The Hospitals of the Future

Aug 5, 2022


Chyrill Sandrini, Richard Reamer


Chyrill Sandrini  00:12

Hey, welcome to HTM Insider, we’re glad to have you back along with our guests today Rich Reamer of McLaren health. So excited to have him on. We had a conversation last week that I just can’t wait to share this with you guys. It’s a it’s a new thought, a new way of doing business in the hospital. And so with no further ado, I’d like to introduce you to my new friend, Rich. Rich, tell us a little bit about yourself.


Richard Reamer  00:36

Well, thank you, hopefully, I won’t go too long. It’s boring story. No. I’ve been doing this for 30 years in this business. So I’ve been all over the place


Richard Reamer  00:48

and in the ISO business and been in the manufacturers side of things, and now I find myself in McLaren Healthcare as an in house, regional manager for clinical engineer, spend a lot of fun spent a lot a lot of challenges over the years, as you can imagine, but I survived it here I am.


Chyrill Sandrini  01:13

Sounds like an amazing career. So for those that don’t know, where is McLaren health? Where are you out of?


Richard Reamer  01:19

McLaren is based out of Grand Blanc, Michigan. And we have 15 hospitals that are all over the state of Michigan. And also we have a hospital in Ohio. So we’re we’re multistate now. And the hospital that will be kind of discussing the the achievements is located in Petoskey, Michigan, which is way up at the tip of the Lower Peninsula, and a beautiful area.


Chyrill Sandrini  01:50

So I saw an article about the team that you’re mentioning, and what has happened there. And once I saw that, I knew I had to reach out because I thought it was new, its innovative. And I know our listeners are always looking for that new idea maybe that they could adopt into their hospital systems. So why don’t you tell tell everyone about ERCI, What is it?


Richard Reamer  02:13

Well, um, ECRI is the ECRI Institute, they handle all of the recalls and alerts throughout, you know, our medical industry, very big name, international name. And they had a opportunity for us to apply to an award that they give out. And it’s the Health Technology Excellence Award. And I didn’t realize how big of a deal it was until we actually got into the process. And there were five nations actually applied for this award. And we were selected. So it’s been an amazing journey. And, you know, I can’t speak highly enough of how professional they’ve been. And through this process of getting us to where we are, and the amount of press and other things that they’ve actually provided and shown our, our efforts to potentially the world, which is pretty awesome.


Chyrill Sandrini  03:26

It is it’s a quite the accomplishment when you start to look into it. So let’s just dive right in. So were you laying in bed one night, you had a new idea? How’d it all come about?


Richard Reamer  03:39

Well, getting started with what we built at Northern Michigan is really years in the making. And, you know, we went through


Chyrill Sandrini  03:50

Wasn’t there a construction project, Wasn’t there something?


Richard Reamer  03:53

Yeah, we were we were knee deep into the construction project. And we’re going through the planning process, meeting with the architects and all this other stuff. And, you know, leadership, myself, and, you know, also clinical engineering leadership, we really wanted to get into a position where we weren’t just building a space, we’re building the future, you know, everybody says the future of healthcare, we truly wanted something that was going to be somewhat future proof and get it to the point where we have the best system that we could potentially have, you know, obviously money is a factor and we had to we had to get that figured out. But we have a fantastic foundation up there that found us some money which is fantastic. We were able to accomplish really everything that we set out to do on and initially, you know trying to bring nine different vendors together and coordinate that effort. The initial part of it is just, you know, how do you bridge the gap between We know all these vendors that want to provide their system and all of their system, they didn’t want to just provide what they’re the best at, they wanted to provide everything that they thought they were good at, as well. You know, but not everybody builds the best of the best of everything. So we, we went through the process to actually invite all of them to a single room, which they thought they were coming to a, you know, kind of like a dog and pony show where they were just going to show what they had to offer, and not necessarily talk with other people that provide either competing or, you know, systems that would complement their system. So it was really interesting, when we invited all these folks along, and they all showed up to the boardroom. And we, we kind of sprang it on them, there was a lot of a lot of looking around the room, a little bit of nervousness, you know, sales, and their tech teams were there. And nobody really knew what was happening. Except for our side.


Chyrill Sandrini  06:05

I love it, I can imagine they all kind of thought they’re showing up with some type of value analysis or get up pitch their product. And we were talking the other day, I thought was pretty interesting, when you said what we’re gonna have to learn how to work together. Right?


Richard Reamer  06:20

You know, initially, when they come in the room and I started talking, there was just silence, you could hear a pin drop. And they were just not willing to open for this conversation. But after the awkwardness faded, one of the vendors just grabbed a hold and started saying, hey, if I send you this, you can send me that we can share this information. And it was it was a process and they all started opening up to the idea of what we were actually going after. Because we asked them, what would it look like if you worked with your counterparts in this room? To build the best integrated system for us? What would it look like? What would it take to get us there? And I’d have to say, you know, years after that meeting, we came to a really good spot and, you know, we have probably 95% of everything we were looking for working on words, we’re delivering it in phases to the end user, because there’s so much information, we want to make sure we’re not overwhelming. We’re not, we’re not creating an environment where they’re like, Okay, turn that off, I don’t need this much information. But we’ve seen amazing results with some of the systems that are currently in there working. And, you know, just the numbers that we’re seeing for some of the safety events that that could have not necessarily would have gone gone miss. But there’s so much that was captured in created a an opportunity for staff to actually create a safer environment. And it’s, it’s working, and we’re really excited about it.


Chyrill Sandrini  08:10

So let’s just talk about a few things. Let’s start with the patient’s room. So what have you done differently? And how’s it working out for you?


Richard Reamer  08:19

The patient room is very, very well integrated. We have beds that talk to whiteboards we have


Chyrill Sandrini  08:30

What’s a bed that talks to a whiteboard? I haven’t seen one!


Richard Reamer  08:32

Yeah, well, we’ll dive into that. Initially. We wanted to have smart beds, you know, beds that did more than just have patients, you know, sleeping in or being cared for. And so we went to Stryker and said, Hey, what do you what do you have in this environment, they provided a wireless bed, that actually communicates out all of its settings, all of its parameters. And while we were looking at that bed, we found the MEDI+SIGN whiteboard, which was not on the initial list, it was up that we found them are like we have to have that because the bed actually directly wirelessly connects to that that whiteboard. And it does some pretty amazing things.


Chyrill Sandrini  09:20

So you can are replacing that board in the room they write in nurse Nancy, at 7am medication at this time, it replaces all that it


Richard Reamer  09:31

It does. It reduces the frustration of the staff for keeping up with the board and and also creates an environment where the patient knows really what’s happening. And it’s it’s actually directly connected to our our electronic medical record, which is Cerner. And Cerner updates a lot of that board automatically by sending information to MEDI+SIGN. So you know, comes right out of the nurses hands goes directly into an automated process. But there are situations where the nursing staff and the caregivers can actually leave notes electronically on the board, from their nurse station or from their wild card, they can log in and leave a note for the patient or the family members. It’s a really unique situation, but and back to the bed sending the info if the patient is a fall risk, and this is where the safety really comes in, if the patient is deemed to be a fall risk, then the bed is set up appropriately for that patient, and the fall is set within the bed. But the bed is now configured. And at a point, hit side rails up, head of the bed at the right angle, brakes are set, the alarms are set, and that’s all displayed on the MEDI+SIGN. And if the patient happens it is and if the patient happens to exit or to begin to exit the bed, and the alarm goes off, the board doesn’t just sit there and say okay, there’s an alarm going off, it actually gets involved with the process by changing its state and changing to this great big obnoxious board that says please get back in bed your caregiver is coming. And it doesn’t just change into a physical log, it actually changes and actually audibly says in the patient’s native language. It says, please get back in bed, your caregiver is coming. So it’s it’s really a cool system in you know, not just in the room, but the whiteboard is actually posted upside the door. So you have all of your you don’t have all these sticky notes or magnet cards or flip on indicators or anything like that on the door anymore. It is a white, you know, the electronic whiteboard that delivers the information about the patient in the room. And, you know, so it takes it to that next level. And then on the nurse’s station, the whiteboard is also there, and provides all of the same information that the other two boards provide in more of a streamlined approach. And it gives you exactly what the patient is doing it’ll show either out of bed or the brakes aren’t set or or it’s not properly, you know, built so people can go take action on that. And it’s it’s just a great, great system.


Chyrill Sandrini  12:31

That’s amazing. Now, are your rooms? Are they all private rooms? Or do you have semi private rooms? And how is that addressed?


Richard Reamer  12:40

We do have currently in the new space, it’s all private, we will have some semi private rooms in the existing space, but it will be a small number. And we’ll only use them as a semi private when we have to, you know, extend our our bed capacity a little bit.


Chyrill Sandrini  12:59

I wanted to ask that question because you and I talked about something else, which was totally amazing. Talk about the interaction with the nurse and the patient in the room.


Richard Reamer  13:09

Well, we have a hands free communication style, which is provided through Vocera hands free bed. So there’s no touching of the badge and then going to wash your hands because you’ve dealt with other patients is completely hands free. And obviously through the last couple of years, everybody’s looking for infection prevention that is beyond this world. So we went with his hands free. But it also, you know, the staff will be wearing and this is a system we haven’t turned on yet. They will be wearing the hospitals wired for this wearing another badge that actually get the location of that caregiver. And it communicates that information back to Vocera communicates that information back to the nurse call system. So as the caregiver enters the rhythm, if the patient has an alarm situation, the caregiver enters the room. And the alarm will be canceled automatically without touching anything because of the badge because the system knows that that person is entering the room and going to take care of that issue. And on top of that, because they’re wearing this location badge, it’s associated with that caregiver, and only that caregiver. So now we have the opportunity to introduce that caregiver to the patient by displaying the caregivers information and their picture on the MEDI+SIGN. So as they enter the room, the system recognizes them and post a picture of them on that whiteboard. So awesome. Yeah, it’s a constant reminder of your care team gives a better recognition people that have, you know, some memory loss situations potentially, they will see their face on that board and they’ll know that they belong in that room. Maybe they forgot who they weren’t, but they will know that they belong there.


Chyrill Sandrini  15:03

I think that your patient satisfaction surveys have probably gone up?


Richard Reamer  15:07

Yeah, well, in the view definitely helps with that, you know, look, we have a phenomenal view of the bay. So, that definitely helps. But also all of this integration, and the fact that they know we’ve invested in their stay to this level, you know, and also, we even thought of the patient as far as entertainment goes, you’re laying in that bed for, you know, days on end, potentially, and you’re gonna, I know, I would, I would lose my mind laying there. So, you know, if you’re stuck in that situation, you need something to relieve you and help you find a better state of mind. So we looked at a system called CURV, Al Rigo. And also telehealth, IPTV. And the rego device is a handheld pillow speaker with a touchscreen built into it. And it allows for, you know, surfing the net, doing FaceTime, Facebook, whatever social media you have, they can log into their email, they can check their, you know, the status of their family, if they’re not able to visit. And it’s, it’s really opened the opportunity for them to still be connected to the outside world. And, you know, even though they’re in the hospital, but it also provides education for their condition, it provides a link to a virtual nurse that is actually present through the television, and a, it’s called the Banyan bridge, that their system sits on top of the TV. It has a built in microphone speaker. And it’s basically a computer condensed down it has a video camera. And the patient can see the nurse on the TV, and the nurse can see the patient via the camera, the camera can tilt Pan Zoom all that time. So they they truly are another set of eyes in the room. And the patient is connected to a nurse pretty much any time they want them. Yeah, it is. It’s a phenomenal system. And you know, they can pull up test results. They can share images from radiology or any tests that they’ve had done. They can actually work with the doctor. So if the doctor enters the room, he can actually call off the virtual nurse, and have the information shared that way. You know, so if there was a test result that they’re waiting for, they could actually put it right there on the screen. So it’s, it’s just so much easier to have the data available, and have someone on the other end being able to gather it for you and then display it. So yeah, it’s that’s pretty exciting. And then they’re connected with the telehealth the IPTV, so everything is able to be sent directly to that patient. It’s not like it’s, you know, your standard cable, everything is sent directly to that patient, for their care or for their entertainment. And it’s all customizable.


Chyrill Sandrini  18:26

I mean, that’s just great. If I had to be a patient, I’m gonna fly to Michigan, and convey your hospital. So what else is going on? Like you said, You’ve held some stuff back, right, I think you have some, you know, RF capabilities, you have a lot of other things that are going on. So what are you holding back on what else was outside the patient room you guys worked on?


Richard Reamer  18:47

Um, well, we’re holding back on the RTLS. And that’s because there’s just so much more information that will be coming into that situation, knowing where the nurses knowing where the equipment is, and using that system, and then advancing the communication off of that system. The escalations can change drastically when we turn that on, because Vocera can handle sending the appropriate staff per to a situation depending on their location or depending on if they’re in a patient room. All of that can factor in, and make a more efficient process. You won’t have somebody running from the other side of the you know the department to enter the room pow pow that will really be pinpointed in more efficient. So that’s that’s something we haven’t turned on yet. And I’m looking forward to that. We had conversations about that today. So we’re very excited about that. Okay, exciting. Yes. And you know, we didn’t leave the or out of out of our integrations and things like that we we’ve got Olympus and Stryker working together for or complete 4k integration. So we have the highest quality video imaging for the equipment down there. So the doctors are pretty pleased about that, I’m sure. And we also have the capability of sharing video live stream, from the OR to any system within our system that can that compares to, you know, the Olympus. And we have that at two of our other facilities right now. And we’re looking to move that into more. So we can share teaching moments. So we can also share, crossed, you know, specialties. So, you know, we didn’t want to leave the OR out of this at all.


Chyrill Sandrini  20:40

What about that, ER, that place where everybody goes when everything’s gone wrong, right?


Richard Reamer  20:46

Yeah, the ER is, is our next phase, we’re looking to get the MEDI+SIGN in there. And also, you know, late that up to our call system, of course, and have that same functionality that we do in the patient areas. So that will be the next the next phases, or is that as well, they already have the Vocera system. So they’re they’re speaking gains free, which definitely helps in the ED, but some of the other systems have not been put in the urn. Some of it is due to, you know, spacing, outside doorways, you know, ED is a lot tighter space. And we don’t always have the real estate. But then so there’s a little bit of a challenge as far as that goes.


Chyrill Sandrini  21:29

How’s your team clinical engineering, responding to all this? And how is the how is the rest of the staff responding?


Richard Reamer  21:37

Well, clinical engineering, of course, it is a learning curve. And all of this, you know, everybody’s wondering who owns it, once it’s in place, we’ve worked directly with IT, we have very IT department, we’ve shared whose responsibility it is for certain aspects of this. So we’re, you know, it’s new territory, it’s not like this is, you know, you know, an IV pump, it’s not an IV pump, we’ve got a lot of a lot of different ways of looking at the system or getting it corrected if there’s a failure. And my team has been very involved doing all the testing of each system as it come online, and making sure that they’re communicating across the other systems as well. And IT has also been doing that same thing. So it’s been very cross functional. And we’ve we’ve collaborated very well.


Chyrill Sandrini  22:33

And the rest of the hospital staff said, your end users, what are they thinking about it?


Richard Reamer  22:38

The end users pleased I’m in obviously learning curve in through to our COVID days, you know, there’s been a lot of staff change and turnover. So our education department has been phenomenal on making sure as people are on boarded, they get spun up on all this new technology, so that, you know, nothing slips through the cracks. And we don’t end up losing some of our, our advancements through lack of knowledge. Because, you know, if time goes by and you don’t use it, you just, you’re just gonna say, you know, why bother? It’s not useful. But there’s a lot of useful information that’s been shared. So the end users are, are very pleased with the system. And obviously, because we installed everything in the new space, we haven’t retrofitted the existing space as, as much as we were hoping to at this point. You know, construction is what it is. So, you know, they look at each space like this is this is massive. On this side, we have all this technology, when are we going to get it over here. So there’s, there’s a drive to get it. We’re working diligently on making it happen. And, you know, just the actual safety that’s been provided to the patient through some of these systems working together, especially the Stryker and MEDI+SIGN. There’s just been, there’s been a million, literally 1 million safety catches. And they’re not like life threatening safety catches, but they’re all They’re all moments in time. And this is just from August, it from when we went live. So this is August still now. There’s been over a million catches. And some of them have been fixed in three seconds. And some of them taken, you know, like minutes, but they’ve all been captured and they’ve all been corrected. So you just look at that total number of incidents that could have gone unnoticed under the old system until potentially something happened to bring it to your attention. Or the next time that patient is visited by the nurse. You know You just look at it in that respect, are already low fall numbers are being impacted by the system. And, you know, we’ll we’ll just take that as a as a win for everyone.


Chyrill Sandrini  25:12

Oh, no, that’s great. I mean, at the end, we could do in the hospital to promote better patient safety and patient care, I think is a win win. Right? People heal better when they’re taken care of, and they think this system is helping people feel taken care of.


Richard Reamer  25:28

Right? Yeah, if they’re happy in the environment, or at least comfortable, then that definitely aids in the whole process.


Chyrill Sandrini  25:36

So now you have one hospital done, then is this a plan to execute it over the entire system? Or is it going to be a slower process,


Richard Reamer  25:47

um, it will be a little bit slower. Because northern is just one of those places that the Foundation says, Oh, you need that, let me go out and find the money for you. And they come through. So we are very fortunate as far as that goes. Other hospitals have have collected and use some of the systems not all. So you know, the Vocera thing is going to be pretty much network wide, MEDI+SIGN being put in place, and it is in place in in one of our other facilities. There’s interest in it at one of my other facilities. And the, you know, just looking at this as a whole, there’s a lot of money that has to be spent in order for it to be 100% like, what’s that Northern, but McLaren’s commitment is we’re going to do, it’s part of our slogan, we’re going to do what’s best. And doing what’s best is, is looking at the Tech, and making sure that it fits with, you know, the operation of that particular facility. And if it makes sense, we’re gonna go forward with it.


Chyrill Sandrini  26:59

I love it. I love our chat today. And we’re gonna wrap this up. But I want to ask you, we always ask every guest at the end, what is your words of wisdom? What can we leave with the audience know about this experience or your experiences in general over your longevity of your career? What would you like to leave the listeners with?


Richard Reamer  27:17

Just stay alert. There’s so much happening in healthcare right now. Some of it is super challenging. But if you stay alert to what’s available out there, it will allow you to better guide. And that’s what I feel our job is in healthcare technology is to guide the facility in the direction of the newer tech that help with the situation’s you’d find ourselves in.


Chyrill Sandrini  27:47

That’s awesome. I really liked that that stay alert head on a swivel. I mean, it’s a good model for life. Right.


Richard Reamer  27:54

Right. Right.


Chyrill Sandrini  27:56

Well, thanks y’all for tuning in again. Today. Again, my name is Terrell MultiMedical systems and rich reamer with McLaren health, and we’ll post your contact information. Maybe there’s somebody out there who wants to learn more, and I’m sure you’d be happy to share.


Richard Reamer  28:11



Chyrill Sandrini  28:12

Thank you all for tuning in. And you can find us on Spotify iTunes, check out our website at multi medical You can find all the episodes on htm Insider. Thanks again rich and everyone have a great day.