ACT: What are the factors in the critical care setting that make ease of use such a vital part of monitoring?
Harvey Hauschildt: With highly technical equipment that measures some very important vital signs on a critically ill patient, coupled with the pressures of high turnover in nursing staff, an easy-to-use monitor that is straightforward sets a company apart. You should not have multiple layers of menus, and the actual operation of the equipment should be very intuitive. If you are a nursing professional and you understand vital signs, you should be able to look at the monitor and quickly get where you have to go.
That has been the guiding principle behind the designs of all our critical care monitoring — it would be very hard to find products that are as easy to operate as ours.
ACT: Since you mention nurse turnover, what else can ease the transition as new staff are coming in and trying to get up to speed?
HH: To the best of my knowledge we’re the only monitoring company that offers free in-service for the life of the product, and that’s in-service training by an RN. If you call most companies and say you want an in-service education person out to train your staff because you’ve had turnover, what you are going to hear is, “Ok that’s fine; give us your purchase order number,” and they are going to charge you anywhere from $1,000 to $1,200 a day. You can get it but it’s going to cost you.
We provide that for free for the life of the product, as well as free software upgrades for the life of the product.
ACT: Nurse managers have to love that. What are some of their other pain points, and how can selection of the right monitoring system alleviate the issues they face in acute care?
HH: As sophisticated as monitors are, some of the key areas we find that nursing management is most concerned over are pretty basic: They want dependable, accurate monitors, and they need up-time.
When you have a system that goes down, you now have a bed that is down, and you have to worry about how to get that patient monitored. In some cases, it is not only potentially life threatening, but it can cost people money. You don't want to move patients, you don't want to close the bed, you don't want to lose revenue, and in today's cost-cautious environment, up-time is critical.
In addition to that, nurse managers are looking for documentation because of the legal environment that the medical community has to navigate. Our monitors give them 96 hours of full disclosure. It really helps the nurse manager to know what abnormalities have happened; they can track patient events thoroughly, documenting them and creating a kind of a medical trail that also facilitates decisions that may have to be made in the future.
ACT: So what criteria should be at the top of the shopping list when the hospital is buying monitoring equipment?
HH: I am going to make the simple assumption that the monitors all perform the basic physiological parameters. They obviously have to measure and monitor what they are supposed to. And we’ve already talked about ease of use, reliability and the ability to get help when you need it.
But there are two emerging things that I’m hearing a lot about: (1.) The company's ability to do HL7 interfaces — all companies are rapidly becoming able to move patient monitoring data into the hospital information system.
HL7 compliance is critical. We are hearing more and more that if you can't do that, hospitals don't even want to talk to you.
(2.) Telemetry is probably the fastest growing segment of the monitoring market, and cost of ownership continues to be a major consideration. It sounds trite, but simple things, like how long the transmitter can run on one load of batteries, are important. Our monitors can operate two to three times longer on two AA batteries than any of our competitors. That [expense] can actually exceed the cost of equipment in a year to two years, depending on how busy the unit is. The cost of ownership is a huge component when you are buying a monitoring system that you are going to live with for seven or eight years.
ACT: So is that the reasonable life expectancy for monitoring — the seven- to 10-year range?
HH: I have monitoring equipment out there that is 15 to 20 years old — it’s just amazing. But the technology today is almost all PC-based. All companies are in some way leveraging the PC platform. So you have a life expectancy, just based on the hardware, of seven to 10 years. Then pretty soon you get into parts obsolescence.
Central station monitoring is probably the thing that is most often PC-based. The bedside monitors are often proprietary, although some of those are also based on the PC. But the central is universally a PC-based architecture.
We keep ours current through pretty regular software revisions — once or twice a year — making sure all the preventive maintenance on the hard drive is done, and we can keep them as fresh as possible. It’s one of the ways we’re dedicated to focusing on our customers.