Doing more at the mobile point of care

It's only been 16 months since Apple's SDK release empowered developers to unleash their creativity through the iPhone platform, but already there are over 700 medically-focused applications available at the company's app store. While some still question the iPhone's place in the healthcare enterprise, Sarasota, Fla.-based Voalté is among those convinced the ubiquitous smartphone will play a key role in revolutionizing the mobile point of care. Following a successful eight-week pilot at Sarasota Memorial Hospital that is expected to be expanded to include three additional units within the hospital--and with two other hospitals awaiting installation later this month--I caught up with Voalté's original founder and vice president of innovation, Trey Lauderdale, for his take on where the future point of care is headed.

Voalté, which competes with Ascom, Cisco and others, wants to be the central communications engine--or traffic cop--on your healthcare organization's iPhone. According to Lauderdale, the company's solution aims to redefine hospital MPoC communication by delivering a complete application for voice, alarms and text messaging on a robust expandable platform--the Apple iPhone. But while the success of Apple's app store has fueled momentum and sparked opportunity among developers, Lauderdale feels strongly that the time has come for someone to step forward to bring order to the chaos and to stave off the problem of the "nurse's tool belt," where nurses and doctors are stuck carrying around three or four pagers for all of their organization's discrete systems.

In fact, Lauderdale thinks if we're not careful, the iPhone could become a pager tool belt of different applications fighting for notification space--and there won't be any coordination of those different notifications.

"For example, you might get a code blue alarm on your iPhone and then, immediately after, someone hits a nurse call button that needs to get to you, which overrides the code blue," Lauderdale says. "We want to set it up so that we are the body that receives all of those alarms--all that communication--and then we can orchestrate, making sure the right info gets to the right person at the right time on the iPhone."

If you're worried about security, don't be. The workflow model for the Voalté solution functions a little differently than the way the iPhone was intended to be used. The company places large charging stations inside a hospital, which can charge up to 40 iPhones at a time. A nurse begins her shift, picks up an iPhone from the charging station, loads up the application, logs into the iPhone and then Voalté's back-end server associates that nurse with that specific iPhone. So, similar to an Ascom, Vocera or Cisco model, the iPhones aren't owned by the nurses or the doctors.

Voalté's solution doesn't even require an AT&T plan because everything is done over the hospital's Wi-Fi network. In fact, the phones don't even work off-site because Voalté's application will only load on the hospital's network. And because the information being sent via the iPhone only references bed information, not patient data, Voalté has been able to leverage the ergonomic and functionality benefits of the iPhone without having to worry about the HIPAA constraints that other app developers need to focus on.

Maybe that's why even the most technophobic of nurses at Sarasota Memorial hospital came around so quickly. During the eight-week pilot, Voalté received over 90 on-the-fly feedback messages, which enabled the company to make almost immediate improvements to the application, thanks to the Apple SDK.

"That's probably learning lesson number-one for us," Lauderdale says. "Direct feedback from the customer and endusers and the nurses is absolutely critical because they know exactly what it is that's slowing them down, and if you open up those channels of communication, there is so much to learn--and we've been able to really learn a lot from them."

Going forward, the company will continue its push to establish itself as the central communications center on healthcare's iPhones, leveraging its VoIP, text messaging and alarm engine capabilities to function as a traffic cop managing workflow technologies. But it won't just be about the technology. As Lauderdale puts it: "There is no Southwest Airlines of health IT." Recently, after asking 12 different CIOs to identify a health IT vendor that goes above and beyond from a customer experience standpoint, only one offered him an answer: Epic.

"If you think about it, there's a void there. No one has come up and tried to revolutionize the customer experience in health IT," Lauderdale adds. "We feel that our technology and the iPhone's technology is fantastic, but we also want to try to experiment and revolutionize the customer experience as well."

As for the future of the mobile point of care, Lauderdale predicts it will be a case of the industry doing much more with alarms and notifications. For example, a patient monitoring alarm that Voalté receives in its role as traffic cop, once displayed to the user, could be shared through inter-app communication with another application living on the iPhone, like sharing critical lab results with the Epic application.

"It's about not only having the capability to receive receive the notifications, but to take action upon the notifications and do things that would never be possible with other VoIP phones--that's what really gets us excited," Lauderdale says.