b. braun data - klasb. braun recently got approval for wireless on the outlook es pump, but the...

VENDOR BRIEFS

B. BRAUN DATA

BAXTER DATA

CAREFUSION DATA

HOSPIRA DATA

SMITHS MEDICAL DATA

http://www.KLASresearch.com/klas/site/briefs/561ha12wg5.aspx





Smart Pumps Study 2012I 13

Vendor Briefs

14 I Smart Pumps Study 2012 This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the retail price.

B. BRAUN

Overall Score Ranking B. Braun Curlin 78.8* NA B. Braun Outlook ES 66.4* NA B. Braun Space 80.8* NA *Does not meet minimum level for KLAS Konfidence.

Figure 7: B. Braun: Performance Gap Chart

B. Braun is a medical equipment vendor, offering three separate product lines of pumps. They have a strong history of solid, cost-effective pumps and good customer support. In the past year, scores on all their pumps have dropped some as customers have described decreasing customer service and increasing frustration with delays on promised development. Product-Specific Snapshot Curlin (PCA) - The Curlin pumps are one of B. Braun’s PCA offerings, described as reliable and working as sold. Since Moog has been taking over the sales and support of Curlin, it has not been clear who will support current Curlin customers and KLAS scores have been dropping. Some providers described the Curlin pumps as easy to use, but the user

interface is not always intuitive, so it can be challenging for nurses to interact with and program. Reporting is said to be particularly challenging. The Curlin pump does not offer wireless functionality.

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Functionality & Upgrades Service & Support General

B. Braun Curlin

B. Braun Outlook ES

B. Braun Space (LVP)


Vendor Briefs

Outlook ES (LVP) - The Outlook ES replaces the previous Outlook B. Braun pump. The old Outlook pump was Best in KLAS for several years running, but the Outlook ES has been much more problematic. Some concerns are being reported with hardware, interface panels, and battery life. The Outlook ES did deliver wireless functionality late 2011, and early reports are positive. Space Pumps (LVP, PCA, syringe) - The Space pumps have a modular approach, with modules available for LVP, PCA, and syringe. Clients KLAS has spoken with have been fairly pleased with good scores, but KLAS has not been able to validate enough sites running the Space to validate their performance beyond early data, despite the product being on the market for several years. New Technology—EMR Integration &Wireless Progress While they have been open in communicating to customers, B. Braun has been slow to give promised developments, including some needed upgrades and wireless functionality. Providers have been patient, but some are becoming frustrated. As one director commented, “We are supposed to have wireless functionality, but we have been waiting for that to get fixed for a year. B. Braun is all talk and no action.” B. Braun recently got approval for wireless on the Outlook ES pump, but the Space pump is still waiting. B. Braun currently has no sites live with EMR/pump integration but is reported to have two sites going live in the near future with Cerner. Drug Libraries/Reporting B. Braun received some of the lower ratings on their drug library compliance. Few providers are using B. Braun’s CQI reports, and those using them indicated that they have been difficult to use and ineffective. The challenge comes from a delay in data coming in, since each pump has to be manually plugged into the station for that data to update. Clients are waiting on wireless functionality and EMR integration to address those concerns.


Figure 8: B. Braun: How well do wireless drug library updates work?

Figure 9: B. Braun: Have you identified programming errors that fall within the soft limits?

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Vendor Briefs

Figure 10: B. Braun: How effective are the reports from this pump?

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Figure 11: What actions are you taking based on the report data?

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B. Braun Outlook ES 3 33% 33% 100% B. Braun Space 2 B. Braun Curlin 1

Figure 12: What do you need to make data from this smart pump more useful?

n Analytical Tools

Better Organized Data

Additional Reports

B. Braun Outlook ES 3 33% B. Braun Space 3 33% 33% B. Braun Curlin 3 33%


Vendor Briefs

BAXTER

Overall Score Ranking Baxter SIGMA Spectrum 80.8 3rd (of 4) Figure 13: Baxter: Performance Gap Chart

Baxter has marketed the Sigma Spectrum pumps since 2009. In 2010, the FDA issued a recall ordering all COLLEAGUE pumps (Baxter’s other LVP pump) to be replaced by the middle of July 2012, and many providers switched from their COLLEAGUE pumps to the Sigma Spectrum pumps. Product-Specific Snapshot Sigma Spectrum (LVP) - Throughout their transition from Sigma to Baxter, older Sigma customers have been more frustrated than newer customers who have only known Baxter. Promises previously made by SIGMA around PCA and syringe pumps have not been delivered. The 510(k) file for the syringe pump has been submitted and is currently awaiting FDA approval. Service and support scores have stayed high, as service has met the demand created by the COLLEAGUE replacements. Providers like the pump’s small size and large screen, and Sigma was the highest-ranked product for ease of use.

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Baxter SIGMA Spectrum


New Technology—Wireless & EMR Integration Progress Baxter has been pushing their wireless technology, and over 60% of clients reported using it with a solid experience: “It was absolutely worth the additional expense to go wireless. We have hundreds of pumps, and before we went wireless, biomed had to go to each pump and update it. Now all we have to do is send the wireless updates out. That is awesome for both us and biomed. Before, we were updating every six months or a year because it took that long to get an update done.” Baxter has a large customer doing EMR integration with a custom EMR. They are not currently doing autoprogramming, but rather send a validation banner to the screen for the nurse to check against. They also are doing autodocumentation of I&Os and routing pump alarms to the EMR. Baxter has two other customers in process of integrating their pumps with the EMR, one with a custom EMR and one with Allscripts. Drug Libraries/Reporting Baxter automatically starts in the drug library and does not require the nurse to opt-in. Baxter was one of the highest-rated vendors for compliance with the drug libraries. Thanks to their wireless capabilities with the Sigma pumps, customers were also able to update libraries as needed: “The pushes for the wireless drug library for the Baxter Sigma Spectrum pump have gone well. As soon as the units shake hands, or connect to the server, the server knows exactly which library for which hospital needs to be sent out to the pump and it does it right away.” Baxter customers were less likely to be actively using CQI data. However, providers ascribed part of that lag in reporting data usage to their newness to the pumps, having recently moved from the COLLEAGUE pumps.


Vendor Briefs

Figure 14: Baxter: How well do wireless drug library updates work? (n=13)

Figure 15: Baxter: Have you identified programming errors that fall within the soft limits? (n=18)

Very Well46%

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Figure 16: Baxter: How effective are the reports from this pump? (n=20)

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Vendor Briefs


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Baxter SIGMA Spectrum 12 75% 83% 58% 17% 25%


n Analytical Tools


Additional Reports

Baxter SIGMA Spectrum 9 33% 22% 44%


CAREFUSION

Overall Score Ranking CareFusion Alaris PCA module 79.9 3rd (of 3) CareFusion Alaris Syringe module 80.2 1st (of 2) CareFusion Alaris System LVP 80.9 2nd (of 4) Figure 19: CareFusion: Performance Gap Chart

CareFusion has traditionally been considered a technology leader. Their pumps are in a modular design, with their LVP, PCA, and syringe modules all connected to a central brain. The Alaris pump can be combined for up to four infusion channels on one PC. Product-Specific Snapshot CareFusion Alaris System (LVP), CareFusion Alaris (PCA), CareFusion Alaris (syringe) CareFusion’s LVP, PCA, and syringe modules are all controlled via the central brain, and the experience is consistent across all three modules. All are solid performers. CareFusion is rated well for their service and support, though providers described them as a more expensive vendor and said that they felt nickel-and-dimed at times: “CareFusion kept talking about all these features that were coming. I asked if they were included in the price that we had paid, and their answer was basically that they would have to see. It feels like we

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CareFusion Alaris System LVP

CareFusion Alaris PCA module

CareFusion Alaris Syringe module


Vendor Briefs

are going to have to pay as we go if we want any of these new features.” That said, CareFusion can boast that 98% of their customers reported they would buy their system again—a significantly higher percentage than any of the competitors. New Technology—Wireless & EMR Integration Progress CareFusion offers wireless across their pumps, and most of their clients have moved to that option. Their customers reported a very good wireless experience. CareFusion has been surprisingly slow to enter the pump/EMR integration race, but appears to be jumping in with both feet. They recently had their first two Alaris sites go live with Cerner and report to be in process with six more customers (five Cerner and one Epic). Drug Libraries/Reporting CareFusion rated highest for the best wireless drug library update experience. Clients said their drug library capacity is being pushed but anticipated that upgrades will relieve that pressure. Most customers were engaged with and using their CQI reports. Drug compliance was strong across all three modules.


Figure 20: CareFusion: How well do wireless drug library updates work?

Figure 21: CareFusion: Have you identified programming errors that fall within the soft limits?

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Vendor Briefs

Figure 22: CareFusion: How effective are the reports from this pump?

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CareFusion Alaris System LVP 25 80% 92% 56% 40% 36% CareFusion Alaris PCA module 14 86% 86% 57% 29% 36% CareFusion Alaris Syringe module 15 93% 93% 60% 40% 33%


n Analytical Tools


Additional Reports

CareFusion Alaris System LVP 18 33% 28% 17% CareFusion Alaris PCA module 8 25% 13% 25% CareFusion Alaris Syringe module 10 30% 30% 30%


Vendor Briefs

HOSPIRA

Overall Score Ranking Hospira LifeCare PCA 81.1 1st (of 3) Hospira Plum A+/MedNet 76.3 4th (of 4) Hospira Symbiq 81.7 1st (of 4) Figure 25: Hospira: Performance Gap Chart

Hospira offers two LVPs and a PCA product. All of Hospira’s pumps have wireless capability, which has been well received by their provider base. Product-Specific Snapshot Plum A+ (LVP) – The Plum A+ is Hospira’s older pump but is still actively sold. Providers described the Plum A+ as a steady workhorse, though several indicated they had maxed out their drug library capacity and needed more space. The Plum A+ did have the lowest percentage of reported compliance, as providers said the drug library is not user friendly and the setup makes it easy to bypass drug libraries. Symbiq (LVP) – The Symbiq has been in recall since April 2010 but just recently received clearance from the FDA. Despite the recall, the Symbiq pump was the only smart pump with a significant score increase in the past year as all measured areas saw increased satisfaction. The Symbiq offers newer, more advanced technology. It can be run as a

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multichannel pump and has strong wireless capabilities, though providers view it as more expensive. Clients reported that the user interface is intuitive and makes using the drug library easy to use. The Symbiq pumps have the highest-reported drug library compliance among LVPs, at 93%. LifeCare (PCA) – LifeCare has been the highest-rated PCA for the past two years. Providers liked their wireless functionality and barcoding scanning capability. The pumps were described as easy to use, reliable, and stable, though a little heavier and bulkier than providers would like. New Technology—Wireless & EMR Integration Progress Providers have been pleased with Hospira’s wireless capabilities, with 85%–90% of clients who went live in the past two years reporting the process as going well: “We have been extremely happy with the wireless capabilities. Having the pumps updated automatically has dramatically decreased the amount of time the biomedical and IT teams spend on addressing each pump individually to update them. We are also assured that all pumps have the most up-to-date libraries from the pharmacy.” Hospira leads other vendors in EMR integration, with early success on both the Symbiq and the Plum A+ pumps for a couple of providers. Four more sites have reported to be in the process of integrating their pumps. Most sites that are doing integration are on Cerner, but Hospira is the only site that has currently integrated with Epic. Other clients are still looking for EMR integration: “For better compliance, we have to connect the pumps with our EMR to allow for barcode and automatic programming of the pumps.” Drug Libraries/Reporting Although Hospira’s drug library updates are enabled with wireless capabilities, wireless providers were less likely to report a good experience. Some mentioned that the update process was more complex and took more time than they expected, especially with the Plum A+: “The updates really don't work out well for us. Getting them in is not a very efficient process. We are about to upgrade, and the difficulty of the process is supposed to change, but for now, we have to go to each pump. I can't just do updates on the fly. I can't just flip a switch. But, again, my understanding is that once we upgrade, we will be able to do future upgrades on all the pumps at once. Right now, upgrades have to be planned events.” Hospira has a large number of providers who reported actively using CQI data. A few Symbiq sites are pushing to be able to do more sophisticated analytics.


Vendor Briefs

Figure 26: Hospira: How well do wireless drug library updates work?

Figure 27: Hospira: Have you identified programming errors that fall within the soft limits?

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Figure 28: Hospira: How effective are the reports from this pump?

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Hospira Plum A+ 20 85% 75% 55% 30% 30% Hospira Symbiq 14 79% 64% 57% 43% 36% Hospira LifeCare 18 83% 72% 72% 39% 39%


n Analytical Tools


Additional Reports

Hospira Plum A+ 14 57% 21% 29% Hospira Symbiq 12 42% 42% 17% Hospira LifeCare 15 47% 33% 33%


SMITHS MEDICAL

Overall Score Ranking Smiths Medical CADD-Solis 80.2 2nd (of 3) Smiths Medical Medfusion 75.3 2nd (of 2) Figure 31: Smiths Medical: Performance Gap Chart

Product-Specific Snapshot Smiths Medical CADD-Solis (PCA) – Providers liked the small size and versatility to do both PCAs and epidurals with the CADD-Solis. The CADD-Solis is the only ambulatory PCA pump. The CADD-Solis does not yet offer wireless functionality, and clients described some difficulty with pump durability, including broken PCA buttons, air-in-line alarms, and battery life issues. Smiths Medical Medfusion (syringe) – Medfusion is described as a workhorse, particularly for pediatric departments and hospitals. Clients said that the pumps rarely break or have downtime but they can be difficult to update, since the process is still manual for most. Smiths Medical has been slow to deliver wireless functionality, which has been their customers’ biggest frustration. They recently got clearance through the FDA. Their first live site reported a good experience.

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Smiths Medical CADD-Solis

Smiths Medical Medfusion


Vendor Briefs

New Technology—Wireless & EMR Integration Progress Smiths Medical has been slow to deliver wireless to their clients, although they finally received FDA clearance on their Medfusion syringe. It remains to be seen how quickly Smiths Medical will be able to roll out wireless to a significant portion of their clients and how long it will take to make the move to pump/EMR integration. Drug Libraries/Reporting Without wireless functionality, few clients knew what their drug library compliance was, and less than half of Smiths Medical customers were actively using reports for CQI data. Like with all pumps without wireless, providers using the syringe pump rated the reporting capability lower, indicating that it was hard to get data in a timely manner.


Figure 32: Smiths Medical: How well do wireless drug library updates work?

Figure 33: Smiths Medical: Have you identified programming errors that fall within the soft limits?

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Figure 34: Smiths Medical: How effective are the reports from this pump?

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Smiths Medical CADD-Solis 4 75% 50% PCA Average 37 81% 76% 57% 32% 32%

Smiths Medical Medfusion 5 80% 80% 60% 20% 40% Syringe Average 20 90% 90% 60% 35% 35%


n Analytical Tools


Additional Reports

Smiths Medical CADD-Solis 6 33% 17% PCA Average 32 34% 25% 22%

Smiths Medical Medfusion 12 42% 50% 33% Syringe Average 22 36% 41% 32%

b. braun data - klasb. braun recently got approval for wireless on the outlook es pump, but the...

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