I’m in San Francisco this week at HealthBeat 2013, a new event that’s exploring “smart hospitals” and “smart practices” to help healthcare decision-makers identify the technologies transforming the industry. Trey Lauderdale moderated a session with Julie Vilardi, RN, MS, Executive Director of Clinical Informatics and Strategic Projects at Kaiser Permanente, and Darren Dworkin, Senior VP and CIO at Cedars-Sinai Medical Center. Here are some highlights:

As a practicing nurse for over 25 years, Julie spoke from experience when she painted a picture of the chaotic environment of hospital nursing.

“When you look at the nursing population, they are very smart and industrious, and used to a disjointed environment,” Julie said. “It takes some study and focus to bring in new technology, because if it doesn’t work they’re going to go back to their manual process. They need one standardized device that can be used for voice and text, that’s reliable and delivers a return on investment.”

Julie went on to discuss the importance of the user experience, and the expectations nurses have for slick consumer devices. “When you get inside the hospital walls,” she said, “those experiences are beginning to be the expectation, and we so don’t deliver it right now.” 

When Trey asked about the trend toward BYOD, Darren acknowledged hospitals worry about the security issues of mobile technology, but emphasized that care providers have come to expect those technologies at work. 

“A lot of our clinicians are using technology in other aspects of their life,” Darren said. “They want to know how come they can’t have a healthcare version of that.”

The answer, he said, is a balance between convenience and security. “If a device is not convenient enough, people will use a personal device that is not secure.”

As EMR begins to be integrated into mobile devices, user interface and security issues will only increase in importance. Both of today’s panel experts pointed to the need for hospitals to introduce nursing technology intelligently, with an end-to-end solution that works across hospital departments.

If you or a family member has ever been admitted to a hospital, you know how important nurses are. They take care of us when we’re most vulnerable, and comfort us with a smile when we’re in an unfamiliar place and facing an uncertain future.

Nurses are the heart of the hospital. They are also at the heart of everything we do here at Voalte. 

When Trey Lauderdale came up with the initial concept for Voalte five years ago, his goal was to make it easier for nurses to communicate with each other. Nurses at our local hospital, Sarasota Memorial Health Care System, were first to use Voalte One smartphones back in 2009. The feedback they provided then and continue to provide today has helped us shape Voalte One into a rich, dynamic solution that’s now used by leading hospitals throughout the country. 

Every year, we pay tribute to our local nurses with a celebration during National Nurses Week. Last Tuesday, we joined our friends at Sarasota Memorial for a Voalte-sponsored game show, where we handed out gift cards from local restaurants and spas, and awarded cash prizes and Voalte goodies to some lucky winners. For us, the prize is always seeing smiles on the nurses’ faces. And those smiles aren’t only reserved for Nurses Week. It may be due to our bright pink pants, but happy nurses are always first to greet us when we visit Voalte hospitals.

While Voalte solutions and our vision have grown beyond bedside communication to include other functions vital to a smooth clinical workflow, nurses know they always come first for us. Whether we’re on-site at Children’s of Alabama, Cedars-Sinai in Los Angeles or here at home at Sarasota Memorial, nurses thank us for making their jobs easier. Considering that nurses have one of the most difficult jobs in the world, we consider it the least we can do. 

Last week, we released the results of our first Special Report: “Top 10 Clinical Communication Trends.” More than 1,000 nurses responded to a national survey sponsored by Voalte and American Nurse Today, the Official Journal of the American Nurses Association. Our goal was to identify the communication pain points that make it difficult for nurses to do their jobs efficiently. Some of the results were shocking; others were reassuring. Be sure to check it out to see what nurses are saying about the struggles they face every day.

At some point, we all may find ourselves being admitted to the hospital. When that time comes, let’s hope the nurse assigned to our care has the tools he or she needs to do their jobs efficiently … and with a smile.

_{Shown above: Voalte Account Manager Nate Levine (center) with Sarasota Memorial Health Care nurses: Kathleen McDonald, RN, Maria Murray, PCT, Sara Campbell, RN, and Karen Van Der Weert, RN.}

Years ago, a wise COO told me, “I can’t help you if I don’t know what you need.” When dealing with a problem or issue, the first step is to understand the nature of the challenge. The same holds true of nursing practice issues or barriers. Speculation or assumptions about the communication, resources and support needs of nurses at the bedside may lead to wasted time, misunderstanding, and even mistrust and loss of engagement.    

In an effort to fully understand the end users of our products, Voalte partnered with American Nurse Today, the Official Journal of the American Nurses Association, to conduct a national survey of nursing leaders and staff nurses. The purpose of the survey was to solicit their perceptions of the work environment related to time available for care coordination and patient needs, devices available for communication, and support for the effective use of technology.  

Now is the time to fully understand the nursing care micro-system and the dynamics of daily communication between stakeholders. Changes in our healthcare arena are challenging hospitals to change their care delivery systems and reevaluate both their basis and paradigm for decisions. The operational strategies that have worked for decades will not necessarily work in this reformed healthcare environment. All previous assumptions must be tested, and rejected if they no longer apply. 

More than 1,000 people responded to our survey. With the assistance of Dr. James Lani and Jeanine Glase, the amazing biostatisticians at Statistic Solutions, we compiled the main findings into a Special Report: “Top 10 Clinical Communication Trends.” For those interested in nursing workflow and communication, this report is a must-read for insight into the clinical communication landscape in the nation’s hospitals. Once you understand the challenges, you can start coming up with solutions.

As I travel from hospital to hospital as a User Experience Manager for Voalte, caregivers I train frequently ask me, how Voalte will be useful in their particular unit?  Depending on the type of communication device the caregivers have previously been using or the lack thereof, many caregivers just cannot visualize how Voalte could benefit their unit. 

I often respond with a question… "With whom do you communicate on a regular basis?"  The responses from the caregivers vary depending on their unit workflow from Pharmacy to Respiratory to Physicians, Care Techs, etc.  Then I ask, "How have you been communicating with them?"  Their responses are amazing!  Some have been using pagers, which have been obsolete for individuals outside the hospital setting for quite some time.  Others say they have phones that they can use to call the intended party on.  The trouble with this is that both parties must stop what they are doing to speak to one another by phone.  In this scenario, both caregivers must be available at the same moment and caregivers don’t consistently have the same phone number, resulting in the caregiver dialing 4 or 5 extensions before they find someone to answer.  Lastly, many caregivers respond to my question by saying, "We just yell down the hall or go find the person."

When I explain how the Voalte One solution will allow them to text and call other caregivers by tapping on the desired individuals name or unit, they are thrilled!  Being able to text caregivers and other units throughout the hospital excites them, realizing how this form of communication will help them to better manage their requests from other individuals more effectively.  They are relieved when they learn that they will now be able to see which caregivers are at work on a particular shift, thus eliminating the dialing of multiple extensions to find someone to answer their call. 

I am excited to report that it does not take much convincing for Voalte’s caregivers to agree that we have transformed how they do business!

You may have heard about cloud computing, but what is it and where did it come from? If you’re a Voalte user, you are already using the cloud. Congratulations, you’re on the cutting edge of technology! 

Cloud computing got its name from engineers' practice of drawing networks as clouds on whiteboards. Drawing a cloud is easier than drawing a bunch boxes and lines for the connections between the client and server. Over time it also became an easier way to talk about server computers too.

The term is used to describe various ways of sending data across a network from one computer (like your iPhone) to another (like the Voalte server). The server then processes your data for you. In this case, it’s the Voalte cloud! Think of it as an assistant doing your bidding. Or think about it like an iceberg. The software running on the iPhone or on the desktop is the tip, but underneath there’s big chunk of software in the network doing its job. That software is running on the server computer.

When you send a message on your Voalte phone, despite what you might think, you’re not sending it directly to your co-worker. Your message goes through the hospital’s WiFi network to a computer called a server. This is a computer in an equipment rack somewhere in your hospital’s IT department. The software on that computer then looks at your text, figures out if your co-worker is logged in and can be reached on WiFi, then relays that text. Otherwise it waits until it can reach your co-worker and sends that message later.

As a Voalte engineer, my co-workers and I create features by writing code on the server, on the iPhone, and on the desktop clients. That software has to communicate across the network. We also define the network protocol that our software uses to talk across that network.

When we find problems, we have to figure out if the problem is on the iPhone, desktop, or the server. Or, maybe there’s a network communication problem in the middle? We don’t like WiFi problems any more than you do!

Writing networked software can be challenging, but it’s also rewarding. I enjoy writing our Voalte software and seeing it used for an important purpose: taking care of patients.

A lot of people talk about what they want to do or who they want to be. Companies do it too. They talk about their vision or their purpose, but what does it all really mean? To believe in what you are doing, is that vision? What is the purpose of the work I am doing?

These were the types of questions I asked myself when I was sitting in a chair at Sarasota Memorial Hospital. My wife was recovering from complications with her Diabetes, so I had a lot of time to sit, stare blankly at my laptop screen, and ponder the impact our solution has on healthcare and even further, on my life directly, in this moment. I had the same reoccurring thoughts, as I watched nurses come in every thirty to sixty minutes to test her blood sugar levels. This isn’t just marketing; they are really using the product to help my wife recover. This is real.

I did not understand the true importance of the Voalte solution until I saw it in action. I watched as someone triple checked the basal rate of insulin my wife received every hour. The nurse used the product we sold, making sure not to double up on the dosage. It really hit home at that moment, how lucky we were to be in one of the best hospitals in the world, a hospital, which is running Voalte.

You hear sales pitch after sales pitch, involving the vision or purpose of a company, but you don't really understand the reality until you experience it first hand. I understand, now more then ever, what it means to have purpose in my work. It’s not about hitting a sales goal. It's about building something that is capable of impacting the quality of care your child, parent, or spouse receives. I love being a part of something like that... I was sitting in the hospital room while my wife recovered when purpose slapped me in the face.

On Tuesday, October 23, 2012, at 10:00AM PST, Apple released the iPad Mini.

On Tuesday, October 23, 2012, at approximately 10:05AM PST, physicians, nurses, and other caregivers began asking IT when the iPad Mini would be supported by the organization.

Below are three things to consider regarding the iPad Mini’s immediate impact on healthcare:

1. Ease of use. The iPad Mini has the same intuitive user interface and application standards that the iPad and iPhone feature. Users will have no problem picking up the device and using it with little-to-no training. Standardized products and ubiquitous experiences have their advantages.

2. No form factor. The iPad Mini is a dream device for physicians and nurses who are looking for a lightweight, mobile platform that can fit in their lab coat pocket. It’s big enough to enable both reading and writing information in an EHR, yet small enough to easily carry around throughout a shift. When it comes to the deployment of the iPad Mini, the real question will be, how quickly EHR vendors can optimize their applications for the iPad Mini’s new form factor? Epic’s Cantu and Cerner’s PowerChartTouch were both designed for a regular sized iPad. Not all features and functions that have been built into their iPad app will be suitable for a smaller screen size, so expect customization to occur.

3. Enterprise readiness. Right out of the gate, the iPad Mini runs Apple’s iOS, which is accepted by almost all IT organizations in one fashion or another. With the plethora of mobile device management solutions (such as Voalte Connect, powered by Airwatch), the iPad Mini will have no problem receiving the go-ahead from IT in terms of enterprise readiness. (This, of course, is a 180-degree change from the launch of the iPhone in 2008!)

Wondering how the iPad Mini will play into your organization’s mobility strategy? Feel free to give us a call here at Voalte and we will be happy to help guide the way.

As a young, fast growing company, trade shows can provide a wealth of knowledge, and lead to an overwhelming amount of success. Two weeks ago, Voalte had the chance to participate in the Cerner Health Conference out in Kansas City, Missouri. We had a booth setup, ready to demonstrate our Voalte One Nursing Communication Solution where we were able to speak face-to-face with current customers in addition to potential customers. Our booth screamed pink and green and our “pink pants crew” triggered lots of attention across the show floor driving more traffic towards our location.   

What made CHC different from other shows I had attended in the past is that it was a user conference. In other words, only Cerner customers were able to attend. In addition, Voalte and Cerner were able to join forces to enhance communication at the point-of-care, by integrating with Cerner on a few different levels at the conference. We showed Voalte One integration at the CareAware Connect station as well as the Alert Link Alarm Management Station. Cerner showcased these products and others in their Solutions Gallery. This Solutions Gallery was an amazing resource of EMR knowledge. We were able to learn as much as possible about their EMR and Middleware platforms, iBus and Alert Link, as well as new up-and-coming Cerner products!   

Looking back, I can’t help but think of CHC’s tagline, “Because it’s personal”. At the end of the conference, I was able to meet face-to-face with hundreds of potential customers, some of which I had been speaking with for seven months or more. Which goes to show you, building relationships before hand is key, but being able to interact face-to-face can make all the difference. And when you stop and think about it, the same is true in healthcare.

Healthcare is personal, shouldn’t clinical communication be personal too? 

The release of a new Apple device has become associated with adults behaving like children.  We camp out in sleeping bags with friends (in front of the nearest Apple store).  We stay up until 3 a.m. (to pre-order).  Some of us may even throw mini temper tantrums if delivery is delayed a day (not mentioning any coworker’s names).  And if we’re among the poor souls who have to wait, we become very, very jealous of the “in” crowd’s new toys.  Whether you’re reading this on your shiny new iPhone 5, pining away for one until your upgrade is available in January (moi), or just watching this whole game unfold like a football fan on Sunday, you’re probably aware of the existence of “device envy.” 

It doesn’t matter if you’re a consumer aching to trade in your phone or tablet for a fancier new model, or a healthcare administrator exploring intrahospital communication solutions – there are a few basic questions you should ask yourself before donning a clown costume and jumping on the upgrade bandwagon (Google the origin of “bandwagon” if you didn’t get the Bozo reference – interesting story…).

Is it necessary?
Don’t panic.  Answering “no” doesn’t categorically mean you should halt research on upgrades, but it’s important to understand your own or your facility’s motivations before assessing your options.  A non-essential upgrade may only be realistic when personal, department, or organizational budgets allow.

Is it practical?
Sure, Voalte is the communication solution used by U.S. News and World Report’s top ranked hospital, Massachusetts General.  And, yes, CNET just listed the iPhone as the best cell phone yet again.  But if you oversee a small rural facility that operates sans WiFi, or you’re in the Peace Corps in electricity-free Northern Ghana, no matter how great they sound, well, expensive ice cubes just aren’t that useful for Eskimos.

Does it have a documented history of success?
Whether it’s for posting your Facebook status updates, or its purchase represents a significant investment of hard-earned fundraising dollars, you don’t want to plunk down a hefty chunk of change for a fly-by-night device or solution that may not be around next year, or might not have the resources to provide quality, comprehensive service.  ‘Nuff said.

Is it a long-term solution; can it grow with me/us?
These days, it’s all about the “expanding platform.”  There’s no way around it – the world has changed, and when considering options for both personal and professional devices, your lifestyle or workflows are likely going to dictate that an expanding platform is the only viable solution.  Literally every day, new applications and new uses for existing hardware are developed; you’ll want to have access to them.  Be certain to make a sound investment in a device and company that has the ability to evolve with the dynamic communication landscape we operate in.

So there it is.  Now if you’ll excuse me; I’m off to pull another day from the Pinterest-inspired “Countdown to iPhone 5” calendar I created.

There is no question that the iPhone is the king of smartphones when it comes to clinical communication. No other device has been so widely adopted by nurses, doctors, and other caregivers.

In celebration of the iPhone 5 release, the five improvements listed below ensure that Apple’s latest iPhone continues to be the king of communication devices in the enterprise healthcare space:

1. Larger display with 44% more color saturation. As more applications provide medical document and imaging features, the richer and better display continues the iPhone’s dominance as the essential medical device for accessing patient information.

2. 802.11N support. The iPhone 5 supports 802.11 a/b/g/n on 2.4Ghz and 5Ghz. This is a HUGE, HUGE win for future VoIP support on the iPhone. It also supports secure information downloading on an enterprise’s wireless network.

3. 4G LTE connectivity. The future of mHealth depends on ultra fast connectivity in locations outside the walls of the hospital. Furthermore, 4G LTE support from iPhone promotes video and other telehealth focused applications.

4. A6 CPU – faster performance, better battery life. Having the iPhone survive through a 12-15 hour shift is critical for point-of-care communication. The iPhone 4S was easily able to make this mark – with a new and improved battery, we can expect the iPhone 5 to last even longer at the point-of-care.

5. 20% lighter, 18% thinner. Caregivers have to carry around many tools to do their job. A lighter, thinner iPhone is just icing on the cake.

Apple continues to amaze and dominate the smartphone market with the design and functionality of their products. It’s incredible to see the improvement from the first iPhone 3 to the new iPhone 5. One can only imagine what the iPhone 10 will look like in 5 years…

Long live the king of mHealth!