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Consumerization of Healthcare IT Is Coming. Are You Ready?

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Do you know anyone who doesn’t use a smartphone? Nearly half of all adults in the United States now own at least one “smart” mobile device, and it won’t be long before those without are in the minority. 

So what does that mean for the way we work, and in particular how clinicians work in a healthcare setting? Many doctors and nurses use smartphones in their personal lives, but few have the same technology available to support their work. In fact, they often still use landlines, pagers and PDAs – technology that was obsolete long ago in most workplaces – to communicate with their colleagues. 

Get ready for a change. The consumerization of healthcare IT is coming, and it’s about to revolutionize not only the way clinicians communicate but also how they care for patients. As mHealth delivers comprehensive, integrated healthcare solutions, traditional boundaries will inevitably break down. The result: onsite, offsite, any time, anywhere communication, collaboration and access to information. 

Clinicians who are accustomed to having maps, weather, news and the latest viral video at their fingertips in their personal lives want the same timely and reliable access to information when treating patients. That includes medical reference apps such as Epocrates as well as access to patients’ electronic medical records (EMR). 

Healthcare organizations that embrace these inevitable changes are moving in the smart direction, improving quality and efficiency, reducing costs and meeting governmental requirements for meaningful use of EMR. More important is the ability to focus on their primary mission of caring for patients. Other benefits will likely include higher job satisfaction and lower turnover among their staff. 

I’m not saying it’s going to be easy. Robust privacy and security features are integral to the successful transition of smartphones into the clinical workplace. And the challenge of working within a hospital’s existing wireless network is not for the faint of heart. 

Fortunately, Voalte has spent the past four years working through these issues at some of the nation’s top hospitals. As we start Q2 of 2013, I’m pleased to announce we experienced record-breaking growth of 280 percent over Q1 last year, with 18 new hospitals signed on to implement Voalte solutions. 

The foundation of our exponential growth is our stellar executive team, made up of the most talented professionals in their respective fields. In my new role as president of Voalte, I’m looking forward to working with this team and our entire staff as we continue to lead hospitals in the smart direction. 

One Tool, Many Uses

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I am thrilled to have joined Voalte as VP of Product and Alliance Management. As the leader of the Product Management team, my primary role is to make sure we build the right product, to be available at the right time, and designed in the right way to deliver a cost-effective, compelling communication solution for caregivers and support staff. Just as mathematicians can’t live without a calculator, we want clinicians to feel the Voalte empowered smartphone is the best tool to help them deliver a high level of patient safety and quality of care. Of course, no one piece of equipment is a silver bullet that solves every problem, but ultimately we want to deliver an increasingly valuable and powerful tool that is reliable, efficient and – most importantly – effective. 

At Voalte, we understand that to be successful at meeting that lofty objective, the product and alliance/partner teams must go out and talk with nurses and physicians inside and outside the hospital. The participation and guidance of actual users is the foundation of everything we do at Voalte. Based on our users’ proactive input and constant feedback, Voalte has built a solid reputation for designing apps with the functionality and usability that has resulted in a quantum leap in solving the communication challenges of today’s healthcare personnel.

We’re also dedicated to building compelling alliances with companies that make related best-in-class healthcare products that are ideally suited to co-reside on the smartphone with Voalte apps. In certain cases, it makes sense for such products to be tightly integrated with Voalte applications, and in other cases to be more loosely coupled, as in basic interoperability. While the majority of such partnerships will be in software applications, we are actively building alliances with hardware vendors to deliver even more effective uses for our compatible and complementary products. 

Done right, the integration of barcode medication administration (BCMA) and radio frequency identification (RFID), integrated with the smartphone hardware and our leading voice, alarms and text messaging capabilities, will demonstrate our commitment to delivering what nurses and doctors need to provide safe, efficient and effective patient care. Naturally, Voalte is fully engaged with the leading EMR vendors to create clinically compelling applications built on the Voalte communication platform … and is open to many more alliances and uses.

Communication is well recognized as a huge challenge for hospitals. The dynamic environment requires the exchange of a plethora of communication types, such as voice, alarms and text, but also is evolving rapidly to include images, video streaming and voice dictation. Add to this the requirement for managing all communication based on work schedules, real-time availability and roles, responsibilities and certification/licensing levels, and before you know it you’re talking about a truly complex communication challenge.  

In my new role at Voalte, I’m looking forward to helping caregivers do what they do best – saving lives and creating positive patient outcomes. At Voalte, we believe that arming hospital staff and caregivers with a single, versatile communication tool is one of the most significant ways to make a positive difference in healthcare for the 21st century.

World-Class Engineering

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As we grow, Voalte faces a common challenge: how to expand an already impressive engineering team quickly, without sacrificing quality. 

We’ve attracted some of the most talented software engineers in the industry by opening our search to people from all over the world … and letting them stay right where they are. As a result, we have engineers in Florida, New York and Seattle, as well as Uruguay, Vietnam, Romania and Spain.
 
When I joined Voalte as V.P. of Engineering, I realized that our choices of less common programming languages and new, in-demand technology like iOS meant the number of people who can do that work is relatively small. I also knew that while we might be able to attract a full staff with the correct skill set in New York City or Silicon Valley, that wasn’t going to be possible here in Sarasota, Florida. By finding the most talented, highly educated people who are passionate about this technology and letting them work from home, the entire world suddenly opened up to us. 

Telecommuting is a hot topic recently, thanks to Yahoo CEO Marissa Mayer announcing an end to the company’s work-at-home policy. Here’s how we make it work at Voalte. 

First, I work remotely most of the time, because my family and I live in Orlando, and the Voalte office is a 2-hour drive away in Sarasota. In my experience, attaching a few remote workers to a mostly on-site team is a recipe for failure. Instead, all members of our team communicate the same way, whether one desk away at our home office or 3,000 miles away in Barcelona. With me working as a remote executive, we all have to walk the walk, at every level of the group. 

Also, collaboration tools have improved greatly in the past few years. With our engineers spread across the globe, remote tools such as Google Hangouts and HipChat have become our default methods of communication. We can get 15 people into a real-time video chat, with great picture quality and the ability for people to come in and out of the discussion at their leisure. Our engineers meet in daily morning Hangouts, and every Friday afternoon we host an engineering forum, where someone presents a topic or proposes an item for discussion. All day, every day, we use HipChat as a critical command center for most conversations. 

Finally, we bring everyone together face-to-face on occasion to extend the relationships that make it easier to work together remotely. Twice a year, all of our engineers from around the world gather at an engineering summit in Sarasota. 

It takes a certain attitude and personality type to work from home. Fortunately, computer programmers tend to be well-suited to telecommuting since they are comfortable communicating online. For Voalte, the payoff is in attracting world-class engineering talent that translates into world-class products.

Every Voice Matters: Nurses Speak Up

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Years ago, a wise COO told me, “I can’t help you if I don’t know what you need.” When dealing with a problem or issue, the first step is to understand the nature of the challenge. The same holds true of nursing practice issues or barriers. Speculation or assumptions about the communication, resources and support needs of nurses at the bedside may lead to wasted time, misunderstanding, and even mistrust and loss of engagement.    

In an effort to fully understand the end users of our products, Voalte partnered with American Nurse Today, the Official Journal of the American Nurses Association, to conduct a national survey of nursing leaders and staff nurses. The purpose of the survey was to solicit their perceptions of the work environment related to time available for care coordination and patient needs, devices available for communication, and support for the effective use of technology.  

Now is the time to fully understand the nursing care micro-system and the dynamics of daily communication between stakeholders. Changes in our healthcare arena are challenging hospitals to change their care delivery systems and reevaluate both their basis and paradigm for decisions. The operational strategies that have worked for decades will not necessarily work in this reformed healthcare environment. All previous assumptions must be tested, and rejected if they no longer apply. 

More than 1,000 people responded to our survey. With the assistance of Dr. James Lani and Jeanine Glase, the amazing biostatisticians at Statistic Solutions, we compiled the main findings into a Special Report: “Top 10 Clinical Communication Trends.” For those interested in nursing workflow and communication, this report is a must-read for insight into the clinical communication landscape in the nation’s hospitals. Once you understand the challenges, you can start coming up with solutions.

We Love Nurses

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Nurses Week at SMHIf you or a family member has ever been admitted to a hospital, you know how important nurses are. They take care of us when we’re most vulnerable, and comfort us with a smile when we’re in an unfamiliar place and facing an uncertain future.

Nurses are the heart of the hospital. They are also at the heart of everything we do here at Voalte. 

When Trey Lauderdale came up with the initial concept for Voalte five years ago, his goal was to make it easier for nurses to communicate with each other. Nurses at our local hospital, Sarasota Memorial Health Care System, were first to use Voalte One smartphones back in 2009. The feedback they provided then and continue to provide today has helped us shape Voalte One into a rich, dynamic solution that’s now used by leading hospitals throughout the country. 

Every year, we pay tribute to our local nurses with a celebration during National Nurses Week. Last Tuesday, we joined our friends at Sarasota Memorial for a Voalte-sponsored game show, where we handed out gift cards from local restaurants and spas, and awarded cash prizes and Voalte goodies to some lucky winners. For us, the prize is always seeing smiles on the nurses’ faces. And those smiles aren’t only reserved for Nurses Week. It may be due to our bright pink pants, but happy nurses are always first to greet us when we visit Voalte hospitals.

While Voalte solutions and our vision have grown beyond bedside communication to include other functions vital to a smooth clinical workflow, nurses know they always come first for us. Whether we’re on-site at Children’s of Alabama, Cedars-Sinai in Los Angeles or here at home at Sarasota Memorial, nurses thank us for making their jobs easier. Considering that nurses have one of the most difficult jobs in the world, we consider it the least we can do. 

Last week, we released the results of our first Special Report: “Top 10 Clinical Communication Trends.” More than 1,000 nurses responded to a national survey sponsored by Voalte and American Nurse Today, the Official Journal of the American Nurses Association. Our goal was to identify the communication pain points that make it difficult for nurses to do their jobs efficiently. Some of the results were shocking; others were reassuring. Be sure to check it out to see what nurses are saying about the struggles they face every day.

At some point, we all may find ourselves being admitted to the hospital. When that time comes, let’s hope the nurse assigned to our care has the tools he or she needs to do their jobs efficiently … and with a smile.

Shown above: Voalte Account Manager Nate Levine (center) with Sarasota Memorial Health Care nurses: Kathleen McDonald, RN, Maria Murray, PCT, Sara Campbell, RN, and Karen Van Der Weert, RN.

A Salute to Voalte Nurses

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As a writer at Voalte, I have the opportunity to work with our marketing team, software engineers, salespeople and support specialists (or BFFs, as we fondly refer to them). It’s especially a pleasure to spend time with our on-staff nurses, who bring a unique perspective to the products we build and the services we offer. For National Nurses Week, I sat down with Melissa Ross, Clinical Nurse Lead, and Kate Cotroneo, BFF, and asked them about their experiences as hospital nurses.

Melissa Ross: I work with patients who are recovering from open heart surgery. The most gratifying part of my job as a nurse is watching how quickly patients progress. When they start out in the ICU, they can’t get out of bed and are in so much pain. Only a week later, they are walking laps around the unit, getting ready to go home and have a whole new attitude toward life.

Kate Cotroneo: I’ll never forget one of the first patients I worked with in the ICU. He was about 60 years old and had a heart attack. He was restricted from eating or drinking anything, so when I finally was able to give him a drink of water, he said to me, “Honey, that was the nectar of the gods!” It was so nice to be able to take care of him and watch him recover, and he was so grateful.

Melissa: Some of my favorite patients are the ones who are hospitalized long enough that I form a real relationship with them. I hear about their life, listen to their stories and get to know who they were before they got sick. We have patients who come back and visit the nurses on my unit. 

Kate: When I’m caring for someone who is hooked up to machines and with tubes all over the place, it’s important to remember that they are still a person. Even if they are not conscious, I talk to them and tell them what I’m doing. And the patient isn’t the only one who needs to be taken care of. Their families are sometimes even more sensitive than the sick or injured person.

Melissa: The hardest part is dealing with patients dying. I feel so down and depressed every time. I’m there as a nurse to help people heal, and even if they are older and sick, it’s still hard. Having a spiritual background helps me deal with the situation.

Kate: As unfortunate as it is, it’s the circle of life. Whether a patient is 25 or 85, as nurses it’s our responsibility to do whatever we can to take care of them. I was working once with a nurse tech who had been on the job for nearly 30 years. She told me, “We’re just doing God’s work until he takes them home.” 

As we wrap up National Nurses Week, we salute all nurses everywhere. We are especially grateful to our own staff nurses, who split their time between caring for patients and helping Voalte create healthcare technologies that make the difficult job of nursing a little bit easier. 

Photo from left to right: Melissa Ross, Clinical Nurse Lead, and Kate Cotroneo, BFF

Are Your Nurses Being Served?

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Every Chief Information Officer I know works hard to meet their hospitals’ needs and create a positive experience for patients. After all, patients are a hospital’s most important “customer.”  Few CIOs, however, seem to view nurses in the same light. 

Recently, I’ve been fortunate to meet some really good CIOs who recognize that nurses are also important customers, and that when the IT department delivers the tools nurses need to do their jobs effectively, patients also benefit. Two recent studies point to the importance of meeting the technology needs of hospital caregivers. 

Technology research firm Ponemon Institute found U.S. hospitals lose more than $8 billion per year in productivity due to the use of archaic communication technology. The study reports hospital doctors and nurses waste 46 minutes each day when they use pagers to exchange information, rather than more efficient alternatives like texting on smartphones. (See “Pagers Cost Hospitals Billions,” CNN/Money.) 

Our own survey, sponsored with American Nurse Today, the Official Journal of the American Nurses Association, also indicates significant communication challenges in our nation’s hospitals. Our Special Report, Top 10 Clinical Communication Trends, finds that nurses who have text communication available for use on their unit say they experience fewer communication barriers than nurses who do not have texting. That doesn’t surprise us, but we were surprised to discover that nurses spend more than half their shift on tasks such as communicating, charting and waiting for information, taking away significant time from hands-on patient care. 

The good news? Our survey also uncovers a positive trend: Half of executive-level nurses say they have an influence on their hospitals’ technology decisions. If you want to deliver the tools your clinical staff needs, it makes sense to give them a voice in decision-making. Unfortunately, we also found while nurse leaders are gaining a seat at the table with the IT department, the overwhelming majority of staff nurses still do not have an opportunity to weigh in on the devices they use every day. 

If your hospital is like those in these two surveys, and your nurses are struggling with their communication tools, it’s time to make a change. I know it’s tempting to solve your problems with a quick, proprietary solution, but be cautious about a knee-jerk reaction. Instead, consider your long-term strategic plan and upcoming meaningful use initiatives, and choose a technology platform that will allow you to continue innovating as the landscape changes. 

Your hospital, your IT department, your clinical staff, and most importantly, your patients are depending on you to deliver positive experiences for all your customers well into the future.  

Highlights from HealthBeat

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I’m in San Francisco this week at HealthBeat 2013, a new event that’s exploring “smart hospitals” and “smart practices” to help healthcare decision-makers identify the technologies transforming the industry. Trey Lauderdale moderated a session with Julie Vilardi, RN, MS, Executive Director of Clinical Informatics and Strategic Projects at Kaiser Permanente, and Darren Dworkin, Senior VP and CIO at Cedars-Sinai Medical Center. Here are some highlights:

As a practicing nurse for over 25 years, Julie spoke from experience when she painted a picture of the chaotic environment of hospital nursing.

“When you look at the nursing population, they are very smart and industrious, and used to a disjointed environment,” Julie said. “It takes some study and focus to bring in new technology, because if it doesn’t work they’re going to go back to their manual process. They need one standardized device that can be used for voice and text, that’s reliable and delivers a return on investment.”

Julie went on to discuss the importance of the user experience, and the expectations nurses have for slick consumer devices. “When you get inside the hospital walls,” she said, “those experiences are beginning to be the expectation, and we so don’t deliver it right now.” 

When Trey asked about the trend toward BYOD, Darren acknowledged hospitals worry about the security issues of mobile technology, but emphasized that care providers have come to expect those technologies at work. 

“A lot of our clinicians are using technology in other aspects of their life,” Darren said. “They want to know how come they can’t have a healthcare version of that.”

The answer, he said, is a balance between convenience and security. “If a device is not convenient enough, people will use a personal device that is not secure.”

As EMR begins to be integrated into mobile devices, user interface and security issues will only increase in importance. Both of today’s panel experts pointed to the need for hospitals to introduce nursing technology intelligently, with an end-to-end solution that works across hospital departments.

It's Not the Technology, It's How You Use It

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“It’s not the consumers’ job to know what they want.” – Steve Jobs

Last week I met with a large, community-based healthcare system. Like many CIOs I meet, they wanted to know: How does Voalte fit into our current workflow?

That’s the wrong question. The reality is, hospitals can enjoy the full range of benefits Voalte provides only when they adapt their workflow to incorporate new smartphone-based technologies. 

Hospital nurses are using Voalte One in over 25 hospitals across the country. In every one of them, texting is the preferred and most effective form of communication. Since most hospitals have never used text messaging before, the success of Voalte One has depended on our customers asking how they can make their existing workflow more efficient.

The hospital group I met with wanted to know how Voalte One would work with its nurses’ current workflow of communicating with the pharmacy. When a nurse needs a pharmacist, she calls a single phone number that’s sent to a ring group, which rings every pharmacist’s phone until one of them picks up. 

What if all the pharmacists are busy and can’t answer? No one knows if someone answered and responded to the nurse’s request, or if the nurse hung up. No one knows who filled the request, or when. It doesn’t make sense to simply plug Voalte One into this ineffective system, and expect to achieve measurable workflow improvements.

Instead of using the voice function in Voalte to call that same ring group (fitting new technology into the hospital’s traditional way of working), a nurse should send a group text message to all pharmacists. When a pharmacist is available, he or she can respond to the nurse and know the request has been handled. 

To truly improve the way your staff communicates, you need more than new technology. You also need a new way of working. And that starts with asking new questions.

Revisiting History

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It’s amazing how history repeats itself. 

Years ago, I worked with Wang Laboratories, a Massachusetts company that pioneered word processing back in the 1970s. At that time, word processing was available in two formats: a software application running on an expensive computer, and a designated, one-application device specifically for word processing.  

Numerous computer companies attempted to convert secretaries using typewriters to computer users, an idea that flopped miserably, causing the companies offering that solution to opt out of the market. Meanwhile, word processors that were sold as a new office tool exclusively for word processing had tremendous success. Wang was most successful, becoming the darling of Wall Street with revenues of $3 billion and 33,000 employees at its peak. 

Fast forward to the early 1980s and the advent of the personal computer. The market suddenly recognized that word processing was simply an application running on a computer, and other applications such as spreadsheets, overhead presentation software, and simple database files could all connect to each other. It seemed as if overnight, single-function word processors became obsolete, and Wang began to lose market share. The company ultimately filed for bankruptcy in 1992.

Today, we are seeing a replay as legacy telephones used by hospitals are losing their luster. These single-function devices can make calls, and may receive alarms. While some have texting, their numeric keyboards make it impractical for widespread use by busy nurses.

Smartphones, on the other hand, are inexpensive, handheld computers for which voice is simply one application. Just as the PC added numerous uses, the smartphone can be used for alarms, sophisticated texting apps designed just for nurses, and a plethora of medical apps like medical directories and pill identifiers. In the near future, a bar code reader for medication administration, a tool to access and update electronic medical records (EMR), and even a flashlight will all be available from this single device.

The floodgates are just beginning to open on smartphones as the nurse’s tool of choice, with early adopters singing their praises and EMR vendors looking at new ways to provide easy and efficient access to valuable digital records. For these forward-thinkers, the future is now. For others, it is time to rethink your communication choice: Continue to invest in legacy devices or prepare for the coming smartphone revolution.

Without computing capability, a software development kit and a large community of developers, legacy telephone devices are bound to follow standalone word processors in the graveyard of obsolescence. 

Top-Shelf Service

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As Voalte has grown, our customers’ needs have grown as well. In the early years, many customers believed in our vision, but hesitated to jump in and implement new smartphone technology throughout their hospitals. Instead, we typically started with small trials of 30 or 50 smartphones in one or two units. After much testing, training and support, we would gradually expand to other units as caregivers and IT staff became comfortable with the new technology and workflow.

Today, as hospitals embrace the huge potential of mobile technologies, we not only have many more customers, but also significantly larger projects going live on a broader scale. The model we used to launch a small trial of Voalte One simply doesn’t work when rolling out 1,000 smartphones, or implementing a brand-new platform across a multiple-hospital system. Now we’re talking about not just a new way for staff nurses to communicate, but a mission-critical system that needs to integrate seamlessly and perform effectively across a wide range of departments and existing technologies.

As Chief Experience Officer, my priority is to give all Voalte customers a superior experience, from product deployment to day-to-day support. That means scaling our services model to meet customers’ growing needs. Our BFFs (as we call our Customer Service team) are always available to answer caregiver questions or troubleshoot challenges that crop up mid-shift. We started with one BFF, and now have a staff of five friendly professionals chatting live with end users every day. 

We also have expanded our Voalte Care Specialist (VCS) team to increase our presence in each hospital, based loosely on a supermarket merchandising model. A company like Frito-Lay sends company reps into stores to make sure its chips are nicely aligned on the shelves. In the same way, our VCS team checks on our customer hospitals, making sure all phones are in working order, addressing any issues with batteries or charging, and talking to the caregivers who use the phones every day. 

As a result, we guarantee you’ll never see a box of discarded, damaged or non-functioning Voalte phones in one of our hospitals. Our VCS team visits regularly to dust charging carts, check cables, organize phones and battery packs, and generally be our eyes and ears in the field. If Voalte were selling potato chips, you can bet they’d be fresh, crispy, beautifully displayed, top-shelf products that keep customers coming back for more.

Talk About a Revolution

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It’s an exciting time in the mobile health space. 

That excitement was evident a couple weeks ago at HealthBeat 2013, a new event that identifies technologies transforming the healthcare industry. While nobody would argue that healthcare IT still needs a lot of improvement, I’m encouraged by the new startups, innovative technologies and fresh business models shaking up the old ways of working.  

I moderated a lively discussion with Julie Vilardi, RN, MS, of Kaiser Permanente and Darren Dworkin of Cedars-Sinai Medical Center about how we can create mobile devices with consumer-like experiences for hospital caregivers. I also sat in on breakout sessions and impromptu discussions with progressive thinkers who are borrowing from the consumer space to update healthcare technologies. 

One fast-growing startup has been called “LinkedIn for Doctors.” Doximity announced at HealthBeat a new collaboration with the Cleveland Clinic to take continuing medical education (CME) into the online space and out of the traditional conference hall. Like online learners around the world, doctors can keep their credentials up-to-date from the comfort and convenience of their home or office. 

Another interesting concept is Practice Fusion, an ad-supported EMR model that offers physicians free, web-based electronic records. Doctors get help with calendaring, scheduling and billing with a business model that’s unique to the healthcare industry but familiar to consumers who organize schedules, pay bills and manage files online.

Of course, the buzz around wearable technologies like Google Glass and Apple iWatch continues to grow, with huge potential for healthcare applications. A new study published this month predicts the global mHealth market is expected to reach $10.2 Billion by 2018. Remote patient monitoring, post-acute care services and strengthening of healthcare systems with smartphone technologies were cited as having the biggest impact.

Most remarkable is that all this growth has occurred in an incredibly short time. Our Chief Technology Officer Ben King attended the Apple Worldwide Developer Conference (WWDC) in San Francisco last week. I met Ben at WWDC in 2008, the same year Apple released its software development kit (SDK) for the iPhone and launched the App Store. It’s hard to believe it was only five years ago that Ben and I met at WWDC and discussed the initial concept for Voalte.

In that time, we’ve seen amazing growth here at Voalte as hospitals embrace smartphone technologies that have changed the way most of us live and work. In a young marketplace, not every idea will stick, but I’m excited to see an influx of new players and fresh ideas fueling the mobile health revolution.

Do More with Less

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American companies are performing fairly well, despite high unemployment, a weak economy, slow job growth and stagnant wages. The stock market also has performed well recently, with corporate revenue growth mostly stagnant but earnings and profits on track or exceeding expectations.

How? The answer is: “Do More with Less.”

This phenomenon has also hit healthcare, with CEOs, CFOs, CIOs and CNOs being asked to “Do More with Less.” The largest group of workers in every hospital is nurses, so any meaningful attempt at this approach will have to impact this group.

One way hospitals can “Do More with Less” is by using a single device to do the work of many devices. As handheld computers that happen to make phone calls, smartphones answer this need by consolidating many of the tools nurses use every day, such as:

- Legacy phones 
- Computers on wheels (COWs) 
- Bar code readers 
- Pagers 
- Flashlights
- Medical manuals and guides 
- Notebooks 
- Overhead paging 
- Directories of contacts

All these tools can be replaced with a single smartphone and the right applications. Having every tool on a single device and always at a nurse’s disposal eliminates time spent searching for other devices, reduces storage requirements and simplifies infection control.

Having one device to address a multitude of needs can improve the productivity of every nurse in every unit on every floor. The streamlined workflows that follow can greatly impact efficiency, improve response to patient needs and boost HCAHPS scores.

If you are feeling pressure to “Do More with Less,” take a look at smartphones. They could be just the solution you need to succeed in a challenging financial environment.

iOS 7 Is the Most Significant Update Since the Original iPhone

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That’s what Craig Federighi, Sr. VP of Software Engineering at Apple, said about iOS 7, and I completely agree. I was at WWDC in San Francisco when Apple unveiled iOS 7, the latest version operating system for the iPhone and iPad. Here are my thoughts on the most exciting changes:

A complete redesign. Apple decided to totally change how everything looks on the iPhone. The cleaner, simpler user interface (UI) puts all the focus on your content, using every pixel possible without wasting any space. iOS 7 encourages you to design your app edge-to-edge rather than being inset or surrounded by borders. By getting rid of boxes around buttons, and eliminating gradients and shades, Apple has removed the “chrome” so your content gets all the attention.

New fonts. Apple also designed new, cleaner fonts that are easier to read at all sizes. Users can specify type size not by number but by purpose: heading, subhead, body copy and so on. With iOS 7, you can change your type size in one place and have that change carry over globally to all your content. The new fonts and better legibility also go a long way in advancing accessibility and usability. It all feels so natural, you don’t even think about usability.

UI dynamics. Apple has built a physics engine into the UI that really opens up some interesting possibilities. Apple has always been a big user of animation, but iOS 7 truly makes your content come alive. With a flick of the finger, your image scrolls down to the bottom of the screen and bounces back up again just like bouncing a ball in real life.

With the iOS 7 announcement, Apple wants us to rethink the way we create apps, using a more simple and elegant UI. For complex apps, like those that will tie into EMR systems, iOS 7 will make it easier to present data-rich user interfaces with the ability to animate views, and expand or shrink as needed. 

The new look, improved fonts and a UI that makes your content come to life will definitely inspire some amazing new apps for healthcare.

The Pursuit of Happiness

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With our company based in beautiful Sarasota, Florida, the Voalte team enjoys over 300 days of sunshine each year and some of the world’s most magnificent beaches. Our staff is an active group: We run, play volleyball, bike, do yoga on the beach and jump the waves on kite boards. Product Manager Alex Brown recently organized a fiercely competitive bi-weekly kickball game at the park behind our new office. 

So this 4th of July, you can be sure we’ll take time out for those pursuits, plus barbecues, boating and fireworks over the bay. But we’ll also spend time thinking about what Independence Day means, and how it relates to what we do every day here at Voalte. On July 4, 1776, the Continental Congress approved the Declaration of Independence, the preamble of which any American 4th grader can recite by heart:

“We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable rights, that among these are life, liberty and the pursuit of happiness.”

The self-evident truths of a brand-new country resonate with the mission and vision of our young company. Healthcare may be the one industry that inevitably touches us all at one point or another. Whether we’re caring for an elderly parent, raising our children, managing an illness or responding to a sudden medical crisis, we all need – and deserve – the care of trained, compassionate medical professionals who have the tools they need to do their best. 

Everyone admitted to the hospital is a person, not just a patient. Like us, they have families and friends and hobbies they enjoy. Every hospital staff member, from doctors to nurses to pharmacists to ancillary staff, has dedicated their life to treating the ill or injured, and getting people healthy as quickly as possible.

Here at Voalte, we never lose sight of our goal to help those who heal us. As we celebrate “life, liberty and the pursuit of happiness” this week, we wish everyone a safe, happy and healthy holiday. With the many things we love to do, nothing makes us happier than making a difference in the lives of caregivers.

Leave Voice Badges in the Past

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Have you noticed that the personal phone you carry is light years more advanced than the device you depend on for complex clinical communication?  

The number-one reason for sentinel events in healthcare is a breakdown in communication, yet most hospitals are fighting this battle with outdated, voice-only technology such as voice badges. While many hospitals have the latest technology to create 3D images of our anatomy, they still aren’t able to send a simple, secure text message from one caregiver to another. Most communication technology is decades old, yet hospitals keep spending precious HIT dollars on the same capability year after year. 

Meanwhile, secure text messaging has emerged as the preferred communication method of most consumers, as well as clinicians. It allows busy people to multitask, managing their communications around their personal availability. Most communication needs in a hospital setting don’t require a real-time voice conversation. Asynchronous text messaging serves clinicians’ needs extremely well without the downsides of ringing phones, discussing private health information in a public setting, searching for phone numbers, leaving voice mail that may or may not be retrieved, and so on. Texting is preferable in public over the noise and disruption of voice calls, plus it facilitates group conversations and makes it easy to send departmental messages. 

So how can hospitals break away from unreliable, voice-only technology and embrace smartphones with secure texting as a meaningful upgrade from their current communication tools?

One important component is implementing a secure smartphone strategy with ongoing operational support. A Mobile Device Management (MDM) solution added to a hospital-owned, shared smartphone will add security, software control, asset management and reporting, and remote wipe capabilities. Third-party solutions are readily available to make smartphones more rugged and extend battery life. A huge benefit of hospitals adopting a solution originally intended for personal consumers is the vast third-party ecosystem of suppliers and applications, which drives costs down and innovation up. 

You also should ask how your current communication technology ties in to future mandates for electronic medical records (EMR). While voice badges are restricted to communication functions, smartphones put the power of EMR literally in the hands of clinicians while they are caring for patients, when they need it most.

Healthcare has been stuck in a rut, replacing one vendor’s mobile voice communication system with another, only to end up with the same essential capability – the ability to place a voice call. Even worse, voice badge vendors are recommending hospitals “upgrade” their current system with new hardware “features” that should have been there in the first place (durability, better microphone, louder speaker and so on). An upgrade should be a real upgrade, with features like a QWERTY keyboard, 4-inch Retina display, flashlight, camera, speakerphone, industry-standard OS with extensive third-party applications, built-in clock with timers, third-party protective cases and batteries, and more.

Before you spend any more money on communication devices, step back and ask what you are trying to accomplish and what you are really getting for your money. Avoid spending precious funds for a solution that does not significantly impact your clinical workflow today or prepare you for the Meaningful Use criteria of the future. We have a long way to go to improve clinical communication, and relying on obsolete technology is not going to reduce those potential sentinel events anytime soon.

Inside the Hospital, a Shared Device Model Is Your Best Alternative

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The rewards of BYOD sound so sweet: Just imagine the funds you can save on mobile devices if employees bring their own smartphones to work! Think of the savings on your cellular plan!

But like many things that sound too good to be true, allowing your staff to use their own smartphones within your hospital walls requires a closer look. Rush ahead without addressing the potential pitfalls, and you may open a can of worms that will be difficult to close. 

The savings from nurses, managers, lab technicians and pharmacists using their own wireless plans may have you seeing dollar signs. But what happens if those employees exceed their monthly minutes and data plans? Or if they break their phones at work? Are you willing to pick up the bill?

Imagine the consequences of a dead battery causing an alarm to go unanswered. How will you keep your staff’s smartphones charged throughout a long shift? Will you require them to purchase expensive battery packs, or will the hospital provide them? How many different types of extended batteries will you have to stock to accommodate various smartphone models?

If you’re considering the potential convenience and cost savings of a BYOD policy inside your hospital, you need to carefully consider privacy and security as well. It seems every week we hear of another major breach that costs patients their privacy and costs hospitals millions of dollars in fines. Ponemon Institute’s 2012 Benchmark Study on Patient Privacy and Data Security reports 45 percent of healthcare organizations experienced more than five data breaches within the last two years. 

Keeping your data secure and ensuring HIPAA compliance will require a robust mobile device management (MDM) strategy. But even if you do develop a plan for protecting the data on your staff’s personal phones, what’s the likelihood that they will let you have access to their personal data? And how will you manage your employee directory without making personal phone numbers widely available?

On the IT side, your team will grapple with numerous other issues. If you opt for VoIP on the hospital Wi-Fi, how will you optimize for the different devices your staff uses, from iPhones to Android to Blackberry? How will you choose medical apps such as pill identifiers and medical dictionaries if those apps are not available across all devices and operating systems?

At Voalte, we address these issues with a hospital-owned, shared device. You control what devices your staff uses, what applications are on each device, and how devices run on your secure VoIP Wi-Fi network without requiring cellular plans. Hospital caregivers with Voalte phones use our enhanced texting 9-to-1 over phone calls. Our alarms work with all major nurse call and middleware players, and incorporate all the functionality these vendors require for integration.

Huge potential exists for BYOD for physicians and others working outside your hospital walls. For staff nurses and other internal hospital staff who don’t need access to patient data once their shift has ended, a shared device plan is the only way to stay in control and in compliance, and keep all the worms safely inside the can. Call us when you’re ready to consider Voalte as a proven alternative.

Let Your Fingers Do the Talking

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To simplify communication for busy hospital nurses, some mHealth companies believe the answer lies in “hands-free” devices. By wearing a voice badge, they say, nurses are free to talk even when their hands are busy.

If only it were that simple. Unfortunately, broadcasting patient information over a speaker worn around a nurse’s neck raises serious HIPAA-compliance issues. Say a nurse is busy with one patient when she receives a call about a second patient. The caller first asks if the nurse is free to talk. The nurse must excuse herself and go into the hall or a private area where the caller can’t be heard, or tell the caller she will call back later. The first patient hears the conversation, and wonders why his or her care is being interrupted. 

Beyond the broken workflow and constant interruptions inherent in voice badge technology, nurses also have to grapple with the challenges of voice recognition software. Those with regional accents, non-native English speakers and people who speak quickly will need to slow down and speak unnaturally to be understood. And while the latest voice badges can display alarms and text, their postage-stamp-sized screen requires text to be so small that most nurses need to reach for their reading glasses to see important messages. Not so hands-free after all.

At Voalte, we’ve found most nurse communication involves sending a message or task, such as:

- Lab results are ready for Rm 222.
- Patient would like ice chips in Rm 243.
- Can you cover for me while I’m off the floor?

For this type of communication, text messages easily replace voice calls. After switching to Voalte iPhones, one customer found their clinicians used texting at a 9-to-1 ratio over phone calls. Texting eliminates ringing phones, reduces overhead paging and eases the hunt for an alternate caregiver. Text messages also give nurses a date- and time-stamped to-do list so she can prioritize her tasks or delegate to another caregiver. 

Smartphones also handle alarms, provide access to third-party medical apps and integrate with nurse call systems. And unlike proprietary voice badge technology, smartphones are geared toward emerging technologies that will tie in to electronic medical records.

If a hands-free device requires a trade-off in more interruptions, more noise, more communication challenges and more HIPAA violations, the benefits aren’t worth the cost. While we’re talking cost, it may be a good time to mention the special promotion we’re offering through September 30, 2013. If you’re being asked to trade in an obsolete legacy device for a new version with no new functions, it might be time to consider letting go of the past. For a limited time, we’ll give you up to $100 for every voice badge you trade in for a true upgrade … to a Voalte iPhone.

For more information, go to www.voalte.com/TheRealUpgrade. We’ll put you in contact with a team member today. 

Stop Hunting and Gathering

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When Voalte teamed up with American Nurse Today on our first clinical communication survey, we were surprised that nurses said they spend more than half their shift, or up to 6.3 hours, on tasks such as communicating with colleagues, charting and gathering critical patient information. 

It’s clear that for hospital nurses, the search is always on. Hunting for supplies, equipment and physicians consumes valuable time. Gathering information from other nurses and departments is challenging. It can also be tiring: According to a report by the California Healthcare Foundation, “The average nurse can walk upwards of four miles each day, from the bedside to the nurses’ station, to the medication room and back to the bedside.” 

So how do you reduce this back-and-forth, and eliminate much of the hunting and gathering that goes on in today’s hospitals? Our new white paper, “Less Chaos. More Patient Care: 3 Ways Smartphones Offer More Time by the Bedside,” explores how smartphones can help free up nurses’ time for hands-on patient care.

Nurses play a crucial role in our hospitals, coordinating patient care, juggling a large amount of information, and bringing together the right team members. To provide patients with a satisfactory and safe experience, they need the right tools for this challenging job. 

With smartphones, reaching a lab technician or a pharmacist is a simple matter of sending a text. Texting eliminates many of the phone calls, voice messages and call-backs that make internal hospital communication so frustrating. A nurse can see when her text has been received and read, and usually receives a quick reply. Checking a menu with a nutritionist, confirming a medication order with a pharmacist, arranging a patient transfer with the transport team: All can be accomplished quickly and easily via text.

In addition to making it easier to communicate, smartphones equipped with the right applications can connect nurses to reference manuals, hospital procedures, medication guidelines and more. Many Voalte customers have their Voalte iPhones provisioned with Epocrates for a valuable source of pill identification and medication interaction information. Others add their own internal documents, detailing new procedures or reinforcing old ones. Imagine having all this information at the caregiver’s fingertips, without the need to hunt for bulky manuals or printed instructions.

Smartphones give nurses efficient ways to communicate and put information at their fingertips. Taken together, these benefits combine to provide more time for the most important job at hand: caring for patients and families.

Top 10 Things You Will Never Do on a Legacy Phone

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One of the first questions I ask hospital employees is, “What kind of phone do you use for your personal communication?” About 99 percent of the time, they name one of the latest smartphones. In other words, most people abandoned legacy-style brick and flip phones years ago. Yet in healthcare, the industry-standard wireless handsets continue to provide the same, old limited functionality: They only make phone calls. 

Let’s take a look at what you’re missing with my David Letterman-style list, Top 10 Things You Will Never Do on a Legacy Phone:

10. Use a presence-based directory to see if care team members are at work and available.
9. Use Favorites or Search to find and contact care team members immediately.
8. Send text messages on a full keyboard to respond to requests quickly and quietly.
7. Work from an automatically generated and prioritized task list of alarms and texts.
6. Access EMR and record patient vitals at the bedside.
5. View and respond to alarm details in an easy-to-read format on a touchscreen.
4. Access drug identification and interaction reference tools and hospital-specific protocols.
3. Translate for non-English-speaking patients and family members.
2. Photograph and upload wound care documentation.
1. View a cardiac waveform in diagnostic detail.

By contrast, smartphones do all this and more. With a smartphone platform that can be customized for your hospital system and even for specific units, the list of ways caregivers can use a Voalte iPhone gets longer every day.

You upgraded your personal phone years ago. Isn’t it time to upgrade the communication tool you provide to your caregivers?

For a limited time, we’ll give you up to $100 for every voice badge you trade in for a true upgrade … to a Voalte iPhone. For more information, go to www.voalte.com/TheRealUpgrade. We’ll put you in contact with a team member today. 
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