Sramana Mitra: You did about $25 million in the second quarter of 2012?
Brent Lang: That’s correct. For the quarter, we did just shy of $25 million.
SM: You said a nurse can say the name of the person he’s trying to reach into his Vocera badge. Could you flesh that out a bit? Who is the nurse trying to get in touch with? And how does the work flow on the back end?
BL: It’s a great question. In terms of who’s talking to whom, it could be just about anybody in a hospital. We have hospital customers where virtually everybody is wearing a badge. Nurses are the largest group of users. The most visible part of the solution is the badge itself. This is a little two-ounce device that’s worn around your neck, and when you want to reach someone, you push a button on the front of the badge, and you’ll hear a Vocera prompt. When you hear that prompt, you just say the name of the person you want to speak to, and you’re connected.
Behind the scenes, that speech recognition is being sent to our server software, which has a speech recognition engine, a user database, and a bunch of call control capabilities. We keep track of all of these users in a giant database, so we know who’s on the system. We know their names, the roles they serve, and where they’re physically located within the building because we track them relative to which wireless access point they’re connected to. As a result, we can connect the call to the most appropriate person. I can even say something like, “Find the nearest member of security,” and our system will look up who’s logged in, who’s a member of security, where he is in the building, and where I am. Then it will let me know who is the most appropriate person for me to interact with. All of that intelligence is baked into our software. The ability to be able to call someone by name, role, or group is all part of the software intelligence on the server side.
The system operates over the Wi-Fi infrastructure in the hospital. We don’t have to worry about cellular coverage or anything like that. We connect up to the Wi-Fi access points and to the phone system. You can place phone calls from your Vocera badge out to a phone, cell phone, doctor’s office or other outside system. More recently, we have introduced software clients that run on smart phones, on BlackBerrys, iPhones, and Android phones, and we allow them to participate in our ecosystem and communicate with the software platform as well. That expands the group of users out to doctors or physicians.
To put a little more depth into this, I thought it might be helpful to talk about specific examples of how the system is used.
SM: Exactly. You could take a use case of a nurse calling a doctor or pathologist for some action. What is the work flow of that? Is this a device that’s just for communicating with somebody?
BL: It behaves like a phone once the call is set up. If I were to call you, your badge would chime, then we would have a live voice conversation, almost as if I was wearing a speakerphone around my neck and you were wearing a speakerphone around yours. Or it could be an entire group of people having a live voice conversation. Let me give you an example of how this might work.
Many hospitals are moving their telemetry techs – people who watch patient monitors – off the nursing floor and into special areas where they monitor 24/7, all of these screens. It almost looks like an air traffic control center. The idea was that they could be totally focused on watching the monitors and not be distracted by other things going on in the hospital. The problem was that, historically, they had been using pagers. When a telemetry tech saw something abnormal with one of the patients, what she would do was send a page to the nurse responsible for that patient. In one particular hospital, we measured that it took more than nine minutes for that communication loop to be closed. The telemetry tech would page the person, the person would be doing something else, would eventually go to the phone, and finally might call back the telemetry tech. It would take nine minutes to close the loop. What they did was put Vocera badges on the telemetry techs and on the nurses on the floor. Now what happens is when a telemetry tech sees an abnormality on one of these monitors, he pushes a button on his badge and says, “Call the nurse for room 203,” and the badge for the nurse who’s responsible for that room will ring. She will accept the call and have a live conversation with the telemetry tech. The telemetry tech can describe exactly what he’s seeing and what’s going on. There’s a whole tone of voice and sense of urgency that gets communicated because it’s a live conversation rather than just a text message. It’s been routed to the nurse who’s responsible for that patient, even if it happened right after a shift change has occurred. So, it might be that five minutes earlier a different nurse was responsible for that patient, but our system has the intelligence on which nurse is responsible for which patient.
After implementing the system, the entire interaction went from being more than nine minutes to being less than 40 seconds. The patient [can] be seen to address whether it’s a critical issue, or maybe one of leads from the patient monitor had simply fallen off the patient. There is a direct effect on patient safety in providing this closed loop communication process.