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Room Service

February 1, 2006
by Mark Hagland
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If form follows function in patient care delivery as it often does in architecture, then the future of mobile computing cart vendors is assured. More and more functions—from medication management to nursing documentation—are moving to the patient bedside, and with them, the carts sector is advancing rapidly.

Most agree that being able to provide a higher level of functionality will be the keys to success for cart vendors. Certainly, clinician and IT leaders in hospitals and health systems are looking for more from their cart solutions, as they see mobile computing, medication management, and mobile storage needs converging, and while enhanced patient monitoring capabilities continue to be added to mobile carts' functionality. That convergence is now obvious, says Ellen Hansen, R.N., director of clinical informatics at Children's Healthcare of Atlanta, an integrated health system encompassing two hospitals and 24 satellite care sites.

"As we move into the realm of electronic medical records, we're trying to look at the way we do work, and determine how we can create good workflows and a good setting for the patient in an electronic environment," Hansen says. As more patient documentation and other tasks move to the bedside, key concerns of cart end-users will be reliability, go-anywhere mobility, and ergonomic comfort, she adds.?

Mobilizing workflow
The drive to meet the expanding needs of patient care organizations like Hansen's is fueling vendor expansion, says Keith Washington, vice president of business development for the Norcross, Ga.-based FLO Healthcare, a supplier to Children's Healthcare of Atlanta. The carts market is still immature; hospital adoption rates are around 30 percent, he notes. But what was once seen as a furniture-like item is now viewed as a true component of enhanced mobile computing, he adds. Adoption is accelerating as products rapidly improve "in terms of their functionality, the fit and finish level, and the level of integration," Washington says.

The overall shift toward paperlessness is a strong trigger for cart evolution, says Gary Brayton, national sales manager for JACO Inc., Franklin, Mass. "People have decided they want more functionality out of the cart, as far as the software provided, tracking methods, and the number of ancillary components they want to put on there—IV poles, scanner guns, vital signs monitors—it's all a part of things the industry is trying to do," he says.

Gary Coonan, chairman and CEO of Stinger Medical, LLC, Murfreesboro, Tenn., says he sees carts vendors moving quickly to bring as many devices as possible to the patient bedside. But hospitals must revamp their workflow and patient care processes as they convert to mobile computing, he notes.

Shifting form factors
What is very clear, says Todd Ross, marketing director of Columbus, Ohio-based Artromick International, is that mobile computing carts are quickly moving away from their original incarnation as "computers on a stick." Among the advances in the past few years have been greater physical and ergonomic flexibility, thin-client connectivity, and enhanced battery power. And, with a sudden generational leap in technology and design improvement about three years ago came a "rush" of new vendor entrants into the marketplace, Ross notes.

While some carts vendors are fighting for supremacy in particular niches, one vendor executive says there's a need to look at big-picture technology shifts that could change future design plans. For example, increasing miniaturization may be on the horizon for certain clinical care functions, and that could cause a shift in the whole cart landscape, warns Gary Davis, director of healthcare products sales and marketing at Winchester, Va.-based Datalux Corp. He notes that some patient monitoring equipment now carried on carts will become small enough to be worn by patients and sophisticated enough to interface, even at that size, with a hospital's wireless network.

Most predict continued expansion of products—and in some cases, of cart vendors—in the next few years, followed by vendor consolidation as the market matures.

Inevitably, says Hansen, mobile cart-based computing will become the norm for many clinicians, since it facilitates more efficient clinical documentation, medication management and patient monitoring.

Mark Hagland is a contributing writer in Chicago.

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