will clinical users go for the IOS device or Blackberry (even if it has a capacitive touchscreen)? A CIO in the audience (toting an iPad) spoke of their dual prong strategy of delivering voice and messaging on Blackberrys, but applications and reference on IOS devices (Note: the key there is that they are making the employees responsible for the device. It breaks; you lose it, your responsibility).
• There is still a great deal of fuzziness of the role of middleware for enabling integration to clinical application (both legacy and contemporary). While there are clearly difference between what Amcom and Wallace Wireless (not to leave out Globestar who was absent in Boston), this remains very hard to understand stuff for  those responsible for acquiring solutions.  All made even fuzzier when you bring Blackberry into the mix with its own middleware layers. Can RIM project a clear unified delivery vision, yet leverage the strengths of their ISV partners? And can it be delivered at a doable price point?
• Traditionally Blackberry development resources were hard to find. While the RIM staff at the event were quick to point out that customers like UPMC Mercy are able to deliver heavy weight Blackberry driven solutions without Blackberry specific development of their own, mobile application enablement is not plug and play for ISVs. Can RIM get and keep the attention of developers, and can they overcome the lack of application development talent comfortable with their framework? RIM needs to prove that its platform is not only powerful from a development perspective, but also that it’s easier than we are accustomed to.
• Will the carriers and big iron PBX manufacturers be an impediment to the practicality and affordability of the Blackberry Mobile Voice System (MVS)–RIM’s fixed mobile convergence play. Clearly RIM sees the great potential in delivering a seamless communication experience for mobile workers, but what will the TCO be (including all sides of the solution)? There is also the issue of their solution being IP-PBX only. In my experience here in the Northeast, there is a significant portion of the market with substantial investments in legacy TDM technology (MVS with WiFi won’t work for these folks).
• Dropped voice calls are annoying but something we’ve all come to tolerate. Unreliable transmissions of time sensitive critical alarms and worfklow communications are not. How will RIM deal with the fundamental challenges or delivery of their solutions in Healthcare, both from wireless perspective, but also from a basic operational standpoint? In spite of increasingly improved WLANs, hospitals are an RF (and operations) jungle. Indeed the wireless networks are there, but the dirty little secret is that nearly everyone trying to deliver converged solutions via WiFi is having more trouble than they want to admit.

For RIM much is at stake. If I took anything away for the summit, they are clearly willing to do what’s necessary to stimulate the interest and efforts of their hospital customers. They have put considerable effort into bolstering the efforts of initiatives at UPMC Mercy, MD Anderson and elsewhere, and they are ready to do more. As Roger Tobias (who leads their healthcare efforts) noted they are more than willing to put their own resources on the ground to kick start hospital projects.

What’s your take on RIM in healthcare?

I have two customer discussions going on at the moment – both require real time asset tracking, one is looking at a WiFi solution (plus software and appropriate tags) and the other is looking at a tag-centric solution with it’s own radio network running alongside their WiFi (concerned about traffic). Aside from the cost differences – what does the group think about the perceived “competition” between these two approaches. No plugs for your own company’s solutions please ! – objectivity appreciated.

The thread is very lively, with folks from different camps (and manufacturers) defending their point of view. As respectful as the tone is here, there is a bit high tech mud slinging going on here that is telling regarding the state of the industry. All too often when talking to customers, the conversation starts with infrastructure. And the predominant marketing messaging out there is that the infrastructure is the solution. This can be pretty dangerous thinking.

In fairness to Shoalib, his query was specific to RTLS from an infrastructure perspective, so it’s fair that the thread is about infrastructure. As we work with customers we often find that technology buyers all too often want to boil it down to A or B. I would suggest that by not focusing on broader applications and “solutions,” the industry has seriously confused and kept away customers through slugfests like this. Overall adoption rate is nowhere any of us expected it to be at this point. Why is that? As some of the folks in thread suggest, there has been lots of over promising going on, and the technology needed to improve. But in spite of the improvements, the reality is that infrastructure alone will not deliver the results that customers are looking for when purchasing an visibility solution. One of the responders, Trish Messiter, smartly tries to reel all this in by suggesting:

The real question here is what is best for requirements? The answer, unfortunately, is “it depends.”

I’m with Trish on this one. While everyone is piling on regarding whether WiFi is a good solution or not, we don’t really get to hear what Shoalib’s customer is trying to accomplish, nor do we have a good enough understanding of the environment. In many cases, WiFi will make sense, or the infrastructure may be a hybrid one, with a location engine listening to different types of sensors used for different purposes.

Note: this is actually the most popular link on our website, so based on market demand, we’ve updated it for Version 4.1. Thanks for stopping by. While you are here, can we interest you in our customized Vocera headsets, Vocera training and implementation services, or Vocera support services?

So what are some good examples of passive RFID in healthcare and what should you look out for? First, think of passive RFID as EZ-Pass in a hospital. The technology is very good for capturing the incidents of a tag that passes by it and when. It does not do a good job of knowing your location on the highway or bridge after you pass the toll. This is where active works well.

Here are some good examples of passive RFID in a hospital :

• Patient elopement (walk-outs) in the ED.
• Equipment containment within a floor or a unit
• Securing equipment at entrances and exits.
• Tracking cardiac catheters in and out of inventory.

So, what should you be aware of prior to exploring a passive RFID solutions?

• The big issue is that if you begin to tag equipment, it’s likely that you will not be applying an active tag in the future. It’s certainly possible, but highly unlikely for the next few years.
• Make sure that the technology you choose can detect motion and directionality. Up until recently, passive RFID systems could only tell if there was a tag within its reading zone. Given the use case, you’ll want to know if someone is going out, or going in and also whether the tag is moving or just happen to be near the reader.
• Choose tags wisely. It’s a bit of an art to determine the right tag for different applications. Factors such as metal content, water content, distance and orientation to antenna all play in determining the right tag solution.
• Know what you are going to do with the data collected. Example: Do you need an audible alarm each time an IV pump walks off the ICU? Or maybe to record the event? Do you need security to get an immediate message that a wheelchair leaves the building? Or maybe the control center should get a pop-up on their screen.

There’s no question that active RFID is much more evolved in healthcare applications. There are many active RFID vendor solutions that are well documented. Awareness and education of another possible solution could save you time and money.

There were some earlier explorations with Sprint and Blackberries, but nothing that has taken hold to date. While hospital customers are not necessarily doing widespread enterprise adoptions of iPhones, physicians and executives are either showing up with their own devices, or pushing their IT organizations to allow them, in essence forcing the issue. The Vocera iPhone app is a further disrupter, especially because it begins to tear down the walls communication wise between home, office, and hospital facility. This is an especially interesting development in light of the work that Voalte has done in bringing voice and alarm notification to the iPhone,  iPad, and Blackberry. Whereas Voalte first took and alarm notification starting place, then added in voice, Vocera has come at this from the other way around. Alarm notification is likely not far behind.

We are in line for some messiness as enterprise IT tries to work through the management of these new multi-modal devices; however, given widespread consumer adoption of smartphones, this is precisely the competitive innovation the market is hungry for.

Ongoing loss and replacement of these durable assets can become a large cost burden on hospitals and biomedical equipment suppliers, with even small-to mid-size hospitals reporting the loss of dozens of units per year. The typical replacement cost of a cardiac telemetry transponder can range from $2,500 to $7,500; pulse oximeter probes are in the $100-$200 range. Protecting these assets with a passive RFID-based Asset Rescue will reduce or eliminate this loss and associated financial impact.

In this application, assets at risk of accidental discard are tagged and protected with passive RFID tags. One or more fixed RFID readers are deployed at places in the facility where laundry is processed (either in-house or dispatch to a laundry service) and trash is handled. The system is parameterized with the RFID tag identities of the tagged assets (either individually or by a range of identities, depending on user application requirements). One or more detection zones are logically defined at the laundry and trash egress doorways and routes.

Interested in finding out how you cut down on loss? Read our Mobile Asset Rescue for Biomedical Equipment Solutions Paper.

TPC Healthcare today announced a partnership with Patient Care Technology Systems (PCTS), a subsidiary of Consulier Engineering, Inc. (NASDAQ: CSLR). The partnership brings PCTS’ location-enabled workflow applications to TPC Healthcare’s growing portfolio of healthcare solutions. Under the agreement TPC will market PCTS’ automatic tracking and workflow automation solutions for healthcare with specific focus in New England, the New York Metropolitan area and the Mid-Atlantic.

With over a decade of experience in healthcare specific workflow application, PCTS’s platform gives TPC the opportunity to bring high performing, location-enabled workflow applications to new and existing customer alike. PCTS comprehensive Amelior 360 degrees Enterprise Visibility Platform™ includes products for hospital emergency, perioperative, interventional cardiology and diagnostic imaging departments, as well as facility-wide asset and patient tracking.

“In these times, results matter. As we looked to bring the right location-based solutions to our customers, PCTS’ proven ability to deliver measurable financial and operational impact to hospitals in the ED, OR, and across the enterprise really caught our attention,” says Kenny Schiff, founder and President of TPC Healthcare. “PCTS is our kind of solution. They are focused on providing the right applications to deliver customer success and not on any one specific RFID infrastructure,” he says.

“PCTS and TPC Healthcare have a similar solution-oriented approach to healthcare,” says Tony Marsico, President and CEO of PCTS. “All too often these types of solutions are not given the upfront or aftermarket attention they require. TPC Healthcare has a reputation of truly delivering what the customer needs, from pre-sale to implementation and beyond.”

About TPC Healthcare
Headquartered in Wilton, Connecticut, TPC Healthcare provides mobile point-of-care communication technologies, such as RTLS/RFID, wireless voice, alarm notification, and workflow automation to hospitals and healthcare organizations in the New England and Mid-Atlantic regions. TPC Healthcare’s unique blend of technology expertise, exceptional service, and years of experience successfully delivering point-of-care solutions help hospitals and healthcare organizations improve clinical workflow, increase patient safety, and provide better utilization of patient care equipment. For more information about TPC Healthcare and/or its services, call 888.427.2215 or visit www.tpchealthcare.com.

About Patient Care Technology Systems
Patient Care Technology Systems, a subsidiary of Consulier Engineering, Inc. (NASDAQ: CSLR), helps health care providers to improve patient flow, increase capacity and improve patient and staff safety by visualizing the real-time location and status of people and equipment throughout their facility. Each year PCTS solutions support over 2 million patient visits managed through its various solutions and has shown a proven return on investment in high turnover, high-acuity units such as the emergency department and perioperative suites. The Amelior Enterprise Visibility Suite™ is interoperable with all leading locating technologies, including active-RFID, infrared, ultrasound, ultra-wideband, Wi-Fi and ZigBee. PCTS customers have been recognized nationally for improvements in efficiency and clinical excellence. For more information, visit www.pcts.com.

Here are some key points to consider from my recent article in EnterpriseMobileToday.com.

1. Usability matters. A NICU nurse whose hands are busy diapering a baby has very different needs than someone dispatching code teams, or an anesthesiologist. In pointing out the difference between purpose-built healthcare devices like those from Ascom, Vocera or Cisco (and say a BlackBerry or an iPhone), Emergin often talks about “buttonology.” Visualize code team members fumbling for the Chiclet-sized keys on a BlackBerry Bold when needing to respond to an emergency situation. When seconds matter, better to have a single button push on a Vocera badge, or a simple soft key on an Ascom Medic handset.

2. Where are the applications? Healthcare-specific applications do exist for the BlackBerry, and Palm and Windows mobile smartphones, but they are far from perfect, often without true device/application integration. And mobile healthcare professionals require devices with deeper and tighter integration between hardware and applications.

While software providers like Globestar have smartphone-ready, hospital-friendly applications for alarm notification, escalation and dispatch, they lack tight device integration, making them imperfect. Again, the purpose-built applications, like Ascom phones or Vocera badges, currently have the leg up on the competition, though this may not last for long.

3. It’s the Network. If you don’t have a reliable network that can handle mobile communications, you’re going to run into problems. And in a world where medical professionals traverse from office to hospital to home, that network may really be a network of networks. While it may be okay to drop a call mid-conversation when chatting out on the street with your buddy, it’s not okay when a nurse misses a critical alarm from a fetal monitor.

In spite of significant efforts, the medical grade network (even purely at the building level) is not a reality yet. And while fixed mobile convergence (FMC) vendors like DiVitas (or the big PBX players like Nortel, Siemens and Avaya) have solutions that manage the transitions between networks for multi-mode devices (e.g., in-building wireless’3G), they can’t really fix the network of networks problem. And even if they could, the purpose-built, multi-mode device with true application integration has yet to appear.

4. What about workflow? Spend time in an Emergency Department or Operating Room suite recently? This incredibly fast moving world doesn’t lend itself well to ad-hoc asynchronous communications like email or text messaging that is de rigueur with normal consumer smartphones, especially given all the possible sending and receiving points. Reliable communication starts first with designed workflow and an understanding of the journey information must take from inception to delivery, to acknowledgement and response. Once you have a workable flow, then software applications and devices can be considered.

For more information, see In Healthcare Communications, One Device Does Not Fit All … Yet

Kenny Schiff is a contributor to Internet.com’s EnterpriseMobileToday.com. He is founder and President of TPC Healthcare, a specialty provider of real-time location and point-of-care communication technologies to hospitals and healthcare organizations.