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, Sotera’s 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 patient’s 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 patient’s 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 can’t 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 Sotera’s 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.
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 Skylight’s 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 patient’s 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 hospital’s 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 hospital’s 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 can’t 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 don’t 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 government’s 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 company’s 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 wouldn’t 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.