HIMSS 2012 – Draeger, David Truncer

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Dr. Howard Rollins, EHRtv AIMS specialist and medical consultant, interviews David Truncer, Senior Marketing Manager IT Solutions, Perioperative Care of Draeger.

Category: AIMS, HIMSS12, Tradeshows
Date: March 19, 2012
Views:4,901 views

Dr. Howard Rollins: This is Dr. Howard Rollins with EHRtv. I am here in Las Vegas at HIMSS 2012 and I have the pleasure of speaking with David Truncer who is the Marketing Manager for Innovian anesthesia, David thank you very much for joining us.

David Truncer: My pleasure.

Dr. Howard Rollins: Now I am an anesthesiologist and I have been using Draeger products for about three decades mainly in the Anesthesia Machine product line and so I am very familiar with the company but we are here to talk about something different.

David Truncer: Sure.

Dr. Howard Rollins: We are here to talk about Innovian anesthesia which is your aimS solution, is that right?

David Truncer: Right, that is correct.

Dr. Howard Rollins: The first thing that strikes me is Draeger seems to be an all-encompassing provider for anesthesiologists in the operating room because you have the Anesthesia Machines and here you have a very fine Aims solution. Tell me a little about how that works.

David Truncer: Sure well, our concept is basically to provide a cockpit for an anesthesiologist. So we have got obviously the Anesthesia Machines, we have got the monitoring solutions as well and with our capability of incorporating an aimS solution into a monitoring device like a C700, we provide the anesthesiologists essentially with all the tools that they need to not only care for the patient but to also record and track the interventions that happen during the introduction of anesthesia to the patient.

Dr. Howard Rollins: Now in the event that an anesthesia group does not have Draeger machines and they are not planning to make a change, is that an issue if they want to move into an aims product and are considering Innovian?

David Truncer: Yeah that’s not an issue at all. We have got many implementations out there where we are actually integrated very well with other product lines, GE, Phillips, Monitoring Systems, GE Anesthesia Machines. That’s not a problem at all. We provide interface capability to virtually every device out on the marketplace.

Dr. Howard Rollins: Got it. Now you have a list of some rather prestigious clients that are using Innovian anesthesia.

David Truncer: That’s correct. First and foremost is the Department of Defense. In 2009, we won the sole source contract for the DOD. So virtually every military facility in the US as well as overseas that has a surgical suite will by the end of March have Innovian Anesthesia completely installed. We are actually kind of celebrating that issue here in the booth by asking our guests, folks that come in to see our solution to have their photograph taken against the green screen. Everyone that does we will donate to the fields house which is essentially the Ronald McDonald House for the Military, a $5 donation to support that effort and this is an organization that provides housing for military families at military treatment facilities where soldiers who are wounded are receiving treatment. So it’s a very, very well known, very well informed organization and we are actually very proud to support them.

Dr. Howard Rollins: Very good.

David Truncer: We’ve also got a number of large academic facilities that are using Innovian Anesthesia, Duke University Medical Centre, Rhode Island Hospital in Providence, Rhode Island and a host of other commercial customers who are also very big players in the VA market space as well.

Dr. Howard Rollins: How have implementations gone, have they been smooth?

David Truncer: Yes they have. We are actually rolling out our version 4 which was released in October of last year and we have kind of changed our implementation methodology. In that we are taking a more hands on, more focused educational approach to make sure that when we leave and the customer is alive that they are completely satisfied with the application and the training that they have received. We have actually had some success in that implementation kind of transition with Virginia Medical College just recently going live probably 6 weeks ago and they are very happy customer, very thrilled to be on our latest version. As a matter of fact we have just secured and will have secured by the end of this week an additional 4 POs for upgrade. So we are very excited.

Dr. Howard Rollins: Very good and so what is the approximate time that implementation will take?

David Truncer: Obviously it’s going to depend on the size of the facility but typically it ranges about 12 weeks from PO issue to live event and we provide them with a whole host of professional services, up to and including complete workflow analysis to make sure that the workflow that they expect to get out of their solution can be supported by the application. We actually provide them some counsel, some guidance relative to how they can get workflow tweaks if you will out of the application.

Dr. Howard Rollins: Right.

David Truncer: To help maximize that workflow, shorten room turnaround time and make them a much more productive department.

Dr. Howard Rollins: So now let’s get into the crux of Innovian. What is special about it, why do I want it for my operating room?

David Truncer: Well obviously it’s a complete anesthesia recordkeeping solution from Pre-op to Post-op.

Dr. Howard Rollins: But it’s much more than that. Isn’t it?

David Truncer: Absolutely. It’s a solution that also integrates with the Anesthesia Machines, the monitoring solutions and accepts vital signs, gas usage and basically tracks all of that during the surgical procedures.

Dr. Howard Rollins: Clinical Decision Support?

David Truncer: Yeah Clinical Decision Support is coming, the medication that’s administered to the patient during the examination and so it’s a very robust application and what is very unique about the product is that it also is network fault-tolerant. So for those…

Dr. Howard Rollins: So that is what that means?

David Truncer: So for those facilities for instance particularly important for the DOD obviously because of potential combat situations. If the connection between the device and the server is lost or cutoff, the device itself will still continue to capture and collect data and as soon as that network connection is re-established the system automatically replicates that data to the server, so there is no loss of clinical content, there is no loss of financial data, the drugs that are administered, the…

Dr. Howard Rollins: Right it’s all there; it’s like the black box?

David Truncer: Exactly right. So it’s a very powerful tool and that’s kind of what sets us apart from our competitors and we are actually very proud of it.

Dr. Howard Rollins: Is that right? Do you think that might be why the DOD chose Innovian?

David Truncer: It does have a lot to do with their decision as well. Obviously the DOD is very cost sensitive as well.

Dr. Howard Rollins: But what other things do you think led them to make the decision to go with your product?

David Truncer: Well feature function certainly. It’s a very robust application, it’s very stable, very easy to use, touch screen capable and so it is very easy for an anesthesiologist working at the head of the patient to simply record a complete case with a few touches on a touch screen.

Dr. Howard Rollins: Out of curiosity when they went about making the decision were anesthesiologists involved?

David Truncer: Absolutely. They were actually the biggest drivers of that decision making process.

Dr. Howard Rollins: That’s important to know.

David Truncer: Certainly. They had a lot of clinical input; they had their own IT groups, the various services involved as well but the decision ultimately was driven by the anesthesiologists.

Dr. Howard Rollins: I see. Now are mobile devices supported with your system?

David Truncer: Yes we are actually just getting into that market space now. We are working currently on a browser agnostic capable tool that will allow the application to be used in many respects on devices like the iPads or Android solutions. We are also working on getting the application to work in a remotely hosted environment. So for those senior anesthesiologists who want to oversee cases…

Dr. Howard Rollins: Right.

David Truncer: Supervise cases remotely they can simply do that via some sort of tablet or handheld device.

Dr. Howard Rollins: Going forward I am sure you know a little about what the future might hold for your product and for Aims in general. I know market penetration has been lagging – HER market penetration and we…

David Truncer: Sure.

Dr. Howard Rollins: Most of us know the reasons why anesthesiologists aren’t the most compliant bunch when it comes to making major changes in the operating room.

David Truncer: Sure enough.

Dr. Howard Rollins: But I think it’s starting to move into the private practice setting more and more, do you?

David Truncer: Absolutely, we are seeing that market trend happening.

Dr. Howard Rollins: How is Innovian going to adapt to increased market penetration? Are there new things on the horizon, new updates? Can we look forward to an even better product as we go forward?

David Truncer: Absolutely. Since I started 8 or 9 months ago we have kind of re-thought our release strategy and we have gotten ourselves now into a cycle of annual release or so every October right around ASA we will have a new release. We will have one in obviously this October ready for…

Dr. Howard Rollins: Will that be 5.0?

David Truncer: 5.0 and we’ve actually defined a long-term roadmap and it will include things like decision support capabilities, drug-drug interaction. We are working with various vendors who provide that level of capability. We are working with First DataBank. We are also obviously going to need to provide and support the transition to ICD-10 if and when that happens. So we have got a lot on the horizon but really what we want to be able to do is provide the anesthesiology team not only with the solution that allows them to capture the clinical content but also give them the ability to do research on the data that’s collected in order to improve the quality outcomes of the care that they deliver. That’s really as far as I see one of the biggest market drivers now. Obviously with reimbursements being tightened by Medicare and Medicaid and more closely tied to reporting of quality measures and all the Skip protocols and those types of things, we are working to provide a much more robust reporting capability for our customers than ever before because we see that as having an important impact on not only their business but the business of healthcare as well.

Dr. Howard Rollins: Right so as a person who clearly knows probably more about your product than most of the human beings on this planet, how will Innovian improve patient care. I know that it will improve workflow; I know that it will help the anesthesiologists. How do you see it improving actual care of the patient?

David Truncer: Sure, well ultimately our goal is to basically provide a solution that will give the care provider, the CRNA, the anesthesiologist with alerts, reminders of potential downturns of the patient’s care. Right so, if based on monitoring information that’s being received into Innovian Anesthesia coupled with anesthesia gas machine data that’s being provided, there is a trend that’s recognized for various triggers that are defined by the healthcare facility within a rules based engine. It can actually prompt the caregiver to look at a – or look for a particular condition. If after say drug administration, there is an immediate decrease in blood pressure or the entitled CO2 changes drastically, we want to be able to provide that level of update alerts to a care provider so that they can actually attend to the issue and provide better care to the patient and ultimately drive the quality of care up.

Dr. Howard Rollins: Thank you David, thank you very much, it was really great talking to you. I would like for you to show me a few of the features now.

David Truncer: Sure I would be happy to.

Dr. Howard Rollins: David why don’t you show us a few of the key features of Innovian Anesthesia?

David Truncer: Sure we designed this application to try to replicate how anesthesiologists do their charting now. We’ve got essentially a grid where they can capture various events during the process of providing care to a patient. We have added a number of things to – this is version 4.0 by the way. We’ve added a number of things to this particular version. For instance, providing the ability to track and record and chart compliance issues.

Dr. Howard Rollins: Skip protocols.

David Truncer: Yeah skip protocols, antibiotic compliance, beta-blocker usage, warming therapy, those types of things and it’s a simple matter of double clicking that particular item and selecting the most appropriate response. In this case right, the antibiotic was administered after the incision and now that’s part of the patient’s record. We also have a graph where each user can or for that matter each facility can customize the vital signs that are recorded by Innovian and are simply plotted on the graph during the duration of the case.

Dr. Howard Rollins: Is it easy to deal with artifact because that’s always something anesthesiologists are concerned about?

David Truncer: It is actually very simple, we provide the anesthesiologists with the ability to essentially edit the record as required so they can go back post case and make any modifications or any changes that may have happened during the case.

Dr. Howard Rollins: But those values do stay?

David Truncer: Well absolutely, yes. The original values stay if they can simply go back and make modifications, add notes to that particular event to make sure that it’s completely documented.

Dr. Howard Rollins: Okay.

David Truncer: Now imagine this on a touch screen at the patient’s head and what we have done is basically added these quick events where I can simply select, in this case the patient has entered the OR. I am now going to induct the patient, I may now want to do intubation, I start my surgery and if I go to the summary tab, all of these events have essentially happened, these event statements have happened as a byproduct of me clicking these quick event icons.

Dr. Howard Rollins: And this can be seen by an anesthesiologist that’s running the whole show that day?

David Truncer: That is absolutely correct. You have got a supervisory anesthesiologist. They can see exactly what’s going on in the room.

Dr. Howard Rollins: So the PACU nurses may know that the patient had a rough intraoperative course and is 10 minutes away from coming out and may need a ventilator or a blood transfusion?

David Truncer: That’s absolutely correct. Absolutely right and of course all of these statements are defined by the facility as part of the implementation process, all of the verbiage is completely customizable which is a very nice part of the product because we can actually tie specific event statements to individual users. Right, they can – Dr. A can have his particular event statements completely different from Dr. B so to speak and as I go through the process of ending surgery, I can actually tie temperature, capture and again all of these event statements are defined by the facility.

Dr. Howard Rollins: Now does the system have the ability to generate reports, staff who could help me with staffing models, follow my individual providers, see what their complication rate is on an individual basis?

David Truncer: All of the data elements in the database are completely reportable. We provide customers with an SQL-based reporting tool that allows them to extract any of the data elements that are in the database and slice and dice that data anyway they see fit. We actually provide them with a whole host of standard reports that are modified during the implementation process to their needs.

Dr. Howard Rollins: If their group wants to report to the Anesthesia Quality Institute, is that doable?

David Truncer: Absolutely we do support the AQI database schema as well as MPOG and we are working with the Surgical Outpatient Association, the SAMBA. So we are working with them to make sure that we meet their score solution on a schema as well.

Dr. Howard Rollins: Now finally let’s talk about mobile devices for a moment.

David Truncer: As I mentioned earlier we are working on being able to provide our customers with access to their clinical data on remote devices like an iPad. So for instance here is a perfect example of what is essentially one of the skip reports. We want to make sure that we provide them with in this case a monthly prophylactic antibiotic compliance report. It’s very simple to run, just a couple of quick touches on the screen gets them the data that they want. From here they can submit it, they could print it, submit it in papers, submit it electronically. We have got the capabilities that support both means of submission. So it’s a very robust tool, it is browser agnostic. So it will run on Safari, Firefox, Internet Explorer, all of the major browsers out there. It is a very simple and very easy tool to work with. Now we want to keep it simple for our customers, we give them the access to the data that they absolutely have to have, right.

Dr. Howard Rollins: Okay thank you very much.

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