A Perfect Ten

January 10, 2013

Imageby Donn Wurts, Nexus Director, Healthcare Practice

In gymnastics, competitors strive to receive a score of “10”.  To receive a ten, the gymnast must perform their routine flawlessly, without even the slightest error in execution or form.

Perfection is also the goal for today’s healthcare organizations.  Propelled by demands for improved patient safety, improved outcomes, government regulations, and payment reform, healthcare organizations must transform existing IT models designed to support business applications (email, billing, simple communications) to ones focused on critical care (electronic health record, clinical collaboration, telemedicine,  bio-medical engineering).  With this transformation, comes the need for not only 100% network and application availability, but also the ability to support key initiatives like those published by the Institutes of Medicine and the Office of the National Coordinator of the American Health Information Management Association that include:

  • Immediate clinician and patient access to health information and data
  • Access to new and past test results
  • Remote ordering of prescriptions, test, and other services
  • Bedside decision support systems that include reminders, prompts, and alerts
  • Secure communication between providers and patients
  • Scheduling systems for providers, staff, and patients
  • Access to federal, state, and private reports

To achieve this information delivery perfection, healthcare organizations will need:

  • The right technologies – Healthcare organizations must implement systems and applications that are designed from the ground up to be redundant, reliable, scalable, and secure.  They must also be easy to manage and maintain and provide the flexibility to support changes in treatments, processes, or the regulatory environment. The right Core Foundation Services.
  • The right processes – Change management, security management and disaster recovery are just a few of the processes that must be altered to ensure 100% information availability.  However, these processes must also be combined with and supported by the “right” management systems and software to guarantee continuous access enabling clinical workflows and information at the point of care.
  • The right people – In many cases, the most significant challenge that healthcare organizations face, is to find the “right” people and trusted partnerships.  Currently, there are just not very many IT professionals whose skill sets combine experience in both healthcare and large system design, implementation, and management.  As a result, many healthcare organizations are turning to companies like Nexus Connected Healthcare that have the clinical experience, methodology, and processes to support them throughout the transformational, almost evolutionary process.

Not many gymnasts reach their goal of a “perfect 10”.  But for healthcare organizations, perfection isn’t just a goal, it’s an obligation.

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Three Cheers for Collaboration!

October 24, 2012

By Dave Elsner, Nexus VP of Sales & Marketing

I spent yesterday afternoon at the football game watching my daughter, a cheerleader, root her team on to victory.  I probably wouldn’t have been able to do that just a few short years ago when we didn’t use Cisco collaboration technologies (Unified Communications, WebEx, Telepresence, Jabber).  Cisco’s collaboration tools enable me to utilize my time efficiently and provide me with the flexibility I need to manage my business, stay in touch from anywhere, and, more importantly, spend time with my family.

Collaboration tools also let me to be in two places at once.  While I’m on the road visiting with customers, business partners, or my staff; I can still:

  • Use Telepresence to interview candidates for sales and management positions at Nexus.
  • Use Telepresence and WebEx to host meetings with my sales management team.  Employing these tools, we’ve reduced our onsite get-togethers from four times per year to only once.
  • Participate in scheduled and impromptu meetings, audio and video conferences, and remote presentations.

Just last week, one of our customers wanted to know if Cisco’s VDI (Virtual Desktop Infrastructure) could prevent users from adding apps to their company owned iPads.  I was able to check the availability of one of our practice managers using Cisco Jabber, then initiate an impromptu conference call with the customer and the practice manager to answer their question.  (The answer by the way, was “yes”, but the customer would need some additional management software as well.)

Cisco’s collaboration tools make it easy for me to stay connected with customers, business partners and my staff.  However, I think that the best thing about Cisco collaboration, is that they allow me to spend more time with my family and at the football game!


Reduced CapEx Isn’t the Only Reason Our Customers Love Nexus Connected Collaboration

September 11, 2012

– by Mike Heiman, VP of Engineering

One of the services that is becoming very popular with our customers is our hosted collaboration service – Nexus Connected Collaboration (NCC).  The service is based on the Cisco collaboration suite and integrates voice, video, web conferencing, messaging, mobility, and customer care.  It also includes our next generation wide area network (WAN) service – Nexus Connected Next Generation WAN.  Nexus Connected Next Generation WAN automates more than 50 network management functions, allowing companies to provision remote teleworkers, branches, and retail offices world-wide.

Nexus Connected CollaborationMany of our existing customers chose NCC as a way to expand their existing premise-based Cisco collaboration solution to new sites without spending precious capital dollars.  However, once they began to use the service, they realized that NCC provides much more than just a way to conserve their capital.  The NCC solution is not new technology – it’s a new consumption model.  It also:

  • Gave their businesses greater flexibility – With NCC, our customers were able to integrate remote staffers and contractors as well as personnel and sites secured through corporate acquisitions quickly and easily.   Instead of weeks or even months of planning, design, and implementation, our customers can add new users in just minutes.
  • Saved money– Using NCC, our customers didn’t have to overprovision existing systems to accommodate growth.  Instead, they pay only for the services they use, when and where they need them.  Additionally, NCC removes the need for additional maintenance contracts and the time-consuming process of software upgrades.  Keeping things running and up-to-date is our job!
  • Enabled IT staff to be more productive – Our customers love the fact that their staff can now concentrate on deploying new technologies that will differentiate them from their competitors, not the mundane tasks of deploying and provisioning basic voice, data, and web services.  Using NCC’s management interface, adding users is a snap – and a task that is easily handled by customer service or administrative personnel.

Finally, our customers like the way that Nexus Connected Next Generation WAN (which uses military-grade encryption and has a full Public Key Infrastructure with automated certificate maintenance) combines with NCC to extend corporate collaboration services to trusted third parties (suppliers, contractors, customers) without supplying them with access to internal systems. 

Both new customers and existing on-premise customers are finding value in the fact that the same Nexus deployment and managed services teams are supporting them regardless of solution model.  NCC is fast becoming one of our most popular service offerings.  It’s easy to deploy, saves money, is secure, and, most importantly, provides our customers with the flexibility they need to grow.


Leveraging Technologies in Poison Control Centers

September 7, 2012

Nexus Connected Healthcare– by Kathleen Gaffney, Healthcare Transformation Specialist, Nexus Connected Healthcare

The poison control system, an established network covering the United States, is in place to reduce poison-related morbidity, mortality, and hospital admissions.  Poison Control Centers (PCC) receive calls from the public and healthcare facilities for toxicological consultation after a suspected poisoning or overdose has occurred. The PCCs are staffed by pharmacists, physicians, medical toxicology specialists and nurses with specialized clinical toxicology training and operate 24 hours a day, every day of the year.  For every dollar spent on poison control, at least $7 is saved in public health care costs due to instant intervention and effective use of resources, often by preventing unnecessary and costly visits to the emergency room.   PCCs are state and federally funded but funds have been cut significantly making it more important that the PCCs operate as efficiently and productively as possible. 

PCCs currently perform most of their duties through the use of telemedicine – which in the majority of cases means a telephone.  Typically, PCCs provide the following services:

  • Poisoning triage and treatment to the public
  • Poisoning triage, consultations and medical recommendations to ED physicians and emergency medical transport personnel
  • Toxicological consultation after and medical recommendations to rural healthcare facilities and medically underserved regions
  • Toxicological services to non-healthcare organizations such as correctional institutions, cruise ships, etc.
  • Input and advice regarding hazardous materials toxicity and management to the state’s emergency management agencies
  • Analyzes calls in real-time for trends and events that might be of public health significance (e.g. food poisoning, terrorism, product recalls)
  • Public health services during disasters (with adaptation to workflows)
  • Perform patient “follow‐ups” and/or home management of poisoning services
  • Consultation services to patients (e.g. counseling and information for drug and other exposures during pregnancy and lactation)
  • Training site for pharmacy students, nurses, EMS/paramedic students, and physicians and residents in emergency medicine, pediatrics, family practice and other specialties
  • Increase public awareness, education and prevention services to the public of common toxic substances, specifically as they relate to young children
  • Poisoning triage, treatment, education, and prevention services for animals

In the near future, PCCs will provide many of these services via technology.  Easy to implement and cost-effective use of technology will include connecting with the public through text messaging, Twitter and Facebook or publishing Podcasts on YouTube to share health content with the general public.  Clinical toxicologists’ collaboration with physicians and emergency medical personnel will take place via desktop sharing and web conferencing.  The use of emerging telemedicine technologies that leverage audio and videoconferencing within poison centers will enhance the ability of the clinical toxicologists to deliver services to their patients.  For example, PCCs may use a telemedicine kiosk or cart that supports visual clinical toxicologists/patient encounters through the use of telepresence, remote-controlled point-of-care camera, FDA approved medical devices and an EMR.   Many organizations currently utilizing telemedicine are considering a model that is internet based.  This would allow PCCs to work with doctors and patients from any location utilizing any computer or similar device. 

All of these technologies will help PCCs achieve the primary goal of improving access to care while lowering the overall cost of care.


Does the Smartphone Era Make IP Phone Services Irrelevant?

February 18, 2012

by John Welsh (samplefive)

A number of years ago, one talking point when selling Cisco IP Telephony solutions was to mention IP phone services. These are the XML based applications that can run from the screen of the phone. While the idea of applications running from your phone at the time was new and caused a lot of oohs and ahhs during demonstration, my personal experience was that very few of the people that deployed Cisco phone systems also deployed XML phone services with them. I heard several IT directors say things like, “our users want a phone, they’ll never use an application on the phone, it just doesn’t make sense to them”. This was new territory for a lot of companies. While there were plenty of people using Blackberries and Palm Treos, the idea of applications other than contacts and e-mail running on your phone was not really a mainstream idea yet. While there were many compelling use cases for the technology, it just didn’t seem to catch on as widely as I thought it might.

Fast forward several years and all sorts of people are using applications on their phones. Some of the least technical people that I know have either an Android or iPhone device. The same people who have difficulty with their PC can launch apps from their phone with no issues. In fact, I know many people who use the apps on their phones far more than they use apps on their computers. With technology trending this way, one might think that applications on Cisco IP Phones would be exploding. While others may have different experiences, from what I have seen the rough percentage of people that use these XML based services is roughly the same as the pre-smartphone area.

So why is it that when Apple is close to having it’s 25,000,000,000th (that’s 25 billion) app downloaded that XML IP phone services seem to remain about as popular as they were before? Is it because of the shiny touch screen applications that are available on smartphones compared to a majority of greyscale screens on Cisco phones (though there are color screen options)? Maybe. Is it because there isn’t a QWERTY keyboard for text entry on a Cisco phone? Possibly. Is it because the smartphone is mobile while your Cisco phone is largly stationary at your desk? I don’t know. To tell you the truth, I think that all of those reasons are why smartphone apps are more popular than XML apps, but I don’t think they are the reason that XML phone services haven’t grown as much as they could have. I think that the main reason is awareness of what is possible and understanding that they are great additions to your phone system.

As you can tell from what I wrote above, the answer is no, the smartphone era doesn’t make IP Phone Services irrelevant. Now I’ll go through some specific use cases where I have seen them excel.

Rapidly Deploy Applications

Because it is so easy to bulk deploy XML phone services to Cisco phones, you can quickly roll out access to a business system without even having to go to a user’s desk. While the screen and interface may not be ideal for all of your applications, there is definite value to having certain things able to deploy in an instant, whether for primary or backup use. Here’s a couple of items I have seen for rapid deployment of applications to the phones:

  • Unified Contact Center IP Phone Agent. Cisco provides this XML application as part of the UCCX suite and I have deployed it in a couple of different instances. If you have a large workforce of call center agents that don’t have computers (I have seen this in Elections offices where the call center is just there to answer questions from citizens and not take any data) or if you have an emergency where your primary call center is no longer available and you need to immediately deploy new agents while you are still getting their PCs set up this service is a great fit. I’ve even seen customers use this when they didn’t have computers that met the requirements for running the desktop agent.
  • Help Desk Access. A number of years ago I wrote a custom application (more on that later) for IP phones to tap into the SQL database of the help desk software that the company I worked for used. I did this because we had a number of campuses that interns went between. They didn’t have laptops to take with them, but I wanted them to be able to check their open tickets at the site they were at before they left. A simple log in to any phone (because we rolled it out to every phone in the organization) and they could see what open tickets they had and close out the ticket they had just done (I didn’t add resolution description to it, just the option to close it. They could add a description when they got back to the office).
  • Time Cards. I almost didn’t mention this because this is one of the IP Phone services that has been out there for awhile and talked about. There are many different third parties that can provide a time card application that will hook into your current time tracking software and then employees can clock in from anywhere in the organization.

Situational Awareness

I recently shared a booth with IPCelerate at a trade show focused on Education. One of the key things going on in today’s schools is an emphasis on physical security. With the XML services that IPCelerate brings to the table, you can tap into your surveillance cameras on your phone if a security situation arises. Rather than walking into a situation blind or having to find a computer to bring up the camera feed, you use a phone from a nearby classroom and bring up a video feed to see what is going on.

This is one of those features that makes buying color screen phones make sense. Having a color image pop up on the screen of your phone that auto-refreshes every 5 seconds really helps to tie things together from a surveillance perspective.

Custom Applications for Your Data

One of the nice benefits of XML services for IP phones is that it is very easy to get started with creating them. To do simple text displaying applications you can be up in a few minutes. For more complicated services, Cisco has a Software Development Kit that can give you guidance to get to where you want. If you have any dynamic web developing skills, you can pair this with the XML laid out in the SDK and create useful dynamic IP phone services for your organization.

I’ve mentioned one custom service that I did earlier in this post to interface with a helpdesk application, but some of my favorite uses for custom apps are to provide employees with important company information. Namely information about HR policies, maybe a company locations lookup, or any number of uses. The point to this is that while you may be able to look up this information on your computer, having it on your phone just a couple of button pushes away could make employees lives easier and reduce the number of calls to some departments.

With regards to custom applications, the one that I have probably most deployed is a holiday calendar for companies. I have found over the years that many people don’t know what days off their company has scheduled. While they have a document somewhere in the organization, employees don’t always know where that document is and end up calling HR to find out if they have Monday or Friday off when a holiday falls on a weekend.

With all that being said, are XML IP Phone Services for every application you have in your organization? Absolutely not. In the past, I remember hearing that the phone on your desk was like a little computer. While those days are closer with VXI, I don’t think the 7960 series phone will be taking over e-mail and word processing anytime soon. Despite that, the processing capabilities of the XML parser built into most of Cisco’s phones can be a powerful tool to streamline processes and get functionality out to locations where computers just aren’t available.


3 Statistics to Make You Think – Round 2

November 9, 2011

This next segment of our statistics series will make you think (again!) about the ever-increasing volume of traffic moving over your network. With the bandwidth and storage demands of business video and unified communications tools, this topic is more timely than ever.


Virtual Collaboration

July 29, 2011

With the consumerization of IT in the workforce today, businesses are spending more and more time chasing down support for virtually unlimited types of devices. From iPads, to PCs, Macs to Android devices, every day seems to introduce a new device that employees want to use.

By decoupling applications from operating systems, we can deliver information securely to virtually any device today – and devices that have yet to be introduced – without significant effort. With virtual collaboration, applications can run on devices such as iPads, Cius tablets, zero client backpacks, PCs, and Macs transparently. Applications such as WebEx Connect can run in a virtual environment, yet still control physical phone devices on the user desktop.

Nexus experts understand the data center, borderless network, and collaboration elements involved in delivering applications to any device safely and securely. This demo we recently gave at Cisco Live shows you the first phases of virtual collaboration, and where the technology is headed:


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