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Bridging the Gap Between eHealth Vision and Current Realities 

Bridging the Gap Between eHealth Vision and Current Realities  | IT Support and Hardware for Clinics | Scoop.it

The rise of health-related technology solutions is correctly perceived by healthcare professionals as a revolution that will ultimately drive improvement in patient care and increase practice efficiency. This efficiency improvement allows providers to take on more patients and increase profits. It seems like a win-win situation for patients and providers but unfortunately, there are barriers to the adoption of telehealth, telemedicine and mHealth (mobile health) that will take some time to overcome.

What are the adoption barriers in Australia? Why does eHealth offer great potential for Australians? How can we roll out eHealth solutions that benefit healthcare providers and their patients?

 

Go Digital

Perhaps the most visible “challenge” of technology in healthcare was the attempted introduction of personally controlled electronic health record (PCEHR), now rebranded as myHealth Record, in 2012. Despite costing $1 billion, adoption rates by Australians were around 20 per cent, with even healthcare providers unsure how to implement the system in their practices. In 2016, policymakers have decided to introduce an opt-out system where all Australians will have an account automatically unless they deliberately cancel it. This may increase perceived adoption rates but actual usage is another matter entirely as clinicians have yet to see value in it. Targeted training and national promotional campaigns are expected to reverse this trend.

 

With the correct security policies in place, changing from paper-based data to a digital format is not only advised, it is essential, especially in a technological age where collaboration is possible between healthcare profession, their colleagues, specialists and patients. When patient care is the focus, relying on couriers or fax machines to share documents is far less effective than many other solutions available today, such as video conferencing, remote diagnostics and health monitoring devices, for example.

 

Early adoption

Hanging on for dear life to obsolete paper-based methods is a mistake when you consider that even government legislation is driving a conversion to digital. It is the early adopters that will succeed, surpassing the efforts of their competitors in keeping pace as legislative requirements evolve. Early adopters are open to change, can easily adapt their processes to meet changing needs and, yes, will also be more efficient. Whether it is the use of practice management software to simplify administration and store medical records or the sharing of data for consultation with specialists in another region, those who rely on paper-based processes are at a disadvantage. Early adopters and the forward-thinking entrepreneurs that provide working solutions to the healthcare industry all encourage Australians to embrace new technology that will provide tangible benefits to all, not only by improving efficiency and level of care but also streamlining processes and increasing practice profits.

 

Technology

Perceiving future trends, an increasing number eHealth firms that bridge the gap between ideas and products is turning vision to reality, providing a wide range of solutions that solve tangible issues in a country where patients are often located a long distance from healthcare providers. These include but are not limited to:

  • Data availability – The use of cloud-based solutions allows any browser-based device to access on-premise data from anywhere. The use of permission-based access ensures all data is safe and can only be viewed by your healthcare professional
  • Integration of practice management data with medical record storage (including X-rays and images) and compliance with industry and legislative requirements
  • Remote home-based health monitoring for patients with ongoing conditions
  • Video communication with colleagues, patients and specialists for quick diagnostics
  • Patients can monitor themselves using mobile apps or specific hardware that uploads data to your healthcare provider in real-time
  • Secure storage and backup of all data that far exceeds paper-based file storage that is easily compromised or destroyed
  • The use of mobile clinics – a fully equipped mobile clinic can perform as well as its on-premise counterpart if the correct technology is implemented

 

The use of these solutions can result in reduced clinic visits without impacting on care levels, allowing clinicians to prioritise clinic time for those who need it. It is only a matter of time before all clinics adopt technology to eliminate the problems associated with the long distances between clinics and their patients. Some will go on the road with mobile clinics and perform their tasks in exactly the same way as from the main clinic. Others may prefer long-distance video consults. It really doesn’t matter what process is used as long as patient care levels are maintained, data is secure and all processes comply with industry best practices.

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Advanced Software Offers Metal Artifact Reduction For Extremities

Advanced Software Offers Metal Artifact Reduction For Extremities | IT Support and Hardware for Clinics | Scoop.it

Carestream Health will demonstrate new optional advanced metal artifact reduction software for its Carestream OnSight 3D Extremity System at the Radiological Society of North America tradeshow (Booth #6713). Carestream’s OnSight 3D Extremity system captures high-quality, low-dose 3D extremity exams. The company’s new metal artifact reduction software is pending FDA 510(k) Clearance.

“Carestream’s second generation of software takes our state-of-the-art original metal reduction software to a new level. It provides enhanced flexibility depending on the metal content present and reduces the visual distortion caused by screws, implants, rods and other metal objects to create improved visibility and diagnostic confidence,” said Helen Titus, Carestream’s worldwide marketing director for ultrasound & CT.

The optional software makes it easier for radiologists and orthopedic surgeons to accurately diagnose a patient’s condition and develop treatment plans. Image processing can be adjusted and optimized according to the amount of metal present.

The software uses information from the original scan to eliminate the need for additional imaging studies, which reduces costs and lowers radiation exposure for patients.

An intuitive touch screen interface allows technologists to adjust for either moderate or complex metal content. The metal artifact reduction software can be activated prior to the scan or it can be applied after the original reconstruction is complete. Both the original and corrected images are always available to view and compare.

The OnSight 3D Extremity System also assists surgeons in detecting occult and non-union bone fractures. Unlike traditional CT systems, this cone beam CT system has a large-area detector that captures a 3D image of the extremity in a single rotation, which takes only 25 seconds. A patient simply places the injured extremity into a donut-shaped opening in the system. Since the patient’s head and body are not confined, patients do not experience the claustrophobia that often occurs with traditional CT systems. Dose is significantly reduced because only the affected body part is imaged.

The compact extremity system can be installed in an exam room and plugs into a standard wall outlet.

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In Situ Cured Silicone Could Enable Personalized Implants

In Situ Cured Silicone Could Enable Personalized Implants | IT Support and Hardware for Clinics | Scoop.it

Medical-grade silicone is a highly valued, versatile biomaterial widely used for medical implants. Often associated with applications such as cardiovascular pacemakers, cochlear implants, hydrocephalus shunts, implantable infusion pumps, and even intraocular lenses, silicones began to be used for a broad range of orthopedic medical applications beginning in the 1960s. The idea of replacing the small joints of the hand with silicone implants was first introduced by Swanson about 50 years ago.1 Since then, medical-grade silicone elastomer implants have become common in the replacement of diseased small joints. Typically, silicone elastomers are used to fabricate components of devices or entire devices, which are then assembled, packaged, and sterilized prior to implantation via surgery. Now, new dispensing technology serves as a means to provide an alternate method of surgical implantation, where uncured pre-sterilized silicone can be provided as a part of the surgical kit and cured in situ during the orthopedic procedure.

 

Benefits and Innovation
Silicone provides a diverse range of characteristics that make it useful, with properties ranging from very sticky to very slippery, and from soft and pliable to stiff or rigid. Consequently, it is very attractive for different medical uses, such as molded parts or lubricious coatings for medical devices; soft silicone adhesives for wound care; soft tissue implants; and even high-modulus tubing.

 

Device manufacturers often choose silicone for its established pedigree of biocompatibility, unique physical properties, and its ability to be altered at the polymer level. This ability to let manufacturers custom-modify material properties to satisfy specific medical device requirements has given silicone a reputation as a high-technology biomaterial that invites innovation.

 

Innovation in silicones, however, is expanding beyond the properties of the biomaterial itself. A new development in sterilizable dispensing systems allows sterile, uncured silicone elastomers to be considered for therapeutic use in orthopedic and other applications where pre-formed silicone implants are traditionally used. By enabling the silicone to be cured to its final form in situ within the specific area in the body receiving the implant, new approaches to orthopedic device design, fabrication, and implantation have the potential to be developed.

 

Medical-Grade Silicones: Value for Implantable Devices
To explore the value of in situ cured silicone elastomers in orthopedic applications, it’s helpful to examine some key traits and performance considerations that make silicone particularly appealing for implants.

 

Biocompatibility: Medical-grade silicones have been proven to be chemically stable for use in long-term implantable devices, with results demonstrating that biocompatible silicones are not harmful to living tissue.

 

The biomaterials supply crisis of the early 1990s presented a significant testing and documentation challenge for medical device manufacturers. There was a need to provide exhaustive safety data to obtain the regulatory approval required to market their products. Silicone especially, as the primary material from which breast implants are made, received intense evaluation. As a result, more than two decades of laboratory and clinical research and experience with silicone-containing medical devices of all types has produced thousands of peer-reviewed articles, as well as carefully considered regulatory decisions. These findings validate the safety and biocompatibility of implantable devices manufactured with silicone.

 

Customization: Silicone-based implanted orthopedic devices have multiple therapeutic applications, whether for finger joints or even spinal repair. Depending upon how it is used, each device has unique physical property requirements, such as firmness, cushioning ability, or flexibility. The advantage of silicone is its ability to be highly customized, so the desired properties such as elasticity, fatigue resistance, and durometer can be formulated for the appropriate functionality in a device.

 

Durability: Cured silicone retains its properties over long periods of time. This is especially useful in applications such as finger joint replacement, where the elasticity of the moving joint is a key characteristic. In long-term implantable applications, whatever balance of elasticity or firmness the device manufacturer specifies needs to be sustained over the life of the implant.

 

Curability: To fully leverage the properties of silicone, the material must be cured to activate these properties and make the material chemically stable. A widely used method for curing silicone is platinum-catalyzed addition cure. With this method, a platinum-based catalyst is included in the silicone formulation to activate crosslinking. Depending upon the final application, the silicone can cure to be relatively flexible or very hard. Platinum-catalyzed, addition cure chemistry is frequently chosen for implanted medical devices because there are no catalyzation byproducts; all formulation components are chemically bonded in the polymer matrix. Another benefit is the platinum catalyzation allows for flexibility in controlling the cure rate over a wide range of time and temperature.

 

Benefits of In Situ Cured Silicones in Orthopedics
The distinctive features of silicone offer tremendous potential value for therapeutic orthopedic applications. For example, they can create a seal, fill a void, provide cushioning, or enable flexibility. These types of applications can perform best when they fit the anatomy of a patient.

 

Until recently, silicone orthopedic devices were typically produced, cured, and sterilized prior to surgical implantation. However, the advent of silicone that can be cured in situ at the site of the implant is appealing for several reasons. In situ curing of medical-grade silicones in the body, rather than fabricating the device outside the body and implanting it, increases the ability to customize the fit of implanted orthopedic devices, since it is more of a “real-time” implant. In fact, research has already been conducted on the use of in situ-cured silicones in spinal applications. In vertebral repair, for example, it is conceivable that in situ-cured silicone could enable a custom-fit device. Using in situ-cured silicone implants also opens possibilities for less invasive implantation procedures. In addition, customization of in situ-cured silicone enables the material properties to be “tuned” in accordance with specific therapeutic requirements. For example, viscosity can be defined to make in situ implantation and curing easier to accomplish. The cure time can be tuned, so that the silicone cures in situ at body temperature. Moreover, the final physical properties of the material can be precisely defined to provide the desired performance, such as a specific level of hardness, if the orthopedic application is to support; or softness, if the orthopedic device is meant to cushion.

 

Sterilizing Silicone for Implants
As the industry reviews the potential for versatility and usefulness of in situ-cured silicone materials for orthopedic implants, another key factor to consider is sterilization. In order to be implanted, devices pre-fabricated with medical-grade silicones must be sterilized—so an efficient and fully verifiable sterilization solution is necessary.

 

The traditional method for producing silicone orthopedic devices uses a multi-step process. Although methods vary between manufacturers, most implants are molded from liquid silicone, which is then cured. This cured, molded part is typically placed along with other devices used for a specific therapeutic application into a single package or tray, which is then sealed and sterilized before it is delivered for use with a patient.

 

A number of processes can be used to sterilize uncured silicone. However, these processes have had challenges in the past with sterilization of platinum-catalyzed, addition cure silicones in their uncured state.

 

  • Gamma and electron-beam irradiation: May cause premature cure
  • Dry heat and autoclave: May be detrimental for heat- or moisture-sensitive formulation ingredients and packaging components

 

Exposing the silicone to ethylene oxide (EtO) gas is a widely used and effective sterilization method when used with compatible packaging to allow for ingress and egress of the sterilant gas. The implant is typically packaged along with the other components in the orthopedic surgical kit and sterilized as a single unit.

This process works for implants that are fabricated and cured prior to implantation. However, a technical challenge often faced by silicone manufacturers is how to package uncured silicones, so they can be sterilized then later used for in situ-cured therapeutic treatments.

 

New Packaging Enables Sterilization
Designed specifically to allow sterilization of uncured medical grade silicones, a new innovation in silicone dispensing systems makes in situ-cured silicone implants for orthopedics possible.

This novel, patented system2 features a dual-cartridge prefilled dispensing system. One cartridge contains the uncured silicone while the other contains the catalyzing agent. Each cartridge has a gas-permeable plunger seal that allows EtO sterilant gas to permeate through the plunger seal to sterilize the contents of the cartridge.


Key features of the packaging system include:

  • Disposable syringes that are available in a variety of sizes—5.0, 10, 25, 50, and 75 mL—which offers choices to help match the needs for the specific quantity of material required
  • One-step sterilization of both the material in the cartridge and the packaging
  • Easily adaptable to a variety of injection technologies
  • Engineered for use in complete surgical kits

 

Testing of this two-part dispensing system demonstrated that, after sterilization, the uncured silicones were fully sterilized, and there was no residual EtO remaining in the material. Equally important, there was minimal change to key silicone physical properties, such as rheology, durometer, modulus, work time, and cure rate.

 

Thus, the highly valued material properties of silicone—and the increased versatility and custom-fit capabilities offered by in situ curing of silicone—are now more viable through a dispensing system that can be efficiently and effectively sterilized prior to the orthopedic procedure.

 

The development of a new patented dual-cartridge prefilled silicone dispensing system makes in situ silicone curing a practical reality, offering the orthopedic community the potential to explore new therapeutic approaches that provide better outcomes to meet the implant needs of patients.

 

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FDA Clears IlluminOss Medical's Bone Stabilization System

FDA Clears IlluminOss Medical's Bone Stabilization System | IT Support and Hardware for Clinics | Scoop.it

IlluminOss Medical, a privately held, commercial-stage medical device company focused on minimally invasive orthopedic fracture repair, announced that it has received U.S. Food and Drug Administration (FDA) de novo clearance for the IlluminOss Bone Stabilization System for treatment of impending and actual pathological fractures of the humerus, radius and ulna from metastatic bone disease.

The IlluminOss System incorporates the use of a thin-walled PET balloon that is infused with a liquid monomer and delivered in a minimally invasive fashion into the intramedullary canal of the bone through a small incision.

Once the balloon is infused with monomer, it conforms to the shape of the patient’s specific bone. The surgeon then activates a light source which delivers visible light to the PET balloon, polymerizing the monomer. The cured, hardened implant provides longitudinal strength and rotational stability over the length of the implant, stabilizing the fracture.

The IlluminOss System, which has been commercially available in international markets and been in clinical use since 2010, will now be available to patients in the U.S. for the treatment of pathological fractures of the humerus, radius and ulna.

“The FDA marketing clearance marks a significant milestone for IlluminOss Medical, allowing us to bring our products to the U.S. market,” said Robert Rabiner, chief technology officer, IlluminOss. “The IlluminOss System was developed with an aim to provide improved patient experiences and outcomes when treating pathologic fractures. There is a critical need to make less invasive orthopedic fracture repair options available to an aging and underserved market segment.”

Surgeons’ experiences with the product in the international markets have reported smaller incisions, shorter procedural times, faster return to patient’s daily living activities, with reduced hospital stays and lower complication rates for patients.

“The IlluminOss System has significantly changed the way we are able to approach the treatment of certain impending and actual pathological fractures resulting from metastatic bone disease,” said Dr. Richard McGough, Department of Orthopaedic Surgery, University of Pittsburgh Medical Center. “We were able to offer patients a quick, reliable surgical option that minimized pain and hospitalization. We were also able to consolidate their treatments; in some cases, we moved from two-day admissions to outpatient surgery, and we were ultimately able to complete radiation much more quickly.”

“I am delighted that we now have an improved option to help patients with metastatic bone disease of the humerus,” said John Healey, Chief of Orthopaedic Surgery, Memorial Sloan Kettering Cancer Center. “Since this device doesn’t violate the rotator cuff and can be inserted with reduced operative time and blood loss, it relieves pain and restores function more effectively than alternative treatments, in my experience. Furthermore, this new technology is versatile, and I anticipate that new applications will follow.”

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Nerve-on-a-Chip Platform Makes Neuroprosthetics More Effective

Nerve-on-a-Chip Platform Makes Neuroprosthetics More Effective | IT Support and Hardware for Clinics | Scoop.it

Neuroprosthetics—implants containing multi-contact electrodes that can substitute certain nerve functionalities—have the potential to work wonders. They may be able to restore amputees' sense of touch, help the paralyzed walk again by stimulating their spinal cords and silence the nerve activity of people suffering from chronic pain. Stimulating nerves at the right place and the right time is essential for implementing effective treatments, but still a challenge due to implants' inability to record neural activity precisely. "Our brain sends and receives millions of nerve impulses, but we typically implant only about a dozen electrodes in patients. This type of interface often doesn't have the resolution necessary to match the complex patterns of information exchange in a patient's nervous system," said Sandra Gribi, a Ph.D. student at the Bertarelli Foundation Chair in Neuroprosthetic Technology.

Replicating—and Improving—How Neuroprosthetics Work
Scientists at the lab run by Dr. Stéphanie Lacour, a professor at EPFL's School of Engineering, have developed a nerve-on-a-chip platform that can stimulate and record from explanted nerve fibers, just as an implanted neuroprosthetic would. Their platform contains microchannels embedded with electrodes and explanted nerve fibers faithfully replicate the architecture, maturity, and functioning of in vivo tissue.

The scientists tested their platform on explanted nerve fibers from rats' spinal cords, trying out various strategies for stimulating and inhibiting neural activity. "In vitro tests are usually carried out on neuron cultures in dishes. But these cultures don't replicate the diversity of neurons, like their different types and diameters, that you would find in vivo. Resulting nerve cells' properties are changed. What's more, the extracellular microelectrode arrays that some scientists use generally can't record all the activity of a single nerve cell in a culture," said Gribi.

The nerve-on-a-chip platform developed at EPFL can be manufactured in a clean room in two days and is able to rapidly record hundreds of nerve responses with a high signal-to-noise ratio. However, what really sets it apart is that it can record the activity of individual nerve cells. The research has just been published in Nature Communications.

Inhibiting the Activity of Specific Neurons
The scientists used their platform to test a photothermic method for inhibiting neural activity. "Neural inhibition could be a way to treat chronic pain like the phantom limb pain that appears after an arm or leg has been amputated, or neuropathic pain," said Lacour.

The scientists deposited a photothermic semiconducting polymer, called P3HT:PCBM, on some of the chip's electrodes. "The polymer heats up when subject to light. Thanks to the sensitivity of our electrodes, we were able to measure a difference in activity between the various explanted nerve fibers. More specifically, the activity of the thinnest fibers was dominantly blocked," said Gribi. And it's precisely those thin fibers that are nociceptors—the sensory neurons that cause pain. The next step will be to use the polymer in an implant placed around a nerve to study the inhibiting effect in vivo.

Distinguishing Between Sensory and Motor Nerve Fibers
The scientists also used their platform to improve the geometry and position of recording electrodes, in order to develop an implant that can regenerate peripheral nerves. By running the measured neural data through a robust algorithm, they will be able to calculate the speed and direction of nerve impulse propagation—and therefore determine whether a given impulse comes from a sensory or motor nerve. "That will enable engineers to develop bidirectional, selective implants allowing for more natural control of artificial limbs such as prosthetic hands," said Lacour.

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'Dual Mobility' Hip Replacement Implant Reduces Risk Of Dislocation

'Dual Mobility' Hip Replacement Implant Reduces Risk Of Dislocation | IT Support and Hardware for Clinics | Scoop.it

Hip replacement surgery is highly successful in relieving pain, restoring mobility, and improving quality of life. More than 330,000 procedures are performed each year in the United States, and that number is expected to almost double by the year 2030.

As with all surgical procedures, the possibility of a complication exists, and dislocation is the most common problem. The risk of dislocation is higher in patients who have had a second hip replacement, known as revision surgery. Some people need revision surgery many years after their first hip replacement when the original implant wears out. Hip instability after joint replacement is another reason a patient might need a revision surgery.

Research conducted by Dr. Geoffrey Westrich and colleagues at Hospital for Special Surgery and other joint replacement centers indicates that a newer type of artificial hip known as a "modular dual mobility" implant could be a good option for patients who need a revision surgery. Their study was presented at the annual meeting of the American Association of Hip and Knee Surgeons in Dallas this month.

"Although the concept of dual mobility was originally developed in France in the 1970s, the technology is relatively new in the United States," said Dr. Westrich, director of research of the Adult Reconstruction and Joint Replacement Service at HSS. "Our study found that the newer technology with modular dual mobility components offered increased stability, lowering the risk of dislocation, without compromising hip range of motion in patients having a revision surgery."

"Dual mobility" refers to the bearing surface of the implant—where the joint surfaces come together to support one's body weight. A hip replacement implant is a ball-in-socket mechanism, designed to simulate a human hip joint. Typical components include a stem that inserts into the femur (thigh bone), a ball that replaces the round head of the thigh bone, and a shell that lines the hip socket.

Modular dual mobility implants provide an additional bearing surface compared to a traditional implant. With the dual mobility hip, a large polyethylene plastic head fits inside a polished metal hip socket component, and an additional smaller metal or ceramic head is snap-fit within the polyethylene head.

"Currently, there are few large-scale outcome studies on the modular dual mobility device in revision hip replacement," Dr. Westrich noted. "We set out to determine the rate of dislocation and the need for another surgery following revision hip replacement using this implant and report on the functional outcomes."

The study included 370 patients who underwent revision hip replacement with the dual mobility implant between April 2011 and April 2017. The average patient age at the time of surgery was 65.8 years. Clinical, radiographic, and patient reported-outcome information was collected.

To be included in the final report, patients needed to be seen for follow-up for at least two years after their surgery, and the average follow-up was 3.3 years. "At the latest follow-up, we found that surgery with the dual mobility implant resulted in a very low rate of instability for the revision patients, namely 2.9 percent, with good functional improvement and a low rate of reoperation," Dr. Westrich noted. "While longer-term follow-up is needed to fully assess the newer device, in our study there was clearly a benefit provided by the dual mobility implant in the first few years following revision surgery."

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Information Technology in Today’s Veterinary Practice -

Information Technology in Today’s Veterinary Practice - | IT Support and Hardware for Clinics | Scoop.it

5 Common challenges of the traditional veterinary practice

  • Paper record keeping, appointment scheduling, service reminder distribution
  • Increased labor cost due to inefficiency
  • Difficulty in accurately managing inventory and accounting
  • Lack of advertisement avenues and initiatives
  • No connection with necessary modern medical equipment, associated practices, or specialty practices

We will now discuss the advantages of moving to a cloud based practice management system.

Why should a practice utilize cloud based technology?

Accuracy of records, reporting, and scheduling

In a paper record practice, patient files can be difficult to locate, reference, and store. Staff may be frequently disorganized, and it may slow the process of patient care. Your staff will likely spend more time shuffling paperwork than providing medical attention.

With a cloud based practice, patient files are easily accessible, updated real-time, and require no physical space for storage. The ability to schedule appointments is streamlined and accurate, reducing client wait-time and cancelled visits.

Increasing client compliance

In a paper record practice, staff is responsible for tracking services due which may lead to missing service reminders or sending redundant communications. But with a cloud based practice, the system does the work for you.  It allows you to send reminders in a variety of ways; postcards, emails, and text messages.

Reducing costs of operation

In a paper record practice, the cost is obvious. The physical storage demands are large and those costs will only continue to grow over time.  The inefficiencies in finding records, tracking service due dates, and communicating with the client is large and are frequently error prone. And in an installed system, you have to worry about the cost of purchasing equipment and updating that equipment.

 

With a cloud based practice, no servers or backups are required which frees up the staff and resources to allow them to provide better patient care. Cloud based systems usually have a low upfront cost with a reasonable monthly subscription price. The monthly price includes the system, automatic updates, support, and training.

Staff productivity and satisfaction

Let’s be honest, most veterinary clinic staff members joined this industry to spend time with animals and to help provide quality care. Managing paper records or an installed system isn’t something they bought into. However, they can leverage their system to help with the quality of care.

 

With a cloud based practice, staff can become more efficient giving them more time to do what they love which is being with the patient and providing that care. A happier staff normally translates to higher revenue.

Client interaction and communication

For a paper record practice, client interaction is limited to office visits, phone calls, and direct mailings. But with a cloud based practice, you get all those plus the ability to email, text message, client portal (pet portal), and social media.

Business growth and expansion

The record keeping process with which you run your practice shouldn’t prevent growth. Using paper records will take a toll on resources and will stifle growth.  An installed system will require more upkeep as hardware becomes outdated.  It is also very common to start with a hardware setup to support your clinic, but then grow out of that hardware setup. This would require new hardware and servers.

With a cloud based practice, servers are managed by the software vendor and are set up to grow with the business.

Medical technology and cross practice connectivity

For a paper record practice, there is no option to seamlessly pull in lab results, radiographs, or specialists’ reports – they must all be stored separately.  Coordinating this with a multi-location practice is near impossible.

With an install system, you can at least connect your software to external devices like lab analyzers and x-ray equipment. However, you can’t easily connect multi-location practices.

With a cloud based system, you can do both and do both well. In a multi-location practice, you can easily access one or more clinics from the same computer or device. You can also share clients and patients across locations reducing double entry. In most cases, you can run reports that show a group practice view which is near impossible with paper or installed systems.

Eddie Heinz is the CEO of eVetPractice.com, a leading provider of veterinary practice management software. Founded in 2011, the company’s clientele spans more than 40 states within the United States, as well as Canada and Australia.

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4 Industries That Find Blockchain Technology Useful

4 Industries That Find Blockchain Technology Useful | IT Support and Hardware for Clinics | Scoop.it

 

By 2024, the global blockchain market is expected to be worth $20 billion, and according to a recent study by IBM, one-third of C-level executives are considering adopting these technologies. Does that surprise you? Is your organization exploring blockchain or distributed ledger solutions?

 

Recent reports indicate that blockchain has the potential to reduce certain industries’ infrastructure costs by 30 percent. Additionally, there’s a $8-12 billion annual savings for certain industries that use blockchain technology. Let that sink in.

 

Companies of all industry types are using blockchain technology to help them improve transparency, traceability and trust; but here are four industry-specific benefits.

 

  1. Healthcare: Hospitals are now able to seamlessly access patient data shared between member hospitals and participating hospitals.
  2. Banking: Financial institutions are able to simplify and speed up the transfer of funds, while ensuring the identity of the user.
  3. Supply chain: Manufacturers can ensure the authenticity of goods and products with better transparency and accountability.
  4. Insurance: Companies can eliminate common sources of fraud, and use smart contracts to improve efficiency and improve customer experience.

 

With all of these sample use cases, blockchain helps companies increase efficiency and reduce friction. Sirius offers various services to help organizations define and develop their blockchain solution.

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Is it ok to store my clinic data in the cloud?

Is it ok to store my clinic data in the cloud? | IT Support and Hardware for Clinics | Scoop.it

If like me you enjoyed gazing out of the window at school, watching the clouds go by during double maths this is for you. Everything seems to be in the cloud these days; music, pictures and all the app things I use to try and make my life a little easier. But as much as I enjoy gazing upwards what is it all really about? What does it mean for you and your clinic? Let’s start at the beginning.

What is the cloud?

In the simplest terms, the cloud means storing and accessing data and programs over the Internet instead of your computer’s hard drive. That’s probably almost as much as you need to know but please read on!

 

When you store data on or run programs from the hard drive, that’s called local storage. Everything you need is physically close to you, which means accessing your data can be fast and easy, for that one computer. But there are downsides. When information is only stored on your computer’s hard drive you are at risk from all of the usual dangers in life; coffee spills, loss of computer …. computer dying, I’m sure we all have stories along those lines. So what does it mean to have your information in the cloud?

 

Well, “The Cloud” is a buzzword that suggests everything is floating in the sky. But the reality is that the cloud is not floating above our heads, it is a physical infrastructure, its many computers all over the world. Unsurprisingly many people don’t take the time to wonder where their data actually goes or how it gets there they are just happy that it works.

What are the benefits to working in the cloud?

Working in the cloud can allow your clinic to be nimble, efficient and cost-effective. If your clinic quickly needs access to more resources, it can be scaled up quickly in the cloud. Also, if you experience any of the events mentioned above which would have a serious impact on your business your information will be safe as it’s not directly inside the damaged or lost computer. I hope that all makes sense now? Now for the really clever TM3 bit.

Cloud and Data storage

At Blue-Zinc we have a systems team who manage and develop the TM3 business cloud and as we are always trying to improve things we came up with the best possible solution available. The team has taken the flexibility of the cloud but rather than having your information roaming on random servers somewhere your data is stored in the UK (data centres certified with ISO 27001 and ISO 9001) on dedicated servers which Blue-Zinc own and the guys lovingly maintain and polish on your behalf. Security patches are regularly applied to our servers to ensure that any vulnerabilities are patched as soon as they’re identified. In addition, the SQL server database with encrypted VPN services gives users the highest levels of security available and all data is automatically backed up for you!

Feature-rich private practice software

So, with TM3, you have flexibility and safety all in one. It also means that you have access to our other cloud services Pronto, Online bookings and many more features which 10,000 practitioners worldwide enjoy on a daily basis. So, for now, my head might be in the clouds but at least I know where my data is!

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What is telemedicine involved and how much does it cost? 

What is telemedicine involved and how much does it cost?  | IT Support and Hardware for Clinics | Scoop.it

Now that the use of telemedicine is surging to an all-time high, organizations can easily get lost in implementing the technology just to stay on top of the latest and greatest, but it is easy to get lost in the vast amount of telemedicine technology and equipment options available.

 

If you are researching your telemedicine options, applying for a grant or just need to put your budget plans together, here are six key elements and associated costs for you to consider.

1. Medical Devices for Specialties

The specific medical devices you need may vary depending on the specialties you plan to serve with telemedicine. The good news is you don't need to have all the answers right away because many equipment providers have scalable and modular telemedicine systems. This means you can purchase just what you need to get started and then add additional devices later on as your program expands into additional specialties. 

 

The cost of medical devices for basic primary care services can range from $5,000-$10,000, and this would include devices such as an examination camera, ENT scope, and digital stethoscope.

2. Communication Platform and Video Conferencing Needs

How you plan to manage the patient-to-remote encounter is also a key component to consider for clinical telemedicine applications. Since you are communicating a patient's critical diagnostic data, the optimal choice is to do it securely and in real time. After all, the beauty of telemedicine is the functionality to have a live interaction between a patient and a remote specialist.

 

AMD Telemedicine recommends using a Web-based encounter management portal to communicate and aggregate medical device data and share it live with the remote physician. This is truly the best way to offer telemedicine services that are as close to an in-person visit as possible. For video conferencing, it is best to first evaluate any video conferencing investments your organization might have already made to see if these can be leveraged for your current application. Many times they integrate seamlessly with encounter management platforms.

 

Depending on your video conferencing needs, you can complement a Web-based telemedicine portal with either software- or hardware-based video conferencing. To go the software-based route can cost as little as $1,500 per patient site with no cost for the remote provider. The cost for hardware-based video conferencing can start around $10,000 per patient site and increases with the number of remote provider sites you need.

3. Packaging Design and Mobility

Telemedicine carts, cases, wall mounts, and other equipment are all just various ways to package the telemedicine hardware and software. Although there is a difference in how aesthetically pleasing they are (or are not), the main thing to keep in mind is whether this packaging will fulfill your intended use, not just now but also in the near future.

 

Ideally, you want a telemedicine cart or case that is modular and can be easily configured for additional medical specialties so it can evolve with your program. For some applications, such as school-based health centers or long-term care facilities, it is helpful to select a telemedicine system that is an all-in-one package. This helps streamline the purchasing, maintenance, and support for those that don't have a dedicated IT team for their telemedicine programs. All-in-one telemedicine systems that include the telemedicine software, primary care medical devices and the mobile cart/case can range from $20,000 to upward of $28,000.

4. Bandwidth and Internet Connection Recommendations

You may be pleased to know that you don't need to invest in a significant infrastructure overhaul to make telemedicine a reality for your clinic. Of course, your specific needs will vary depending on factors such as location and size or your organization, but the most important consideration is not how much bandwidth you need, but rather how reliable and consistent your bandwidth is.

 

The most common Internet connections are shared with others, which can cause the upload and download speeds to lag and be interrupted at busy times. So finding a reputable Internet service provider with a commitment to reliable service is the first step. If possible, purchase a business-grade service so you experience a more consistent bandwidth capability to ensure your real-time data is not interrupted or compromised in any way.

5. Training

You already staff your organization or practice with top-notch doctors and nurses, so the next step is to provide these health care professionals with the skills and knowledge they need to best make use of your new telemedicine technology in daily operations.

 

Fortunately, clinical telemedicine equipment training isn't a complicated need to meet, especially if your staff has any familiarity with basic medical devices and modern communication technology.

 

There are two types of training programs to ensure the long-term success of clinical telemedicine programs: user training for clinicians and nurses, and technical training and installation for the IT staff. Training programs like these can range from $200 to $2,000 per site depending on the complexity of equipment, the number of users and other factors. Additionally, the American Telemedicine Association is a fantastic resource for training and education.

6. Support

Finally, the increased reliance on network connectivity and Internet technology at your office means that you'll need to ensure that you have adequate IT staff support. This is likely more of a concern for smaller practices that may not have an in-house IT department. It's a good idea to talk to your telemedicine vendor to determine if it provides installation services, as well as what technical support options are available if you don't have an IT staff of your own.

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Professional Development Advice from Technology Leaders

Professional Development Advice from Technology Leaders | IT Support and Hardware for Clinics | Scoop.it

This edition of AppointmentPlus Radio brings together two industry leaders within the tech sector. Raymond Wiley, a general manager with Sun-Tec America, shares the story of how he landed his current position, as well as the philosophy that shapes his professional interactions. Dhruv Bhate, a senior technologist who works in 3D printing, offers insight into how reflection on your true values can lead to a meaningful work life. The two also discuss:

 

  • The importance of finding your professional “sweet spot”
  • How to understand, and communicate your professional value
  • Why defining what you do also mean defining what you don’t do
  • Plus: 5 must-have personal technology recommendations and 2 must-read books to overhaul your professional mindset

 

 

About Raymond and Dhruv: 

Raymond Wiley is the general manager at Sun-Tec America, LLC where he is responsible for the go-to-market strategies for Sun-Tec’s high precision lamination, labeling, and taping equipment portfolio for the Americas and European markets. He is the primary interface between the customer and the Sun-Tec design engineers located in Japan and is charged with overseeing the entire sales process through every phase of the project. Previously, Raymond spent 21 years at Motorola in the Semiconductor Products Sector serving in a variety of increasingly responsible positions including operations manager for the Small Signal and MEMS Sensor Businesses in Japan.

 

Dhruv Bhate is a Senior Technologist at Phoenix Analysis & Design Technologies, Inc. (PADT) where he leads R&D efforts in Additive Manufacturing, with a focus on high-performance polymers and metals. Prior to joining PADT, Dhruv spent 7 years at Intel Corporation developing laser-based manufacturing processes. Dhruv has a Ph.D. in Mechanical Engineering from Purdue University and a Master’s from the University of Colorado at Boulder, where he developed fracture models for ductile metal alloys and to simulate adhesion in MEMS.

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Online Scheduling Software Is Revolutionizing the Wellness Industry

Online Scheduling Software Is Revolutionizing the Wellness Industry | IT Support and Hardware for Clinics | Scoop.it

Appointment-Plus, the industry leader in online customer self-scheduling software, announced several major additions to its growing wellness and health screening client base. Major program providers such as Lifecare, Inc., which serves more than 4.5 million individuals, have quickly implemented Appointment-Plus web-based scheduling software to solve many of the thorny scheduling issues often associated with corporate wellness and health screening programs. Appointment-Plus seamlessly manages these large appointment volumes by allowing corporate employees and healthcare members to self-schedule via a secure Internet portal.

 

In addition to Lifecare, Appointment-Plus was also recently selected to be the online scheduling solution utilized by Self-Insured Schools of California (SISC), a health insurance group of over 300 school districts in the California education system. SISC will use Appointment-Plus software to allow thousands of school district employees and dependents to schedule health screenings across the State of California. With the integration of both the online self-scheduling software and the call center services offered by Appointment-Plus, SISC will maintain a comprehensive scheduling solution that meets all aspects of the employee and dependent scheduling process.

 

The appointment-plus software offers wellness providers the ability to customize the system to meet very specific scheduling needs, including the option to private label both the member scheduling view and the administrative view of the system. In addition, Appointment-Plus offers an enterprise solution if required for large projects. The enterprise solution allows wellness providers a web services toolkit to interface Appointment-Plus information with other systems.

 

Because Appointment-Plus operates on a software as a service (SaaS) model, wellness providers can implement the system with virtually no up-front or capital costs. In addition, because the member self-scheduling process eliminates much of the traditional manual scheduling process, using Appointment-Plus is a cost-saving measure for programs. Appointment-Plus accounts are scalable to allow scheduling across multiple client-companies and client-locations. With its robust reporting functionality, Appointment-Plus also effectively manages wellness project information needs.

 

“The flexibility and functionality of the Appointment-Plus system have been a key factor in its success for wellness providers,” said Jeff Fleming, Director of Business Development for Appointment-Plus, “Wellness providers, their clients, and their members really appreciate the simplicity of member self-scheduling and the corresponding business efficiency.”

 

Appointment-Plus is a technology firm that specializes in the development of web-based scheduling and appointment software for a wide variety of applications and industries. Appointment-Plus software clients include Fortune 500 companies such as Pepsi and Comcast, federal and local government, universities and schools, and small/medium sized businesses worldwide. In 2007, Microsoft Corp. selected Appointment-Plus software as its referral source for all appointment manager software clients.

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Making your clinic & staff more efficient

Making your clinic & staff more efficient | IT Support and Hardware for Clinics | Scoop.it

Data collection on staff activity allows managers and leaders to determine how their team is spending their time and which activities take up the most of their working day. This post will help make your clinic and staff more efficient.

 

Data collection tools give you a clear picture of how your staff spends their time at work and how they can become more productive.

 

This is important in health businesses, as you are able to determine where your front desk and administration staff are spending their time.

 

I will use one of our clients as an example, they have two clinics and the managers found that there was always a workload on the weekend staff for scanning and administration. The staff that worked during the week were never able to complete the scanning, filing and other administrative tasks during their working day, resulting in a backlog of weekend staff.

 

By using the activity tracking software, they found out that the weekday staff was spending all of their time on the clinical software booking appointments and taking calls. This confirmed that the workload during the week was too much for the staff and allowed the client to justify hiring a new front desk staff member to complete the scanning and filing during the week.

 

You can use the data to:

  • Challenge your staff to spend an hour less a day on emails and use this hour to work on a project
  • Determine the average time staff spend on social media whilst they are in the office and raise alarms if, for example, a staff member has spent more than two hours on Facebook
  • Set yourself some goals, for example, spend less time on administration and more time using the clinical software.

 

A product that we use and is RescueTime. It is installed on all the devices in the workplace and it gives both staff and management a report of their efficiency, productivity, and areas of concern.

 

We use this software to determine processes in our workflow that need to improve and find out how productive we are compared to other staff members.

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Simple Tips to Ensure Clinical Data Security

Simple Tips to Ensure Clinical Data Security | IT Support and Hardware for Clinics | Scoop.it

While we are aware of the importance of the integrity and security of clinical data, recent onsite surveys conducted by REND Tech showed that more than half of the health businesses in Sydney did not implement strong security policies to protect clinical data.

There are a number of steps that will help you increase the security policies around your clinical data. Below are our top five tips:

 

  • To stop unauthorized internal data access, the server must be protected by an administrator password known only to the management team.
  • To ensure that no viruses or malware products are downloaded on your workstations, all computers must be protected with a business grade antivirus product (not the free version of AVG). We recommend NOD32.
  • Management and IT staff should be the only people allowed to access the server. This includes providing server access to pathology companies, Medicare Local staff and so on. If access is required you need to authorize it first and then notify your IT team.
  • To avoid network hacking, change your router password from the generic password to an administrator password. – If you have a Windows XP machine then you need to consider changing it. Recent studies showed that they are six times more likely to be hacked.
  • Never install software on your business computers that have not been approved and authorized by your IT team. Work computers must host clinical and business applications only.
  • If you access your clinical data remotely then you need to ensure that the remote access application you use is secure and password protected. Never share those details with anyone, including your colleagues.

 

By following the processes above, you should be confident in the security of your clinical data. It is highly recommended that you arrange for a security audit every six months to ensure that all the relevant security policies are in place. Take the opportunity to rate your level of data security.

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Tips To Help Ensure A Successful Surgeon Design Team

Tips To Help Ensure A Successful Surgeon Design Team | IT Support and Hardware for Clinics | Scoop.it

Design surgeons and surgeon design times have been at the core of the significant advances that have occurred in the medical device market in the last few decades. Working with surgeon design teams is inspirational, mentally demanding, and exciting.

 

Let’s assume a new opportunity has been identified that will improve your organization’s financial position. The marketing team has studied the market space—that is, classified at least three types of current and potentially new innovative strategies this opportunity should incorporate (as was described in the March/April 2018 issue of ODT, “Innovation and the Development Engineer”).

 

Once a complete financial plan, which includes cost to develop/introduce, and a sales/marketing plan have both been vetted and approved by the organization’s senior staff, it is time to move ahead to develop the surgeon design team.

 

I have had experience with two different types of surgeon design teams. The first—a “Hub and Spoke” model—was utilized in situations where aligning with a given group of surgeons or an institution would alienate others from using the product once it was released. The second is the more traditional surgeon design team with a group of surgeons selected to work on a project from beginning to end.

 

The Hub and Spoke model concept relies on one or two core key opinion leading (KOL) surgeons to serve as the hub of the wheel. Different surgeons or groups of surgeons meet independently with the KOL surgeon and the development engineering lead at a series of low-key meetings held at various time points to obtain feedback on different aspects of the design. There is a significant amount of reliance placed upon the KOL surgeon as the amount of involvement of the non-KOL surgeons is substantially less than in a traditional surgeon design team model. In this model, the non-KOL surgeons are assisting with validating the market assessments and need requirements, as well as providing market acceptance feedback of the new product later in the process. It is the responsibility of the KOL surgeon and the development staff to turn that information into a viable product.

 

With the more common traditional surgeon design team, assembling a good design team is critical to the success of the endeavor. The product development team needs to work closely with the marketing department in the selection and assembly of the surgeon design team. The selection process is very much like picking players for a team sport. The desire is to pick the most talented team, with personalities that mesh with each other while becoming aligned to win in the same way.

 

The training and clinical experience of the surgeons, the number of surgeons on the team, and their geographic locations are just a few of the important factors to be considered. The surgeon’s CV is a great reference as are their publications to discover where and by whom they were trained, as well as if they have any won any awards or honors. This process helps an organizer begin to understand a surgeon’s philosophy so as to determine if it matches with the objectives of the project. If these elements do not seem to align, it is best to move on. Further, there are other important considerations—is this the first design team the surgeon has been a part of or is it just the most recent? Has he or she been a part of prior design projects, and if so, what has been the success of those products? You need to fully understand the motivation of a surgeon to be a member of a design team.

 

It is critical the surgeons understand the commitment they will need to make to be part of the design team, as there will be meetings and other activities that will take them away from their clinical practice and surgery. Provide an understanding of the duration of the project and the time periods where their involvement will be greater than other periods as the project progresses. For example, one design project required great commitment from the surgeons as it met approximately every two to three weeks and for full weekends. As a result of the commitment from the surgeons and support of the company, a very large implant/instrument project was conceived and introduced in 18 months. Conversely, projects without full commitment from all surgeons has resulted in the opposite effect, significantly delaying the project, and doubling the anticipated time to market. Therefore, if the surgeon is not willing to commit the time, they are not a good candidate.

 

I have had the opportunity to work with a wide group of surgeons from around the world on numerous design teams. All were excellent surgeons, but their interests and how they assisted the design teams varied greatly. There were some true innovators and designers who would design or create their own drawings of new and innovative products. When the product was introduced, they were willing to stand behind the new concept until it was clinically proven, even in the face of being questioned by traditionalists. Others were known for performing clinical studies or understanding the issues surgeons were facing. Still others offered their strengths in addressing the surgical technique. It is crucial to understand the strengths and weaknesses of the members of the design team.

 

Regarding the project itself, it is vital to have the project well-scoped. The scope needs to be flexible in nature but, at the same time, there need to be boundaries in place to avoid creep and to ensure the end results fulfill the original unmet market requirement. What is the new product or service expected to perform and what is it not going to address? What shouldn’t be addressed is, many times, more important than determining what needs to be. Ensure everyone understands the project’s clinical scope, the financial objectives, and the other innovative aspects desired. In order to keep the team focused and grounded as time progresses, it is often necessary to reflect back upon the scope to avoid derailing and delaying the project.

 

Having the development engineer/staff gain the respect of the surgeon design team is also important. The engineer must have a wide base of knowledge to keep multiple elements of the development project within his or her view. As the process progresses, certain elements of the product are being locked down that impact the long-term commercial success, design attributes, manufacturability, inventory costs, marketing/sales, user experience, and clinical outcomes. Throughout the project, subject matter experts (e.g., the surgeons, manufacturing engineers, etc.) will provide input and support, but the development engineer is ultimately the one who must sift through all the information and recommendations to decide which to accept, modify, or reject. As such, the development engineer must be a jack-of-all-trades. Leading a development program should not be handled as if it is a democracy, but rather, as a benevolent dictatorship. The leader must listen, assess the situation, make a decision, and move on. Attempting to satisfy all parties will only cause delays.

 

There are techniques that can be used to help sort through the issues to attempt to make the best decisions. One technique is to note how many times the same concern is raised. If the issue is repeated by numerous surgeons and/or other advisors, it likely requires further exploration. If it is rarely stated or only by one surgeon, it may be safe to consider it a much lower priority. If the factor significantly impacts cost, however, determine how significantly it could impact the marketability of the product.

 

If a new, creative solution is conceived by a surgeon that seems to have originated from out of left field, it should not be automatically dismissed. Instead, challenge the surgeon to “sell” the idea to the rest of the design team. If he or she cannot earn their acceptance, it may be best to move on. This does not mean the concept was not worthy, but perhaps it needs to be sidelined from the current program and examined independently on its own merits at a later time or for a future generation of the product. Some creative solutions may seem like an idea that makes sense, but ultimately, must be considered within the scope definition for the project.

 

When having a design meeting, it is important to know the outcome ahead of time. Since design meetings can sometimes become confrontational, first addressing key topics individually with surgeons to understand their concerns and issues will provide a means to be better prepared for the full meeting and make it more productive. If there are controversial issues to be addressed, have one of the surgeon designers present them, which can also assist in making the meeting more productive.

 

After the concept for the product design has been finalized, enroll a second group of surgeons not part of the original design team to objectively review the new product concept. This can help ensure market acceptance and help identify issues that may have been overlooked. All members of the design team are too close to the project to objectively review the new product. While this review occurs late in the design process, it is still early enough to allow for modifications to be made relativity inexpensively.

 

Surgeon design teams have been and will continue to be a critical element for the advancement of healthcare in the development of new and innovative medical devices. Leading surgeon design teams is a skill a development engineer needs to hone and refine. It involves technical knowledge, psychology, business acumen, and most importantly, strong leadership attributes.

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Why Firms Of All Sizes Need To Outsource? 

Why Firms Of All Sizes Need To Outsource?  | IT Support and Hardware for Clinics | Scoop.it

I was working as a product development engineer at AcroMed (a spinal implants manufacturer that was acquired by DePuy in 1998), when I noticed a gap in the medical device industry. There were plenty of companies coming up with great ideas for devices, but there were holes in the product development cycle thanks to a lack of resources or expertise.

 

That’s when I decided to grab a shovel and start filling some of those holes. First came Empirical Testing Corp. (ETC), which focused on testing devices. It was all we did, so we got good at it over the course of 20 years. Through ETC, we heard from clients who needed small-batch manufacturing and prototyping, so we launched Empirical Machine. Clients came to us for regulatory support through both of those specialty companies, so we added Empirical Consulting to our group of companies. Each branch of our corporate family tree developed as an answer for companies or individual developers lacking a critical in-house resource.

 

For companies large and small, outsourcing specific aspects of device development builds forward momentum and supports the entire industry.

 

Andy Fauth is an engineer by training. For 13 years, he’s worked in a private-equity, privately owned business he says owes its growth to finding the right vendors. He’s now chief technology officer for SMV Scientific, a company that specializes in the bone-implant interface and designs, develops, and manufactures orthopedic devices. The company began as a two-person research and development venture four years ago and has grown into a 17-person business with three devices on the market and six 510(k)s completed.

 

“As an emerging company, we don’t have the capital to have the equipment internally or hire everybody we’d like to hire for the right way to handle this stuff,” he said. “The only way we could incubate this company and grow was to outsource.”

 

Even for larger companies, it often makes sense to outsource specific parts of device development, he said.

 

“There’s always a bottle neck somewhere—that’s why there is an outsource market,” Fauth said. “Some of that stuff is specialty. When you’re going to do it once every couple of years, you don’t want to do that internally. There’s always specialty equipment, whether it’s a test frame or test fixture or experience with a certain protocol you don’t have in-house, or don’t want to invest in having that in-house long-term. You just need to use it once and check the box.”

 

Raymond Cloutier, vice president, Engineering & Development, Advanced Technologies at Exactech, said despite significant resources and commitment to Exactech’s in-house resources, he also turns to outside vendors for specialized support. Sometimes it’s an issue of capacity, but he also appreciates the benefits of outside expertise.

 

“[Outside vendors] are in a somewhat privileged position,” he said. “They’re also doing work for other companies, which helps them know the benchmark or industry standard. Sometimes when we’re in our own world as a company, we don’t have as much understanding of how requirements should be interpreted. An outside consultant may better understand what expectations, for example, the FDA may have. Suppliers generally have seen how multiple companies prepare submissions.”

 

He said bigger companies may, at times, err on the side of being overly cautious.

 

“Oftentimes large companies take very conservative positions because they have a lot at stake,” Cloutier said. “The question is, are they being ‘overly compliant’? Are they doing things more rigidly than what the external regulatory bodies require? Sometimes an outside perspective helps you better know the answer to that.”

 

David Poirier is founder and owner of spinal implant company Presidio Surgical, which has a staff of eight. He keeps quality control, marketing, sales, distribution, and accounting in-house, but the bulk of his device development work depends on outside vendors.

 

“Everything we do, we pay for through sales and distribution of our products,” Poirier said. “They have to be right. There’s really no room for error. We’ve made errors. They hurt.”

 

At first glance, it may appear outsourcing is more expensive than keeping things under your roof. But those numbers can be misleading. You may pay $200 per hour to a single vendor—which is often more than an employee’s hourly wage—but you’re not paying benefits or down time when the employee is not actively engaged on the project, Poirier said. There’s also a matter of prioritizing in-house expertise to make the best use of time and money, he said.

 

“If I take someone in quality engineering and say, ‘I need you to work on this gauge design,’ my project may have a mid-level priority, but I’ve taken them from a much higher-level project; there’s an opportunity cost,” Poirier said. “There’s the cost of the benefits and true cost of employees, then the opportunity cost. It’s a general management issue you have to think about. With consultants, you’re only paying them for what they deliver instead of the full cost (of an employee).”

 

Paying for support a la carte is less expensive than developing that service for your business, Poirier said.

 

“I only pay them for the work they do,” he said. “When you’re outsourcing, it can be a benefit if you have really good experts. You’re paying them for what you want and get what you need. You’re paying for specific service rather than a staff member. It’s hard to find good people.”

 

Working with consultants who are well-known in the industry has its advantages, Fauth said.

 

“Just to get the expertise for third-party validity for our customers, we’d outsource,” he said. “We actually had to challenge and re-invent new standards. We worked with the FDA to develop protocols and standards that didn’t exist at the time. When you have an outsource company that’s done all of that already and has a reputation of being a good firm, it lends a lot of credibility and merit to what you’re trying to do.”

 

Word-of-mouth referrals and networking are solid first steps toward finding the partner.

 

“Reputable is the key,” Cloutier said. “One test that gives me an indication is how careful they are at protecting other companies’ knowledge. If they share confidential information from other companies with you, then they’re probably sharing your confidential information with others. Observing this helps me judge who is a trustworthy supplier to work with and who isn’t.”

 

And even as you consider outsource options for aspects of your project, never forget the big picture, Fauth said.

 

“I look at anybody we interact with as a potential partnership, not just a customer/supplier relationship,” he said. “If something goes bump in the night, I want everyone equally committed to fixing it.
I also want it to be a win for both parties. That’s the right way to do business long-term. It’s not always about price or lead time. Those are factors. It’s also about quality, it’s about trust, it’s about faith they’re going to make it right if something goes wrong and everybody’s going to work for everybody else’s best interest.”

 

Dawn Lissy is a biomedical engineer, entrepreneur, and innovator. Since 1998, the Empirical family of companies (Empirical Testing Corp., Empirical Consulting LLC, and Empirical Machine LLC) has operated under Lissy’s direction. Empirical offers the full range of regulatory and quality systems consulting, testing, small batch and prototype manufacturing, and validations services to bring a medical device to market. Empirical is very active within standards development organization ASTM International and has one of the widest scopes of test methods of any accredited independent lab in the United States. Because Lissy was a member of the U.S. Food and Drug Administration’s Entrepreneur-in-Residence program, she has first-hand, in-depth knowledge of the regulatory landscape. Lissy holds an inventor patent for the Stackable Cage System for corpectomy and vertebrectomy. Her M.S. in biomedical engineering is from The University of Akron, Ohio.

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EMPOWR Porous And Complex Primary Knee Systems

EMPOWR Porous And Complex Primary Knee Systems | IT Support and Hardware for Clinics | Scoop.it

DJO, a provider of medical technologies designed to get and keep people moving, introduced the EMPOWR Porous Knee System and EMPOWR Complex Primary Knee System at the 2018 Annual Meeting of the American Association of Hip and Knee Surgeons (AAHKS). These new additions to the EMPOWR Knee Platform expand one of the industry’s most modern total knee replacement systems, which now offers primary, cementless primary, complex primary, and tibial revision solutions for surgeons and patients.

EMPOWR Porous Knee System is based on two decades of clinical experience and highly porous materials designed to enhance early implant fixation, while creating an ideal environment for both immediate and long-term biologic fixation.1 DJO’s surface coating technologies, including DJO’s proprietary, highly porous coating, P2 aids in bone apposition for superior in-growth performance.1 EMPOWR Porous’ bladed keel has a bone sparing geometry optimized for cementless application.2 The bladed keel of the asymmetric baseplate was developed to provide robust fixation, while the cruciform pegs provide initial component fixation and durable rotational stability.2

EMPOWR Complex Primary Knee System, with the EMPOWR Universal Tibial Baseplate and EMPOWR Varus Valgus Constraint (VVC) Tibial Insert expand the utility of the EMPOWR Knee Platform and provide a wider range of solutions for complex primary and revision knee arthroplasty. These new implant technologies are designed to provide an efficient and seamless transition from standard primary to revision knee procedures, with a minimal number of additional instruments and trays. The EMPOWR Universal Tibial baseplate maintains the EMPOWR System’s characteristic asymmetric footprint which maximizes cortical coverage and prevents component overhang to ensure long-term fixation without tissue irritation4. This baseplate also provides the ability to stem and augment when more supplementary fixation is required. The VVC insert is offered in e+ polyethene, formulated to reduce long-term wear3, while the insert is designed to provide the necessary support and stability in knees with supportive soft tissue deficiencies.

“DJO has a proven record of bringing high-quality products to market with incredible cadence—faster than any other implant company today,” said Dr. Eugene S. Krauss, an orthopedic surgeon with Northwell Health. “In 2018 alone, the EMPOWR Porous Knee and EMPOWR Complex Primary Knee launches have significantly expanded our ability to treat a wide variety of patients in our practices.”

“The efficiency of DJO’s instrument trays and the streamlined instrumentation enables my surgical team and I to perform up to 12 knee replacements in a single day, making the system well-suited for both hospital and ambulatory surgery center environments,” said Dr. Krauss.

Over the past decade, the science of highly porous metals, including DJO’s P2, has significantly advanced, helping to improve implant longevity and ultimately patient outcomes. These scientific advancements coupled with a younger, healthier patient population, have resulted in a resurgence of cementless knee arthroplasty. Therefore, the contemporary design of the EMPOWR Porous Knee, is certain to have a meaningful impact on the market.

“DJO Surgical’s strong growth over the past few years is a reflection of our commitment to developing products and solutions that help improve clinical outcomes and enhance patient experience,” said Jeffery A. McCaulley, Global President of DJO Surgical. “Our continued expansion of the EMPOWR Platform reflects the overwhelmingly positive reaction we’ve received from surgeons and patients since the first EMPOWR Knee System was launched here at AAHKS in 2015.”

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Robotic Arm Offers Self-Help Mobile Rehab For Stroke Patients 

Robotic Arm Offers Self-Help Mobile Rehab For Stroke Patients  | IT Support and Hardware for Clinics | Scoop.it

The Hong Kong Polytechnic University (PolyU) recently developed a robotic arm to facilitate self-help and upper-limb mobile rehabilitation for stroke patients. The lightweight device enables the patients to engage in intensive and effective self-help rehabilitation exercise anywhere, anytime after they are discharged from the hospital. The robotic arm, called “mobile exo-neuro-musculo-skeleton,” is the first-of-its-kind integration of exoskeleton, soft robot, and exo-nerve stimulation technologies.

Stroke is the third leading cause of disability worldwide1. In Hong Kong, there are about 25,000 new incidences of stroke annually in recent years2. Research studies have proven that intensive, repeated and long-term rehabilitation training are critical for enhancing the physical mobility of stroke patients, thus helping to alleviate post-stroke symptoms such as disability. However, access to the outpatient rehabilitation service for stroke patients has been difficult. Due to the overwhelming demand for rehabilitation services, patients have to queue up for a long time to get a slot for rehabilitation training. As such, they can’t get timely support and routine rehabilitation exercises. Stroke patients also find it challenging to travel from home to outpatient clinics.

The “mobile exo-neuro-musculo-skeleton,” developed by Dr. Hu Xiao-ling and her research team in the Department of Biomedical Engineering (BME) of PolyU, features lightweight design (up to 300g for wearable upper limb components, which are fit for different functional training needs), low power demand (12V rechargeable battery supply for 4-hour continuous use), and sportswear features. The robotic arm thus provides a flexible, self-help, easy-to-use, mobile tool for patients to supplement their rehabilitation sessions at the clinic. The innovative training option can effectively enhance the rehabilitation progress.

 

Dr. Hu Xiaoling said development of the novel device was inspired by the feedback of many stroke patients who were discharged from the hospital. They faced problems in having regular and intensive rehabilitation training crucial for limb recovery. “We are confident that with our mobile exo-neuro-musculo-skeleton, stroke patients can conduct rehabilitation training anytime and anywhere, turning the training into part of their daily activities. We hope such flexible self-help training can well supplement traditional outpatient rehabilitation services, helping stroke patients achieve a much better rehabilitation progress.” Her team anticipated that the robotic arm could be commercialized in two years.

The BME innovation integrates exoskeleton and soft robot structural designs—the two technologies commonly adopted in existing upper-limb rehabilitation training devices for stroke patients as well as the PolyU-patented exo-nerve stimulation technology.

Integration of Exoskeleton, Soft Robot, and Exo-Nerve Stimulation Technologies
The working principle of both exoskeleton and soft robot designs is to provide external mechanical forces driven by voluntary muscle signals to assist the patient’s desired joint movement. Conventional exoskeleton structure is mainly constructed by orthotic materials such as metal and plastic, simulating external bones of the patient. Although it is compact, it is heavy and uncomfortable to wear. The soft robot, made of air-filled or liquid-filled pipes to simulate one’s external muscles, is light in weight but very bulky in size. Both types of structures demand high electrical power for driving motors or pumps, thus it is not convenient for patients to use them outside hospitals or rehabilitation centers. Combining the advantages of both structural designs, the BME innovative robotic arm is light in weight, compact in size, fast in response and demands minimal power supply, therefore it is suitable for use in both indoor and outdoor environment.

 

The robotic arm is unique in performing outstanding rehabilitation effect by further integrating the external mechanical force design with the PolyU-patented Neuro-muscular Electrical Stimulation (NMES) technology. Upon detecting the electromyography signals at the user’s muscles, the device will respond by applying NMES to contract the muscles, as well as exerting external mechanical forces to assist the joint’s desired voluntary movement. Research studies found that the combination of muscle strength triggered by NMES and external mechanical forces is 40 percent more effective for stroke rehabilitation than applying external mechanical forces alone.

Rehabilitation Effect Proven in Trials
An initial trial of the robotic arm on 10 stroke patients indicated better muscle coordination, wrist and finger functions, and lower muscle spasticity of all after they have completed 20 two-hour training sessions. Further clinical trials will be carried out in collaboration with hospitals and clinics.

The robotic arm consists of components for wrist/hand, elbow, and fingers which can be worn separately or together for different functional training needs. The sportswear design, using washable fabric with ultraviolet protection and good ventilation, also makes the robotic arm a comfortable wear for the patients.

The device also has a value-added feature of connecting to a mobile application (APP) where users can use the APP interface to control their own training. The APP also records real-time training data for better monitoring of the rehabilitation progress by both healthcare practitioners and the patients themselves. It can also serve as a social network platform for stroke patients to communicate online with each other for mutual support.

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Health Care Providers Face More Direct Billing, More and Tougher Collections

Health Care Providers Face More Direct Billing, More and Tougher Collections | IT Support and Hardware for Clinics | Scoop.it

Opponents figure that they pretty much killed the Affordable Care Act in December when they ended the individual mandate. They may be right. The mandate – the part of the ACA that required Americans to buy health insurance or face a minor penalty – was a key to trying to broaden and deepen the insurance pool, mitigate payers’ risk and, not least, keep premiums at least remotely tethered to people’s ability to pay.

 

Another part of the ACA is also under threat. The law allowed states to agree to an expansion of Medicaid that was meant to help people who couldn’t afford to meet the mandate on their own.  Still another: it also offered subsidies to help payers meet the expenses of covering all the previously untreated people they’d have to insure and of covering everyone’s pre-existing conditions. 

Premiums in fact did not grow as fast in states that accepted the Medicaid expansion during the past three years and as an estimated 40 million more people gained some form of health insurance.

The end of the individual mandate, the junking of one of the subsidies for health insurers and last year’s drastically truncated open enrollment period for the remaining Exchange plans, however, have again started to reduce the number of Americans with health insurance.

 

These changes affect more than practice volume. They impact operations for practices that retain patients, too.

For without increased attention to “revenue cycle,” all health care providers can expect to be doing more direct billing of patients, doing more collections work and assuming more bad debt from people with higher, tougher-to-pay deductibles in the coming months and years.

 

Here’s why: No one yet knows how many people who bought insurance only because they were required to. There’s reason to believe the end of the individual mandate will start making them drop out of all kinds of plans during the next open enrollment period.

A federally truncated open enrollment period October-December, 2017 has already reduced the number of insured people in the nation.  A number of forces are leading fewer people – and fewer younger, healthy people – to buy plans, and some predictions have premiums rising an extra 10 percent this coming year.

 

More shrinkage is coming. Newly permitted work requirements for Medicaid coverage promise to push still more people into the ranks of the uninsured. Kentucky’s new rules, for example, will drive an estimated 40,000 people out of Medicaid coverage during the next five years. As of this writing, nine other states are considering imposing new restrictions on who can qualify for Medicaid coverage.

 

The increase in the numbers of the uninsured obviously has disturbing implications for the nation’s health as a whole. It will also force payers to raise premiums to make up for the rising costs of being able to spread their risk across smaller, riskier customer pools.

 

The uninsured aren’t the only ones threatening practice finances.

Rising premiums, in turn, are leading employers to offer employees more high-deductible health plans. These HDHPs have lower premiums but higher risk for patients, who in addition to their premiums must pay an average of the first $2,400 of their families’ medical bills out of their own pockets. Some plans have deductibles as high as $10,000.

 

The lower premium costs, however, are attracting more and more people.

 

They are also higher risks for physician practices, which have a harder time collecting from patients with HDHPs. Thirty-seven percent of the people working for employers who offered plans in 2017 chose high-deductible plans. That’s up from 28 percent in 2016. The same year, that accounted for 39.3 percent of all Americans on employer-based health plans. All told, up to 37 percent of insured Americans, regardless of where they bought it, were using HDHPs.

 

But there have been dire unintended consequences. With the costs of care so high, 64 percent of those with high-deductible plans say they’ve put off care because they didn’t want to or couldn’t pay the deductible. And 62 percent said that, despite the lower premiums, they end up spending more on health care than under their previous plan.

 

People with the high-deductible plans thus tend to be bigger financial risks for providers.

Of HDHP customers, 15.5 percent reported having trouble paying medical bills in 2016 (versus 10.3 percent of those with “traditional” plans).

 

In sum, this means everyone in health care – providers, hospitals, practices – are going to chance offending more patients by billing them directly and, at minimum, going to have to devote more resources to revenue cycle and collecting what patients owe them.

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4 Advantages of Maintenance Support

4 Advantages of Maintenance Support | IT Support and Hardware for Clinics | Scoop.it

Managing your hardware and software maintenance contracts can be overwhelming. Most IT assets are under contract and need ongoing support, and with every contract comes a tremendous amount of administrative work to keep those assets covered. As your assets grow in numbers, so does the total across your entire IT infrastructure, making it difficult to track properly.

 

Whether you are managing the contracts on your own, overseeing asset turnover, handling aging assets, or monitoring service levels compliance, it requires continuous effort. This is true for both hardware and software components. As more and more products move from hardware-based to software-based, it creates even more tracking challenges simply because there is no longer a physical asset. Tracking all of these assets with so many moving pieces and multiple manufacturers—from individual asset stop dates to maintenance coverage—can get confusing, convoluted, and leaves a margin for error.

 

Mistakes made could lead to a lapse in contract coverage, costing more money to renew in the long run. When you work with a maintenance support services partner, your assets are effectively managed so you can use them to drive more business.

 

Four Benefits of Having Your Maintenance Handled for You

 

1. Better analysis

With many individual assets to manage, it can be difficult to find the time to identify what needs to be done to remain compliant and run most effectively. With maintenance support, you no longer have to worry whether the information looks right or wrong. Instead, you will receive a thorough analysis of all of your information so you can make the best decisions for your business based on that analysis.

 

2. Cost savings

Not only does a proper analysis provide more accurate data management, it is also a friend to your bottom line. Ongoing asset analysis tackles the complexity of maintenance contracts, including multiple manufacturers, so you can prioritize what’s most important for your business. Not only is someone monitoring your assets for you, but they are also determining if the information is up to date and, in turn, identifying areas that can be reallocated, ultimately cutting costs.

 

3. Time savings

With cost savings, comes time savings. You can remove hours of time from your day, while getting a clearer depiction of your assets. When a maintenance support services partner is tasked with analyzing your assets, you’ll receive more efficient reporting, allowing you to make better and faster decisions for your business.

 

4. Lifecycle management

Get the help you need with lifecycle management and streamline your current support to be as efficient as possible based on your specific assets. With a coverage methodology, you can rest easy knowing that your assets and devices are subject to a thorough analysis, which ensures that everything is functioning optimally. By understanding your inventory and how everything is working together (including aging devices) you will be positioned well for future budgeting and remove any roadblocks if there are specific support issues.

 

Get the Support You Need to Focus on Business Priorities

Having the support you need can help you focus on your business, instead of dealing with the logistics and tracking associated with complicated maintenance contracts. Take advantage of better, more efficient analysis so you can make more informed decisions about your hardware and software devices, save on time and costs, and improve your lifecycle management capabilities.

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Cloud performance tests reveal the impact of location

Cloud performance tests reveal the impact of location | IT Support and Hardware for Clinics | Scoop.it

If a cloud-based EHR isn’t fast enough to meet the needs of hospitals and other medical facilities, quality of care will suffer, clinicians and support staff will become frustrated, and provider organizations operating on thin margins will have wasted valuable IT dollars on inadequate technology.

 

Several industry trends make it clear that providers are increasingly confident cloud-based EHRs can deliver data and applications at sufficient speeds because vendors have dramatically reduced latency. Epic Systems, the largest EHR vendor in the U.S., began offering cloud services in 2014 to medical groups and small hospitals. The company said in 2016 that it has seen a big shift among its customers toward cloud-based systems. One of those customers is University of California San Diego Health, which announced in August 2017 that it is migrating its Epic EHR to the cloud.

 

Cerner has also revealed that a number of healthcare systems are moving onto its hosted cloud environment. Inspira Health Network, a nonprofit healthcare organization that serves communities across New Jersey, and Bay State, an integrated health system in western Massachusetts health system, have both moved to Cerner’s cloud hosting model.

 

Another EHR vendor, Athenahealth, offers only cloud-based EHR services to its network of 56 hospitals and 106,000 providers that serves more than 100 million patients. Ellenville Regional Hospital in upstate New York, reports that running its EHR on a single network gives staff in all departments real-time access to patient records.

 

For health systems that will select their own cloud host, after considering the cost of strategic planning and security, the success of a migration ultimately rests on performance. Can EHR data, applications and services be delivered fast enough to support the needs of clinicians? Cloud performance is generally measured by average latency which represents the delay between the time when a client computer requests data and the cloud platform responds.

 

Tests have shown that distance between the cloud provider and the enterprise can have a significant impact on latency with delays of as much as 50 percent when the cloud is at a great distance.

 

Cedexis tested services and found distance was a leading indicator of performance

 

Monitoring company Cedexis performed tests throughout the United States that quantify this. Tests were performed on all of the major cloud platform vendors. The determining factor in latency performance was distance from the test client system to the servers at the cloud data center, with a deterioration of as much as 50 percent seen over longer distances within the same region.

 

For example, tests performed in the northwest region recorded latency was as low as 63 ms. when the cloud was near; a latency of 92 ms. was recorded on a cloud system at a greater distance from the test location. A test on cloud platforms in the northeast found 66 ms. latency on the low end and 78 ms. on the high end.

 

A number of vendors offer cloud performance tests that are free to be used during an evaluation process. One example is

 

CloudHarmony who offers a free service that will test performance for many of the leading vendors at a variety of their geographic locations. The test, at Cloud Harmony Speed Test will provide results for DNS query, downlink and latency.

Integration challenges


Migrating an EHR system to the cloud rarely is an all-or-nothing process. Rather, many healthcare IT managers are moving incrementally, evaluating the success of each application migration, learning from mistakes, and carefully preparing the next move based on need and experience. For example, some may decide to first migrate back-office or HR applications, and eventually, migrate clinical apps and billing data at a later date. Providers certainly can choose a one-shot migration to the cloud, but they run the risk of network and system disruptions, loss of productivity, and bandwidth limitations.

 

After cloud migration goals are set, computing models are chosen, and a migration plan established, healthcare providers can begin choosing a CSP (or more than one). For providers with concerns about potential latency issues, selecting a CSP with a hosted location close to the provider’s facilities makes sense. The provider’s IT staff and the CSP can then begin the cloud migration. This process involves addressing several integration challenges.

 

Perhaps the primary challenge is to prevent disruptions to systems or services during or as a result of the migration that would impact clinical care, staff productivity, or IT processes. Other challenges include protecting and backing up migrated data and connecting to and integrating disparate systems.

 

Integration may involve linking cloud-based apps and data with non-cloud apps in legacy systems. “An illustrative scenario could involve a multi-hospital operation which chooses to retain on-premises EHR for inpatient operations but wants to leverage public cloud services for geographically distributed outpatient clinics,” according to the Cloud Standards Customer Council (CSCC).

 

The CSCC argues that a successful cloud EHR migration depends on security and network connectivity.

 

“Whether you are ensuring insurance coverage for the public, developing the next generation of cancer drugs, or providing critical care/tier I trauma services, the new emphasis is being put on providing network availability, performance and security,” CSCC writes. “Although creating a highly available network might be expensive, those costs can be offset by the capabilities provided to the organization.”

 

The vast majority of healthcare providers today have moved or are moving applications, infrastructure, or development platforms to the cloud because they recognize the performance benefits and cost savings. For a cloud migration to pay off, providers must develop a realistic migration strategy and goals, choose the appropriate cloud computing and services models, find one or more CSPs whose services, support, and pricing match their needs and ensure that their networks have the bandwidth capacity to handle cloud-based workloads.

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5 advantages of cloud computing and how they can benefit your practice

5 advantages of cloud computing and how they can benefit your practice | IT Support and Hardware for Clinics | Scoop.it

While the specialty may vary, practices of all sizes across Australia are turning to the cloud to run their business. With the launch of Clinic to Cloud (C2C) in early 2015, over 1200+ healthcare professionals, operating from hundreds of different practices are now computing with our cloud-based platform. With new clinicians joining C2C daily, benefits of the cloud services are now being widely recognized and accepted as the norm.

 

So if you’re looking to open a new practice for the first time or hoping to migrate your existing practice to the cloud, let’s look at 5 advantages of cloud computing and how your practice can benefit:

 1. Staying in touch

Cloud computing is storing and securely interacting with data over the internet, rather than your computer or local server. That puts connectivity and real-time data as the clearest advantage of working on the cloud. Yes, someone changed the WIFI password without telling you or the careless construction worker nearby didn’t check before drilling. However, one can argue that servers fail and files get lost. The internet is truly an essential resource, which is why it has become so readily accessible and available from multiple sources, smartphone, portable WIFI device, personal connection, net hubs at cafes, offices and even some commercial planes will essentially keep you connected.

 

What does this mean for the clinician? Not only that your data is stored in state of the art datacentres, as long as you are connected, but you can also run your practice.  Control you practice on-site, from home, hospital, on break at your favorite café or even on the flight to your next medical conference from a desktop or mobile device. Full connectivity anytime, anywhere – this is the cloud.

 

  1. Tools of the Trade

Smartphones, tablets, and ultrabooks are essential tools for any busy working professional. With top cloud services offering dedicated mobile apps, working on the go also means working with your indispensable devices. Like the stethoscope to the physician or the scalpel to the surgeon – The Clinic to Cloud App gives you the tools to stay conveniently connected with your practice whilst on the go. For time-poor clinicians, buying time during your super busy schedule comes from having your entire practice visible from your smartphone.

 

  1. That new software smell

Top cloud providers are regularly updating and improving their software. The moment updates are released, they are made available for the benefit of all customers. You would have noticed those design changes and new features on your social media account without you manually needing to install or upgrade anything. Simply log in and updates are there. Clinic to Cloud follows suit, we typically update every 3 to 4 weeks to better user outcomes and reduce practice costs. On release date, all our subscribers then benefit with the best part being at no extra cost. For the clinician - you are not wasting time having to update your practice software or pay for often expensive IT support to run updates. It’s cloud and it’s simple.

 

  1. Soft on the Wallet

Moving to the cloud can save you large capital expenditure, as you do not have to purchase expensive servers and other I.T hardware to host your data or run your software. Accessing your cloud application, in many cases, simply requires an internet capable device (smartphone, tablet, or computer) and an internet connection. Not to mention, local servers also have expensive on-going maintenance and repair costs and backup requirements as well. Clinic to Cloud does not require complex IT infrastructure and server equipment with messy cabling disrupting the feng shui of your practice. A modern desktop or laptop computer and you are on your way to the clouds.

 

  1. Security and Data

One of the concerns with Cloud is typically security and many are concerned about the safety of Cloud hosted software applications. Although we understand the feelings behind the concern, studies have shown that the cloud is safer than on-premise servers that are susceptible to virus and hardware failure and data loss daily. Cloud solutions can be compared to Airline travel; they remain the safest way to do business.  At Clinic to Cloud, we have taken additional security measures such as to Factor Authentication and high levels of encryption.

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8 Health IT Trends to Watch

8 Health IT Trends to Watch | IT Support and Hardware for Clinics | Scoop.it

“We’re in the middle of an incredible moment in the healthcare industry, where expectations and standards are shifting.”

 

That statement was part of the opening remarks from Cerner’s Senior Vice President of Population Health John Glaser at the 2017 Cerner Health Conference. His position was a strong one: The industry, he says, is shifting from reactive sick care to proactive health management, from fragmented niche care to a cross-continuum care system and from reward for volume to reward for quality, efficiency, and safety.

 

Today, we’re watching as the physician, long considered to be at the center of the healthcare universe, is moving aside in favor of the consumer.

 

These shifts aren’t happening in a vacuum: They’re touching in every area of the industry, and they are reshaping the way the business of healthcare is done. Here’s a look at some of the top trends that will push the industry forward in 2018.

 

Consumer-centered health care


We talked a lot about the rise of consumerism in health care over the last year, and that train is not going to slow down in 2018. Increasingly, we're seeing people wanting to have a more active role in managing their own health and care (this is particularly clear when we consider the rise of mobile health apps and wearables). They expect the same level of information, detail, and options that they have in other industries when it comes to making purchase decisions, and there is a rising call for data transparency and access.

 

While there have been some great strides toward empowering the individual with healthcare organizations working to improve the patient experience, we're still waiting for the healthcare industry to wholly adapt to the needs of the consumer.

 

At Cerner, we recognize this as a new era, where the consumer will, at last, join their own health care team. That's why, at this year's CHC, Cerner President Zane Burke announced that we’re making a free consumer-directed health record available within our clients’ enterprise portals, providing individuals more control over how their data is used and shared. Each patient will have his or her information compiled on their behalf and can direct the use of that information to create their own experience.

 

The era of the consumer is here – and it’s time for the healthcare industry to embrace that.

 

IoT


From controlling the thermostat on your phone to monitoring your health with technology, the Internet of Things (IoT) is transforming the way we work, live and interact with the world around us. IoT has been a popular phrase in health care for the past few years, but today, the conversation is shifting. The primary issue now is understanding how we can take the plethora of big data available from connected systems and tailor it to provide person-centric care.

 

Moving forward, we need to harness the potential of IoT to drive better efficiencies. From a data collection perspective, the advantages of connected medical devices are vast. When we can provide data bridges from disparate health care systems within a single organization, we’re making critical patient information more accessible to clinicians and care teams and ultimately impacting patient outcomes.

 

Through the use of IoT devices, we have the opportunity to deliver true virtual care for chronic condition management, virtual visits, and other care coordination activities to streamline and benefit the patient. Connected devices enable more real-time insights and health status for a person.

 

“IoT is tied to consumer enablement, which ranges from remote patient monitoring to mobile applications,” Hamilton says, “and it certainly includes the ever-increasing trend of telehealth, which isn’t going to go away.”

 

Artificial Intelligence


“Intelligence isn't a new idea,” Glaser said at CHC. Our cars tell us when the oil is low, and they’ve been doing that for years. But we’re about to take a significant leap in the intelligence of our devices. We’re already seeing this with products from companies like AWS, Azure, and Google.

 

We're in the early stages of seeing how artificial intelligence will play out in the healthcare industry. One example is in precision medicine, an approach for disease treatment and prevention that accounts for individual variability in genes, environment, and lifestyle for each person. This approach relies heavily on big data analytics, where machine learning algorithms and precision molecular tools make it possible to understand the mechanisms of disease and match up individual problems with personalized treatments. The implications for genomics and precision oncology are significant.

 

We’re also beginning to see AI algorithms affect and enhance medical imaging. These algorithms find patterns in images, identifying specific anatomical markers and scoping details that the human eye can’t – while simultaneously combing through a patient’s history, helping clinicians make efficient and quick diagnoses. The future of AI in health care won’t see clinicians being replaced by machines but rather empowered by them.

 

Big Data


“Data is the new oil,” Andreas Weigend, Amazon's former Chief Scientist, said recently. It’s a bold statement, but he has a point: Big data and cloud technology are changing how we interact with data, and previously untapped data sources are now attainable.

 

One of the greatest examples of big data’s implications for the healthcare industry is in predictive analytics, where data is used to identify behavior patterns in a patient or population and forecast outcomes. For example, when EHR data is organized into meaningful groups, such as social determinant factors, it can help predict hospital readmissions and can shed some insight on strategies to improve readmission rates.

 

This power to affect additional value and efficiencies within a hospital setting is no small thing. Perhaps most critically, these newfound big data insights are pushed to those that can make a difference: clinicians and care team members. Acute and ambulatory decision support, for example, can be enhanced by creating an empowered care team with a clear picture of the patient, thanks to increased access to patient data that's built directly into the existing daily workflows. And big data has exciting implications for precision medicine.

 

Whatever route organizations hoping to take with big data, it's clear that it will be a catalyst for change for the better good and health of society.

 

Data governance


As organizations begin to share data across departments and with other health systems, there can be a few questions: Who owns this data? Have the appropriate parties consented to its release? What are the rules, conditions, and terms of data sharing?

 

“Data governance is a huge thing that organizations are struggling with right now, even as they try to solve for it,” says Hamilton. In a recent survey, only 44 percent of hospital leaders said they had data governance capability across their entire organization, while 56 percent said they had inefficient governance standards.

 

What organizations really need is a governance strategy that everyone understands and can abide by, Hamilton says. In the future, we’ll see more and more healthcare organizations looking for help from external experts to create and refine their data governance protocol and practices.

 

Open platform development and API usage expansion


Open data access and increased interoperability are continuing to clear the road for development in health IT (HIT) – particularly when it comes to academic medical centers and rural health care systems. This trend will only continue to grow as open standards, like SMART Health IT and the HL7 FHIR standard, encourage a new level of collaboration and innovation.

 

As the FHIR standard matures, we’re going to see an explosion of new apps that can integrate with EHRs to help improve workflow efficiencies and achieve better outcomes. Application programming interfaces (APIs) offer direct programming access to the underlying health IT system and enable 'app' developers to create tools that can ingest EHR data and provide new services to consumers.

 

In a previous blog post, Cerner's Dr. David McCallie discussed how, through projects like SMART® on FHIR®, providers are becoming familiar with APIs that support customization of the EHR experience. However, API access is not limited to providers. A new class of APIs will give consumers the ability to access their health information on demand via apps of their choice. These APIs are emerging thanks to consumer demand, and they are also driven by major regulations coming into effect – particularly Meaningful Use Stage 3.

 

Consumer-directed access will place control of personal health information in the consumers' hands. APIs that allow the transfer of discrete data will help drive the advancement of interoperability by delivering more specific data where it makes sense within the workflow, in a way that positively impacts outcomes.

 

UX and health IT


On the coattails of the rise of consumerism in health care is a growing emphasis on integrating user-centered design into healthcare products and solutions. To optimize any solution, user experience (UX) must be engineered in at every step of the solution design process. This way, the experience for the HIT user – be they a clinician or a patient – should meet or exceed their expectations.

 

Cerner's Vice President of User Experience, Paul Weaver, discusses the integration of UX design thinking and health IT through the example of mobile health apps. "When you think about consumer apps today, there is a huge amount of competition to get people's attention," Weaver says. "If you search for a notes app on the Apple store, for example, there's probably a few hundred for you to choose from. So, if I'm an app developer, how do I design the app of choice?"

 

The answer, Weaver says, is by providing a quality user experience.

 

"In the health space, historically, this has been a little bit of a walled garden," he adds. "You go to a health provider, and they give you a link to the app they want you to use, and there's no choice in the matter." It's the responsibility of the UX team to think about that application in the context of all their other solutions available so that whatever they're designing sits alongside its contemporaries in an equal level of quality.

 

UX is about more than just creating user-friendly applications. It’s a state of mind – a perspective that favors taking a human-centered approach to creating solutions. "That's what we're starting to achieve here," Weaver says, "and we're on the cusp of it becoming real for our end users, which is fantastic. How there be anything more exciting than an application that actually helps your health?"

 

Payer-provider convergence


One of the most significant trends in today’s market is the blurring of roles between providers and payers. As the industry shifts toward value-based care, it should become increasingly easy for payers and providers to collaborate at the point of care. A person’s relevant medical history, including medications and treatment plan, should be available to both the healthcare provider and payer – that way the patient’s insurance benefits are included in the provider network and are in sync. Shared access to this data means that clinicians are empowered to provide the right care at the right time to the right patient.

 

That’s payer-provider convergence in theory – but the reality is that there are two dynamics happening in tandem.

 

“You've got providers trying to take on characteristics of a payer because they’re doing at-risk relationships, and you’re seeing the payers making a direct play into the provider market,” says Ryan Hamilton, Cerner’s Senior Vice President of Population Health. Recent moves, such as UnitedHealth’s Optum purchasing DaVita Medical Group and Amazon’s push into pharmaceutical distribution, suggest that the trend of payers and providers merging together will continue to rise.

 

Along the same lines, there’s a lot of interest right now around provider network management – and that focus is only expected to grow. “How you actually recruit, manage and maintain a high-quality network of providers is and will continue to be a huge focus for our client base,” Hamilton says.

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Keep Your Appointments Afloat! 

Keep Your Appointments Afloat!  | IT Support and Hardware for Clinics | Scoop.it

Summer can be a busy time for sailing and boating businesses as people flock to the beach, bays, rivers and lakes for a fun day on the water. Online scheduling software from Appointment-Plus can be the perfect partner for operators looking to spend less time booking reservations and more time on the water with their customers.

 

Used by businesses coast to coast for scheduling sailing lessons and booking boat rental reservations, Appointment-Plus helps these operations automate and streamline their appointment-setting procedures with such functionality as online self-scheduling, which allows customers to view availability and book their lessons and reservations online, 24 hours a day; automated e-mail and text message reminders, which inform customers of their upcoming appointments and reservations; accurate recordkeeping and report-generating features; and e-marketing capabilities for sending current and past customers information on specials, discounts and other news.

 

“Sailing and boating businesses provide fantastic recreational opportunities for individuals and families throughout the nation,” says Jeff Fleming, marketing director at Appointment-Plus. “Our software helps automate and streamline the entire appointment- and reservation-scheduling process, allowing them to spend more time focused on their operations and their customers.”

 

A Software as a Service (SaaS) application, Appointment-Plus is Web-based and accessible from any Internet connection. This gives operators the ability to access their scheduling calendar from outside of their home or office. Additionally, Appointment-Plus does not require a Web site, expensive hardware or time-consuming installations to use. Pricing starts at $39 per month with no long-term contracts and free set-up assistance with a dedicated coach.

 

Businesses that utilize the online self-scheduling feature can expect a significant drop in the number of phone calls from customers looking to book appointments and check availability. This functionality is especially beneficial if the operator does not have an office or receptionist and routinely takes phone calls at the dock or on the water while giving lessons.

 

“Just think of the convenience of allowing your customers to schedule their lessons or reserve their watercraft at any hour of the day and at their own convenience,” Fleming adds. “Plus, you’ll spend less time answering the phone call and returning messages.”

 

Appointment-Plus supplies almost 4,000 clients throughout the United States, Canada and 10 other countries the tools they need to schedule customer and patient appointment times, book rooms, accept registrations and many other services. Geared primarily toward small businesses such as doctors’ offices, spas, health clubs and massage therapists, users of the service also include Fortune 500 companies; colleges and universities; healthcare agencies and facilities; federal and local government; and freight and delivery companies.

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Doctors Software for Clinic Management  

Doctors Software for Clinic Management   | IT Support and Hardware for Clinics | Scoop.it

Clinic business is extra complicated than ever, with Doctors Software for Clinic Management, you get easy solutions for each part of your routine work, from scheduling appointments to billing. We take care of your business by providing the perfect solution so you take care of your patients more efficiently. Doctors Software for Clinic Management was designed with the help of a medical doctor and clinic staff to make it a fit choice for your working environment. Our Doctor’s module is easy to use. Connection with Labs, Pharmacies and more, make your work easy and quick and it works the way you work.

 

Doctors Software for Clinic Management is an efficient and automatic way of dealing with health facility with options like Doctor’s appointments, administrative activities, patient’s treatment history, diagnostics information, and billing, etc. Doctor’s software for clinic management is good for a hospital with single/multiple locations. It was developed keeping in mind the small and medium-size polyclinics too, and the focus was especially on portability and ease of use. Doctors Software for Clinic Management covers most of the standard features often found in software made for clinics or hospitals.

 

Ease of use, manageability, multi-user functionality, the fast information retrieving in Doctors Software for Clinic Management are exemplary as compared to other such programs. Deciding to use Doctors Software program based on the cloud platform is very cost effective for the clinics. Doctors Sofware for Clinic Management is a good choice for the small as well as huge hospitals or clinic setup. It requires no much expenditure on equipment, hardware or trained IT staff. Those are the resources that a health facility, assisting an in-house IT setup to have to utilize, which are costly. This optimized Doctors Software for Clinic Management is updated, configured and maintained within the cloud through the skilled IT professionals. The users are, hence, free from the burden. It results in price saving and the staff pays attention to the main functions of the Clinic.

 

Easy to use, and Efficient

Doctors Software for Clinic Management gives rapid, simple and easy solutions for the Hospitals or Clinics to manage daily tasks. It allows for streamlining report generation, inventory management, patient management, employee’s attendance and other tasks. Doctors Software for Clinic Management smoothly integrates with your workflow. This cloud-based software program easily distinguishes scheduling for different physicians and a simple interface that consists of tabs for speedy switching across different features and functions. With these features, an easy to use patient portal, detailed reporting, and customizable workflow, Doctors Software for Clinic Management covers the various aspects of clinic management and administration.

Doctors Software for Clinic Management is very easy to use, and effective software program to control the management process of clinic or hospital. This Software Program is one of the best for individual Doctor Clinic or a hospital. In case you are looking for easy to apply and easy to keep software in your clinic or small health center, this software program is best for you. At a very affordable price, you not only get the software but also free training and support from our company.

A Product of EVision Techno Services

Doctors Software for Clinic Management is a Module of EVision’s Hospital Management System.

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Avoid Clinical Data Loss

Avoid Clinical Data Loss | IT Support and Hardware for Clinics | Scoop.it

Have you checked your clinical data backups in the last four weeks? Do you have a signed document from your IT vendor agreeing to your patient confidentiality policy? Finally, as a business owner or manager, do you know what security policies and technologies are in place to protect your patients’ data?

 

If you’ve answered no to any of those questions, then you’re not alone and unfortunately, your business might be at risk.

 

43 percent of the health businesses audited by REND Tech Associates in 2013 believed they implemented adequate security measures in their businesses. However, our audit results told a different story.

 

One of the costliest technology risks to a healthy business is the failure to recover current patient data easily and promptly. The inability to do so can have severe medico-legal implications for health businesses and their patients. Such risk is always linked to the backup policy that businesses chose to implement.

 

To minimize the risk of not being able to recover your patients’ data when you need it most, I suggest contracting an eHealth engineer to design and tailor a backup plan unique to your business and available technology.

 

The second major source of data loss risk is the unauthorized access to clinical patient data by IT vendors. Whilst we can agree that not all IT vendors actively choose to access clinical patient data, there have been cases reported where practices and health businesses have faced legal actions due to their inability to provide signed confidentiality agreements from their IT vendors and staff.

 

If you don’t have a signed document from your eHealth engineer stating that they meet your patient data access policy then you need to obtain one now.

 

If you’d like a confidentiality agreement template then please feel free to call us and we’ll be able to send you a generic template.

 

The third security risk to health businesses is the unauthorized access of patient data, which we all commonly know as hacking. However, most health business owners or managers aren’t aware that half the hacking cases reported aren’t external hacks but internal ones.

 

An internal hack is when an unauthorized staff member or stakeholder within the business is able to access clinical or business data that they are not supposed to.

 

To remove the internal hack risk from your business you can implement a few simple steps. The first step is to ask the clinical staff not to share their passwords with other staff members. The second tip is to ensure that no one except the business owner, manager and IT vendor can access the server. The third tip is to audit your business IT platform every 12 months. It is important to have an external eHealth engineer audit your current IT platform and check the level of service that your IT provider is delivering.

 

Ongoing regular audits ensure that your business is protected from downtime due to technology failure, medico-legal complications due to unauthorized data access and most importantly, ensuring that you can always use your backups when needed.

 

If you enjoyed this article and would like more useful tips, then I’d encourage you to visit our website for more useful articles, tips, and recommendations.

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