Very soon your web browser will become your next telephone!  Surprised.  You should be.  Soon you will be able to make voice and even video calls to anyone running the latest web browser.  No apps to download, no installs and no sign ups.  It’s just you and your web browser.

WebRTC is a free, open project that enables Real-Time Communication (RTC) capabilities to be built right into the web browser without any extra plug-ins or software.  In addition to voice and video calls, it will also be possible to screen share and transfer files. 

What does this mean for you?
Websites will become more interactive “environments” where other users will be able to interact and communicate in real-time, rather than static pages of text and images.  It will also allow for imagine browsing on an online store, being able to chat with other shoppers or even talk with a salesperson or customer support directly and immediately.

What does this mean for healthcare?
This will make telemedicine easier and cheaper to achieve because it won’t require any special hardware or software to setup a videoconference between a patient and a healthcare provider.  It could also change the landscape of medical devices, for example, a nurse could receive a critical alarm that links to the patient monitoring device showing the live waveform or real-time values like heart rate.

What browsers have it? 
WebRTC is not generally available in any web browser yet, but you can try it in early experimental versions of Google Chrome, Mozilla Firefox or Opera.

When will it be generally available? 
I guesstimate that 2013 will be the year of WebRTC and it should be available on all major web browsers.

I am very excited about this new technology because it will take web browsers and communication to the next level.  Telecommunications started with landline telephones that only made voice calls, then wireless smartphones enabled voice, video and data and now the web browser will have the ability to allow easy real-time collaboration between individuals and offer direct access to real-time data.

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? 

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!

In my travels working with customers and partners I have the pleasure of talking with hospital management teams and end users about Voalte. Frequently our conversations gravitate to the lack of modern wireless communication solutions in healthcare and the truly unique capabilities Voalte brings to the market.

1. Convenience – Voalte eliminates the need for the nurse's "tool belt" of multiple devices and applications. Text messaging, alarms/notifications, and voice communications all flow naturally to a single smartphone application.

 

2. Ease of Use – Why is Apple selling 350,000+ iPhones Per DAY? It's intuitive and simple to use. Voalte leverages the advantages of the robust iPhone hardware and a software application that provides all of a caregiver's communications needs on a shared device with a single sign-on.

 

3. Functionality – I tried text messaging on my old Nokia cell phone. Remember pushing each button 1,2, or 3 times to get the letter you wanted? Forget it. The advent of full keyboards made text messaging a mainstay of communication in the modern world. The non-smartphone handsets currently used in most hospitals today provide the same functionality you abandoned 10 years ago in your personal life.

 

4. Efficiency – The workload of nurses and physicians is astounding. Few jobs require keeping multiple "balls in the air" quite like the hospital environment. A study shows that communication with team members, or other departments, accounts for 20.6% of nurse's time. Providing more streamlined communications leads to happier more effective caregivers. The result is more time spent at the bedside with patients and fewer mistakes. Voalte provides better outcomes and happier patients. This all leads to higher reimbursement and lower cost to the hospital and our over burdened healthcare system.

 

5. Flexibility – The typical process for replacing broken wireless phones in the hospital is for the telecom team to order the same proprietary phones they have been using for decades. The "new" handsets may be a different color or shape, but provide the same limited functionality and user interface they've always had. Why replace a dead-end phone with another dead-end phone?

 

Voalte can custom provision iPhones tailored to the hospital system's needs or even customize by department. Voice, alarms, and text are just the beginning. Voalte puts the power of 50,000+ medical applications in your hands at the bedside – drug reference, med math calculators, language translation – the options are endless and growing every day. Shouldn't your wireless hardware and software solution have the flexibility to grow and change with your communication needs?

After having worked for Voalte for six months now people have asked me; “what question do you hear most often in the field?” When explaining what we do to hospital executives the over whelming majority ask, “if Voalte is a smartphone application can we just download it on our personal phones?” 

The simple answer is no, but the underlying importance is the reason why. Nurses all over the country have used different legacy devices ranging from complicated phones to simple single-use pagers. Now days all of the emerging technology is wonderful but we cannot lose focus on the end users. Hospitals are busy places and when a new technology is proposed caregivers are left wondering if they are going to have to learn how to use a new device or system?

This is where, as we say, a full “turn-key” solution is necessary to address the problem. After seeing our solution successfully rolled out at a number of hospitals across the country I have to come to realize that the reason for the success starts with the nurses being receptive and embracing the technology. Our end user training does just that. Our project management team ensures integrations are performed and infrastructure is configured correctly. Our go-live support maintains a successful rollout, while our ongoing supports keeps the solution up and running as it should. Lastly, our “app” in combination with our specialized devices and charging solutions deliver the efficient and effective communication nurses and caregivers need to deliver the best care possible.

It’s more than just about the app…it’s about our people and the overall experience.

As my colleague, Frank Watts, mentioned in his post “Noise and Patient Anxiety,” a cacophony of alarm signals, nurse call equipment sounds, and the like, can wear down a patient’s recuperative efforts and assurance that they are receiving the best possible care. So, too, can a frequency of alarm noises cause anxiety in hospital caregivers, which in turn, can deplete their ability to provide excelled healthcare. This syndrome, known as alarm fatigue, occurs in a clinical scenario when alarms sound so often that responders become desensitized causing them to respond slowly, inaccurately, or not at all. Another issue of “alarm discriminability” arises which affects the clinician’s ability to discern between one or more alarms. Hence the need for a better alarm delivery solution – Voalte One!

In a survey summary published in the MedSun Newsletter #65, October 2011 by The Medical Product Safety Network*, nine of the 350 health care facilities included in the network reported on the most common alarm fatigue challenges in their demanding and time-critical environments. The respondents represented a cross-section of the hospital staff: risk managers, staff nurses, nurse managers and biomedical engineers. Nearly two-thirds of the respondents experienced alarm fatigue daily, while the other one-third were clearly aware the term and the issues involved. Generally, many of the respondents felt that the varying alarm sounds required extra diligence that involved relying on other sources of observation. In order to determine the correct priority of an alarm, many clinicians would check central monitors in the nursing room, search from room-to-room, use split screens in patient rooms, etc.–all requiring invaluable time when seconds really count the most. Even with varying pitch and tone, many alarms in a localized area were still hard to distinguish properly.

Building considerations as to the overall size of the unit, high levels of noise, and closed patient room doors also factored into the ability for proper alarm signal discernment. That particular consideration and other conditions contributed to the survey-wide result that visual alarms faired better than auditory alarms when providing reliable, and rapid, information regarding alarm location and level of urgency.

When the respondents were questioned regarding their recommendations for better technological solutions to alarm fatigue and alarm discriminability, receiving alarm notification text messages on a smartphone was a survey-wide answer. Additionally, the ability to monitor alarm notifications and information portably through an iPad or similar tablet product was also mentioned as another important technology advancement.

*The Medical Product Safety Network (MedSun) improves FDA’s understanding of problems with the use of medical devices so that the FDA, healthcare facilities, clinicians, and manufacturers can better address safety concerns.

Whether you call them a HUC, an NCT, a MST, a UCA, etc., the hospital Unit Secretary is a professional juggler of tasks, Jack of all trades, chief communicator, mission control, and in many cases Mother Hen to everyone with whom they come in contact. Caregivers, Physicians, and patients alike appreciate what they do and reap the benefits from their daily interactions with their Unit Secretaries. Voalte would like to take a moment to recognize these amazing individuals.

The Top 10 Reasons we LOVE our Unit Secretaries:

#10: They work tirelessly

 #9: They are very knowledgeable about the workings of the department
       and are a wealth of information

 #8: They are always willing to lend a helping hand

 #7: They always know where to find everything

 #6: They know who to call in any situation

 #5: They always work hard to help everyone out

 #4: They are in control

 #3: They know how to fix any and all problems

 #2: They keep us organized

 #1: They ROCK!

To all Unit Secretaries all over the world, we acknowledge and value your ongoing commitment to your patients and your team. You make a HUGE impact, one interaction at a time!

Thank you!

Well maybe it’s not perfect, but it’s pretty darn close. Before doing a house wide deployment, many of our sites decide to test run on a single unit. The downfall to just going live with a single unit is that you miss the crucial interaction/communication between units and ancillary departments. The other thing you miss out on is the buy in you get from different groups within the hospital.

The University of Iowa Hospitals & Clinics noticed the importance of including departments outside of nursing. UIHC selected a single nursing unit and then included all the Physicians, Residents, Pharmacists, Dieticians, Social Workers, Physical Therapists, and Nursing Administrators that the unit communicated with. Phase One was hugely successful–probably one of the best I have ever seen!

When we went live, users immediately noticed the value of the Voalte One communication tool. Nurses loved the fact that they could find Pharmacists no matter where they were in the building. Residents loved the ability to text Nurses during rounds. Voalte was an all around win with all of the Hospital groups.

However, there were unintended consequences. Now that a few pharmacists, dieticians, and others had trialed Voalte, everyone else now wanted one. I guess it’s a good problem to have…

I've been thinking a lot about the impact of mobile technology on Healthcare. For the last few months I have been working with a task group with mHIMSS that is attempting to prepare hospital IT staff for the flood of mobile connected devices heading their way and recently released the “What’s Next Work Group Report: Emerging Tech Trends 2012”. Some of the BIG trends that are moving more rapidly than we expect will change everything. In this blog I will take a crack at some of those issues.

Everything is going wireless… EVERYTHING! This is tough because hospitals are traditionally hostile environments for radio waves. They have lots of concrete and steel walls, long hallways, elevators and lots of electrical equipment that radiates interference.

It is time to get serious about your wireless infrastructure. Many hospitals have relied on 3rd party service providers to maintain their wireless networks. These networks may have been designed a decade ago with only data-quality capacity and little concern for fast roaming, packet loss, jitter and a myriad of other considerations needed for today's demands. Access points maybe hidden under ceiling tiles, have poor power settings, or have an obsolete topography and channel settings. When was the last time you had a top-to-bottom, campus wide assessment / audit of your network?

Have you been thinking much about the "Internet of Things"? Maybe you should. The amount of R&D that is pouring into development and use of wireless sensors is mind-boggling. Sensors will soon be arrayed throughout the physical space to detect a variety of adverse conditions…think smart beds, smart rooms, smart gurneys, medical devices. Sensors will be worn in clothing, stuck to the skin (smart band aids and patches), taken internally or embedded under the skin.

All of these sensors will need to be connected into a data network where they can accumulate massive amounts of information. All of these wireless devices and sensors are producing massive amounts of data and that leads me to the topic of Big Data. We will need a way to store, access and analyze petabytes of information. That's right, petabytes… 2,000,000,000,000,000,000,000,000,000,000 (plus 20 more 0's) of data… but who's counting. Hidden in this data will entirely new medical protocols, diagnosis and disease markers just waiting to be discovered. Healthcare institutions will be drowning in data if action is not taken immediately.

The future is roaring down on vendors and providers and we all need to be ready to embrace the change. So…buckle your seat belts and hang on! 

Voalte does “Service” with more care and attention than anyone else in the business, and at the end of the day, our service component is what makes all the difference when it comes to the implementation, adoption, and success of the Voalte solution.

If you ever start to wonder how we do it, all you have to do is look at our people. Our customer focus extends from our Voalte BFFs to our Engineers. It is completely ingrained in our culture, and it is what makes it a point of pride to earn your “Pink Pants”. We develop such a strong relationship with our customers that they cannot help getting involved too:

“I keep meaning to tell you that Belinda is awesome!! The staff loves her, the managers have even commented that she's great and she's been super to work with… How long until she gets some pink pants? :)” –Jen Lassonde, Senior Project Specialist, Massachusetts General Hospital

I’m a project manager at Voalte, which gives me the unique opportunity to take part in every customer interaction from the project kickoff to post-go-live support. A ton of details go into a full implementation, but there is one detail in particular that I believe is critical to our success, and that is training. Training is the first chance we get to make a lasting impression with our customers, the clinicians.

 

Our trainers have a tiny window, 60 minutes, to make sure that our clinicians are comfortable with the iPhone and the Voalte One application. They help staff who have never touched a smartphone before conquer their fears and discover how they can benefit from this amazing technology. It takes a unique gift to adapt to different environments and people while maintaining the same exceptional level of service. For that reason, these final quotes go out to our team of talented Voalte Trainers:

“Amy has done a fantastic job. She is a wonderful facilitator and is able to manage large classes with ease. She has provided staff with one-on-one help after class to those who need a little extra practice. The class content is exactly what our staff needs.”  –Clinical Educator, Lurie Children’s Hospital

 

“Great class, GiGi!!!” –RN, Cedars-Sinai Medical Center

 

“I just want to recognize Amy Demski for doing an phenomenal job these past 2 weeks with training. Amy has trained over 1,000 users in 12 days. She has accommodated large class sizes and extra impromptu sessions while providing a high quality education.” –Arnold Butiu, Manager of Clinical Applications, Lurie Children’s Hospital.