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Spyglass Consulting Group's most recent healthcare study, "Point of Care Communications for Nursing," reveals how incompatible hospital communication solutions are making it difficult for nurses to effectively communicate with patients and collaborate with care team members.


Hospitals are purchasing communication solutions from different vendors requiring different mobile handsets that operate over different wireless frequencies. Nurses are forced to carry multiple communications devices to address specific job functions and responsibilities. Critical messages, noncritical messages, and spam are frequently interspersed on the same or different devices, making it difficult to filter, manage, and prioritize communications from team members.


Wireless networks are not optimized to support nurses at point of care. Seventy-one percent of hospital-based nurses interviewed indicated that their wireless networks were poorly designed, resulting in coverage gaps, wireless interference, and overloaded access points. Frequently dropped data and voice connections make it difficult for nurses to document patient care at the bedside or use VoIP handsets to communicate with team members.


Hospitals are investing in point-of-care communications, but deployments are limited. Sixty-six percent of hospital-based nurses interviewed reported that their organizations had deployed VoIP-based communications to provide nurses greater mobility to perform their jobs more effectively at point of care. Cost considerations have focused deployments on specific hospital departments and limited distribution of VoIP handsets to key nursing personnel.


At point of care, VoIP communications can be disruptive. Hospital-based nurses interviewed thought that VoIP communications could be disruptive at point of care for the nurse who receives telephone calls from team members while performing patient procedures or treatments. Interrupting a nurse's train of thought can easily introduce medical errors into the patient care process.


Point-of-care deployments require nursing involvement. Nurses interviewed believe that successful point-of-care deployments require nursing involvement during the design phases of the information technology (IT) project. Hospital IT must collaborate with nursing staff to understand existing workflow inefficiencies and how wireless communications and mobile computing technology can be used to support new and existing processes at point of care.


The report "Point of Care Communications for Nursing" presents the findings of an end-user market study focused on the current state of communications adoption by nurses across the United States. It builds on the findings of a similar study published by Spyglass in November 2006 entitled "Trends in Mobile Communications."


Content for "Point of Care Communications for Nursing" was derived from more than 100 in-depth interviews with nurses working in acute care and home health nursing environments nationwide. Nurses interviewed were technically competent and representative of a broad range of nursing specialties, organization types, and organization sizes.


The telephone interviews were conducted over a 3-month period starting in June 2009. The purpose of the interviews was to identify the needs and requirements for communications at point of care through discussions about existing workflow inefficiencies in communicating with colleagues and patients, current usage models for mobile communications devices and solutions, and barriers for widespread mobile communications adoption.


Spyglass also evaluated key vendor product offerings and identified early adopter organizations that have successfully deployed point-of-care solutions.


Spyglass Consulting Group is a market intelligence firm and consultancy focused on the nexus of IT and healthcare. Spyglass offers products and services in customer and market intelligence, strategic partnership development, product marketing, and investment due diligence. Spyglass' current research is entitled "Healthcare Without Bounds," which focuses on the current and future potential of mobile computing and wireless technologies within the healthcare industry.


The complete market study "Healthcare Without Bounds: Point of Care Communications for Nursing" is available for US $2495 from Spyglass Consulting Group at



EmFinders has announced EmFinders EmSeeQ wide-area location device and service. EmFinders EmSeeQ is an emergency response solution designed to work in conjunction with law enforcement officials and the 9-1-1 community to help immediately locate adults and children with cognitive and developmental disabilities, including those diagnosed with Alzheimer disease and autism, if they wander.


According to a recent report by the Alzheimer's Association, there are currently 5.3 million Americans living with Alzheimer disease; current national statistics reveal 1.5 million people diagnosed as having autism. An online survey conducted by the National Autism Association showed that 92% of children with autism are prone to wandering, and the Alzheimer's Association states that 70% of those with dementia are likely to wander in the course of their illness.


The EmSeeQ solution uses a watch-like wearable device, activated on remote command, and the locator service works in coordination with emergency responders. Cellular network-based Uplink Time Difference of Arrival technology pinpoints the location of the device. This method is used to calculate the location of mobile phone subscribers making 9-1-1 calls. Unlike other solutions (GPS, A-GPS, RF), EmFinders EmSeeQ can reliably locate wanderers who are indoors or are otherwise blocked by a wall, roof, or building, regardless of how far they wander from home.


EmFinders EmSeeQ is integrated nationally with current E9-1-1 systems. EmFinders coordinates directly with PSAP (public safety access point) dispatchers in emergency situations to eliminate the "search" portion of search-and-rescue missions, reducing the time needed to locate and recover wandering individuals.


In emergency situations, caregivers make two telephone calls, the first to 9-1-1 and the second to EmFinders. The cellular network then provides 9-1-1 dispatchers the location of the missing individual.


The bracelet fits like a wristwatch, reducing awkwardness and embarrassment and increasing acceptance. The combined cost of the device and monthly service fee is similar to that of a mobile telephone. The service is offered on a month-to-month basis, with a discounted 1-year subscription option. EmFinders EmSeeQ can be purchased at


EmFinders, based in Frisco, TX, is a new technology company that has developed a device and subscription service for locating people with Alzheimer disease or other impaired adults and children who wander and become lost. EmFinders is a privately held subsidiary of Liberty Media Corporation attributed to the Liberty Capital group, which owns a broad range of electronic retailing, media, communications, and entertainment businesses. For more information, visit or



A recent survey of College of Healthcare Information Management Executives (CHIME) members shows that chief information officers (CIOs) are concerned about their ability to implement the standards recommended by the Healthcare Information Technology (HIT) Standards Committee in time to meet currently established deadlines.


The survey drew 176 responses, nearly 13% of CHIME's 1400 members who make up CIOs or top information executives of provider organizations.


With few exceptions, most respondents reported that their organizations are early in the process of implementing applications that are based on standards under consideration by the Office of the National Coordinator for Health Information Technology and the Centers for Medicare and Medicaid Services.


This summer, the HIT Standards Committee recommended roughly 20 standards for the electronic exchange of health information. Implementing applications that use those standards are expected to affect health organizations' chances of qualifying for stimulus payments based on achieving the meaningful use of electronic health records.


Nearly two-thirds of all respondents said that they were at least somewhat worried about their ability to implement standards-based applications and how that would affect meaningful use determinations for their organizations. Only 8.3% said that they were not worried about achieving deadlines. Some 37.3% of respondents said that they were either very concerned or worried about meeting deadlines for implementing standards; 27.8% said that they were somewhat worried; 26.6% said that they were a little worried.


Respondents confirmed that their ability to implement standards-based applications would depend on a variety of external factors. There was significant concern that healthcare IT application vendors will not be ready to offer standards-based products that will enable providers to meet the deadline; 21.6% of all respondents listed vendor readiness as their top concern.


The need to implement upgraded or new systems to comply was mentioned as the top concern by 14.8% of all respondents. Also mentioned as the top impediments were insufficient capital, 15.3%; lacking staff with needed skill sets, 10.2%; and insufficient staff, 8.5%.


When specifically asked about preparedness to use vocabulary standards, organizations are currently using clinical systems that incorporate only some of the vocabulary standards.


The most widely deployed vocabulary standard is SNOMED CT, the standard designated for clinical problems and procedures, with 51.1% of respondents reporting that their systems can support the nomenclature. The standard vocabulary for laboratory tests, LOINC, is supported by 40.5% of respondents' organizations. Other vocabulary standards have much less penetration. For example, 59% of respondents said that their systems do not support RxNorm, the proposed standard for drug and medication allergies, whereas 51.7% of respondents said that their systems do not support UCUM, the proposed standard for units of measure, and 55.8% said that their systems do not support UNII, an ingredient allergies standard.


In terms of content standards, providers' answers suggest that they are not as far along in implementing systems that are based on newer standards. For example, 51.2% of respondents said that the systems of their organizations support HL7 v2.5.1 for clinical messaging, but fewer than 25% can support NCPDP and HL7 standards for pharmacy order content.


Survey results showed that standards adoption is a complex area for top IT executives, even at organizations that are implementing advanced clinical systems; that is particularly true for smaller organizations that do not have staff specifically assigned to standards adoption. Respondents often showed a great deal of uncertainty about whether their systems currently support either the content or vocabulary standards. For example, 36% of respondents did not know if their systems supported UNII; some 30.2% did not know if their systems were based on UCUM; and 19.1% did not know if their clinical systems support RxNorm.


Both a full report and executive summary of the survey may be accessed below:


The CHIME is an executive organization with more than 1300 CIO members and 70 healthcare IT vendors and professional services firms dedicated to serving CIOs and other senior healthcare IT leaders. For more information, please visit



Many new IEEE LAN/MAN standards, including 802.11n, have recently been approved and are now available in IEEE Xplore.


* IEEE 802.11n: WLAN Enhancements for Higher Throughput


* IEEE 802.1AB-2009: Station and Media Access Control Connectivity Discovery


* IEEE 802.3at-2009: Data Terminal Equipment (DTE) power via the Media Dependent Interface (MDI) enhancements


* IEEE 802.11w-2009: Protected Management Frames


* IEEE 802.3av-2009: 10 Gb/s Passive Optical Networks


* IEEE 802.3bc-2009: Ethernet Organizationally Specific Types, Length, Values (TLVs)


* IEEE 802.15.3c-2009: Millimeter-Wave Based Alternative Physical Layer Extension



Visit the IEEE Web site,, to request a free trial of IEEE Standards Online.


CONTRIBUTORS TO THIS ISSUE[horizontal ellipsis]

William Perry, MA, RN, is Senior Systems Analyst Kettering Health Network and Adjunct Instructor, Wright State University College of Nursing and Health.