Providing A Better Last Mile Experience For Medtech And Patients

Every part of health care today needs connectivity, says Cisco’s Troy Yoder. He explains the unique role the company’s technology plays in ensuring patients get the best care the medtech industry can offer.

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Troy Yoder and colleagues at Cisco have been fielding the same questions from the health care industry for some time now. “Aren’t you routers, wireless and networking?” they ask. For Cisco, the Annual Conference of the Healthcare Information and Management Systems Society (HIMSS22) in Florida was a good opportunity to walk people through the connectivity journey and explain the increasingly significant role that Cisco plays as health care delivery continues to transform.

Cisco's Troy Yoder

Cisco is not a health care company; however, it does have an Industry Solutions Group focused on solution development for health care, a dedicated health care customer experience team for solution delivery, and an innovation leader in Troy Yoder.

“We developed the technology that powers the experience," he told In Vivo during the conference. “We’ve been doing it for 20 years – from the Cisco phone and video endpoints to the call manager infrastructure for medication changes…” These offerings and the applications they are hosted on all work together, he said.

The connectivity specialist company finds itself in the unique position where, as a result of its system architectures, it can do things for the health care sector that no other vendor can do quite so well, Yoder claims. “We have wired networks, wireless networks, security, Webex and contact center portfolios, and the data center.”   

He explained that Cisco technologies are built on a horizontal perspective and serve as the wrap-around ecosystem for health care partners such as artificial intelligence computing company Nvidia, GE Healthcare and Royal Philips, among many others. “They need the data, connectivity and security, and we help them deliver a better last mile experience,” Yoder said.

Partnering with players in the ecosystem takes place via company’s open API (application programming interface) concept. “In talking to hospital CIOs about their EMRs, say, it’s clear they are not going to change the technologies they’ve already invested in – at least not overnight.”

“Health care systems look at Cisco in most cases as a significant partner in their success”  ̶ Troy Yoder

“We are not a point solution someone buys and goes away,” he stressed. “Health care systems look at Cisco in most cases as a significant partner in their success,” Yoder said, underlining the company’s uniquely broad delivery role.

Yoder’s own role in this is to engage in strategic partnerships that drive innovation. The biggest question he gets is around how health care professionals can give more patient care at the bedside. Another common one from HCPs is how they can use applications to send data in real time to a care provider to process information and get a result.

These types of interaction give Yoder confidence that Cisco technology is becoming an established tool in HCPs’ and health systems’ day-to-day operations. “Think about the health stack that has to deliver health care today – particularly since we moved to ‘call-click-chat’ functionality ̶  which relies on Cisco technology from start to finish,” said Yoder. 

“Everything needs connectivity today. A key part of what we can deliver as an organization overall is to connect devices to the network securely.”

The company is also investing in its country digital acceleration (CDA) initiative for entire countries wishing to implement digitization. Cisco makes co-investments to help countries create the opportunity to improve the patient experience for citizens across a variety of use cases. “We invest for the outcomes,” said Yoder. 

The CDA concept was presented to the HIMSS22 audience in a session hosted by Cisco’s senior VP and global innovation officer, Guy Diedrich.

Influencing Health Care Delivery

System-wide, Cisco influences several areas of health care delivery, be it wireless networks, security solutions or contact solutions. “It’s difficult not to have Cisco technology somewhere in your organization, given our leadership position in the market, based on the breadth of offerings and simply what our technology can do for health care organizations,” said Yoder. “We help build smart hospitals for the future, help people make better informed decisions and predict changes that will arise deep into the future.”

The rise in mobile device usage and applications, automation, use of chat bots and self-service has in turn driven patients’ expectations and their engagement in their own health care. Cisco sees itself as “the digital front door” onto a world where patient engagement and consumerism are converging, and where the virtualization of the patient experience is fully underway.

“We help health care move to that virtual experience. Call-click-chat was how virtual health care started. It was universal, and it increased the pace of the digital transformation of health care," Yoder said. 

“A health care campus is massively complex in terms of devices.”

But health care IT is resource-constrained. The number of devices in a given patient room is probably 20 or more – and the number individual endpoints they need to secure and connect is well over 150,000.

On average, individual health care systems need to use and manage over 278 unique systems. It takes that number of applications to help health care run. “All are sitting on a mobile, tablet or workstation," Yoder said. "We are no longer tethered to a desk, and the reality is that a health care campus is massively complex in terms of devices.”

The people, assets, devices and data must all work together. “That intersection between the right application, the data and person using it, and the security to bring it all together is where we are working, with a goal of making a better future for health care.”          

Physician Burnout

Digital applications and connectivity can enhance the clinician experience in many ways. Yoder believes delivering efficiencies for them gives them more time for patient-facing work. “Studies have been done that talk about the impact of imperfect communication on patient outcomes. Being able to provide more care at the bedside is a huge component in improved outcomes,” Yoder noted.

“If we, with our devices in the hand, alarms and alerts, can deliver a little bit of efficiency that saves a couple of minutes of a nurse’s time simply with a couple of clicks on a mobile device, it helps in all respects.” Clinician burnout and patient engagement go hand-in-hand, in Yoder’s view.

Part of the Cisco offering is a Webex multi-content solution that uses the hospital’s existing  technology. Sharing screens and “expert on demand” are functionalities that use the Google glasses- type technology (there are now three  vendors of the technology). This set-up allows a pathology report on one screen, EME telemetry on another and CT scan data on the third, while the fourth offers a real time view of the patient – a screen overlay – with the camera seeing everything the doctor sees.

Cybersecurity Questions

As a global collaboration provider, Cisco needs to comply with global regulations regarding data sovereignty – Europe’s General Data Protection Regulation (GDPR), Canada’s Personal Information Protection and Electronic Documents Act (PIPEDA) and the US Health Insurance Portability and Accountability Act (HIPAA) among them – to meet the highest levels of security.

Countering Providers’ Security Threats

The Brooklyn Hospital medical center built a 24/7 security operations center (SOC) within two weeks, in response to the concerns of its CIO Sam Amirfar. It engaged the security architecture of Cisco Managed Detection and Response to be able to detect and contain threats at an early stage. In the past 10 years, it has become more difficult to secure data, said Armifa, adding: “We have close to 30,000 different IP addresses and endpoints. Before, it was a constant struggle to keep up. Now, we have greater visibility and can respond to attacks faster than ever before.”

This is another reason for choosing Cisco, said Yoder, where “security is built in, not bolted on.”

Understandably, there are many different customer needs, architectures and payment types. “We have different solutions and pricing models – some are consumption based, some are large enterprise agreements, and some pay by the minute.”

In the midst of all this technology, Yoder has a simple aim: “I am only concerned that you have and use a Webex license – so it can connect and allow everyone to collaborate.” For instance, Cisco can offer telehealth with a link using WebRTC, with no need for downloading of apps, or entering user names and passwords. “That connects users to a secret session of telehealth.”

But in an environment where everything starts with call-click-chat, those without broadband will be excluded from some of basic medical offerings. “We’re trying to bridge the digital divide to make it easier for all to get access to care. It’s one of the reasons we doubled down on WebRTC technology,” Yoder said. “Any smart technology phone with Safari or Chrome can do a telehealth video call.  It is WebRTC-enabled, so there are no risks of incompatibilities.”

Next Stages

Some new research is oriented towards use of Wi-Fi 6 in the hospital, which is almost three times faster than Wi-Fi 5. Virtual telerobotic surgery is on the horizon, with real time haptic feedback leveraging connectivity bandwidth and low latency that has not been available hitherto.              

In future, video will take a primary role in routine patient experiences, Yoder said. “If there is a silver lining to COVID, it is that the technology adoption curve has lessened.” The push back on technology as a solution had been significant. Clients did not want to be the first in the peer review mentality that prevails in health care. “Now, however, the expectation is that technology can solve the problem.”

The experience is a truly connected experience, with data at your fingertips that can be transferred in real time. “In the care continuum, wherever health care needs to happen, Cisco has the unique ability to provide information quicker than many others can,” Yoder said.