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December 7, 2022: Clinicians are highly mobilized workers, so they need a simple, secure, and most importantly, contextual method for communicating to provide the highest quality care for their patients. Mobile Heartbeat MH-CURE connects the whole care team through a single, unified platform. How does this help to advance care coordination across the healthcare enterprise? Mike Iwanek, Vice President Professional Services at Mobile Heartbeat joins us to show how easy and simple it can be for the care team to communicate the right information at the right time, with the right level of urgency.

Key Points:

  • One of the hardest things for a clinician to do is to connect with another clinician
  • The discharge workflow is one of the biggest areas where a communication solution can really help
  • Why are voice applications challenging in a hospital setting?
  • Mobile Heartbeat
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Today on This Week Health.

Every clinician in the United States is busy, right? The work is time sensitive. There's a huge amount of pressure. There's alarming systems going off all the time. And to be able to find the right person to talk to and then engage with them quickly, reliably, is really challenging. And the whole Mobile Heartbeat platform, which we call MH-CURE is designed from the ground up to make it easy for clinicians to find each other through a range of different methods and then engage with each other.

Welcome to a solution showcase. You know, one of the things that is really hard to figure out is communication within a health system. Sometimes that clinician to clinician interaction in connection is really hard to establish within the health system itself. They need a simple, secure method for communicating. And today we are talking with Mike Iwanek, Vice President of professional services at Mobile Heartbeat, who shares how their solution MH-CURE is connecting the whole Care team through a single unified platform so that they can focus on what matters most patient care. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of this week Health, A set of channels dedicated to keeping health IT staff. And engaged. You can subscribe wherever you listen to podcasts, apple, Google, Spotify, Stitcher, overcast, or just go to this week, and subscribe there as well. And now onto 📍 the show.

all right. We have a solution showcase today, and we are joined by Mike Iwanek, the VPA Professional Services for Mobile Heartbeat. And Mike, welcome to the.

Hey, thanks so much, bill. Great to be here.

Looking forward to the conversation anytime we get to dig into a use case, I I thoroughly enjoy that. But before we get into use case, I want to cover some groundwork here. So give us an idea of the problem. What's the problem that Mobile Heartbeat solves for healthcare?

That's a great question, bill. So, Something we've learned over the 10 years that we've been working with hospitals in the United States is that the hardest thing for a clinician to do is to connect with another clinician. And to understand that statement. You have to appreciate that every clinician in the United States is busy, right? The work is time sensitive. They're busy. There's a huge amount of pressure. There's alarming systems going off all the time, and to be able to find the right person to talk to and then engage with them quickly, reliably, is really challenging. And the whole mobile heartbeat platform, which we call MH-CURE is designed from the ground up to make it easy for clinicians to find each other through a range of different methods and then engage with each other. So that's, that's really what we're all about.

I was actually just sitting down with a cio at a major academic medical center, and I was saying what's one of the biggest challenges you, you have? He said, well, we're dealing with a problem right now, and it's a workflow issue in that the attending physician. Needs to approve something to discharge the patient. And we're finding that they can't track that person down. And sometimes we have people sitting in rooms, and by the way, we're out of rooms, but we have people sitting in rooms that we can't discharge cuz we can't find that person, communicate with them, get them back, and actually discharge the patient. I mean, and there's, there's real implications to that. There's real dollars associated with.

Right, exactly. I think the discharge workflow is one of the biggest areas that a communication solution can really help, right? Because the whole discharge process is based around coordinating multiple different people given approval for that discharge to occur.

And that's very, very difficult if all you have is landlines. So having a solution like mobile heartbeat, where you put smartphones in the hands of all the clinicians, you create ways for them to coordinate. You integrate with patient information so you can really coordinate around these patients. It makes such a big difference.

So is this just a, a texting solution? Is it a voice solution? Is it a, I mean, give us an idea of the, of the technology platform.

you know it, it incorporates both texting and. And they're both really important pieces. Texting is we all use texting in everyday life to talk to each other, to coordinate each other. We group chat and that stuff's incredibly important. But the voice piece is also a huge part of delivering a successful what we call CC and c, clinical Communication and Collaboration Solution. What we have across all of our customers is, is roughly for every four texts. A user will make one call.

So you think if you were to think how many texts you send a day, how many calls it would be if you were calling one every four text? That's an enormous number of calls, right? Because a call is the best way to communicate with someone in real time, right? It's real time synchronous voice communication.

You can exchange ideas, you can talk to each other very, very quickly and easily. So our solution delivers high quality. High reliability voice in addition to the texting. And then on top of that, our platform layers in the whole sort of patient engagement that's connecting with the EHR to be able to coordinate around patient care, understand where patients are, who's in the care team.

Then also receive alerts and alarms. So we, we integrate with a lot of nurse call systems, a lot of middleware solutions, a lot of workflow systems, sepsis detection. So there's a huge range of things make up the platform. The real core of this is that ability to be able to send and receive texts and make and receive calls. That's the absolute core pieces that you need for a successful ccnc solution. Cause if those pieces. Cannot work reliably. All the things you're building on top are not gonna be received well by clinicians.

So reliably ends up being a, a key, key word here. Cause I know we, we had some challenges in our various hospitals just based on how they were set up, different platforms that we're using and those kind of things. Why is voice difficult or challenging in a hospital setting?

Firstly going back to what I said right at the beginning, right? These clinicians are extremely time pressured. They've got a lot of priorities. Nothing is more frustrating. Then being on a call with a physician and the call drops dropped calls, missed calls, inability to make calls, even the inability to find the right person to call.

These are extremely frustrating experiences for an end user. You can imagine if you are using an iPhone and a call drops out halfway through, that's extremely frustrat. And in our experience there's very, very, very few vendors who can actually make voice work reliably. Cuz you have to think there's a lot of different pieces to it.

Firstly, you have to have a fantastic wireless network. We have a great relationship with Cisco. We have a great relationship with Apple to make sure that these devices can work correctly on the wireless network. The second piece is having a solution that integrates tightly with your existing infrastructure to be able to.

Guarantee that you are always able to make calls reliably and receive calls reliably. And a lot of that comes down to our experience in the space. We've been doing this for more than 10 years at this point. We've got great familiarity with how all of these components fit together.

There's a lot of vendors in the space where calling is kind of an afterthought, right? We're kind of talking about the texting is the absolute core piece. You're layering in calling as kind of an afterthought and not appreciating that you really need a hundred percent liabilities on those calls, so you're gonna have a lot of disappointed and frustrated clinicians.

So we've seen a lot of health systems go out and try to get to a single device, right? It it, you, it wasn't uncommon at one point to see a nurse walking around with a whole tool belt worth of stuff, trying to figure things out. we're consolidating these things down to a single device, but that single device.

Has a couple of challenges, right? So first of all, it has to work. It absolutely has to work. And more times than not, it's not gonna work on the, on the cellular network or, that network that's out there. So it's gotta work on the internal network. And in a lot of cases, that means voiceover IP and the complexity associated with that. So that's. Definitely actually several of the, of the challenges that we do have, how do you make that, that whole thing work for a health system?

you've hit on some really good points there. And one of the most important things to appreciate about voiceover IP for healthcare is it's not as simple as doing just voiceover ip and the fact that one phone can call. Right. What's important is that you can also integrate tightly into the hospital's phone system. So you've got all of these departments, you've got all of these desk phones deployed. You may even have some older handsets. And the clinician's minimum expectation is that they can use these newer smartphones to connect with those older numbers.

What that means is you have to integrate with a hospital's existing phone system. And that's that's a challenge. The big vendors we see in this space, Cisco's a very big player. You've got a buyer's, a big player, and then there's a a few other kind of vendors out there. But you have to find a solution that could integrate tightly with Cisco.

And that means having a developer relation with Cisco means testing your product with Cisco, ensuring everything works and similarly with other vendors in the space. So that's something we've been investing in for many years is exactly how do we make sure on a wireless device that you can reliably pick up calls from Cisco.

And you've gotta think about this, right? You might even, you've gotta think about, I might lose wireless for, for one second. If I lose wireless for one second, it's really important. My call doesn't go away. My call needs to resume. There's, there's a whole lot of little bits and pieces that we've built up over 10 years about call recovery session persistency and other things that really make sure that that call will reliably connect.

And on top of that, we've added in. A lot of, of kind of optimization tools, so I can see in real time how good my call is. For example, we've implemented something called a mosco so that I can look back and say, for every single call that you made on mobile heartbeat, what was the core quality? And you can dig in and see, was it, was it a wireless challenge that perhaps impacted the quality of the call?

Did my wireless degrade and it gives it teams, the tools they need to mitigate any network impacts that you may experience. And that's that's so important.

The other challenge we had, and I, I'm curious how you addressed this challenge is So they had their personal phone, but that's not the phone they were using when they were on the floor. We had a bank of phones, do you charge 'em? And whatever. So they were just pulling one out of there and using whatever phone happened to be available. And now we're talking about integrating into a phone system and that kind of stuff. Talk, talk a little bit about how your system is flexible in order to handle that scenario.

Yeah, so, so we call those shared devices and when we work with any of our, our hospitals and our partners, we work with them to kind of put these banks of phones in which sit in the charging stations and in our system, the phone number is tied to the user. And that's an extremely important differentiator from some of the other systems in for some of the other vendors in this space. Because it gives you one phone number that will stay with you persistently, and you can use that one phone number for tight integration into nurse call, into patient monitoring and other capabilities where those systems need to know one persistent phone number for an individual. And we handle a lot of that with our integration with Cisco.

So it functions very differently to kind of native devices, but we have this again, this kind of great relationship with Cisco where we've been able to build up this shared device model where the phone number will follow the user around and it means, If, if it says smartphone is running low on battery during a shift, it's no problem. You drop it back, you pick the next phone from the doc, your profile comes with you, your phone number comes with you, so there's absolutely no disruption to the workflow mid-shift.

So it's interesting when you're talking about workflow and whatnot, I think of EHR integration and whatnot are you integrated with the major EHRs as well?

Yeah, a hundred percent. We integrate with with Epic, with Meditech, with McKesson, with Cerna. We have sites using all of these. And particularly with Epic, we've invested heavily in that relationship. We are an Epic development partner and we're in the Epic app market formally was known as the App Orchard, and it's possible to actually integrate the Epic Haiku app and the Epic Rover app into our application to make voice calls.

And that's something. That we have deployed at a few different sites today. And again, it's just about building up this, this sort of whole platform of applications on this mobile device. And as you, you kind of talked about these shared devices, mobile heartbeat's, not necessarily the only application installed.

You can install multiple apps and then integrate them tightly together through mobile heartbeats, APIs. So it's not just a product, it's a platform as.

So let, let's dig into a use case and today we're going to talk about an IDN out of the Phoenix market that you've done some work for. so give us a little bit of the catalyst for mobile Heartbeat's involvement and how did you demonstrate capability to that organization?

So this organization came to us around the summer of 2020 and explained that they had purchased a number of iPhones and they had deployed them across the system and they had deployed some voice applications and they were really struggling. They were getting service tickets in days, evenings, weekends, and it was exactly the situation I was describing where you have dropped calls, you have missed calls, you have low quality calls, and if you are a clinician again, if you, if you cannot make a call reliably with a phone that looks like an iPhone, that's a huge dissatisfier.

And even if I can make a call and it's poor quality, I'm trying to communicate very high sensitivity, very high urgency, very high importance information. Could be about patient medication, could be about patient status, and I'm trying to communicate that by a phone call that's, that's got poor audio.

That's an extremely frustrating situation and this organization came to us and they, they really needed some help We were very, very confident based on our years of experience, that we were the right vendor to help them, and we are able to offer what we call a voice pilot, where with minimal investment from the customer, they just need to install our application in their call manager, the Cisco Unified Communications Manager, we were able to get our application deployed to a few of their devices and get them testing within a week of the first time we spoke to them.

And that customer knew within three or four days that we were the right vendor to solve that problem. Cuz you can immediately see the solution just works and, and I think it kind of speaks to one of, one of the biggest things I've picked up over my 10 years at Mobile Heartbeat. There's so many things that our customers want CC and C platforms to do, right?

There are so many different features, so many different integrations, but the one most important thing that everyone is looking for is quality and reliability. And that organization came to us cuz they'd made this big investment in iPhones and they didn't have those things, and we were able to give them that reliability and quality and demonstrate to them very quickly that we could deliver that to.

So voice first pilot. That's an interesting, interesting way to go into the organization. It's like, Hey, we're gonna prove to you that this works. Talk to me about the level of effort on their side from the from the IT team and the networking team. In order to get to that point where you're doing the voice only pilot.

It's actually extremely straightforward. All that the customer needed to do in this case was deploy the application to a few device. We, they followed our very straightforward documentation to set up the core manager to be able to receive the connection from our devices. And they had to make a couple of firewall rules to allow the devices to speak to us, and that was all that was necessary.

So they very quickly stepped up a small pilot where it was just their IT team. Just exchanging calls, making sure everything worked correctly, and then they gave it out to a unit's worth of nurses just to really put it through its paces. And the the great thing about this organization is they were using a nurse called Product called Round and Responder five.

Which communicates nurse call information through phone calls. So one of their primary use cases was being able to receive these nurse calls through the devices. And again if you are a patient in a hospital and you want a nurse, you've got to have confidence that that's gonna be delivered reliably.

And that was another challenge this organization was experiencing. So with minimal effort from the IT team, minimal investment, they were able to very quickly be receiving these nurse calls, reli.

It's interesting. So now we're at this point, the experience for the nurses. Obviously it, it was successful, it started working and whatnot. Talk about what comes next. We've done the voice only pilot. People are utilizing it and they're saying, okay, I can make phone calls now. And what, what, what's the next step? What part of the solution do you usually move onto next?

A lot of organizations that come to. Have concerns about some of the claims that are made in this space, right? And we are able to establish credibility very quickly by doing this voice pilot and demonstrating that we have credibility. And that that leads into another conversation about can we solve your wider communication and collaboration needs.

So, very quickly, that went from being a voice pilot to being a system-wide deployment of our entire platform. So we installed. The EHR integration, we installed the texting, the calling we installed our alerts and alarms modules and we're in active discussions with this organization about even building in more and more capabilities.

So to give you a sense of the scale where we got to from just that small voice pilot, we do 84,000 calls a. We receive 120,000 nurse calls a month, and we have 3000 users logging in across 1500 devices. So it just gives you a sense of the scale that this organization got to from from a very small start.

The thing I like the most about it is, it's elegance. It's simplicity, right? So the biggest problem they went out and bought. iPhones and they got a bank of iPhones, which by the way, there's part of me that wants to ask you the question, why do health systems go out and just buy a whole bank of iPhones and not know that they're going to work? I guess we as CIOs, we assume they're going to work on our network. Is that essentially what happens?

Yeah, I do think that's a lot of it. I mean, everyone uses iPhones in their day-to-day lives. Everyone's familiar with them. iPhones give you a fantastic voice experience on cellular, and I think people just assume that that same experience is gonna be delivered on voiceover IP and don't, don't appreciate quite how complicated that is.

And the need to find a vendor that's that's able to make it work and is able to make it work in the correct workflow. You were kind of talking about the shared devices. That's, that's something that people don't think about. You don't really think about these clinical systems integrations straight off the bat.

You're thinking, I'm gonna buy some iPhones that's gonna give me a great experience and I'm not thinking about them. How is that gonna integrate tightly with my route and responder five? How's that gonna integrate with my patient monitoring? How's that gonna integrate with all the rest of my clinical systems?

How are people gonna log in? These are complex problems and you need someone with a lot of experience and knowledge in the space to really make all of these pieces tied.

Are there building specific issues that you run into from time to time? Because we, hospitals are notorious for having these dead spots and whatnot, but I assume if we, if the wifi network works there, it it'll end up working.

with close partners with Cisco and other wireless vendors, What we've seen as the years have gone by and the 10 years we've been in business, is that the wireless, the wireless products that these companies put out are more and more optimized and geared towards mobile devices, right? Cisco and Apple formed a partnership many years ago to kind of optimize that experience. And you see the newer the iPhone, the better the wireless chip. So you do get a better experience. And I think a second piece of it is also, There are some really good partners out there who do wireless surveys, who support customers with wireless integration.

CDW is a great example of that, who can really support customers with wifi, amelioration, wifi mitigation. So in my experience, even in the toughest areas of the hospital, with the right equipment and the right partners, it's possible to solve those problems.

Yeah, I, I love the simplicity of implementation. I love getting the nurses on an iPhone because one of the challenges for me was always, Hey, we're gonna buy these new devices. They'd look at me and be like, I've never seen that device before. You gotta teach me how to use it. Whereas we, we stick an iPhone in their hand and they just look at us like, Okay, just tell me what app I need to open.

I remember the very first hospital I ever implemented. It was a small hospital up in Connecticut and I had to explain to nurses how to type on an iPhone three. That's how long you've been doing this .

Wow. Oh, that goes back away.

That was a long time ago.

It's interesting cuz I, I had this, this is my relic. It's a, it's an i, it's one of the original iPhone. Oh wow. And every now and then I look at it and I realize that was a really small screen. Yeah. really was, it was revolutionary for its time, but it's a really small screen and I wonder how much easier it is now with the real estate that we have on the phone to really provide a much better overall experience. It's just, iPhone three. I can't even imagine what we were doing with that back in the.

Yeah, it's unbelievable, right? Even the smallest iPhones today are larger than that phone used to be. And I think it's like anything as technology improves, expectations increase, right?

No one could conceive of using an iPhone three now in any real meaningful capacity. The devices keep getting bigger, the capabilities keep increasing, and, and that's just kind of the way technology goes. I.

Well, fantastic. Hey, Mike, I wanna thank you for sharing your experience with this solution, sharing the use case. I wish I had had a relationship with you guys back in 20, see when was I doing these nurse call systems? And it was, they were so tricky. Everyone was so tricky to have an underlying solution like this. That takes away a bunch of the challenges that we were having would be really nice. Then we could focus on the clinical workflow and the, and the patient get the clinicians back to the thing they want to do, which is to practice medicine and, as we say, return the joy to the practice of medicine. So fantastic solution. Thanks again for your time.

Yeah, thank you so much for having me, bill.

I appreciate it.

What a great conversation. I love sitting down with Mike and talking through that solution because it is so simple and I love the fact that it's integrated as well. It, it really does solve a handful of problems that just pop up all the time. Just fantastic. Appreciate it. We wanna thank our sponsors Mobile Heartbeat for this episode. They are 📍 investing in our mission to develop the next generation of health leaders. Thanks for listen. That's all for now. 📍


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