Today, I got a hug!

Today I got a hug from an old, frail, nearly blind Indian lady.  I got this hug because I was doing my job!  I did a very simple thing:  I listened to her, her problem and simply explained to her what her options were to get her sight restored and helped her navigate the perils of our healthcare system.  I did not give her a discount, I did not provide the care for free, I did not pull any strings for her.  Just the simple fact of treating her like a human being made the difference today.  Her surgery is scheduled and hopefully she will get her sight restored on one of her eyes so that she will be more independent and be a more productive member of our community. 

It also reminded me – like it does every day – the importance of safety net hospitals in our country.  This lady has very limited means and has no insurance.  Without Grady Memorial Hospital, this lady and thousands and millions of people like her have no options.   Without Grady, they would most probably be maimed for the rest of their lives, some would limp forever, some would be sightless, and some would die in child birth.  

This lady is also lucky enough to have one caring person who brings her to the hospital, organizes her community and raise money for her care, and is a strong advocate for her.  Without this individual, she would have had no way to navigate the bureaucracy this country has set to prevent deliver care to individuals without means.   I wonder how many other elderly people out there are in the same position she is in, not receiving the care they need because we are too short sighted to see that if we do not take care of these people, it will cost all of us much more in the long run. 

We need reasonable healthcare available to everyone living in this country.  We have to accept the fact that everyone living here constitutes our community and we have to take care of every individual living in our community.  Only then we can all prosper.

I do not even understand how one can turn a blind eye when one’s neighbor is going blind. 

What Lumos Healthcare mission is based on.

I have worked at major hospitals, created start-ups and observed a lot of different organizations.  With years of work in healthcare, I never felt that I woke up every morning to make money.  I had... I have a different mission.  To create something new and while doing that, to help hospitals provide better care.   The following video, from a speech given by Dan Pink, defines some of the foundation that Lumos Healthcare's mission is and will be based on.  We are here for a purpose: To help hospitals deliver better care.  And I wake up every morning thinking of that mission. 

Welcome to our journey. 

Hakan

RTLS Selection

At 2010 HIMSS I presented a case study titled: "Real Time Location Systems and Clinical Workflow Management: Are they fit for each other?"   It was a product showcase presentation sponsored by Centrak.  In the talk I went in depth about selection criteria for RTLS.  Here are my points from that speach:

1.   Room Based Accuracy:  One of the key challenges with any Clinical Workflow Management System is to be able to determine the location of a patient, asset or staff accurately down to the room/bay level.  There are many different RTLS solutions that deliver a variety of levels of accuracy, from meters down to inches.  However, it is vital for a Clinical Workflow Management System to be able to determine which side of the wall a patient is located.  If the RTLS is accurate down to 12 inches but can not reliably communicate which side of the wall those 12 inches are located, the location data will not be accurate and therefore Clinical Workflow Management System will fail.   Grady used the following criteria in selection:

• RTLS will NOT communicate any incorrect location data; no or delayed data is better than wrong data.
• RTLS will not promote "jumping" where the system constantly changes the location of a tag due lack of definite location identification in complicated physical infrastructures.
• Changes in physical environment will not change the behavior of the RTLS.
• RTLS will have functionality to segment open areas down to smaller zones or down to patient bays.

2.   Ease of Implementation:  Network infrastructure needs must be minimized, with least amount of required cabling, including network or power cabling.  In addition, any cabling that will be pulled needs to be standards based.  Post-implementation testing and configuration needs to be simple and should not last longer than the physical installation phase.

3.   Flexibility:  The system will be easy to reconfigure / adjust post-initial implementation.   Post-implementation networking will be minimized. 

4.   Customizability:  The RTLS will be able to adopt to complexities of the physical infrastructure.   Bleeding (where a tag is picked up from outside the designated area,) cross-contamination (where a tag is picked from a facing bay / area) will need to be able to prevented with system configuration  using standard tools that the system provides.  In addition, the system will provide additional software customizability to ensure accurate and reliable operation.

5.   Reliability:  The RTLS will be reliable and the performance will be easy to monitor.  Same tags will be the same way under similar circumstances.   Button pushes will be received regardless if the tag is correctly identified in a location or not.

6.   Speed :  The RTLS will be able to communicate a location change within 10 seconds or less, less being preferable.

7.   Network Traffic:  The RTLS will not burden the underlying network infrastructure with traffic.

8.   Battery Life:  Battery life of all components used by the system will be minimum 1 year or more.  All battery failure events will be accurately communicated. 

9.   Multiple Buttons:  The RTLS tags will have multiple buttons.  These buttons are used by the Workflow Management System to collect events from the path of the patient, therefore 2 or more buttons are preferable.

RTLS Providers

RTLS (Real Time Location Systems) landscape has gotten very complicated over the last 5 years. A lot of new companies have entered this domain and some have already exited.

There a many companies that provide solutions that integrate integrate with one (or more) RTLS providers.  The RTLS companies that are in the market can be divided up by many different criteria. The most common is the type of technology they are providing. Their approach to the market - that is if they are a hardware only provider that delivers their products through solution providers or they deliver both the hardware and the solution or a hybrid approach is also a criteria.  This article aims to identify only the companies that provide their own technologies to the market regardless if they are also application providers.  Take a look and comment away.

• Centrak: A relatively new entry to the market. Primary technologies used: RF & IR
• Sonitor: The only ultrasound provider. It is a Norwegian company with primary sales operations in US.
• Awarepoint: The only zigbee / mesh networking (RF) provider. They are typically direct to market.
• Aeroscout: Primarily WiFi, supplemented with Low Frequency RF and Ultrawide Band. Wide penetration in non-healthcare industries and good relationships with major networking providers such as Cisco
• Ekahau: Pure WiFi solution.
• Versus: The grand daddy of RTLS. Primary technologies used: IR & RF
• Radianse: One of the earlier vendors. Primary technologies used: IR & RF
• Radarfind: Pure RF technology with a mixed business model. 
• Ubisense:  Primarily non-healthcare Ultra Wide Band (UWB) provider. 
• Time Domain:  Big licensor of UWB RTLS solutions.  Aeroscout licenses their technology.

 Out of business (or haven't heard about them in a long while!)

• Parco:  UWB provider.  They were licensing their solution from other UWB providers.
• Pango:  One of the first WiFi based providers.  Merged with Innerwireless. Innerwireless seems to be a VAR of Aeroscout. 
• Exi:  Was a Canadian provider of RTLS solutions.  I think they first got purchased by Verichip, now their domain resolves to Xmark, provider of wander management and other security solutions. 

 I am pretty sure I am missing some.  Will add more in future posts.