MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'connectivity'. Sat, 03 Sep 2011 02:28:22 +0100 http://www.medworm.com/index.php?rid=4883711&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2011%2F05%2F30%2Fworkflow-impacts-choice-of-connectivity-solution%2F The Medical Device Connectivity group on LinkedIn has some interesting discussions from time to time (you can join here). This week, Muhammad Siddiqui, a clinical analyst at the Cleveland Clinic, Abu Dhabi, asked: I’m looking for some feedback. Why would any healthcare organization choose to go with Capsule if they have 90% Philips bedside solutions? Why would they not consider Philips as the nutural choice for device integration? I want to know and your feedback will be greatly appreciated. As usual, there were numerous insightful responses discussing how the two approaches – connectivity enabled by medical device makers and that provided by vendor agnostic manufacturers – differed. What struck me was that there was no discussion about the workflow that the connectivity ... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=4883711 Mon, 30 May 2011 15:00:12 +0100 4883711 http://www.medworm.com/index.php?rid=4872260&cid=t_103925_122_f&fid=35066&url=http%3A%2F%2Fneurodudes.com%2F2011%2F05%2F27%2Fneurons-with-similar-tuning-more-likely-to-be-connected%2F From the abstract: … we determine synaptic connectivity between nearby layer 2/3 pyramidal neurons in vitro, the response properties of which were first characterized in mouse visual cortex in vivo. We found that connection probability was related to the similarity of visually driven neuronal activity. Neurons with the same preference for oriented stimuli connected at twice the rate of neurons with orthogonal orientation preferences. Neurons responding similarly to naturalistic stimuli formed connections at much higher rates than those with uncorrelated responses. Bidirectional synaptic connections were found more frequently between neuronal pairs with strongly correlated visual responses…. Ho Ko, Sonja B. Hofer, Bruno Pichler, Katherine A. Buchanan, P. Jesper Sjöström, Thoma... neurodudes blogs http://www.medworm.com/rss/comments.php?id=4872260 Fri, 27 May 2011 06:34:34 +0100 4872260 http://www.medworm.com/index.php?rid=4753801&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2011%2F04%2F26%2Fconnectivity-with-or-without-a-server%2F Many medical device makers contemplating connectivity for the first time, prefer to build everything into the embedded system device rather than using a server to implement most of the connectivity features. This design approach is rarely taken, but why? The following is a quick look at the strengths and weaknesses of building connectivity into the embedded device and using a server. Before we launch into the pro’s and con’s, let’s identify the basic functional requirements for connectivity: You must have the ability to get machine readable data out of your medical device. Most all electronic devices have this ability, provided by a serial port. Alternatively, the device can use an Ethernet and/or Wi-Fi (or perhaps some other wireless technology). Next the proprietary d... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=4753801 Wed, 27 Apr 2011 00:50:45 +0100 4753801 http://www.medworm.com/index.php?rid=4676899&cid=t_103925_113_f&fid=34625&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FNeilVerselsHealthcareItBlog%2F%7E3%2FEcS5gp-MhXQ%2F Geisinger Health System, Group Health Cooperative, Intermountain Healthcare, Kaiser Permanente and the Mayo Clinic will join together to promote sharing of electronic health data as part of a new organization called the Care Connectivity Consortium. The formal launch is set for 9 a.m. EDT Wednesday at the National Press Club in Washington, and the event will be webcast here. According to a media advisory, the Care Connectivity Consortium is “a historic interoperability collaboration among five of the nation’s leading health systems to securely share electronic health information and best practices.” Executives from the organizations will be on hand to “will discuss the goals of the consortium, how sharing electronic health data supports high quality, patient-centered ca... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=4676899 Mon, 04 Apr 2011 17:06:21 +0100 4676899 http://www.medworm.com/index.php?rid=4676907&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2011%2F04%2F03%2Femr-integration-for-medical-devices-the-basics%2F Medical device manufacturers in markets that have managed to resist creating connectivity solutions are facing increased pressure from providers adopting EMRs. I mean, what’s the use of automating the EMR if users have to write down numbers read from medical device displays and then manually type them into the EMR? That’s certainly not “automation.” This feature is already a required and necessary feature in some device markets, and rapidly becoming a necessity in many other device markets. Manufacturers in this situation (needing an interface to EMRs for clinical documentation) often come to me with a plethora of questions. Before we get started, let’s frame the discussion. In this post you will be introduced to a framework for clinical documentation connecti... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=4676907 Sun, 03 Apr 2011 18:08:23 +0100 4676907 http://www.medworm.com/index.php?rid=4225451&cid=t_103925_122_f&fid=34756&url=http%3A%2F%2Fbrainethics.wordpress.com%2F2010%2F12%2F03%2Fsex-and-money-common-or-different-currencies%2F How are values computed in the brain? Rewards can be as many things: the expectation when having just ordered your favourite dish; the child’s joy at Christmas Eve; the enjoyment of good music or the wonderful taste of strawberries. But how does the brain process these many different kinds of rewards? Does it treat all types of rewards equally or does the brain distinguish between different kinds of rewards? Rewards can come in many different forms: from sex, social recognition, food when you’re hungry, or money. But it is still an open question whether the brain processes such rewards in different ways, or whether there is a “common currency” in the brain for all types of rewards. Guillaume Sescousse and his colleagues in Lyon recently reported a study on how t... BRAINETHICS blogs http://www.medworm.com/rss/comments.php?id=4225451 Fri, 03 Dec 2010 07:48:52 +0100 4225451 http://www.medworm.com/index.php?rid=3182256&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedicalConnectivityConsulting%2F%7E3%2F-aBYWqnpg9Y%2F There is a FDA (CDRH) Workshop on Medical Device Interoperability scheduled for January 25 - 27 at the FDA’s White Oak Campus in Silver Springs, MD. Here’s a link to the meeting’s official web site, which includes a number of downloadable files on the agenda, meeting logistics and background. There is little question the workflow automation and intelligence offered by interconnecting medical devices can improve patient safety. There’s also little doubt that there is significant market demand for such solutions.  For example, if hospitals could purchase PCA pumps and SpO2 monitors that were interoperable, i.e., the monitor could suspend drug delivery at the first indication of respiratory arrest, such a capability would quickly become a standard of care. Interoperab... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=3182256 Mon, 18 Jan 2010 01:56:49 +0100 3182256 http://www.medworm.com/index.php?rid=2958943&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedicalConnectivityConsulting%2F%7E3%2FwX_DhLS28_M%2F From what I have observed over many years, Hospitals have historically approached medical device connectivity projects as a tactical issue to be dealt with. Up until relatively recently, technology alone could be used to solve the connectivity issue (i.e. getting data from point A to point B) with little to no negative impact on clinical workflow. Further, the scope of connectivity projects has been mainly departmentally focused and deployments have been relatively basic. By basic, I refer to projects that have focused on connecting one or two bedside medical devices to a single CIS application or EMR. Evidence of all of this can be found by looking back at the past 10 or more years and examining typical implementations of biomedical device connectivity to information systems. •    Mo... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=2958943 Wed, 04 Nov 2009 00:32:52 +0100 2958943 http://www.medworm.com/index.php?rid=2851883&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedicalConnectivityConsulting%2F%7E3%2F46h46LaVZm4%2F This is the second post as part of an ongoing series that discusses the market trends that are affecting the evolution of medical device connectivity (MDC) technology. I received some good comments from my previous post – please consider sharing your thoughts, ideas, and experiences. The second trend I’d like to discuss is the shift towards patient safety as one of the key market drivers for connectivity. It is probably not news to anyone that patient safety has become one of the key drivers for many healthcare IT initiatives. But what is the relationship between patient safety and MDC? Ever since the often referenced IOM report, To Err is Human: Building A Safer Health System, hospitals and vendors alike have increased their focus on driving towards significant reductions in medical e... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=2851883 Thu, 01 Oct 2009 18:32:07 +0100 2851883 http://www.medworm.com/index.php?rid=2761972&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedicalConnectivityConsulting%2F%7E3%2FKP9TA8fW1Q8%2F Okay, it’s not all about workflow, just mostly, as you’ll see. A while back Ann Farrell was nice enough to bring an interesting paper to my attention. Titled, “Workarounds to Barcode Medication Administration Systems: Their Occurrences, Causes, and Threats to Patient Safety” the paper is a fascinating read for several reasons. The authors studied barcode medication administration systems (BCMA) at 5 hospitals, and identified 15 types of workarounds and 31 types of causes of workarounds. This paper provides the most detailed and comprehensive description of product and implementation shortcomings centered on the point of care that I’ve ever seen. It’s devastating. Really. So what’s this got to do with medical device connectivity?  Two words: workfl... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=2761972 Thu, 03 Sep 2009 01:12:02 +0100 2761972 http://www.medworm.com/index.php?rid=2757881&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedicalConnectivityConsulting%2F%7E3%2FpWKvehA9nhc%2F Can you believe it? Connectivity started in the 1980s, and it’s taken over 25 years for the first medical device connectivity conference to be held. I am fortunate to be serving as the program chair for the conference, responsible for the topics covered and finding speakers (you can download a program here — pdf). Unlike other conferences that address connectivity as one of many issues, this meeting is all about medical device connectivity. This is the first of what will be an annual meeting delving into connectivity in depth, tracking changes over time. Here’s an overview of the agenda: Define and frame medical device connectivity for this event Industry standards Regulatory issues FDA’s proposed MDDS rule IEC 80001 “Systems of systems” patient safe... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=2757881 Wed, 02 Sep 2009 16:58:48 +0100 2757881 http://www.medworm.com/index.php?rid=2348776&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedicalConnectivityConsulting%2F%7E3%2F7mcOXQNiQfc%2F I’m at GlobeStar System’s annual user group meeting this week, in Lisbon, Portugal. Attendance is about 150, equivalent to last year’s meeting. The messaging middleware market is transitioning from middleware to an enterprise application. GlobeStar has been in the business just over 10 years. Unlike Emergin, who started in paging messaging,  GlobeStar got their start in the 1990s integrating Austco nurse call and Nortel’s Companion (the first wireless phone system in North America). Over the years, the company (and the market) have evolved from a single nurse call/phone integration to a platform supporting many different systems and devices both on the input and output sides — and incorporating workflow automation through rules, alert initiation, and escalati... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=2348776 Mon, 20 Apr 2009 17:15:08 +0100 2348776 http://www.medworm.com/index.php?rid=2348777&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedicalConnectivityConsulting%2F%7E3%2FFvbo_iijQWw%2F The Big Picture Medical device interoperability and standardization is a hot topic, and with the efforts surrounding adoption of the 11073 standard, IHE and patient care device frameworks, and the drive towards implementing electronic medical records, the field has become essential to the future of the healthcare industry. Yet, as we look to realign medical devices and their communication mechanisms away from proprietary intercommunication and towards standards-based communication, we should think “outside the box” to other fields, technologies and technical disciplines for inspiration and guidance on best practices. Perhaps an obvious one that comes to mind is the USB 2.0 standard. The simple idea being proffered is the ability to plug a medical device into a computing platfor... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=2348777 Thu, 16 Apr 2009 18:37:52 +0100 2348777 http://www.medworm.com/index.php?rid=2258300&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FMedicalConnectivityConsulting%2F%7E3%2F9wOu5HvjhzU%2F This is another installment of a series on selling connectivity. You can read the first installment, with links to subsequent posts, here. There is no one product that best fits every customer’s requirements, yet the goal of product management is to develop product requirements that addresses the greatest portion of the market possible. Of course, it is neigh impossible to create a solution that is optimal for every customer. This raises a couple interesting questions. For any given project, how much of the addressable market’s requirements can be met? How are such trade-offs made, and what is the role of sales in all this? Security As a Requirements Trade-off Example A good frame of reference for requirements trade-offs is wireless security for medical devices. There is a plethora of ... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=2258300 Wed, 11 Mar 2009 22:50:09 +0100 2258300 http://www.medworm.com/index.php?rid=2026899&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2008%2F12%2F09%2Fmanaging-patient-context-for-bedside-medical-devices-todays-situation%2F Clinical users have been managing patient context in various ways with medical devices for many years. With some classes of medical devices, this is nothing new.  So you might ask — what is the big deal here with patient context and what has changed that makes this topic relevant today? As I stated in a previous post, managing patient context is all about the clinical workflow.  My working definition of patient context for medical devices is the linking of any information produced by a medical device (including data parameters, alarms, control settings, waveforms, etc.) with a specific patient identifier. From a patient safety perspective, the best way to establish patient context is to tag data leaving a medical device with a unique patient identifier. And ideally this should be p... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=2026899 Tue, 09 Dec 2008 23:47:42 +0100 2026899 http://www.medworm.com/index.php?rid=1938999&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2008%2F11%2F06%2Fwhy-wireless-connectivity-is-different%2F Wireless changes everything … I have been watching the evolution of wireless bedside medical device connectivity for several years now. It is now fairly common for medical devices to communicate wirelessly and most hospitals now have the requisite Wi-Fi networks installed and operational. In fact, the saturation point of WLAN adoption in US hospitals has been reached as the numbers are quickly approaching 90% of all US hospitals. But this posting is not about Wi-Fi or other wireless technologies used in medical devices. Rather it is about additional connectivity considerations beyond the actual wireless connection of the device to a network. Regardless of the wireless connection technology or standard used, wireless changes everything when it comes to connectivity. (more…) (Source... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=1938999 Thu, 06 Nov 2008 18:20:04 +0100 1938999 http://www.medworm.com/index.php?rid=1924444&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2008%2F10%2F31%2Finteroperability-barriers-to-adoption%2F There’s been some great comments on the recent post about the announcement of MD FIRE. That plus some other activities I’ve been involved in have inspired some thoughts on barriers to adoption for medical device interoperability. For this discussion, interoperability refers to the ability of a medical device to be controlled by another medical device or third party information system. Medical device systems from a single vendor frequently include interoperability between the medical devices and applications running on general purpose computers, but since all the components are from the same vendor I’m excluding them from this discussion. Like everything else, medical device interoperability will walk before it runs. In a recent comment, JimW suggests that MD FIRE’s ... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=1924444 Fri, 31 Oct 2008 23:54:58 +0100 1924444 http://www.medworm.com/index.php?rid=1914570&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2008%2F10%2F28%2Fthe-challenge-of-automating-workflow%2F What with all the effort required to get everything plugged together and talking, it is easy to forget that medical device connectivity is really about workflow automation. In other words, providing everything “connects” and works, the question of how it works becomes critical. The October 2008 issue of 24×7 has a story by yours truly on workflow along with some suggestions on how to deal with workflow. The complexity and costs of implementing a medical device system that uses specialized peripheral devices, applications and systems integration with third party applications can add considerably to the cost and time required to install and implement such systems. This seriously impacts one of the most common tools providers have for evaluating vendor’s products. The o... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=1914570 Tue, 28 Oct 2008 18:05:50 +0100 1914570 http://www.medworm.com/index.php?rid=1886334&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2008%2F10%2F17%2Fproviders-press-vendors-for-medical-device-interoperability%2F At the annual meeting of the ASA this morning, a group of providers announced RFP and purchase contract language for use by hospitals in an effort to hasten the availability of medical device interoperability. According to the founders, Massachusetts General Hospital, Partners Healthcare, Kasier Permanente, Johns Hopkins Medicine, and CIMIT (the MD PnP Program), hospitals, “must lead a nationwide call to action for interoperability of medical devices and systems. One way that HDOs [Healthcare Delivery Organizations] can effect this change is by including medical device interoperability as an essential element in the procurement process and in vendor selection criteria.” According to Julian Goldman, interoperability rocket scientist and anesthesiologist at Mass General, this ann... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=1886334 Fri, 17 Oct 2008 17:15:27 +0100 1886334 http://www.medworm.com/index.php?rid=1850952&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2008%2F10%2F03%2Fhistory-of-medical-device-connectivity-for-cis%2F With all the focus on medical device integration for EMRs and middleware vendors like Emergin, many of the hospital’s looking for solutions today know little about how connectivity has evolved. So, we were talking at Capsule the other day and here is a timeline we came up with. This surely isn’t a complete list, and we’re sure there are other significant efforts that should be included. We tried to keep it focused on successful implementations in a production environment of a system extracting data from a medical device into a clinical information system. So let us know what you think is missing! 1970’s and 1980’s Early systems evolved from research work performed in some of the large university teaching hospitals. For more background – see this link. Eventually the mar... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=1850952 Fri, 03 Oct 2008 23:26:13 +0100 1850952 http://www.medworm.com/index.php?rid=1840992&cid=t_103925_122_f&fid=34756&url=http%3A%2F%2Fbrainethics.wordpress.com%2F2008%2F09%2F30%2Ftwo-ways-of-reducing-fear%2F Emotional reactions may come in many forms and have different causes. But one of the main responses is the fear response, which has been shown to involved the amygdala. Different nuclei of the amygdala may contribute differentially to the fear response process. One vital feature of emotion and amygdala is that emotional responses can be reduced, and eventually diminish. This is one of the basic mechanisms at play when we habituate to (or even extinguish) fearful stimuli. But is is also possible to reduce fear responses through more controlled processes, what has been termed cognitive emotion regulation. Such basic cognitive mechanisms underlie the psychological treatment of, e.g., phobias. In other words, there are two ways of reducing fear responses of the amygdala: 1) through habituation... BRAINETHICS blogs http://www.medworm.com/rss/comments.php?id=1840992 Tue, 30 Sep 2008 12:37:54 +0100 1840992 http://www.medworm.com/index.php?rid=1825526&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2008%2F09%2F24%2Ffirst-connectivity-cover-story-in-leading-hit-mag%2F Connectologists rejoyced this month (September, 2008) when Healthcare Informatics magazine published Biomed Joins the Party - Savvy CIOs are considering biomedical devices in their overall strategic plans (link). To my knowledge, this is the very first cover story in a major health care IT magazine about medical device connectivity. As an aside, diagnostic imaging pubs have been writing about connectivity in their market for many years. Contributing editor, Mark Hagland, casts the drama that is connectivity as “two worlds colliding,” - the worlds of IT and biomedical engineering. He builds his story around the integration of medical devices to support EMR charting. In fact, medical device connectivity started almost 20 years ago with the integration of Apple IIs and IBM PCs (no... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=1825526 Wed, 24 Sep 2008 23:22:17 +0100 1825526 http://www.medworm.com/index.php?rid=1672161&cid=t_103925_107_f&fid=36585&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FHighlightHEALTH%2F%7E3%2F351674497%2F This article was published on Highlight HEALTH. Other Articles You May LikeIncreased Coffee Consumption Associated with Lower Risk of Liver CancerDid You Eat Your Fruits and Vegetables Today?More Education Decreases the Risk of Death Remembering Lunch Can Help Reduce the Desire to SnackTired? You May Not Be Getting Enough Sleep (Source: Highlight HEALTH) Highlight HEALTH blogs http://www.medworm.com/rss/comments.php?id=1672161 Fri, 01 Aug 2008 04:19:42 +0100 1672161 http://www.medworm.com/index.php?rid=1639308&cid=t_103925_93_f&fid=36200&url=http%3A%2F%2Fblog.jammedph.com%2Fget-a-chance-to-win-a-smart-bro-prepaid-kit%2F Smart Broadband Inc has released few months ago their new product, Smart Bro Prepaid that allows you to surf the net anywhere there’s a PC without having to worry on Monthly Service Fees since it’s prepaid. The Smart BRO USB modem is a small, palm-sized device that you can carry with you wherever you go. And anytime you need to surf, just plug it into the USB port of your PC, and you’ll get connected in a flash. Total initial payment is P3800 (I also heard the modem itself is worth P4,000.00) with FREE P100 broadband load. Broadband Internet use is P10 for every 30 minutes. It’s a cheaper and more convenient way to surf the web than going to internet cafes and Starbucks for a 100-plus worth of internet connection (of coffee, rather). What’s the advantage of Smart Bro Prep... Jammed: Full into Capacity blogs http://www.medworm.com/rss/comments.php?id=1639308 Sat, 19 Jul 2008 13:38:21 +0100 1639308 http://www.medworm.com/index.php?rid=1622110&cid=t_103925_122_f&fid=34756&url=http%3A%2F%2Fbrainethics.wordpress.com%2F2008%2F07%2F15%2Fbrain-plasticity-and-sexual-aberrations%2F I’m having the pleasure of reading The brain that changes itself by Norman Doidge, as a reviewer for a potential translation here in Denmark. Brain plasticity, or neuroplasticity, has always been a hot topic, from it’s (re)birth in modern neuroscience, and all the way up until today, where researchers are still fiercely debating how plastic the brain is and how functions relate to brain structures - aka the debate of modularism. In its early days, the neuroscientific community strongly believed that the modularity of the brain was established during childhood, and that little, if any, change could occur later on. Researchers suggesting otherwise were eschewed, heavily criticized on the ground that their data/ideas did not fit into the existing model. The land did not fit onto t... BRAINETHICS blogs http://www.medworm.com/rss/comments.php?id=1622110 Tue, 15 Jul 2008 07:20:34 +0100 1622110 http://www.medworm.com/index.php?rid=1543107&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2008%2F06%2F24%2Fmedical-device-start-ups-and-connectivity%2F Entrepreneurs are all about commercializing their novel technology, getting to market, driving adoption and realizing an exit strategy. Yet with the incredible focus on transforming their novel technology into something customers can buy, few startups take connectivity requirements into account until too late in the process. The consequences frequently result in revised go-to-market strategies, like going to market without important features or shifting to niche markets with lower connectivity requirements. Customers Want More than the Box There are many barriers to entry in health care: regulatory hurdles, entrenched competitors and gatekeepers like group purchasing organizations (GPOs). Increasingly, connectivity is becoming a barrier to entry - or perhaps a new price of admission. There... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=1543107 Wed, 25 Jun 2008 20:11:47 +0100 1543107 http://www.medworm.com/index.php?rid=1466007&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2008%2F05%2F23%2Fselling-connectivity-strategy%2F Selling anything starts getting serious when it comes to qualification. For you non-sales types, qualification is an assessment of the likelihood of making the prospective sale. This assessment includes the following basic questions: Is the potential buyer or prospect really going to buy anything - from anybody? Will my product be a serious contender for the sale, or am I simply cannon fodder to help justify a sales process with a foregone conclusion? And if I am a serious contender, how does my product match up against the competition relative to the specific needs of this prospect? Who all is involved in making the decision of what to buy? (More on this in a future post on Selling Connectivity) A common problem in markets where connectivity is new or dramatically innovative is avoiding... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=1466007 Fri, 23 May 2008 20:58:03 +0100 1466007 http://www.medworm.com/index.php?rid=1409690&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2008%2F04%2F30%2Fselling-connectivity-new-knowledge%2F The most striking lesson that I’ve experienced, and witnessed repeatedly, is that when it comes to connectivity, “you don’t know what you don’t know.” This applies to providers (buyers) as much as it does vendors (sellers). When presented with a new problem, it’s human nature to apply current knowledge and mental models in search of a solution - thus the perennial appeal of the “intuitively obvious.” Intellectually we know that problems don’t all fall into the same logical framework. But, for various reasons we tend to apply known solutions to new problems, and only when the outcome is unacceptable do we contemplate the unknown. Decision making insanity aside, this typical approach is inefficient - or worse. The barrier to effectively a... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=1409690 Wed, 30 Apr 2008 17:59:41 +0100 1409690 http://www.medworm.com/index.php?rid=1377934&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2008%2F04%2F16%2Fselling-connectivity-a-series%2F I’ve written much in the past about the technical and product development issues of connectivity. Just as important are the issues that revolve around successfully selling your connectivity solution. (If you’re a provider reading this, this should provide a bit of insight into how to buy connectivity, and why sometimes vendors to the crazy things they do.) You can place to seemingly identical medical devices side by side, with the only visible difference being that one has an Ethernet connector and the other does not. That “small” change makes a world of difference when it comes to selling these two nearly identical devices. Here’s my list of the areas where adding connectivity to a medical device changes almost everything: Required new knowledge Qualifying p... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=1377934 Thu, 17 Apr 2008 02:40:57 +0100 1377934 http://www.medworm.com/index.php?rid=1319336&cid=t_103925_122_f&fid=34756&url=http%3A%2F%2Fbrainethics.wordpress.com%2F2008%2F03%2F21%2Fmy-grandmother-is-where%2F How specific — or sparse — is the neural representation of a memory trace? Quian Quiroga and colleagues now have an article in Neuron (PDF), where they describe their well-known studies using single-cell recordings to well-known faces. As you most likely know, this has given rise to the debate about the “Jennifer Aniston neuron”. Their findings, briefly put, have demonstrated that single cells show quite specific responses to very specific visual stimuli. While one cell may have a preferential response to the Sidney Opera House, another responds dramatically more to Hale Berry, while yet another cell responds to, well, Jennifer Aniston. The Quiroga studies have re-iterated the debate (if it ever went dead) about how specific the neural coding is in the brain. Is it ... BRAINETHICS blogs http://www.medworm.com/rss/comments.php?id=1319336 Fri, 21 Mar 2008 12:36:20 +0100 1319336 http://www.medworm.com/index.php?rid=1188553&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2008%2F01%2F29.html%23a1147 The IHE North America kicked off their Connectathon yesterday. This is the second year (?) that the Patient Care Device domain (PCD) has had something to show in the Interoperability Showcase at HIMSS. I chatted with Todd Cooper via Skype and received the following update: As background, there are approximately 390 engineers from 70 companies and 2 university groups connecting 136 different systems.  On the PCD side, we have the following groups participating: B.Braun CapsuleTech Draeger Epic GE Healthcare LiveData Philips SpaceLabs Welch Allyn The profiles being tested are primarily focused on device data gateway reporting to enterprise applications (this fall the PnP profile will start active testing), and includes the basic PCD-01 message from last year (an HL... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=1188553 Tue, 29 Jan 2008 18:51:34 +0100 1188553 http://www.medworm.com/index.php?rid=1167175&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F12%2F21.html%23a1146 Conclusion: IT (and many vendors) just don't understand clinical workflows. From the Physician study, it seems vendors are still in love with the physician market - not that there's been a lot of adoption to encourage such interest. The inclination to "follow the money" does not fit this market segment. While physicians account for almost all the revenue generated in a hospital, the vast majority of these docs do not work for the hospitals. In fact, in most community hospitals there is this an unhealthy co-dependent relationship between physicians and hospital administration that works against consistent IT usage. Few hospitals have any reason to buy technology for physicians, nor to expect physicians to actually use what the hospital may buy for them. These studies show a hopeful trend. H... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=1167175 Fri, 21 Dec 2007 22:31:07 +0100 1167175 http://www.medworm.com/index.php?rid=1106179&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F12%2F19.html%23a1144 Yours truly was quoted in an article in FDC Reports' newsletter The Gray Sheet (subscription only) last week about connectivity. The story was inspired by a comment from Bill Crounse, the director of Worldwide Health at Microsoft, during the World Healthcare Innovation and Technology Congress held in Washington, D.C., earlier this month. He said, ""I no longer believe that technology is really the issue that prevents us from getting things done. We have the technology ... We've cracked the code on things like mobility and wireless devices and broadband. The remaining barriers are really all-around barriers to adoption." The story provides an overview of connectivity in both acute care and remote monitoring, from both vendor and customer perspectives. The story closes with this observat... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=1106179 Wed, 19 Dec 2007 18:42:17 +0100 1106179 http://www.medworm.com/index.php?rid=1084174&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F12%2F10.html%23a1137 One of my favorite Clinical Engineers called today, prompted by last week's post on the Emergin acquisition by Philips. Like many that I've talked to, this person was surprised that Emergin was not snapped up sooner. A list of potential bidders were mentioned, but my lips were sealed. I will say this about potential suitors for Emergin - the lines are blurring between conventional categories of vendors, on both the health care IT and device sides.Also discussed were two continuing problems with medical device connectivity, alarm notification and point of care automation (we'll just call it "middleware" for this post). The first deals with hidden costs - on both the device side and infrastructure side. As you work through the details of plumbing everything together, you tend to uncover situ... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=1084174 Tue, 11 Dec 2007 01:21:51 +0100 1084174 http://www.medworm.com/index.php?rid=1079692&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F12%2F07.html%23a1136 Philips announced this week that they have acquired private health care IT vendor Emergin for an undisclosed sum. From the Philips press release:Emergin is the leading US provider of software utilized to rapidly transmit medical alarm signals throughout hospitals. The transaction is expected to close in the fourth quarter of 2007, upon which Emergin will become part of the Patient Monitoring business unit within Philips Healthcare sector. Through this acquisition, Philips will expand the use of information technology in healthcare - and specifically in its patient monitoring business - to improve patient outcomes and help hospitals work more efficiently.Philips Healthcare CEO, Steve Ruschowski, brags on Philips' number one position in the patient monitoring mark... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=1079692 Fri, 07 Dec 2007 21:14:30 +0100 1079692 http://www.medworm.com/index.php?rid=1061026&cid=t_103925_122_f&fid=34756&url=http%3A%2F%2Fbrainethics.wordpress.com%2F2007%2F11%2F30%2Fcause-and-effect-in-brain-development-of-paedophilia%2F Physorg reports about an interesting forthcoming MRI study linking paedophilia to regional changes in white matter. Analysing structural MRI using voxel-based morphometry, paedophiles were found to have significantly smaller white matter volumes in specific regions, as the abstract demonstrates: The present investigation sought to identify which brain regions distinguish pedophilic from nonpedophilic men, using unbiased, automated analyses of the whole brain. T1-weighted magnetic resonance images (MRIs) were acquired from men who demonstrated illegal or clinically significant sexual behaviors or interests (n = 65) and from men who had histories of nonsexual offenses but no sexual offenses (n = 62). Sexual interest in children was assessed by participants’ admissions of pedophilic interes... BRAINETHICS blogs http://www.medworm.com/rss/comments.php?id=1061026 Fri, 30 Nov 2007 09:13:02 +0100 1061026 http://www.medworm.com/index.php?rid=976327&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F10%2F24.html%23a1133 Qualcomm released a new 3G chip that supports both EV-DO (Verizon and Sprint) and HSDPA (AT&T and T-Mobile). This will result in radio cards that will run on either technology and provide the greatest choice in selecting carriers. The chips are apparently targeting laptops and should appear in new laptops by the second quarter of 2008.The latest technology to join the 3G alliance is WiMax, which the Qualcomm chip (called Gobi) does not support. In the US, Sprint is the first carrier to announce plans to deploy a nation-wide WiMax wireless network.Pictured right is Qualcomm's QSC6240 chip with integrated radio transceiver, baseband modem and multimedia processor - together with power management functionality into a single chip for WCDMA (UMTS) and HSDPA handsets. (S... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=976327 Thu, 25 Oct 2007 00:38:14 +0100 976327 http://www.medworm.com/index.php?rid=953987&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F10%2F15.html%23a1127 The HealthVault (HV) beta was launched October 4, 2007. Between the confusion surrounding the launch and work, I've tried to gather some thoughts and get some questions answered. The launch was a classic Microsoft launch: big, dramatic, expensive, and well executed, right down to the goody bags (you had to be there to get one, so I missed out). Typical with such events, naysayers were out in force, and there was a bit of confusion. You can also find some good information on the big picture of HV from Vince Kuraitis and Enoch Choi.Perhaps the most confusion around HV is whether or not it is a personal health record (PHR). Many of the "news stories" that recycled the HV press release referred to HV as a PHR. A few, Vince and Enoch among them, noted that HV is in fact not a PHR. From what I a... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=953987 Mon, 15 Oct 2007 23:06:43 +0100 953987 http://www.medworm.com/index.php?rid=908521&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F09%2F26.html%23a1117 Simon Aliwell, Director of the Sensors and Instrumentation Knowledge Transfer Network, National Physical Laboratory, in the UK, has a piece in the latest issue of MDT magazine. His outfit is a network of excellence supported by the UK Technology Strategy Board to develop innovation in sensing. Check out their web site here. In his story Aliwell suggests that regulatory hurdles represent the greatest market barrier for developers of new sensor technology. Technologies for use in the medical arena must undergo a thorough and well defined testing and approval process before they can be adopted. This is the case even when technologies have proven their effectiveness in other fields and applications. Although this is to patients' benefit, it does delay the return on investment for companies and... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=908521 Thu, 27 Sep 2007 02:10:06 +0100 908521 http://www.medworm.com/index.php?rid=906258&cid=t_103925_131_f&fid=35743&url=http%3A%2F%2Fthegenesherpa.blogspot.com%2F2007%2F09%2Fcan-you-fix-typos.html The Sherpa would like to thank all of the readers who have tolerated the foray into mobile blogging that I have undertaken. I have had a few posts which have been hard to read as well as full of typos. Lately given my schedule I have had little time to revise these. I will take more time from now on I promise. Now Back to some interesting stuff!!! Recently in The Journal of the American Medical Association a study was published linking Coronary Artery Disease and Colorectal Cancer. Why am I, a gene guy, posting this study? Several reasons, but first let me talk about the study. Patients in Hong Kong were recruited for screening colonoscopy after cardiac catheterization (a procedure where they look for disease in your heart blood vessels.)Right there I think I several confounders. Aspirin c... Gene Sherpas: Personalized Medicine and You blogs http://www.medworm.com/rss/comments.php?id=906258 Wed, 26 Sep 2007 14:54:00 +0100 906258 http://www.medworm.com/index.php?rid=900851&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F09%2F24.html%23a1113 Dana Blankenhorn, ZDNet Healthcare writer and blogger became an honorary Connectologist today with his short story on medical device connectivity. Dana lead with a consumer electronics comparison of plug and play printers that operate with personal computers.When you buy a printer you expect to find a driver for it, one you can easily install, which will allow ready communication between it and your PC. You expect it to deal with files created by your PC, and you expect your PC to deal with its files, too. It took years for this to become routine, and replicating this ease-of-use is one of the great challenges open source still faces. In the medical device market, however, this work has not even begun. In fact it has barely been imagined.Ah, but it has been imagined - in mind numbing detai... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=900851 Mon, 24 Sep 2007 23:32:21 +0100 900851 http://www.medworm.com/index.php?rid=891459&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F09%2F21.html%23a1109 Yours truly was quoted in a HealthLeaders technology story about, you guessed it, medical device connectivity.Information technology consultant Tim Gee has a nontechnical description of the current state of connecting medical devices to clinical information systems: "It's a mess." Not that direct data capture from medical devices is impossible; some hospitals have been exporting data from devices into clinical information systems for years. But as Gee and other experts point out, the effort can be so confounding that many hospitals don't even try. Even in highly automated inpatient settings, a common method of data capture from the plethora of monitors, pumps and ventilators is good old pen and paper. Someone, often a nurse, writes down the value and either logs it on paper or re-enters th... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=891459 Fri, 21 Sep 2007 23:38:30 +0100 891459 http://www.medworm.com/index.php?rid=885323&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F09%2F19.html%23a1104 I found a blog reader's email in my inbox this morning. It seems not everyone at his hospital is keen on investing in medical device connectivity. He wrote about a near term need for connectivity to a planned EMR. Sadly, medical device connectivity is sort of the Rodney Dangerfield of EMR deployments, frequently an afterthought or put off for some “future phase” – mainly due to complexity and cost. What follows is my reply.Device connectivity impacts EMR adoption in a number of ways. (In no particular order.)User adoption – a jaded observer could view many HIT projects as an exercise in getting one set of users to either change the way they do things, or to take extra steps, for a benefit of other users. Manually enter... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=885323 Wed, 19 Sep 2007 19:31:30 +0100 885323 http://www.medworm.com/index.php?rid=773299&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F07%2F31.html%23a1099 The 2007 Healthcare Unbound conference was held July 16-17, 2007, at the Marriott San Francisco Airport, San Francisco, CA. As I complete the posts about this years terrific Healthcare Unbound conference I will be listing them in this post. Healthcare Unbound 2007 Kicks Off Jay Srini opens the conference, with opening keynote from Vince Kuraitis.You can read other people's impressions of the conference here:Health 2.0: Live from Healthcare Unbound by Matthew HoltReporting on Healthcare Unbound: Wireless Devices & "Health 2.0" by Dmitriy KruglyakRuminations on the 2007 Healthcare Unbound Conference by Vince KuraitisThe Healthcare Unbound conference is a production of The Center for Business Innovation. Attendees can download copies of the presentations using instructions you received ... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=773299 Wed, 01 Aug 2007 01:56:00 +0100 773299 http://www.medworm.com/index.php?rid=773301&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F07%2F31.html%23a1097 Self proclaimed the, “oldest guy with a computer science degree,” John Rushby with SRI International started the second day with a presentation on Accidental Systems. Using aviation as a model, Rushby discussed interactive complexity and system failures. Exploring the causes of accidents, Rushby noted, “that sufficiently complex systems can produce accidents without a simple cause.” He related aviation failures to health care, noting that in many patient safety incidents, it is the system that fails rather than the clinician. Aviation is a good model because the extensive reporting of both failures and incidents. Incidents are “near misses” rather than actual accidents. In aviation, because there was no crash, incidents are a rich source of reliability and fai... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=773301 Wed, 01 Aug 2007 00:53:29 +0100 773301 http://www.medworm.com/index.php?rid=762963&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F07%2F27.html%23a1094 Jay Srini, VP, Emerging Technologies, UPMC and Vince Kuraitis, Principal, Better Health Technologies, opened the conference. Srini provided an update on the demographic tsunami represented by the aging population. Statistics show health care prevention has not worked. Over the last 10 years there has been a steady increase in obesity and diabetes. This is not because we're unaware or have not tried to do better. Lifestyle changes are the biggest impact on health. In fact, the extra weight people are carrying has cost the airlines extra in transporting passengers. Diet is the most critical factor that impacts health. Smoking and drinking also came in for some finger wagging.Jay asked, "When we know there are preventable costs, can we declare we can't afford to insure everyone in the country... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=762963 Fri, 27 Jul 2007 17:19:37 +0100 762963 http://www.medworm.com/index.php?rid=721274&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F07%2F09.html%23a1090 Cisco has aggressively marketed their “Medical Grade Network” that promotes the value of managing clinical data (especially from or between medical devices). Many have asked Cisco just what makes a network “medical grade.” When pressed, what was described to me was a mission critical network, which is fine for patient accounting, but inadequate for life critical data. From their web page (emphasis mine, links are Cisco’s):The Cisco Medical-Grade Network is a scalable, end-to-end solution that simplifies operations and management and supports the necessary regulatory compliance.A Cisco Medical-Grade Network connects all stakeholders in the healthcare system to a single information and communications infrastructure. The network provides a resilient and reliable netwo... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=721274 Mon, 09 Jul 2007 17:07:37 +0100 721274 http://www.medworm.com/index.php?rid=719376&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F07%2F07.html%23a1084 According to a survey by CHIME, more hospitals are reducing restrictions on cell phones.Twenty-three percent of the 185 survey respondents reported their organization has lifted all restrictions on mobile phone use, up 5.5% from a similar survey conducted by the Ann Arbor, Mich.-based organization in 2004. Only 11 respondents, or 6%, indicated that cell phone use is entirely prohibited at their hospitals. Sixty-nine percent of respondents reported mobile phone use is restricted only in certain areas, such as the emergency department or intensive care unit. And 39% indicated their organization has or will install technology to enhance cell phone signals. Respondents, however, also reported that some problems have arisen as a result of increased use of mobile phones in their hospitals. For e... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=719376 Sat, 07 Jul 2007 18:45:30 +0100 719376 http://www.medworm.com/index.php?rid=719377&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F07%2F07.html%23a1083 Robert North, PhD, chief scientist of Human Centered Strategies, and participant in the AAMI committee that is updating the human interaction standards, highlights the impact of user interface design on medical device safety. In speaking for the FDA (?), he notes correctly that the, "FDA views errors during human interaction with a device as seriously as any mechanical, electrical, software, or chemical errors that may make a device cause patient harm." From the MD&DI story:To understand the effect of regulation on the design-research and early concept-testing phases, the overall process that FDA requires must first be understood. This process is succinctly described on FDA’s Web site [here]. It cites AAMI/ANSI HE74-2001, “Human Factors Design Process for Medical Devices.&#14... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=719377 Sat, 07 Jul 2007 18:33:29 +0100 719377 http://www.medworm.com/index.php?rid=719378&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F07%2F07.html%23a1082 The Tyco International spin off of their medical division was completed a couple weeks ago. The new company, Covidien has about $10 billion in sales. With a stable of mature health care technology, Covidien is looking to acquisitions to fuel growth.It is now investing aggressively in research and development in its core devices business and would consider acquisitions in the $60 million to $250 million range, [Richard] Meelia [president and CEO of Covidien] said, as it looks to expand its offerings of surgical, respiratory and energy-based devices.It expects ultimately to boost R&D spending in devices to 5 percent to 6 percent of sales from 2.7 percent today, Meelia said.Like many mature medical device vendors, the company "which makes surgical instruments, ventilators and syringes, st... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=719378 Sat, 07 Jul 2007 18:19:47 +0100 719378 http://www.medworm.com/index.php?rid=718790&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F07%2F06.html%23a1079 Chris Gill from Washington University in St Louis, introduced the second technical session.The papers in this session will touch on distributed control and sensing in networked medical device systems. These are real time embedded networked system infrastructures for MDSS, and the development, assurance and medical practice-driven models for high confidence medical device software.These systems are characterized as being made up of interlocking systems of (control) systems – interoperability, where devices in the system have an overall control structure. Such systems also embody various algorithms for processing data from sensors or other systems. There is invariably a human in the loop when operating these systems. As they develop, these types of systems must overcome systems integrat... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=718790 Fri, 06 Jul 2007 20:48:53 +0100 718790 http://www.medworm.com/index.php?rid=713094&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F07%2F03.html%23a1078 ; Introduction by Glenn Himes, Mitre Corporation.Himes presented a model for medical device connectivity, emphasizing the challenges with interoperability facilitated by medical device controller systems. He then pulled back to show the context that device data and system connectivity plays in the broader health care delivery system.The biggest challenge faced by interoperability is the people rather than the technology. Engineering solutions are very doable. Issues like a lack of consensus, lack of a regulatory path, lack of requirements, market forces, and other factors represent the real (and current) impediments to change. Incentives to change include new market opportunities, improved patient safety, lower litigation and insurance costs, and a lower total cost of ownership.A lot of th... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=713094 Tue, 03 Jul 2007 17:17:40 +0100 713094 http://www.medworm.com/index.php?rid=710472&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F07%2F02.html%23a1077 The following is a continuation from the the Improving Patient Safety through Medical Device Interoperability and High Confidence Software joint workshop last week in Boston. I've got a bunch more notes that I'll be tweaking and posting this week. This next bit is from a panel discussion that described the need for high confidence systems and interoperability. The panel was introduced by co-chair Julian Goldman.The foundation for any quality product is requirements. Inadequate or incorrect requirements mean not just a lousy product, but one that could be unsafe or unreliable. This panel discussion targets the clinical need driving high confidence systems and interoperability.A market for any kind of product is made up of both producers and buyers, each with their own responsibilities. Devi... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=710472 Tue, 03 Jul 2007 05:05:01 +0100 710472 http://www.medworm.com/index.php?rid=710248&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F06%2F26.html%23a1076 After the break, Julian Goldman provided a brief update on the MD PnP program. First, Goldman presented ways integrated systems can support safety, using examples from non-healthcare applications. The classic example from Goldman’s stump speech is the automotive brake/automatic transmission interlock, an almost universal interoperable safety feature. From aviation, the airplane landing gear smart alarm annunciates when a plane is landing if landing gear is not down. This example demonstrates contextual awareness, an important feature needed for health care safety. Clinical analogs that would improve safety were presented including: Heart lung machine and ventilator – switching from bypass and back. Ventilators are sometimes not turned on – simple human error that ... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=710248 Wed, 27 Jun 2007 03:24:57 +0100 710248 http://www.medworm.com/index.php?rid=691223&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F06%2F22.html%23a1073 I was in hog heaven at this year's AAMI meeting. Connectivity was a major theme, and during every time slot in the program there was at least one presentation dealing with connectivity. During my presentation Monday afternoon, there was one I really wanted to see that dealt with alarm notification. Lots of discussion centered around the evolving role of biomeds and clinical engineers and the kinds of training they might need in the future. There were rumblings from some in the ACCE who wanted to hold their annual meeting at HIMSS next year rather than AAMI. There certainly is a life-critical systems role that needs to be filled, and clinical engineers could fill that role. To this observer, it seems that clinical engineers will slowly become marginalized if they do not move in the "systems... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=691223 Fri, 22 Jun 2007 18:39:28 +0100 691223 http://www.medworm.com/index.php?rid=688576&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F06%2F21.html%23a1070 Jeff Robbins, CEO of LiveData, talks about his company's participation in the MD PnP program and hopes for a medical device interoperability standard. I caught up with Jeff at AAMI, after his presentation in the ACCE Clinical Engineering Symposium, Saturday morning. Jeff will also be participating in the joint workshop organized by the MD PnP program and HCMDSS titled, "Improving Patient Safety through Medical Device Interoperability and High Confidence Software," being held next week from June 25 to 27 in Cambridge, MA. You can see a description here, and a draft program here. I have the privilege of presenting some commentary at the conference titled, "View from the Blogosphere."NOTE: Now I know why more people don't put video clips in their blogs! Fortunately, the end result of an excee... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=688576 Thu, 21 Jun 2007 21:15:16 +0100 688576 http://www.medworm.com/index.php?rid=688577&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F06%2F21.html%23a1069 Lantronix has scored their biggest medical device deal to date, "a custom, battery-operated version of its commercially-available WiBox® 802.11 b/g wireless device server for the manufacturer’s medical point-of-care application." (press release)Terms of the agreement include a non-recurring payment and minimum quantity purchase commitment valued at approximately $360,000 over the initial 12 months of production and an additional minimum commitment for approximately $490,000 of next-generation technology based on certain project milestones.The WiBox takes a serial output and converts it to a wireless network connection. Johnson & Johnson's OneTouch was the first point of care glucometer with wireless capabilities, using a terminal server and 802.11 radio from Lantronix. This i... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=688577 Thu, 21 Jun 2007 20:38:54 +0100 688577 http://www.medworm.com/index.php?rid=682472&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F06%2F20.html%23a1068 Respironics was showing Respi-Link, remote monitoring capabilities through an RS232 serial port. The biomed must take the device down to their shop and connect it to a computer that runs a special Respironics client. Through this connection, users can download firmware updates and do run some diagnostics. Respironics is using Axeda for this feature, and support the Esprit, NICO and new vents. No word on wireless network connectivity.Walking down the aisles, I came across the IMT Medical booth. The Viasys Vela ventilator they were using to demonstrate their test fixture sported an RJ45 connector for what is apparently an Ethernet connection. The product page only mentions "data output port for graphic and information systems" - which sounds suspiciously like a serial port to me. Perhaps a r... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=682472 Wed, 20 Jun 2007 19:37:52 +0100 682472 http://www.medworm.com/index.php?rid=682473&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F06%2F19.html%23a1067 I saw the new Hospira pump - you know, the one with the funny name (okay, I'm writing this on the plane and can't remember the Symbiq). It has a very nice color touch screen that covers almost the entire front of the device. The device has an 802.11b radio presently, but will have an a/b/g radio in the third quarter. Surprisingly, there is no patient name displayed on the pump. The helpful and patient folks in the booth attributed this to HIPAA requirements; either their product manager's don't understand HIPAA, or this is spin for what will be an increasingly important question. This apparent short coming could be a consequence of Hospira's dependency on third party meds admin applications to establish patient context. (The good news is the display is all software, so adding the name shou... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=682473 Wed, 20 Jun 2007 01:05:11 +0100 682473 http://www.medworm.com/index.php?rid=682474&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F06%2F18.html%23a1065 The crew from Lehigh Valley presented their experience creating a telemedicine system called aICU (advanced ICU). John Sokalsky lead off, describing how their aICU concept leverages intensivists and critical care nurses in a remote location to serve more ICU patients. The system improves outcomes and reduces costs - always good things. This system integrated their CPOE, meds administration, real-time documentation charting and medical device data via a critical care information system, and finally a camera/digital video system. The strategic initiative was to create and implement an off-site “tele-intensivist” program. This program provides round-the-clock intensivist coverage of critical care units throughout their health care system. Results showed improved patient outcomes and... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=682474 Mon, 18 Jun 2007 20:37:04 +0100 682474 http://www.medworm.com/index.php?rid=682475&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F06%2F18.html%23a1064 Steve Merritt kicked things off today with a presentation titled, Integrating Medical Devices into the IT Infrastructure: Pitfalls and Recommendations. Steve provided a fantastic overview of their experience at Baystate Health in Springfield, MA. Steve started with the regulatory definition of a medical device:A medical device is an instrument, apparatus, implement, machine, contrivance, implant, in vitro reagent, or other similar or related article, including a component part, or accessory which is:  ...intended for use in the diagnosis of disease or other conditions, or in the cure, mitigation,treatment, or prevention of disease, in man or other animals...He noted that the medical device connectivity market has changed dramatically in the past 5 years - with the advent of "smart" pu... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=682475 Mon, 18 Jun 2007 14:49:48 +0100 682475 http://www.medworm.com/index.php?rid=682476&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F06%2F17.html%23a1063 The IHE PCD crew presented Meeting the Challenges of Integrating the Healthcare Enterprise. Didi Davis from HIMSS, kicked things off describing the IHE organization, what the IHE does, and how they do it. The IHE takes established standards and through collaboration with interested providers and vendors results in a series of "integration profiles" that specify how to configure multi vendor interoperable systems. Each integration area of focus, or domain, has a framework of standards designated to support the workflows and resulting integration profiles for a specific domain. Examples of domains include cardiology, eye care, IT infrastructure, patient care devices (PCDs), radiology, and more.The process starts with use cases that describe workflows. These worflows are subsequently implemen... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=682476 Sun, 17 Jun 2007 19:51:35 +0100 682476 http://www.medworm.com/index.php?rid=682477&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F06%2F17.html%23a1062 The day kicked off with a two part session on "Applying Real-Time Integration in the OR." The presenters started with "blood and guts" anesthesiologist, Warren Sandberg. He noted that the surgery department has limited - and frequently constrained - resources. He described the value of extending data beyond the location What Sandberg's describing is more than audio visual data (combining images of displays from various cameras and device displays), but data integration that allows for the rearrangement and massage of data to better manage clinical care delivery.Mark Meyer compared and contrasted the differences between the value of surgical video alone and video with real-time data from patient connected instrumentation combined with operational (procedure, personnel) and clinical data (re... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=682477 Sun, 17 Jun 2007 13:45:01 +0100 682477 http://www.medworm.com/index.php?rid=674771&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F06%2F13.html%23a1049 Software is in the midst of substantial change.The single vendor solution model is braking down, both because the level of automation in hospitals is starting to exceed the ability of any "single application" to address it (not to mention the ability of a vendor to cobble one together through acquisitions), and IT architectures like SOA and web services are making middleware a natural solution for enterprise-wide services (think Emergin and event management). Likewise it seems that every new application has an engine for this and an engine for that - rules engines, messaging engines, interface engines, positioning engines - geez, they're everywhere.As the proliferation of software engines, or "enginification" continues, the value inherent in an application rises from the application code i... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=674771 Wed, 13 Jun 2007 23:02:20 +0100 674771 http://www.medworm.com/index.php?rid=674778&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F06%2F08.html%23a1042 John Zaleski over at MedicInfoTech has an interesting post on the design for a central surveillance system that supports ventilators from multiple vendors. Referred to as the Remote Mechanical Ventilation Manager, the system is a rather conventional affair similar to systems for patient monitoring. The system assumes RS232 interfaces on the ventilators. Changes in hospitals over the past few years have heightened the market requirement for ventilator connectivity. Once limited to critical care areas, ventilated patients who don't require the 1:1 nurse to patient ratio of an ICU have increasingly been transferred to lower acuity on-service units or general care wards. Patients that were once found in highly concentrated locations are now all over the hospital, presenting challenges for resp... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=674778 Sat, 09 Jun 2007 01:26:06 +0100 674778 http://www.medworm.com/index.php?rid=674786&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F06%2F06.html%23a1034 I thought I was done posting for today, until I came across this. The FDA is working on a proposed rule to regulate medical device data that is acquired and stored directly into the EMR's database.“As the ability for direct capture evolves, the current direction FDA is heading is the medical record becomes part of the device,” he [Tim Stitely, the FDA’s chief information officer] said after a panel discussion on health information technology at the 27th annual Management of Change conference, sponsored by the Industry Advisory Council and the American Council for Technology. “I don’t think now [EHRs] as defined will be regulated by the FDA. It is not a medical device, food, drug or other thing we regulate.” Many connectivity features support two predominate us... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=674786 Wed, 06 Jun 2007 21:19:42 +0100 674786 http://www.medworm.com/index.php?rid=637777&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F05%2F23.html%23a1024 Mike Gray continues to evangelize DICOM Archives (his latest here and here-registration required) - which I think has interesting parallels with medical devices at the point of care. Imaging modalities are obviously the medical devices, similar to patient monitors, point of care diagnostics, pumps, vents, etc. at the point of care. The Picture Archiving and Communications System is equivalent to the servers that many of these medical devices communicate, storing data for surveillance, alarm notification and retrospective analysis. The medical device data stored on some device servers are of little value beyond the immediate future (like full disclosure waveform data), while other data has greater long term value (like the CQI data collected by "smart" pumps).As the servers connected to med... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=637777 Wed, 23 May 2007 20:06:49 +0100 637777 http://www.medworm.com/index.php?rid=611475&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F05%2F15.html%23a1021 I noted the other day that fellow blogger Shahid Shah, The Healthcare IT Guy, had a post on a free scanner for detecting the use of USB drives on your network. The tool he mentions is called Endpoint Scan, and has some very powerful features - be sure to read his post (you can see a sample report here).Today I came across some additional info on USB drive security, a white paper and webinar here.A potential problem with medical devices is they probably won't be on either your enterprise network or a private network - otherwise, why would you need to sneaker-net a USB drive around? Without a network to "deliver" the scanning tool, you have no means to monitor USB usage. The security tools above are more interested in the unauthorized slurping of data off the corporate network. But, as I've ... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=611475 Wed, 16 May 2007 00:44:00 +0100 611475 http://www.medworm.com/index.php?rid=611484&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F05%2F11.html%23a1012 Reader Bernard Farrell (who's got a terrific diabetes oriented blog) ask about my recent slam on USB connectivity for medical devices.I'm intrigued by your comment "The good news is that USB connectivity is pretty crude and poorly suited for most medical device connectivity applications and should be eclipsed by Ethernet and wireless LANs." Given how successful USB has been in the camera and MP3 device marketplace, why do you see it as 'crude'? It may eventually be replaced by wireless, but I don't think this will happen until wireless boards are as cheap as USB is right now. Anyway, I'm just curious here and I've love to know more.Medical device connectivity is all about workflow, not just getting data out of a device and into some software application. At one extreme you have the u... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=611484 Fri, 11 May 2007 20:54:39 +0100 611484 http://www.medworm.com/index.php?rid=549616&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F04%2F17.html%23a989 The industry group responsible for the advancement and adoption of USB technology (warning: obnoxious sound track) has created a health care working group. Apparently patterned on the Continua Health Alliance approach, the group is targeting health and wellness, disease management and aging independently market segments. Noted members are also all Continua members: Cisco, Intel, Nonin, and Welch Allyn. From the press release (pdf).The group's initial goal is to develop a USB Personal Healthcare Device Class specification. The new specification will enable health-related devices, such as blood pressure cuffs and exercise watches, to connect via USB to consumer electronics products, such as PCs and health appliances. Interoperability of health-related devices and consumer electronic products... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=549616 Tue, 17 Apr 2007 23:32:22 +0100 549616 http://www.medworm.com/index.php?rid=518486&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F04%2F03.html%23a970 Samsung has a new product called the UbiCell that connects to 10/100 Ethernet and broadcasts WCDMA/HSDPA. It seems that Samsung also has a CDMA version. You connect from your cell phone to your carrier via the UbiCell and an Internet connection. Samsung is negotiated with carriers to offer their service over Samsugn's device. It is not surprising to see products like this in response to new cell phones that roam on WiFi networks when cellular in-building coverage is poor or nonexistent. (Source: Medical Connectivity Consulting) Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=518486 Tue, 03 Apr 2007 21:22:32 +0100 518486 http://www.medworm.com/index.php?rid=482992&cid=t_103925_113_f&fid=34695&url=http%3A%2F%2Fmedicalconnectivity.com%2F2007%2F03%2F19.html%23a966 In health care delivery, the network is a medical device. Okay, not always, but when devices like patient monitors or infusion pumps are connected to a network that carries data critical to patient surveillance or alarm notification, the network is part of the regulated medical device. Now the FDA has been kind enough to mostly look the other way regarding wired and wireless local area networks. The FDA would be well within their legal jurisdiction to tell network vendors to follow the Quality System Regulation (QSR) and get premarket approvals for their products in applications that are regulated medical devices. To date (with a few minor exceptions) the FDA has been content to let people who really know what they're doing (i.e., medical device vendors) manage networks as off-the-shelf te... Medical Connectivity Consulting blogs http://www.medworm.com/rss/comments.php?id=482992 Mon, 19 Mar 2007 17:13:31 +0100 482992