Are nurse call systems dead?

CEO, Andrew Rothon, looks at the unprecedented fundamental challenge faced by the Health Care Industry. That is; how to cope with ever-increasing patient numbers in the face of rising operational costs and tight budgets?  This challenge will continue for the rest of this decade.

The demand for healthcare services is dramatically increasing – due mainly to a growth in the senior population and the number of chronically ill patients requiring continued care. Yet there is a significant reduction in government tax collections and citizens with private health care to afford a medical health system where cost are approaching 15% of GDP and continue to grow at 5% pa. The global financial crisis has exposed the health care industries rapidly increasing costs as unaffordable for a majority of OECD countries and developing counties. 

To overcome the financial crisis and reduced government budgets, hospitals need to increase both efficiency and productivity to optimize the balance of costs to the provider and benefits to the patient. To add to that complexity, many governments are changing policy and regulatory framework of the healthcare industry, leading to a growth in consumer-driven healthcare where patients are viewed as customers. 

As a result, healthcare organisations need to improve their service to appease patient satisfaction, improve patient safety and quality of care. They need to improve efficiency of medical device interconnectivity, enabling access to the right information, at the right time. They need to reduce waiting and treatment times. And they need a better method of caring for patients after they leave the hospital. Furthermore, there are pressing internal issues such as ensuring staff satisfaction, retention and increasing productivity levels. 

The health care industry is desperate to find ways to boost productivity within hospitals whilst improving patient safety. 

The medical devices industry, network IT device mobility industry and the nurse call / life safety systems industries are currently experiencing significant technology convergence. This technology convergence is accelerating to meet demand for, workflow productivity, QA, reporting, efficiency and patient safety. However the legacy Nurse Call Systems, and some current technology nurse call systems provide nothing more than a basic life safety system. These system technologies are analogous to “Florence Nightingale’s 1860 system of telling a patient to ring the bell if you need me”. That’s one hundred and fifty years (150) with no real improvement in patient safety delivered by life safety systems. 

Health Care IT departments are struggling to keep pace with the rate of new medical devices which are being developed and need to connect to their hospital network. Legacy medical device systems and life safety systems operate on private networks, which were designed, installed and supported by the device or systems vendor. This approach required hospitals to assume some responsibility for supporting life critical applications themselves. This created a new issues as one thousand-bed hospital system, on the US east coast  “discovered” over 200 private networks. For many good administrative reasons, the wide spread duplication and proliferation of private networks is cost prohibitive and does not deliver the required efficiencies and interoperability. 

Hospital Electronic Medical Records will further add to IT departments desire for further acceleration and simplification of technology convergence driving the enterprise network which will enable the integration and automation of medical devices, through gateways with low level and high level HL7 interfaces to be recorded as the patient record. Consequently, regulators like the FDA are focusing on ways to reduce compliance so health can benefit from medical device connectivity. 

Middleware messaging systems – the systems that deliver interoperability and enable convergence – will have to handle a range of industry devices to keep up with the proliferation of cheap medical devices. As the basic light and buzzer nurse call companies fail to develop and deploy middleware connectivity to rapidly changing wireless and wired medical monitoring devices like heart rate monitors, pulse oximeters ventilators, infusion pumps etc. will fail to deliver that life safety capability. Conversely, nurse call systems with interconnecting middleware will integrate everything from; wireless devices, radio devices, VoIP devices and direct connected network devices. And pass those messages (life safety, alarms, reporting, event notification etc, to the responsible person – no matter what messaging device they carry (email, wireless phone GSM phone, email or paper report) will dominate the market.

The role of the nurse call system will be to take all patient initiated, device initiated, asset initiate and system initiated calls and send them to the right person, whether, clinical (various competencies), nursing support, admin or management. This division of labor and allocation of responsibility and accountability will drive the efficiency outcome, the government or shareholders or owners are demanding. To ensure these benefits are realised IT departments and CIO’s will take increasingly more control of the nurse call purchasing and rollout cycle.

Recently, some nurse call companies have invested more than $4 million dollars into the production of middleware connectivity only to find this type of development is more costly and complex than they assumed and with nothing to show for their investment. And yet other companies are scrambling to acquire or merge with middleware suppliers. (Phillips and Emergin for example). Some companies may never breach that technology chasm. NiQ with CarePlus™ has a 5 to 10 year lead on these basic light and buzzer systems nurse call systems with our nurse call and middleware in a box approach.

More than half the annual $16 billion market share will soon be dominated by nurse call providers who make the jump to medical device connectivity integrated into the life safety system of nurse call. Only those nurse call systems that can deliver these benefits will survive the remainder of this decade. Thus nurse call systems will morph into messaging handling systems by the end of the decade and the basic nurse call system aka Florence Nightingale bell and buzzer systems will be dead.