Is Middleware Necessary?

by Kourtney Govro

Several years ago, my friend Barry Runyon wrote an interesting paper for Gartner titled, “Is Nurse Call Still Necessary?” He reasonably argued that the legacy design of nurse call would need to retire, and a new design would emerge. The legacy involved several things, including regulations, attachment to how things have always been done, and fear of change (or lack of imagination).

Regardless of the dragging of some manufacturers’ feet, the pause that Covid created in everyone’s world, and all of the other competing priorities….The transformation occurred. Well, kind of, it has emerged as much as the regulatory bodies will allow for now.

The Covid-19 pandemic has highlighted both the vulnerabilities and opportunities that exist in the nurse call industry. This has led to a transformation, with more companies embracing new technologies, even as some manufacturers oppose this transformation. 

From a technology standpoint, the flexibility provided by software has enabled hospitals to change decisions; in most cases, it has put them in the driver’s seat for negotiations with their incumbent provider. The evolution includes software-based nurse call, which can overlay onto legacy hardware—allowing the hospital to maintain its UL1069 regulatory status without changing the hardware. This is the method we used to accomplish with only middleware, but now there are other flexible options. Which enables decision-based on workflow, capabilities, and the clinical process instead of the hardware manufacturer’s limitations. This modification has renovated the remnant mindset that allowed the hardware device in the wall to be a de facto dictator of communication.

As I reflected on Barry’s work, it got me thinking about middleware or the space we call alarm management. Should we put ourselves through the same evolution over the next few years? Are we entering a time when technology is changing so rapidly, and the regulations have some ability to adjust what they are looking for so that we can create positive change?

Over the next few blogs, I will share some thoughts about Technology, Process, and People aligned with the advances in communication, notification, documentation, and information. We will dispel one of my favorite Trey Lauderdale sayings – FUD – Fear Uncertainty and Doubt. We will practically walk through how the caregiver will benefit from changes that could be made to the current industry practices. We will identify some strategies you can use in the evolution.