Time Capsule: Untethered Caregivers = Great Clinical Systems Opportunity

I wrote weekly editorials for a boutique industry newsletter for several years, anxious for both audience and income. I learned a lot about coming up with ideas for the weekly grind, trying to be simultaneously opinionated and entertaining in a few hundred words, and not sleeping much because I was working all the time. They’re fun to read as a look back at what was important then (and often still important now).

I wrote this piece in August 2007.

Untethered Caregivers = Great Clinical Systems Opportunity
By Mr. HIStalk

Networking hardware vendor Cisco made a surprising announcement last week. The company’s two-year-old hospital division has become its growth leader. Sales have doubled in those two years to a cool $1 billion annually. Much of that involves wireless networking. That’s an unqualified "great" for Cisco and a qualified "good" for hospitals.

Healthcare customers were already buying a lot of Cisco gear, so carving out a separate healthcare business may not have made much difference. Still, the company must see a lot of opportunity in hospital wireless, infrastructure upgrades, and new construction. They’re smart.

Cisco will learn from a hospital-focused division. The company supposedly ran afoul of FDA regulations after making meaningless claims about a "medical grade network." It backed off a little, but is now pushing the good concept of integrating medical devices via wireless connectivity.

Hopefully Cisco won’t misstep again when injecting its products between patients and caregivers. If the company backpedals on reliability guarantees or has a patient-harming episode and hides behind legalese, word will spread fast. Cisco has a couple of hot little competitors like Meru and Aruba who would be more than happy to snatch a few of its crumbs.

Anyway, what’s most interesting about the announcement is that, clearly, most hospitals now have some flavor of wireless network. They vary in coverage, reliability, speed, use, and user acceptance, but they’re out there in force. And because of that variation, Cisco and other vendors see a gold mine in replacement the early-generation 802.11b and 802.11g systems that are limping along unimpressively.

Expectations have changed. Wireless is mission critical. Entire clinical systems strategies have been crafted around mobile caregivers wandering seamlessly around buildings while using portable computing devices.

Software vendors haven’t quite caught up. Applications are sometimes mobile user-unfriendly, requiring carefully targeted mouse clicks and keyboard entry that doesn’t work well when cradling a tiny notebook PC in your arm. Less-than-youthful caregivers may have to squint painfully to read screens that were designed for 17-inch monitors. .

The writing is on the wall, however. Wired devices will soon be as antiquated as those early-generation VCRs that had a wire-attached remote control. Wire’s last advantage is about to be eliminated as 802.11n matches or exceeds its speed.

Hospitals will save a bundle by not hard-wiring buildings. It’s painful to sit through construction meetings trying to convince architects and construction project managers that network wiring requirements are just a bit more complex and expensive than running electrical power to wall outlets. That’s a concept you can tell your grandkids about some day, like when TVs had a picture tube or when music came from a store instead of a download.

The downside, as it always is, is cost. We’re re-buying all this gear from Cisco and other vendors, ripping out what we bought just a few years ago. That’s capital that could have been used elsewhere, like virtualizing servers or improving redundancy.

If all goes well, this second round of spending probably buys the performance you expected from the first round.

Still, wireless technology developments are exciting. Hospitals need to figure out how to improve patient care given untethered caregivers who carry an impressive arsenal of technology in lightweight devices. There is cool stuff yet to be done using VoIP communication devices, new bedside patient monitoring and diagnostics, and information systems designed to help deliver care, not just document it.

Clinical systems vendors, it’s a great time to rework or build applications without the assumption that users are sitting at a desk all day. Ubiquitous wireless connectivity changes the game. If you don’t believe it, think about what went on in coffee shops before Wi-Fi.