| May 31, 2009 9:00 PM PDT | |
The Intel Mobile Clinical Assistant (MCA) gives software providers a new opportunity to be among the first to market with next-generation Digital Health solutions for this platform. This article presents this opportunity for the benefit of three separate audiences within the software ecosystem. For C-Level executives, the article reveals the competitive advantages that are available by developing for this platform. For middle managers, decision makers, and influencers, the article introduces resources that can streamline the effort to develop solutions specifically for the MCA platform, as well as for porting existing solutions to it. Finally, for individual developers, the article provides an overview of best practices for tailoring software to the needs of the MCA platform.
Intel Mobile Clinical Assistant (MCA) devices are emerging as an important part of the next generation of point-of-care technologies in the Digital Health area. They specifically target use by clinical personnel in direct contact with patients, such as nurses in hospital rooms and critical-care units. As they become more widely adopted, MCA devices promise to increase staff efficiency, reduce errors, and facilitate integration of various hospital information systems to the point of care.
Software for these devices provides ready access to patient records and other hospital systems, such as pharmacy ordering, radiology testing, and intake/discharge resources. Because of the flexibility and power of these devices, which are lightweight, spill-resistant, durable, and easily disinfected, they introduce the opportunity for a variety of innovative software solutions. Providers that are early to market with products to target MCA devices position themselves for a competitive advantage in this new product area.
Figure 1. Motion Computing's C5, the first product based on Intel's Mobile Clinical Assistant platform, in use at UCSF Medical Center in San Francisco.
MCA is a specification developed by Intel for a class of devices to be built by various original-equipment manufacturers (OEMs). Intel based the specification on an extensive needs analysis performed in conjunction with directors of healthcare facilities, rank-and-file healthcare workers, and Digital Health solution providers. The first production device, the C5 mobile clinical assistant* from Motion Computing, began shipping in early 2007. Philips has also announced the development of an MCA device to ship in 2007.
MCA devices incorporate a number of standard features and technologies that lay the foundation for solutions that increase healthcare staff efficiency, as well as facilitating information transfer and helping to prevent medication errors and other issues that can compromise patient safety. The device form factor is designed specifically to be spillproof, rugged, and easily disinfected, with an integrated handle and dockable design, plus a large screen to enhance ease of use. Wireless connectivity via Bluetooth* and Wi-Fi facilitates interaction with other hospital systems.
Peripheral devices enable flexible innovation, with integrated radio frequency identification (RFID) and barcode readers to facilitate identification of patients, medications, and other items. A built-in digital camera can enhance patient documentation and progress notes. These capabilities allow software solutions for MCA devices to complement and integrate with other Digital Health solutions. To help the market get prepared for products based on the MCA platform, Intel also works with leading industry suppliers, such as electronic medical records software vendors, to optimize their software to run on the MCA platform.
As the practice of electronic medical records replacing paper-based charts becomes the norm in clinical settings, mobile point-of-care technology solutions are of increasing importance. Software that provides access to patient information and the ability to order tests, medications, and other services from bedside allow nurses and other healthcare providers to operate more efficiently. In addition to improving productivity, these solutions can help reduce medication errors, improve communication among medical staff, and help to provide a higher standard of care.
Point-of-care technology solutions are well-suited to the needs of nurses and other medical professionals in hospital settings. Behavioral research at hospitals demonstrates that a nursing shift is comprised of a series of brief, urgent tasks that tend to overlap continually. In order to facilitate that workflow, it is important to provide nurses with constantly ready-at-hand, read/write access to information. MCA devices provide excellent support for those needs, such as direct input of information into a patient's chart.
They also have the potential for a high degree of integration with patient-monitoring systems and the larger hospital information infrastructure. Because MCA devices are based on standard Microsoft Windows* operating systems, they support existing clinical applications. That factor makes them highly compatible with existing systems. Because MCA devices are a natural extension of the existing client-computing infrastructure, they have a relatively low resource impact on the hospital's IT organization.
MCA devices have the potential to bring benefits in a number of key application areas for hospitals and other clinical facilities. The most obvious of these areas is to improve workflows among clinical staff by providing ubiquitous access to patient information, but they have the potential to streamline and improve a number of other process areas as well. By providing instantaneous capture of billable activities, these devices can improve the efficiency and accuracy of billing operations. Automatic maintenance of supply records helps to reduce staff burdens with regard to inventories, as well a preventing shortages of medical, housekeeping, and other supplies where they are needed.
More efficient ordering and tracking of medications and tests can help to take better advantage of hospital resources, reducing patient waiting times while decreasing operating costs. The result is higher patient satisfaction, while at the same time making better use of capital resources such as imaging equipment. Moreover, integration with a picture archival computer system (PACS), radiological information system (RIS), and other existing infrastructure can provide access to test results at bedside or elsewhere, facilitating diagnosis and patient consultation.
As facilities begin to realize these opportunities, software providers that deliver the means to take full advantage of them are positioned for success. The implementation of electronic medical records (EMR) systems continues to gain momentum at healthcare organizations worldwide. Connections between those resources and other systems adds significantly to the opportunity for both the healthcare industry and the technology suppliers that support them. MCA devices are part of the vanguard of innovative hardware platforms that allow facilities to take advantage of these and related transitions.
The unparalleled Intel® architecture software ecosystem provides an extremely large range of compatible applications, drivers, and plug-ins for MCA devices, which providers can take advantage of to facilitate advanced solutions. Since these devices run full Windows operating systems, they benefit from widespread developer expertise, as well as familiar tools, APIs, and libraries. To complement these advantages, Intel provides dedicated development tools that further facilitate MCA solution development.
Intel makes a dedicated Software Development Kit (SDK) available to developers to simplify the creation of software for MCA devices, as well as for porting existing solutions to the MCA platform. The Intel MCA SDK particularly provides resources to help developers emulate MCA devices on Windows XP*-based workstations. These include loopback plug-ins that emulate peripheral devices (such as RFID readers and barcode readers) during development. The intent of these capabilities is to allow solutions to be created without the need to copy binaries onto an MCA device until the final testing phase.
The SDK also provides resources such as development libraries, sample code, and header files, as well as full documentation and help files designed to improve developer efficiency with the platform. It also helps to ensure that the code base for solutions can run on any MCA device. Solution development is also made less complex by the provision of APIs that handle issues such as local image encryption and integration with Citrix* environments, freeing developer resources to focus on solution-specific, value-added tasks. These capabilities can decrease the time and expense required to develop software solutions, as well as increasing overall product quality.
A primary value-added capability of the SDK is that it helps to insulate the developer from differences in hardware among OEMs. For example, the SDK provides a 'code-once' API for devices like RFID and barcode readers, which interacts with plug-ins created by device manufacturers for their specific MCA products. By programming to the API provided by the Intel MCA SDK, developers are insulated from differences among individual devices, so their software is compatible with any MCA device. Likewise, the developer does not need to be concerned with various makes and models of peripheral devices (i.e., RFID and barcode readers or cameras), and solutions can operate transparently over Citrix).
The SDK integrates with Microsoft Visual Studio 2005*, the Eclipse* IDE, or Microsoft Visual Basic 6.0* to facilitate development in multiple languages, such as C/C++, C#, Java*, or COM Visual Basic/JScript*. The SDK download includes example files in these languages to help developers get up to speed quickly with the SDK. Multi-language programming interfaces built on top of the native C-language interface provide access to devices with a variety of languages using a consistent look and feel, facilitating code re-use.
Intel customer-support resources provide technical assistance related to the SDK, including escalation support as necessary to Intel software and hardware engineering staff. Intel® Software Network forums facilitate community discussion and problem resolution, monitored by developers from Intel and key third-party companies. The forums also provide ongoing access to new resources such as SDK updates, release notes, and errata. Intel® Premier Support complements those public channels with a private 24x7 means for developers to interact directly with Intel on specific issues related to the SDK.
Intel provides a proprietary set of runtime middleware software components to OEMs to incorporate into their MCA products, known as the Intel MCA Platform Driver. This package, which is specific to the individual MCA device, handles interoperability of software solutions based on the Intel MCA SDK 'code-once' API discussed above with the OEM's hardware, including all peripheral devices offered as part of the hardware product. This mechanism provides functional translation between MCA devices from various vendors and the broader ecosystem of MCA-targeted software solutions.
Intel MCA Platform Driver binaries for official OEM MCA products are included in the Intel MCA SDK download package. In addition to translation for hardware/software interoperability, the Platform Driver provides device management, logging, and configuration support that helps make that interoperability more robust. It also provides multi-threading support to help take advantage of multi-core processors and Hyper-Threading Technology. The Platform Driver also provides integration with the Citrix environment.
It is important to understand that the Intel MCA SDK and Platform Driver are not intended to operate on the same device at the same time. Attempting to do so will create undesirable results. For example, installing the Intel MCA SDK onto an MCA device will overwrite the Platform Driver and plug-ins on the device. That change will cause applications to attempt to interact with the peripheral devices emulated by the SDK, instead of the actual peripheral devices present on the MCA hardware. Likewise, installing the Intel MCA Platform Driver on the developer workstation will interfere with the functionality of the SDK.
Software solutions that target MCA platforms should follow general best practices for mobilized applications, in addition to being optimized specifically for the MCA platform. Every mobile application must successfully handle seamless operation in a connected or interconnected state, as well as power awareness and efficiency to make the most of battery life. Resources to help developers address these mob ility concerns and many others are provided by the Intel® Mobile Developer Community.
The Intel® Mobile Platform SDK is a key developer resource for the development of any mobile application, including those that specifically target MCA devices. It provides an open-source set of libraries and runtime components that facilitate rapid development of mobilized software, abstracting mobility issues away from the larger development effort. It includes a programming interface that is common across supported platforms and runtimes, maximizing code reuse.
With the Intel Mobile Platform SDK, applications can be easily enabled to manage connectivity transparently, so that users don't have to manage network connections on behalf of the software, improving the user experience. The SDK also helps the application to respond to power events such as going on or off battery power or reaching a prescribed battery level, to effectively balance power and performance, making the most of available battery life. The SDK also facilitates cross-platform compatibility for mobile applications, so that users can access applications on the device of their choice, as well as display detection, to enable applications to respond to connection of the MCA or other device to an external display.
A number of other core mobile capabilities are provided by the Intel Mobile Platform SDK that allow developers to focus instead on value-added features and tasks. For example, applications can easily be made to efficiently discover and utilize available memory and disk storage for caching, local data store, and synchronization. They can also be made to effectively manage network bandwidth, controlling the bandwidth of network traffic in system, application, process, and socket level.
The unique characteristics of MCA devices and the healthcare environment create a number of considerations for developers when creating solutions for these devices, including a combination of interface and security issues. For instance, MCA devices may be used in either portrait or landscape mode, and applications should ideally detect the display mode and reconfigure the user interface as needed. To facilitate hands-free operation, it is preferable that displays should not require the use of scroll bars. Because of patient-privacy concerns and regulatory requirements, security is also an important issue
It is vital to tailor the interface for the specific needs of touch-screen operation, such as making interface components large enough to be easily selected with a stylus. Because the users' hand can easily cover drop-down menus and other expanding items, it is useful for the interface to be user-configurable for left-handed or right-handed users. For example, that setting would control whether drop-down menus expand to the left or right of a control when selected.
Text entry should be facilitated by a large area for ink input, as well as context awareness such as recognizing format restrictions in field types such as dates or e-mail addresses, prompting the user when incorrectly formatted entry is received. Because of the importance of battery level to the operation of MCA devices, battery-powered platform applications should provide a visib le indicator of battery status at all times. For additional information and guidelines related to the development of user interfaces for MCA platforms, see the Mobile Clinical Assistant Preliminary User Interface Optimization Guide.
Because of the sensitivity of patient information and the regulatory environment surrounding it, security is a key component of the evaluation criteria that any healthcare provider must consider when deciding on point-of-care solutions for use in their facility. This set of factors is particularly relevant in the context of wireless solutions, the inherent security of which many hospital administrators may be skeptical. Properly implemented, however, wireless electronic workloads can actually be far less vulnerable to unauthorized access than traditional paper-based charts.
While much of the burden in securing wireless workflows falls to network administrators, application providers must also design solutions with security in mind, while balancing those needs against ease of use. For example, clinical environments typically require both platform and user authentication, to verify to the network that both the device and the user are authorized for specific actions. Applications should also provide different views of data sets according to the needs of specific users, and they must also support the use of strong encryption in the transmission of data.
Intel® Software Network provides a broad array of resources related to developing secure applications for use in wireless environments, including "Delivering Mobile Point of Care with Pervasive Wireless Networks," which is tailored to the needs of Digital Health applications. A more generalized list of security-related resources is available on the Security Technical Documents page.
The implementation of technology solutions to improve healthcare operations has accelerated in the past several years, with robust portable devices based on the Intel MCA specification representing a key aspect of this opportunity. Streamlining workflows for healthcare workers has shown enormous capability to control operating costs. Integrating various aspects of the clinical information infrastructure such as EMR, PACS, and RIS systems with front-end systems based on MCA devices improves point-of care operations, for an increase in overall quality of care.
Together, the ability to improve quality while decreasing costs represents the means to make hospitals and other clinical facilities more profitable and competitive. That capability drives demand for innovative software solutions that help healthcare providers take advantage of it. In turn, software vendors that deliver those solutions stand to build market share in the rapidly growing Digital Health area. Familiar developer tools and techniques combine with emerging practices and resources such as the Intel MCA SDK to allow software companies to rise to the opportunity represented by MCA devices.
The following materials provide a point of departure for further research on this topic:
- Mobile Clinical Assistant Overview is the main Intel portal for information on the MCA platform for healthcare professionals, CIOs, IT professionals, and software developers.
- Mobile Clinical Assistant SDK Download Site provides access to the current version of the SDK, as well as documentation, language packs, and other supporting software.
- Mobile Clinical Assistant SDK forum hosts public discussion and provides Intel expertise to support use of the Intel Mobile Clinical Assistant Software Development Kit.
- Motion Computing: Introducing the Motion C5* gives an overview of an MCA device that is currently in production.
For more complete information about compiler optimizations, see our Optimization Notice.
