Due to rapid advancements in the integration of wireless
technology and health care, the future of post-hospitalization
patient care will soon be coming to a screen nearby: on
BlackBerries, iPads and iPhones.
With the arrival of national health care reform and hospitals
ongoing efforts to implement cost-saving measures, developers of
wireless health care systems are coming up with innovative ideas to
fill evolutionary gaps.
In San Diego, three health-related firms, Sotera Wireless Inc.,
Skylight Healthcare Systems Inc. and CliniComp Intl. each developed
wireless technologies aiming to help hospitals save money by
reducing costly hospital readmission of patients and providing
remote patient care.
Sotera hopes to bring its ViSi Mobile wireless device, which
continuously monitors blood pressure, respiration, temperature,
blood oxygen levels and heart rate, to market in late 2010 or early
2011, pending Food and Drug Administration approval.
Sotera, which was founded in 2004 as Triage Wireless, raised
nearly $11 million in April from such strong venture backers as San
Diego-based wireless firm Qualcomm Inc., Santa Clara-based
technology giant Intel Corp., and Colorado-based investment firm
West Family Holdings LLC, said Gunnar Trommer, Soteras vice
president of marketing.
Automating Vital Signs Routines
The ViSi vital signs monitoring system, aimed initially at the
hospital market, is a wristband slightly larger than a sports watch
that collects data via two sensors one that is attached to the
patients chest and the other to the thumb and transmits it to a
wireless hospital workstation. If vital signs deteriorate, an alert
sounds.
Currently, 70 percent to 80 percent of hospital patients on
general medical floors get their vital signs checked every four to
six hours, Trommer said. Nurses spot-check a patients blood
pressure, blood oxygen level, pulse rate and temperature throughout
the day, leaving a critical window for a patient in a deteriorating
situation.
Our product fills that gap between the four to six hours by
automating the process, Trommer explained.
The device cant predict when a patient may get into trouble, but
functions as an early warning device.
Data from a 50-patient clinical study at San Diego-based
hospitals comparing Soteras noninvasive device, ViSi, to the
currently used standard invasive method to measure continuous blood
pressure found that ViSi is as accurate as the invasive arterial
line, Trommer said.
Trommer expects a planned 46-patient follow-up study at five
hospitals in Los Angeles, Orange and San Diego counties will
confirm the earlier positive results.
In order to have an FDA-approved product, we need to show tests
using the final product, Trommer said. We expect a slam-dunk to
confirm the earliest results.
He declined to give a time frame for the planned duration of the
study or a date when Sotera may file for FDA approval. According to
an article published by Xconomy.com, Sotera plans to submit its
study results to the FDA in late summer or early fall with plans to
sell the device, if approved, for about $2,000 to $3,000. Trommer
did not confirm the above information.
Wider Applications
He did say, however, that the technology has wider applications,
including in hospital ambulances and for monitoring patients who
have been discharged to avoid re-hospitalization.
Given that re-hospitalization of patients for the same cause
presents a huge cost burden on hospitals as insurers are reluctant
to pay for it, more hospitals develop their own programs to monitor
patients remotely, Trommer said.
By applying home monitoring, hospitals can lower the cost
burden, Trommer said.
Privately held Skylight Healthcare Systems technology has
already made its way into hundreds of private patient hospital
rooms nationwide.
If Skylights chief executive, David Schofield, has his way,
patients discharged from hospitals will soon be able to follow-up
on their medical care using their home computers, iPhones,
BlackBerries and iPads.
The Access Interactive Patient System is a computer technology
that converts existing television sets in patient hospital rooms
into an educational and communications platform.
According to Schofield, the system is already in place in some
15,000 hospitals nationwide, including at Sharp Grossmont Hospital
in La Mesa.
This is how it works.
We install our independent fiber optics networks, servers,
routers and satellite dishes in the hospital along with a PC in
every patient room that basically converts the TV into a PC
monitor, Schofield said.
This, in turn, allows the hospital to feed tailored
informational and educational content directly onto the TV screen
in private patient rooms.
By integrating Access with the hospital network, Skylight also
gains access to such sensitive patient data as the reason for a
patients hospital stay and a list of medications, which is used to
customize the content each patient will see on the TV screen.
Schofield gave the example of a patient who is waiting for knee
replacement surgery.
If we know that a patient is in the hospital for knee
replacement surgery, we can send information to the TV screen prior
to the surgery to tell the patient what to expect and how to
prepare, and 12 hours after the surgery send a rehab video and
information on medications, Schofield said.
Privacy Concerns Considered
When asked about privacy issues, Schofield said patients should
not be concerned given that Skylight agreed contractually with the
hospital to abide by Health Insurance Portability and
Accountability Act privacy rules. With a requirement to serve only
single-patient rooms, there is only one TV screen per patient, he
said.
Access saves hospital caregivers time and helps cut costs, he
added.
Typically, nurses take 20 to 30 minutes to educate each
patient on medical procedures using videos, and then need to
document that the patient has viewed the content manually in their
medical records. Access, by contrast, takes about 2 to 3 minutes to
feed the information onto the TV screen and automatically records
that the patient has viewed the information in the hospitals
electronic medical records system, he noted. This frees up valuable
caregiving time.
Hospitals pay $2 to $3 per bed per day to use the technology,
and there are no upfront costs, Schofield said. He declined to give
company revenue figures, but said, that in 2009 total revenues were
up 70 percent from 2008.
This September, Schofield hopes to expand the system by
monitoring patients post-hospitalization.
Linking Laptops to Networks
A new platform, dubbed iCarePassport, currently being tested in
a pilot program at Hoag Memorial Hospital Presbyterian in Newport
Beach, seeks to link patients to the hospital computer network via
their laptops or home computers, allowing patients, for instance,
to schedule follow-up appointments with their doctors.
Schofield plans to test iCarePassport at two more hospitals, and
then, launch it this September. If all goes as planned, patients
will also be able to use their BlackBerries, iPhones and iPads to
link to the hospitals Web site.
The goal of this platform is to reduce patient readmission rates
to hospitals, which is costly to hospitals, Schofield said.
Concurrently, Schofield plans to roll out a second technology
platform, dubbed ICareChat, which is currently being tested in a
pilot program at Mercy Gilbert Medical Center in Arizona.
ICareChat allows hospital patients to conduct videoconferencing
with loved ones who cant visit.
Schofield foresees that especially new moms will be excited to
show off their new bundle of joy to relatives living elsewhere in
the country and abroad, if only virtually, from the maternity
ward.
Hospitals dont have that technology today and we see this as
having a big impact to improve patient satisfaction, he said.
Incentives for Digital Records
With the governments provision of significant incentives for
health care providers to accelerate the adoption of electronic
medical records, San Diego-based CliniComp, which developed an
electronic medical records, or EMR, system that replaces the paper
trail of charting documentation, may greatly benefit from the
initiative.
About $19.2 billion has been made available for health care
providers to adopt EMRs.
Under the Health Information Technology for Economic and
Clinical Health Act, beginning in 2011, health care providers who
demonstrate meaningful use of a certified EMR can be eligible to
receive incentive payments of up to $44,000 from Medicare and
$65,000 from Medicaid per individual physician, and $2 million to
$5 million per hospital to help cover the cost of EMR adoption.
CliniComp President Alan Portela said the companys Essentris EMR
system has wide applications: From supporting single departments
such as an intensive care unit to a cluster of high-acuity
departments, including emergency departments, intensive care units
and the post-anesthesia care unit serving inpatient services,
single or multiple hospitals.
Replacing paper charts with EMRs saves time and money by
allowing multiple caregivers to access and chart patient data, even
from outside the facility; improves the work flow and productivity
by having all patient data in one place; and reduces medical
errors, he noted.
Portela said one of its first clients, Naval Medical Center San
Diego, has saved more than $1 million in transcription fees alone
by adopting Essentris back in 1988.
Other local hospitals that have adopted Essentris include
Paradise Valley Hospital in National City and Sharp HealthCare, he
added.
Clearly our roots run deep in San Diego, Portela said.
He wouldnt give an exact price point, but said that Essentris is
priced competitively compared to other inpatient EMRs.
Costs vary depending on the scope of deployment, types and
number of beds in inpatient clinical areas and the number and kinds
of interfaces to existing hospital information systems, he
added.
Patients Gain Remote Access
CliniComp also works closely with technology partners to provide
remote access to patients.
Our partners provide wireless capabilities for such things as
remote patient monitoring of fetal waveform data through mobile
smart phone devices and telecommunications between remote-based
physicians and their intensive care unit patients, Portela
said.
Health information exchanges, which are uniting health
information electronically in areas throughout the nation, seek to
ensure that patient data will remain secure and confident, he
said.
CliniComp is uniquely positioned in the market to support health
data exchanges as we are the inpatient documentation provider to
the U.S. Military Health System and a leading provider of
electronic medical records to Veterans Affairs hospitals as well as
academic, nonprofit and for-profit organizations in the private
sector, Portela said.
Marion Webb is a freelance writer for
the San Diego Business Journal.
