The need for middleware and Clinical Communication & Collaboration (CC&C) systems in hospitals is evolving with advancements in medical communication technologies. Initially serving as simple bridges for systems like nurse call and telemetry, modern CC&C platforms now incorporate sophisticated features including secure messaging, voice calling, and patient engagement via smartphones and specialized devices. However, the industry's lack of comprehensive planning has led to complex, often unmanageable integrated systems, known as “accidental architecture.” The landscape is further complicated by the dominance of EHR-centric systems like Epic, regulatory constraints on alarm management, and the push towards a unified communication platform. Despite the competition, CC&C and middleware solutions remain relevant by offering essential integration capabilities that EHRs currently cannot, especially in alarm management. The future likely sees a convergence towards single comprehensive platforms, though regulatory and market dynamics will heavily influence this transition.
