Episode 12: Do Hospitals still need Middleware and CC&C?

Podcast Episode Summary 

In this episode of CarePoints, Kenny Schiff interviews digital health specialists John Elms and Brian McAlpine about the role of middleware and clinical communication and collaboration (CC&C) in the hospital enterprise. They explore the evolution of connected devices and workflows, the challenges in managing medical device alarms and alerts, and the impact of accidental architecture in healthcare organizations. Also discussed is the intersection of CC&C and patient engagement, the future of nurse call systems in an EHR-centric universe, and the potential for a single comprehensive platform for communication in healthcare. 

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This Episode’s Guests 

John Elms

Strategic Adviser, Meerkat Technologies 

Co-founder of Connexall USA and former Chief Product Officer at TigerConnect, John is an accomplished executive with over 25 years of leadership experience in the high tech industry. His career spans various roles, including CEO positions at public and privately held companies, venture backed startups and his own entrepreneurial ventures. 

Connect: LinkedIn 

 

Brian Mcalpine 

Digital Health Consultant, Cirkel Consulting Group 

Brian McAlpine has spent most of his 30-year career assisting innovative startups with developing and taking to market solutions focused on the provider side, primarily in acute care. His career has been focused on developing new markets in healthcare IT including device data integration, connectivity workflows, alarm management, clinical surveillance, clinical communications, patient engagement, and medical devices segments. 

Connect: LinkedIn

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Key Takeaways 

Middleware and CC&C play a crucial role in the hospital enterprise and have evolved from bridging systems like nurse call and telemetry to enabling clinical workflow on smartphones and other devices. 

Progress in managing medical device alarms and alerts has been limited due to manufacturers' reluctance to cede control of workflow and integration. 

“Accidental architecture” comes from the lack of a comprehensive design and planning process, and has resulted in complex and unmanageable integrated systems in healthcare organizations. 

There is a need for a comprehensive platform that combines messaging, patient engagement, and all forms of communication in healthcare. 

The future of nurse call systems in an EMR-centric universe depends on regulatory changes and the ability to integrate with IP-based patient engagement systems. 

Patient engagement technologies are becoming increasingly important, both inside and outside the hospital, and may impact the future of CC&C and nurse call systems. 

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Chapters 

[00:25] Introductions 

[01:05] The evolution of middleware and CC&C in hospitals 

[04:45] A tug of war between customers’ and manufacturers’ needs 

[06:55] Impact and challenges of “accidental architecture” 

[12:00] Epic-centric alarm and alert presentations 

[15:00] The obstacles facing standalone middleware 

[19:15] Mid-term prospects and the role of building automation systems 

[22:15] The need for more patient engagement 

[28:15]