Recently I had the privilege of attending User Interface Conference 17 over in Boston where I met some really interesting and talented people. I attended some outstanding sessions and workshops to help us improve and innovate our design process over here at Voalte. One session that resonated with me was Luke Wroblewski's talk on 1st person user interfaces where he spoke about the current trend in touch-based interfaces and how augmented reality and the use of sensors in everyday items will become the interfaces of tomorrow, paving the way for natural interaction interfaces over learned voice or esoteric device specific commands (swipe to delete anyone?).

Being part of such a saturated market, where the new buzz word 'HIPAA-compliant text messaging' is being slapped on everything like a 'Gluten-free'' label, means we constantly have to keep one eye on the goal and one toward the future. This talk got me thinking about some of the cool new ideas we could use to improve healthcare communications in the future.

Imagine being able to use your phone's altimeter (or interpolated location based on WiFi access points) to trace a nurse's route throughout the hospital. You could automatically set them as 'busy' when they enter the cafeteria or the break room and forward alarms to their backup.

There is also the concept of wearables, where users affix an unobtrusive device to their clothing which records information from a built-in GPS, altimeter, pedometer, gyroscope, accelerometer, temperature sensors, and more! We would be able to tell if a physician is sleeping, driving their car, or out on a hike, and look through their backup list to try and not disturb them if another physician is readily available.

New tools and paradigms like this will allow us to gather information about a user's surroundings and let the software work for you, naturally, as you would expect it to. As a software developer and user interface designer, it is a very exciting time to be in the healthcare communication market. 

I’ve written my last couple of blogs on ISDN vs. SIP and Open Source vs. Proprietary PBX’s. Now I would like to conclude this subject with why Hospitals really should implement the SIP protocol on their PBX rather than remain with their legacy PBX, which could be TDM, or even the earlier signaling protocol H.323.

I would like to go over a couple of problems I have seen in the industry with utilizing these legacy PBX’s. The largest complaint on legacy PBX’s, especially the ones with TDM interfaces, is the lack of bearer channels. Every time you want to increase your capacity, you will need to add another T1 card, which of course only adds 23 more bearer channels, or 24 if you have the capability of running a shared d-channel as in a NFAS configuration. A second common problem is the display name being sent over the TDM trunk via the ISDN protocol. Some ISDN protocols use Information Elements (I.E) in the ISDN Setup Message while others may use Facility Messages to send the Calling Name. Sometimes, if supported at all, this configuration can be cumbersome. A third problem also seen, especially in a Tandem PBX, is the lack of the ability to sometimes send the actual calling number or perform any digit manipulation.

With a SIP PBX, especially Open Source, all of these problems can be easily resolved. There is no 23 bearer channel limitation. If you want the ability to place more calls, you just have to make sure you have the appropriate hardware such as memory and CPU power. As for the Calling Name, it can be taken from the Display Info in the SIP Header. This is pretty much automatic, really little to no configuration. Digit manipulation and the calling number are simple with SIP. The calling number is generally sent in the host part of the SIP from header. The calling number can also be obtained easily from what is referred to as a P-Assert or Remote Party-ID.

As for H.323, it really is an end of life protocol, still used somewhat in the public sector, but not much use in the private sector. Although closer than SIP in relation to ISDN signaling, there is little development being done with it today.

So in conclusion, choose SIP for your hospital.

I spend a lot of time on coaching, mentoring and teaching entrepreneurship and innovation to young people. For the last 10 years I have been on the executive board of the Center for Entrepreneurship and Innovation at the University of Florida, Warrington College of Business Administration. I love my involvement. I am also very involved with our local Sarasota County Economic Development and most recently with GrowFL. I love technology and love that when technology is combined with new ways of thinking the results can be transformational. I have seen this repeated many times over the last 30 years.

Many organizations have asked me to share any lessons learned and I am always glad to do so. Not to say that I think that I am smarter, brighter or more insightful than other, but I thought you might be interested. So here goes:

1. Building new companies is hard work… really hard work. The stories you read about Facebook or Instagram are not what you should expect. You should expect long hours, low pay, and sleep, money and time deprivation.

2. You and your team should embrace, not fear, change. Just about everything you thought will change. The average time between change is compressed. Get used to it. Learn to enjoy it.

3. Your personal life should be in order. If you don't have a strong relationship with your spouse or significant other, it will be at risk. Make sure your moral compass is well calibrated.

4. There is a reason that revenue is at the top of the income statement. Focusing on engineering, although important, won't get you any closer to payroll. Always have a clear model of your company works and the source of your growth. Do you need to acquire more customers and at what price?  Or, do you need to increase the value of each of your existing customers?

5. Focus on cash. It is probably more important than your mother. Keep in mind, cash is different than sales and revenue. Sales can go up, revenue can go up and you can still run out of cash.

6. Be generous. Be generous with your time, your ideas and even your money. I am always surprised when you help someone with no expectation in return. I am frequently amazed how these moments of generosity provide unanticipated results.

7. Get out of the office. A single trip to a customer will provide more insight than an expensive research project. When talking and meeting with customers learn to ask questions and then listen carefully… not only to what is being said but what is not being said.  

8. Hire well. Take time to recruit, hire, coach, train and mentor well. Most of us can do better.

9. Test early and test frequently. Sometimes a leap of faith becomes institutionalized before it is proven. This holds equally true for sales and marketing initiative and operational processes. Why are we doing the things we are doing?

10. Eat your own dog food. Ok… I really don't need to explain this one, do I?

I hope you find something helpful here. We need more juiced-up entrepreneurs, more risk takers, more never-say-no'ers, more crazy, foolish start-up junkies if we are going to pull this economy and this country out of the economic doldrums. If you are passionate, driven, obstinate and tireless, entrepreneurship might be right for you. Or, at least visit our job-opening page and let Voalte get your juices boiling.

As a Voalté project manager, I’m able to see and experience quite a bit when going through hospital installations and upgrades. Funny part is that no matter how many times I go through either, the experiences vary every time.

We commonly joke by saying, “Once you’ve seen one hospital install, you’ve seen one hospital install”. Truth is - no hospital is the same and therefore we shouldn’t expect units to be the same either.

An ER at Sarasota Memorial Hospital operates much differently from either a step-down unit in the same hospital or the ER at Heartland Health in St. Joseph, Missouri. That’s where the communication component plays such a critical role. From my experience, building in communication with leaders of each unit can go a long way in making sure a roll-out goes as smoothly as possible.

Getting clinicians involved from the start of the project helps build user acceptance and guarantee project success. Not only does the clinical team act as cheerleaders for the project - aiding buy-in from users that are less apt to accept change or may be technophobic - they also add valuable insight on how to shape the solution to the needs of the hospital and clinicians.

The concept is quite simple. Why buy tools for others to use without their involvement? It’s like having someone else buy you shoes without asking you what size you wear and how you plan to use them - to walk or to run. 

How is your hospital bridging the healthcare communication gap?