Five roles, each a step from the bedside towards the software that serves it

Mandate

Turn a device-and-dashboard business into a clinical product that older patients could use unaided, that nurses could work with, and that would stand up to FDA and customer scrutiny as it added decision support.

Outcomes

• Made cellular kits the default in 2022; first-month reading rates rose from 68 to 90 per cent overall and from 51 to 87 per cent among patients aged 75 or over.
• Redesigned heart-failure alerting in 2023; alerts per 100 patients a week fell from 74 to 31 and monitoring time from 34 to 21 minutes per patient a month.
• Took the heart-failure risk score through FDA marketing authorisation in September 2025 after a four-site prospective study of 2,900 patients.
• Held COPD for a 2024 pilot and released a symptom-led programme in March 2025, with 5,000 patients enrolled by December.
• Enrolled patients grew from 31,000 in March 2021 to 118,000 in December 2025.

Decisions in context

I joined Ardenwick in March 2021, when it monitored 31,000 patients and reported its growth in kits shipped. Thaddeus Brannigan, who co-founded the company in 2014, asked me to build a product organisation clinicians would trust and to prepare for software that would need FDA authorisation. The work has followed a deliberate order. We first made sure readings arrived, by switching to cellular kits in 2022. We then made sure nurses could act on them, by redesigning heart-failure alerts in 2023. The risk score went through a four-site study before its authorisation in September 2025, and COPD went through a pilot before its release that March. I lead 112 people with six direct reports. Engineering reports to our chief technology officer, and regulatory affairs and quality report to the chief executive, which keeps regulatory conclusions independent of my roadmap.

Reason for the move

Current role. Not seeking an executive move; considering one independent directorship with the consent of Ardenwick's chief executive and board.

Mandate

Make remote monitoring of implanted devices workable for device clinics that were receiving more transmissions than their staff could review.

Outcomes

• Introduced a triage view that sorted transmissions by clinical priority; review time per transmission fell by about 40 per cent in a 22-clinic evaluation.
• Moved 410,000 patients' bedside monitors from landlines to cellular connections between 2018 and 2020.
• Led the product work on two premarket submissions for platform changes within the company's design-control and quality system.
• Set up a product-security review for every connected-care release after a coordinated vulnerability disclosure in 2019.

Decisions in context

Pellmore hired me in September 2016 to lead product management for the remote monitoring service that device clinics use to review transmissions from patients' implanted pacemakers and defibrillators. The clinics' problem was volume: more transmissions arrived each day than their nurses and technicians could review carefully, and the urgent ones sat among the routine. We built a triage view that sorted transmissions by clinical priority, and an evaluation at 22 clinics found review time per transmission had fallen by about 40 per cent. From 2018, as vice president, I also led the move of 410,000 bedside monitors from landlines to cellular connections, the product work on two premarket submissions and a security review process introduced after a coordinated vulnerability disclosure in 2019. Working inside a listed device company's design controls taught me to treat documentation as a record of decisions rather than a tax on them.

Reason for the move

Wanted to lead a whole product function at a company where software was the product, and to work on chronic disease beyond the device clinic.

Mandate

Redesign nursing documentation for small hospitals and bring the clinical modules through federal health IT certification for the incentive programme.

Outcomes

• Cut the nursing admission assessment from 212 fields to 96, reducing average completion time from 47 to 26 minutes.
• Brought four clinical modules through federal health IT certification.
• Withdrew a sepsis screening alert that nurses overrode 93 per cent of the time and rebuilt it as a two-step prompt; overrides fell below 30 per cent.
• Kept annual customer retention at about 96 per cent across the clinical applications.

Decisions in context

Quarrystone sold electronic health records to community and critical access hospitals, many with fewer than a hundred beds and no informatics staff of their own. I joined in April 2011 as product manager for nursing applications and became director of product for clinical applications in 2013, after a private-equity investment in the company. My first project was the nursing admission assessment. I timed nurses completing it on fourteen units in five hospitals, then cut the form from 212 fields to 96 and the average completion time from 47 minutes to 26. As director I brought four clinical modules through federal health IT certification for the incentive programme. The sepsis screening alert that nurses overrode 93 per cent of the time was my most instructive failure: we withdrew it within two months, rebuilt it as a two-step prompt, and saw overrides fall below 30 per cent.

Reason for the move

Wanted to work on regulated device software, and on care that continues after the patient goes home.

Mandate

Bring nursing documentation and barcode medication administration onto the hospitals' first electronic systems without taking time from the bedside.

Outcomes

• Completed barcode medication administration on 19 inpatient units by 2009, with scanning compliance of 96 per cent within six months.
• Trained 1,450 nurses through a network of 120 bedside super-users.
• Represented nursing in the 2010 selection of a full electronic health record under the federal incentive programme.

Decisions in context

Wexley Valley's three hospitals were moving from paper to their first electronic systems when I joined in January 2006 as a clinical informatics nurse. I became manager of clinical informatics in 2008, reporting to the chief nursing officer with a dotted line to the chief information officer, and led a team of nine. Our largest project was barcode medication administration on 19 inpatient units, completed in 2009. We taught it through 120 bedside super-users rather than classroom sessions alone, and scanning compliance reached 96 per cent within six months. In 2010 I represented nursing in the selection of a full electronic health record under the federal incentive programme, and I led the nursing workstream of the US$38 million implementation until I left. Watching vendors present their products to us showed me that the choices shaping a nurse's day were made long before a hospital signed a contract.

Reason for the move

Saw that the design decisions affecting nurses were being taken at software companies, and wanted to work where they were taken.

Mandate

Care for patients with heart failure and arrhythmias and those recovering from cardiac procedures; from 2001, run the unit's shifts.

Outcomes

• Charge nurse on a 32-bed cardiac step-down unit from 2001.
• Co-wrote the unit's heart-failure discharge teaching, including daily-weight instructions, adopted across the hospital's cardiology service in 2003.
• Served as a super-user for the hospital's first electronic medication administration pilot in 2004.

Decisions in context

I joined Harwell Memorial's cardiac step-down unit in July 1997, two months after qualifying, and stayed for eight and a half years. The unit's 32 beds took patients with heart failure and arrhythmias and those recovering from catheterisation and cardiac surgery. From 2001 I worked as charge nurse, running shifts of eight to eleven nurses and aides and managing admissions from intensive care and the emergency department. In 2003 I co-wrote the unit's heart-failure discharge teaching, which the hospital adopted across its cardiology service. In 2004 I was a super-user for the first electronic medication administration pilot, and that is where my interest in clinical software began: experienced nurses created workarounds within days because the screens followed the pharmacy's sequence rather than the bedside's. I completed a part-time master's in health informatics in December 2005 and left to work in that field.

Reason for the move

Completed a part-time master's degree in health informatics and wanted to work on the systems nurses use.