Myco promises quick access to alarms without the fatigue

Ascom Integrated Wireless has officially launched its new Myco mobile device, specifically designed to improve nurse workflow and reduce alarm fatigue, to the Australian market.

Myco is a smartphone that can be integrated with communications technologies such as nurse call systems and patient monitors to receive alerts and alarms, but also to a secure messaging system to allow the nurse to communicate with doctors and other hospital staff securely.

Alerts and alarms are immediately shown on Myco's top display, providing the nurse a hands-free way of quickly deciding whether to attend to the alert or reject it and pass the message to other members of staff. It also allows the nurse to connect to patient monitors to see the full picture if required.

It is 3G and WiFi-enabled and is soon to be DECT-enabled as well, the managing director of Ascom Integrated Wireless, Leo Silver, said.

Running behind the device is a middleware product suite called Unite that allows it to integrate with hospital clinical information systems such as laboratory, radiology and pharmacy, as well as a software developers kit (SDK) that can interoperate with third-party apps.

While the device is designed for nurses, Myco also has a sister app that can be downloaded onto other smartphone devices, such as the iPhone and Android 4.x models, to allow other members of staff to view the same alerts and alarms on their own devices.

Mr Silver said the Myco device had been developed specifically to address an emerging problem for nurses – alarm fatigue.

“As we are moving towards the digital hospital with networked clinical systems, we are generating more alerts, alarms, messages ... and typically we are presenting these directly to the frontline caregivers,” Mr Silver said.

“We are swamping the frontline staff, the nurses, with alarms, beeps, messages left right and centre, and that alarm fatigue is the critical area that Myco is targeted at.

“The negative issues we are seeing results in two areas. Firstly is distraction – it's hard to focus on your role when these things are going off on your hip ... and also at desensitisation towards alarms. Alarm fatigue puts people at risk.”

While many hospitals still don't have a BYOD policy – and often restrict access to personal devices for security reasons or refuse to allow them – a recent Spyglass consulting report from the US shows that clinicians are still using their smartphones at the point of care, Ascom Integrated Wireless's sales and marketing director, Feargal O'Farrell, said.

“BYOD is a wave that is building ... and it will be crashing on the shores very soon,” Mr O'Farrell said. “We know that from reports like the Spyglass Consulting report stating that out of the 89 per cent of hospitals surveyed, they do not have a BYOD policy.

“However, the reports are also showing that 67 per cent of nurses are using smartphones at the point of care. The reason for that is they need access to information applications, they need access to applications like Medscape where they can get access to information on things like medications interactions, conditions, procedures and get that kind of background data.

“They need things like secure messaging, they need to be able to contact doctors, surgeons, consultants who are notoriously hard to get on the end of a phone. And they need to talk patient-specific information, so they need an encrypted path to do that.

“The final thing they need also is the ability to easily and readily communicate with their colleagues in the same building, in the campus. So they also need a chat function that allows them to do that but also a secure environment, so it is encrypted and cannot be used for the wrong purposes. The demand is coming from the point of care – the nurses and caregivers.”

Mr O'Farrell said one of the differences between Myco and a standard smartphone is the top display, which has been designed so nurses can wear Myco either clipped on to their scrubs, in their pocket, or clipped onto the waist or a belt.

“The top display is located there and it's integrated so that carers, when they receive an alarm, they can tell the type of alarm, the severity of the alarm and the location of the alarm without even having to touch the device,” he said.

“The top display is integrated so we don't disturb them from doing what they are doing. We allow them to make very real decisions on critical alarms, minor alarms, and they can make those decisions very easily.”

Mr Silver said Myco was both 3G and WiFi-enabled to allow nurses to make voice calls over either network. Ascom has taken the wireless LAN chip and the SIP telephony software from the company's heritage i62 product and used it in Myco, which he said opens up the product to common networks and communications platforms from the likes of Cisco, HP, Aruba and Alcatel-Lucent.

“The clinician in the working environment will have the same device, with the same applications with the same communication suite, available to them in campus, typically over the WiFi network at the hospital, but also remote, maybe to another campus, maybe to another building, maybe to the patient's home, or in between and in transit,” he said.

“We see the 3G, WiFi combination in one device as quite unique and a real differentiator for Myco.”

While there is a lot of smarts behind the whole system, including enterprise-grade interoperability features, Mr Silver said systems were often judged simply by the features of the handset. The handset is waterproof and has been ruggedised for the hospital environment, and can be cleaned with an alcohol-based wipe.

“It has a camera built in that can do 1D and 2D barcode scanning; it has been designed with applications that let you do closed loop medications management,” he said. “The battery is designed to last all shift, and at the end of the shift you can simply unclip the battery and put a new battery in. It is designed to work well in hospitals.”

Mr O'Farrell said Myco has been designed around the nurse, but that it can interface with the devices such as an iPhone or Android device used by other clinicians and administrative staff.

“That's their device of preference and that's the device they'll take everywhere they go, so why should they take a second device with them? What we've got to handle that situation is we've taken some of the messaging features from Myco that can then be put on a small application that runs on their smartphone. This application is called Unite Axess.

“Anyone carrying an Android phone can have this smartphone application set up and they are part of the workflow and they can receive those alerts and messages just as they would if they were using a Myco.”

Ascom has partnered with a number of healthcare equipment and clinical information manufacturers such as GE to enable the device to interact with those third-party systems. GE Healthcare Australia's market segment manager, Paul Merrett, a former ICU nurse, said the launch of Myco was a significant step forward.

Mr Merrett said that by allowing a nurse busy in a drug room, for example, to easily see the nature of an alert, they can then quickly decide whether to respond or pass it on to another nurse.

“You are not dropping everything that you are doing,” he said. “You can accept or send a busy signal and give it to someone else, and have an escalating process. This in itself is a huge paradigm in workflow for nurses. You are suddenly carving off an enormous amount of time, energy and stress, and that nurse can make an immediate clinical decision.”

By using Unite as middleware between the device and GE's patient monitoring equipment, for example, the nurse can also bring up more detailed information about an alert, he said.

“If the single lead ECG is not enough information for the nurse to make that decision, then we can log into the central station and bring up the full monitoring screen on that handset itself,” he said.

“What this does is bring patient monitoring to the nurse. That in itself is more than a paradigm – it is an enormous leap forward.”

Ascom Integrated Wireless said Myco will be available in the first quarter of next year, with a range of pricing models to be released in the next month or so.

While it is designed for the hospital setting, it will also be marketed to nurses in residential aged care.

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Posted in Australian eHealth

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