When the Middleware First Alarm Management Strategy Makes Sense

Posted by: Kenny Schiff on October 19, 2007

A few weeks back a hospital prospect called me in to discuss Vocera, and to meet some of the potential collaborators for a potential VoWiFi project. They’d previously had a very well-received Vocera demo and wanted to make sure that the work that they were doing to build out their wireless infrastructure aligned properly with Vocera’s requirements.

The customer already has made a significant investment in Cardiopulmonary Corp’s Bernoulli patient monitoring technology, and as they look forward they want to make sure that the rich data that is coming from Bernoulli would work in their emerging wireless enterprise, an enterprise that they are increasingly envisioning as a converged one, with wireless VoIP as an integral player.

The meeting generated a great deal of excitement, and we were asked to present a budget for an integrated Vocera solution, based on a newly understood set of requirements. A couple of days later we did a conference call with two of the key stakeholders to share our numbers. I had my concerns that the costs were going to be out of line with their expectations and felt the conference call would reveal this concern.

I was not wrong. On the call, it came out that what we proposed was about 3 times more than they were expecting. Then of course lots of silence.

We’ve seen this before.

The total costs of infrastructure + product + deployment services in the same budget year, regardless of how compelling the business case can send even the best intended initiative into a tail spin or dormancy. And make no mistake, it’s often hard to digest (or hide) the operational burdens that even the best designed solutions will require. Healthcare technology acquisition is not like buying an iPod. It doesn’t just work, and it doesn’t cost $199.

While we’d love to see every hospital in our region have a house-wide Vocera system, running on a flawlessly designed and managed wireless network, integrated with key hospital data systems, the business realities for healthcare aren’t going make this possible.

Vocera can solve lots of problems in an innovative manner. But for clinical and IT teams in hospitals, what is the real goal? If you dissect these initiatives, it often boils down to tweaking basic business processes to improve customer satisfaction, while allowing the organization to operate more efficiently and profitably.

Clearly there are many ways to skin this cat. My newly coined “Middleware First Alarm Management Strategy,” is one of them.

Let’s think through the elements in play here:

  • Existing paging infrastructure that needs augmenting (and may not be going to go away anytime soon)
  • Antiquated nursecall system that’s begging to be part of an integrated framework, and slated to be fork lifted
  • Major wireless infrastructure build out that may be many months from production
  • Vocera is an enticing option, but may be too stressful on resources to implement full blown right away
  • Need for process and workflow improvements

While I’m not sure what this customer is thinking on this right now, in my last correspondence I suggested the possibility of delivering many of the a larger solution’s benefits in the near-term by tying their existing infrastructure together with an Alarm Management middleware solution. The middleware would join their existing pieces together (nursecall, patient monitoring, and pagers) without significant cost, and sets the table for a future system that includes Vocera and other integrations. For a limited investment, they’d get immediate process improvement benefits, and extend the life of their existing legacy technologies.

This week we are about to launch a project with a different customer that is setting out to just that. This particular hospital is in the process of migrating from a very old nursecall platform that has some limited connectivity to pocket pagers, to a new one. And their future plans definitely include Vocera, but they’re not ready for it.

They need to run both systems simultaneously while economizing on pager transmitter ports and also tie in wide-area pagers. And they want to set the table for a Vocera integration to come. Our project uses Alarm Management middleware to provide that bridge. This relatively small financial investment, will solve a short-term problem (keep their old nursecall alive while they switch to the new), give them an extensible platform framework that can incrementally grow.

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