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Technology & Inventions
This blog focuses on the latest products, devices, and ideas to improve emergency medicine practice. Brief news releases and photographs are welcome, and must be submitted electronically. Images must be 300 dpi, in tiff, jpeg, or eps format, and at least 4“x4” in size. Please send information to
Tuesday, March 17, 2015

Emergency Medicine News spoke with Jeff Strickler, RN, the associate vice president of University of North Carolina (UNC) hospitals about Bivarus, an electronic survey methodology. He discussed why UNC’s ED made the switch, how it works, and the differences between Bivarus and paper-based survey tools.

Why did you decide to try this analytics company? Did it have anything to do with Press Ganey dissatisfaction?

The satisfaction with Press Ganey is maybe a strong word but I think it had a lot to do with the limitations related to what was our current customer service survey methodology, which happened to be Press Ganey. But Press Ganey’s not much different than any of the other companies that would’ve been out there. They all have the same limitations, particularly as it relates to emergency departments. We had a very small response rate. The only people that are getting surveys are those patients that are discharged from the emergency department. So for our emergency department, which is admitting 30 percent of our patients, we felt like we were losing a significant voice of people that were not just admitted but tend to be the more severely ill or injured and able to describe their patient experience. So we really kinda felt like that was, you know, missing.


Can you briefly explain how Bivarus works?

So, the person only gets a 10-question survey, so you don’t get the survey fatigue that you get from many of the traditional paper-based survey tools or like HCAPS. So there’re only 10 questions, but those 10 questions are dynamic. They change for each patient. So, there’s a 100-question bank and 10 different categories looking at various things in care, so like, safety, looking at processes of care, looking at communication, etc. The other traditional tools also allow people to write comments but the thing about Bivarus, because it’s electronic and research bears this out, that people tend to be more responsive in electronic survey methodologies versus paper-based tools, and that’s been our experience as well. We receive a lot of comments. So, we have a provider scorecard that we’re able to give to our providers where they can look at what their overall scores are across all of those questions.


In what ways did using Bivarus and achieving such positive results improve patient safety?

During a 12-month period that we looked at it, we noted from the Bivarus review, 242 safety-related comments. And again, it’s key to understand this wasn’t so much questions as much as these were comments. And when those 242 cases were drilled down, we discovered 12 adverse events, 40 near misses, ultimately of which 31 were further evaluated to be preventable. There 23 medical errors with minimal risk, and 167 general safety-related issues. Then we looked at that number, particularly of the 52 adverse events/near misses, and found that only 10 percent of those were actually found in an existing safety event reporting system that our hospital and most hospitals have. So what really kind of dawned upon us was using Bivarus and the patient experience as a patient reportable safety occurrence tool and it enables us to really drill down and make positive change.

          Our interests related to the limitations of the paper-based tools: We think that using electronic survey methodology is a valid way to go now and give them the wide penetration of electronic access. We have found that the representative group from the Bivarus responders to be very similar to the overall ED population. So, we’re not perceiving that there is a statistically significant population that’s being missed by using electronic survey methodology.


To listen to the interview in its entirety:


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Friday, February 20, 2015

CrowdOptic allows emergency physicians to observe patients inside an ambulance en route to a hospital by sharing the perspective of an EMT broadcasting in real-time through a wearable device like Google Glass. CrowdOptic is one of five official Google Glass partners.


“Through 4G on the ambulance, he’ll upload high-definition 1080p video that streams to the Cloud and can be accessed through a secure link by a computer or a tablet or even an iPhone by personnel in the receiving hospital,” said Jim Kovach, MD, JD, CrowdOptic’s vice president of business development.


“An emergency physician can talk through two-way audio to the EMT, and he can [zero] in through a digital zoom to instruct the EMT to look at an EKG or to even conduct a pupil exam to look for a contraction or dilation.”


The company said they hope the technology will lead to a new relationship between EPs and EMTs based on a dialogue that’s going to occur over time, Dr. Kovach said. Currently, the company is primarily working on pilots for health care systems that have large stroke coverage, with letting stroke patients bypass an ED the brass ring of this new technology.


“To be able to save the time of repeating a physical exam could save 25 to 30 minutes and really revolutionize stroke treatment,” Dr. Kovach said.



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Friday, February 06, 2015

Emergency Medicine News spoke with Carlo Reyes, MD, JD, the vice chief of staff and the assistant medical director of emergency medicine at Los Robles Hospital in Thousand Oaks, CA, and the founder and CEO of Health e-MedRecord, a patient-centered and emergency physician-designed EMR solution. He discussed the difference between his EMR and every other product available, the emphasis on patient involvement, and how his product is HIPAA-secure. Below is an abbreviated transcript of the interview. Read Dr. Reyes’ past columns at



Why is the Health e-MedRecord different from every other EMR?

Probably the most important difference of HEMR is that this is a company that was founded by doctors and for the purposes specifically of realizing the potential of what an electronic medical record was intended to do, which was to make doctors and providers and nurses more efficient in delivering high-quality patient care. You know, I’ve been practicing emergency medicine and pediatrics for 12 years now, and as electronic medical records unfolded in the context of meaningful use and all these requirements, it’s actually made us less efficient. It makes no sense to me.

          It’s really a company that focuses on the needs of the providers that actually deliver the care with the purpose of improving workflows and efficiencies that really takes advantages of the technology of today. A lot of the health records that I use are actually antiquated and don’t really use any of the technologies that could make providers more efficient, and so that was my main purpose.

          Another significant difference between our electronic record and those of others is that it’s really a patient-centered concept, in that engages patients to interact with the sharing of documents because the patient encounter is really what determines what really creates a universal record for the patient. And so, there’s no one electronic record that kind of has the whole picture of the patient’s clinical information unless it really incorporates all the encounters in real time. So, that’s really the main focus for Health e-Med Record is really to give the opportunity for patients to share the most accurate record with their providers in real-time.


We know EPs see EMRs as frustrating more than anything. So, what are some tricks you have up your sleeve to change that?

It was really a pinnacle of frustration that got me to start the company. We’re eight physician investors that all share in the frustration. I’ve been doing a lot of research and development for the past year and a half, and now we’re finally into production. We’re very excited. And the first thing we did is we shared some concepts at the American College of Emergency Physicians conference just last year. And we got such an incredible feedback, and the feedback was basically the hope and the vision that doctors can actually be more efficient using the record. I think the main source of frustration is the fact that there are too many clicks and submenus, and there are too many things that make doctors and providers less efficient. That being the source of the frustration, I wanted to show providers that we can use technology today to make doctors and providers more efficient. And so to that end, I plan on going to — me and my other physician investors and founders — plan on really focusing on a lot of medical conferences to show the possibility of what electronic records can be, and then bring that to reality in our product.


As far as the process and timeline of HEMR’s release, what are we looking at?

We anticipate the full provider — that is, the electronic health record version — to be available mid-to-late June. The patient version, we’ll probably release a beta version for testing purposes in April with the idea that we want to do some heavy testing to make sure that the product is as delivered, and I think that releasing the patient version first will allow us to build a very efficient and robust provider version.


To listen to the interview in its entirety:

Tuesday, January 27, 2015

Jennifer Farrell, a Fulbright scholar and fourth-year medical student at Tulane University, founded CriticaLink, a nonprofit mobile app company, to more quickly help first responders get to accidents in countries where emergency medical services are inconsistent or, in some cases, nonexistent.


Calls made through the app will be dispatched through a call center, or app users can send photos and submit geo-tagged information. When accidents are reported, nearby trained first responders will receive a ping and a pop-up notification on their phones. The number for the call center is a long one for now (096 7878 7878), but post-pilot phase, the company will transition to a shorter number, like 911, once they’ve collected enough data and make any necessary changes to the system, Ms. Farrell said.



The app launched in the Google Play store this past November, along with the call center. “We are working on the Apple and Windows version, but since 87 percent of our volunteers run Android phones in Bangladesh — they’re cheaper and easier to come by — [there] hasn’t been a big push,” she said.

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Thursday, January 08, 2015

By Alissa Katz


The U.S. Food and Drug Administration granted Samsung Medison 510(k) clearance for the UGEO PT60A in August 2013, and the company released its tablet-based ultrasound system two months later.


Designed for the portable market, the UGEO PT60A ultrasound system features a 10.1-inch LED full touch screen and Needle Mate technology, which delineates the needle’s location during procedures like nerve blocking, corticosteroid injections, and PIC line insertions. Its SDMR and Spatial Compounding Image technology eliminates unwanted speckle noise and incorporates beam steering and compounding of scan lines to provide spatial and contrast resolution.



The QuickScan feature offers patients an improved service with faster and more accurate diagnoses, and the Auto IMT offers output such as the Framingham Score, risk factors, and a user graph. Additionally, settings including mean, max, standard deviation, and quality index measurements are instantly available.


In addition to a handle for easy transport, the system also features a tilting monitor, lift table, micro probe connector and three additional probe ports, and a basket space with an encased printer and gel storage space. The company produces convex, linear, and phased array probes that are compatible with the PT60A.


Samsung, in collaboration with emergency services vehicles in the Dallas-Fort Worth metropolitan area, is undergoing trials using the tablet-based ultrasound system to help inform advance treatment for critical trauma patients.


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