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September 25, 2009

Talking with Voalté’s CEO, Rob Campbell

Rob CampbellRob Campbell is one of those people who always happens to be in the right place at the right time. He was at Apple in its early days working directly for Steve Jobs, then at Microsoft, working directly for Bill Gates. A serial entrepreneur, he’s responsible for two of the most popular software items in history: FileMaker and PowerPoint. And now, Campbell has been asked to lead Voalté, a company whose existence can be traced to March 6, 2008, when Apple released its Software Developer’s Kit for the iPhone.

The kit intrigued Trey Lauderdale (now Voalté’s Vice President of Innovation), who was a regional sales manager at Emergin Systems, a company that offers a central platform for hospital-wide integrated connectivity across various disparate systems to aggregate, collect and distribute alarms and events to caregivers. He realized that the iPhone, and probably other smartphone devices, could run revolutionary software solutions for healthcare institutions that solve communication problems at the point-of-care, thus improving clinical performance, which in turn improves patient care, safety and satisfaction.

Lauderdale then approached Benjamin King (now Voalté’s Vice President of Technology), the software guru at CardioMems, a healthcare start-up in Atlanta, Georgia and founder of Demand EO. With his degree in Electrical Engineering and a Masters of Science in Materials Science from Georgia Tech, King’s expertise would bring the idea to fruition.

The next person to come on board was a long-time friend of Lauderdale’s Oscar Callejas, a seasoned verteran of the hotel industry and an expert in know how to deliver a unique customer experience.

The final piece of the puzzle was a person who could coordinate all of this talent and bring an initial product to market. That person turned out to be Rob Campbell.

Developed on Apple's iPhone, Voalté (pronounced "volt"—the name is derived from a contraction of Voice, Alarm, Text) is essentially an advanced turnkey unified communications solution enabling phone calls across hospital Voice-over-IP (VoIP) systems, text messaging via the user directory, and user-friendly alarm management. Voalté enables caregivers to receive and respond to alarms dispatched by over 200 hospital systems and devices, optimizing workflow and improving patient satisfaction and safety. Thanks to the flexibility of such smartphones as the iPhone, additional functionality can be added as needed and hospitals can customize the solution to the needs of particular departments and users.

Recently Yours Truly spoke with Voalté’s CEO, Rob Campbell.

RG: In theory, I imagine your system could be adapted to any vertical market, but I see you’ve first focused on healthcare.

RC: Our market is hospitals. We sell directly to IT CIOs at hospitals. Our users are clinical staff, principally nurses, although they may be ancillary departments such as the pharmacy and the like. They may be nurse assistants and nurse secretaries, charge nurses, or nurse managers. Our focus is currently exclusively at the point-of-care. So if it’s an in-hospital caregiver dealing with a patient, that’s who our user is, although the purchasing is typically done by the IT department.

RG: What kind of communications equipment do you encounter in hospitals these days?

RC: It used to be that IT sat on one side of the institution and the telephone / communications department resided on a different side—perhaps they were in separate facilities. That whole environment is becoming very ‘fuzzy’ now, especially in hospitals. We find that when we go integrate our system in a hospital, we almost exclusively encounter Cisco, Avaya or Nortel systems. After all, hospitals are not going to deal with one of the small, although innovative, telephone manufacturers.

To make our solution work properly, we have to integrate Voice-over-IP. In other words, we take our smartphone and we support both the iPhone—Apple is our launch partner—and the Blackberry, since we’re not dealing exclusively with the iPhone. We have to be able to provide a full VoIP, PBX-on-your belt service so that a caregiver can have a voice conversation. We integrate that back through the PBX so they can place and receive outside calls. We also integrate it with all of the systems in the hospital that generate alarms alerts. There may be a simple system capable of such messaging as “Nurse Call” where perhaps a patient in bed presses a button that’s an alarm, and we can get that alarm to the smartphones we serve—to the iPhone, for example. Of course, we log the call information in: When was it sent? Was it dispatched? Who should get it?—which means that we must deal with Presence information too.

Another leg of our stool is what we consider to be a healthcare-ready text messaging system. For example, an alarm may generate an alert to the iPhone, but it may also contain a callback function so the nurse can call back directly to the bed pillow.

RG: It sounds as if hospitals could use a healthy dose of innovation in communications department.

RC: What’s interesting is that you would think that in an industry such as healthcare that controls 16 percent of the Gross Domestic Product, that hospitals would be the bastion of state-of-the-art communications. Well, it’s not that way at all. A typical 500-bed hospital wastes about $4 million a year on miscommunication.

There are vendors, including companies such as Cisco, Polycom and Ascom, that put Voice-over-IP phones into the hands of nurses. The problem is that voice alone isn’t enough. We believe, and it’s kind of fundamental to our corporate mission, that you have to have a tight integration of voice, alarms, and text to deliver the proper communications solution for caregivers. Really, that need led to the genesis of our company.

RG: Certainly what distinguishes unified communications from old-time unified messaging is both Presence and Mobility. The whole world is going mobile.

RC: Over the years, I’ve discovered is that there are certain ‘tipping points’ or ‘inflexion points’. For example, in the 1970s, when I first got involved with Apple Computer, a guy named Steve Jobs was telling everyone that desktop / personal computing was going to change the way we work, the way we educate, and the way we entertain ourselves. At the time nobody really believed him. But because of the impact of the personal computer, entirely new companies that had never existed before came into being. And now, low and behold, the world is a different place.

In the 1980s, with the introduction of bitmapped graphics and mice, once again there was a shift in that, all of a sudden, entirely new classes of applications could be created that you couldn’t create until the enabling technology was available. We believe that the this next generation of smartphones—these mobile devices that are always-on, multi-band, have high-resolution graphics, and are basically deep, rich media handhelds—are really the next big class of computing platforms. As you know, these mobile devices happen to have a telephone application running on them, but the ‘reach’ of these systems capabilities is much broader than simply making phone calls or playing games while you’re waiting in line for the movie to begin.

So we believe that we’ve arrived early in an emerging market that is going to use these next generation platforms to change the way things work. Our focus, of course, is on communication. In any business process, poor communications is the root of most problems. Consider that, in most hospitals, poor communications actually kills people. If you look at The Joint Commission statistics concerning patient health care, more than 100,000 people are killed every year. I didn’t say die—I said killed in hospitals every year, and the Number One cause, according to The Joint Commission, is bad communication. I don’t know about you, but as I get older, I want to ensure that I’m not one of those statistics.

A fascinating aspect of all this, at least from my perspective, is that when you start putting these devices into the hands of nurses, you really do change the way they deliver patient care.

RG: One of my interests is in the Presence area; that the presence manager is becoming more intelligent and will ultimately become an “electronic secretary”.

RC: Presence is interesting, and we deal with that quite a bit. Our company and others are working on what we’ll see in the future, which involves the notion that presence is dependent on location. Once again, I’m looking at this idea through the eyes of clinical staff. When a nurse walks into a patient’s room, she’s now busy, and she shouldn’t have to manually set her presence ‘status’ to a ‘busy’ setting. So this notion of location-based presence becomes really interesting the more you examine it, especially if you start incorporating into the scheme other technologies that also ‘know’ their own presence. For example, if a nurse walks into a room where there happens to be an infusion pump for sending medication or nutrients into a patient's circulatory system, and that infusion pump ‘knows’ that it’s on, the nurse is now part of that field of Presence. When you’re capable of doing that, some really clever things can take place. The problem—and this is facing us all—is that hospitals are 10 years behind other businesses and verticals.

Hospitals still rely heavily on overhead paging and one-way pagers. In fact, 11 percent of all pages go to the wrong person. If you’re waiting for a sales call and not receiving it, that’s one thing. But it’s quite another, more serious situation if you have a patient going into toxic shock, and you’re paging the wrong doctor. So, in an environment where communications has life-and-death consequences, we’re 10 year behind.

RG: Hospitals are bureaucracies. Some of them are slick, well-run, for-profit businesses, but many of their activities have been institutionalized over decades.

RC: Actually, I think, the biggest problem in hospitals are the vendors, not the hospitals themselves. Vendors, attempting to protect their proprietary positions, have been very slow to open their APIs and provide connectivity to other systems. Thus, hospitals tend to be full of ‘silos.’ It reminds me of corporations 20 years ago. With my background—coming out of the packaged end user software world and then seeing what’s going on in hospitals, I was shocked. I thought we were beyond that point technologically. Their equipment hasn’t been upgraded in four-and-a-half years. I think vendors have to assume a big responsibility in this regard. As a software guy, when I look at some of the most expensive IT systems in the hospital, I want to call the vendor up and say, “You should be ashamed.”

We spend all of our time thinking about how we can serve and improve the world of healthcare. When you and I were growing up, hospitals were four walls and a parking lot. Today’s hospital is something that’s campus-based and has multiple sites. There are gymnasiums and therapy centers there are heart centers. They are located in multiple campuses and then there’s the whole area of home healthcare. And so the definition of health care no longer is just those four walls where you go get treated and then you leave. This notion of diagnosis, treatment and follow-on, really transcends location. Some of the process takes place in the hospital, some of it takes place in the imaging lab across town, some of it even takes place in the home when you get back from the hospital. When I start thinking about how these mobile devices can play in healthcare, to me it gets very exciting. I can very easily imagine the day when you leave a hospital and you take home an iPod touch with you and on it is all of your therapy information, your prescriptions, your appointments are all set up with your follow-on documents, and maybe there’s a sensor or two that takes blood pressure, glucose level, and whatever else is necessary.

So, the definition of what a hospital is and the purpose it serves must now take into account the fact that it’s a much more distributed system.

RG: What about the recent enactment of the Health Information Technology for Economic and Clinical Health (HITECH) Act in President Barack Obama's American Recovery and Reinvestment Act (ARRA) of 2009? There’s billions being applied to incentives toward infrastructure and Health Information Exchange (HIE). Billions have been allocated to direct adoption incentives for the meaningful use of certified Electronic Health Records (EHRs).

RC: Right now, to some agree, unfortunately, the government is attempting to pump $19 billion into healthcare for the development and deployment of electronic medical records.  Clearly that’s a starting point, but it’s just that, a starting point. It’s dealing with static information. The problem is that what government is doing will ‘suck all of the air out of the room’ both in terms of vendors and hospitals. In the case of hospitals, they’ll all be asking, ‘How do I get my $3 million? Where do the penalties come?’ and all of the attorneys and all of the consultants are focused on ARRA, which is where that $19 billion is coming from. So in some ways it’s an innovation creator, but on the other hand, as I said, it’s sucking the air out of the room.

In any case, our product’s capabilities have not been dictated from above, from government, but from feedback by our customers. That’s why it’s so effective.

RG: Sounds like a winner. Thanks for the interview!

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