Slow Down To Achieve Expected Results with Medical Device Integration in Med-Surg

Posted by Ken Choquette on Oct 15, 2014 @ 03:00 PM

ID-100269987“Slow Down” may not be words people use when talking about device integration.  Not all device integration initiatives are created equal.  Achieving results within med-surg units requires a bit more clinical involvement than it does in a higher acuity unit. 

Frequently, organizations want to move too fast, which undermines the value of integrating devices in these units, frustrates the implementation team, and worse, destroys end user adoption.  Neglecting the clinicians’ workflow or not conducting a network assessment in the med-surg area could render the system as unusable.  Usually, this is the result of not involving the implementation team in the device integration roll-out and hence, they’re not understanding the issue(s) you are trying to solve.

The decision for device integration in med-surg is the “starting gun” to set goals and to set the finish line.  Start by finding a baseline. 

  • What are you trying to solve with device integration in med-surg? 
  • Who currently collects the data?  How is it collected? 
  • How is data entered into the patient record?  
  • How much clinical time does documentation take away from nursing? 

We know that these are not always the easiest answers to obtain prior to integration, but knowing the current state from start to finish will help an organization set the right expectations for how device integration can improve the efficiency and safety of the existing workflows – and better yet, quantify it.

By taking a little time in beginning of the project – by SLOWING down at the start – your implementation will stay on track and result in FAST adoption and a success story for all to share.

Read More

Tags: Medical Device Connectivity, Medical Device Integration, implementation, Medical Device Infrastructure

Patient-centered Care

Posted by Cyndi Coyne, RN on Oct 10, 2014 @ 05:00 PM

Patient-centered Care … it’s a phrase I’ve heard from the beginning of my nursing career.  But do our actions back up our words?  Is the patient truly the center of our care?  It is certainly what nurses strive to do, what we all want for our patients, and what we expect when it is a loved one who is the patient. But with all of the distractions during any given shift—some necessary, some not—it’s difficult to keep the focus on our patients.

Complicated workflows, redundant, time-consuming documentation, inefficient hospital unit design, unproductive processes can all pull the clinician’s attention away from direct patient care and create unnecessary steps to complete tasks.  There are so many tasks that must be performed during any given shift that it can be difficult, if not impossible, to get it all done. It can be overwhelming. 

With so many responsibilities, there is a risk that nurses may resort to prioritizing the many tasks required and possibly leaving some undone, known as “missed nursing care”, in order to just make it through their shift.  Activities such as ambulation, turning, patient education, and discharge planning are very important duties that, if missed, can cause complications such as blood clots or pressure ulcers, or worse, lead to increased length of stay and a greater chance of re-admission.

As we move from a fee-for-service to a value-based care model (where hospitals are paid a fixed fee according to diagnosis), it is increasingly important to provide the absolute best care possible.  We can’t afford to have anything missed.  Payers will not cover complications, extended inpatient days, and readmissions.

Fortunately, technology is available that can help by reducing obstacles and assimilating seamlessly into clinicians’ natural workflow.  Wearable communication devices aid in locating staff, asking for assistance, and can even alert staff to alarms or call lights.  Rapid sign-on devices can speed up the process of logging in to a computer workstation.  Automating the capture and documentation of the vast amount of data emitted by the medical devices used to monitor and treat patients is very effective in assisting clinicians.  I can speak from experience.  I worked in critical care prior to device integration and it is very time consuming to manually key in all that information.  I can tell you there is a world of difference after the deployment of device integration. 

Capsule has solutions to accomplish device integration.  SmartLinx Vitals Stream can acquire all the continuous data from the devices used in critical care, OR, endoscopy…wherever these type of devices are used.  Even med-surg can benefit from integrating mobile vital signs monitors with Capsule’s SmartLinx Chart Xpress.  And with the addition of the Early Warning Scoring System, the clinician can be alerted to a patient who is at risk of serious decline early so interventions can be set in place to help prevent a serious event.  The outcome of medical device integration is accurate data sent directly to the patient record nearly simultaneously with its collection and greatly reducing the number of necessary steps to complete the process.  This results in the recovery of time that can be redirected to patient care, enhancing the ability of nurses and the rest of the care team to perform the duties essential to helping patients recover.  Time also helps them stay tuned in to the patient’s condition so they can recognize changes that can lead to the development of serious complications.    

Keeping the patient in the center of what we do is what contributes to the overall patient experience and leads to better patient outcomes, as well as higher nurse and staff satisfaction. Most important, though, it’s how we want all patients treated.

Does your hospital promote patient-centered care?
What initiatives have been instituted to ensure the focus is kept on the patient?
What obstacles have you seen that hinder this effort?
Read More

Tags: Patient Care, Medical Device Integration, Nurses

You can change the face of Sepsis. (Yes you!)

Posted by Karen Lund, RN BSN on Sep 30, 2014 @ 05:41 PM

SAMlogo2014According to the U.S. Department of Health and Human Services, care for persons with sepsis is one of the most costly health conditions with a total healthcare expense of over $20 billion every year.  Why put this burden on hospitals and families?

Early detection, early treatment, lower costs, decreased mortality and better long term outcomes all are dependent on the prompt and correct diagnosis of sepsis. And it’s easy to do if your hospital recognizes their data is a critical asset in fighting sepsis. By compiling all data elements from various systems and utilizing that data to its fullest is an indication your hospital sees the value of its data. 

Why would you only use the four data points of Systemic Inflammatory Response Syndrome (SIRS) to detect sepsis when you could be analyzing and evaluating over 120 different data points from the entire EMR for more accurate early detection and communication? Who wouldn’t want to decrease mortality and the number of catastrophic long-term multi-system organ effects of post-sepsis syndrome? 

Does your hospital see their data as an asset? Look to optimize the use of your data to combat sepsis with Clinical Vigilance for Sepsis software from Capsule.

Read More

Tags: sepsis

The Pecking Order of Device Integration

Posted by Halley Cooksey, RN on Sep 26, 2014 @ 03:16 PM

When I first became a nurse, one of my favorite questions to be asked was “What kind of nurse are you?” The fine print of this question, of course, is “where in the hospital do you work?” I would swell with pride and proudly state that I was an “ER” nurse.

As far as I was concerned (at that time) an ER nurse was the best kind of nurse anyone could be. Sure, working in the critical care area must have its challenges, but how hard is it to take care of an intubated patient who I had so kindly stabilized for you? As for the nurses on the floor, I mean, really? These patients were of the walkie-talkie population. Hang a few bags of IVs, push a little Lasix and remind your nurse tech to measure their output. Obviously nothing compares to the ER.

Fast forward many years to today and I have to tell you what an awakening I have had. After leaving the ER for a myriad of reasons, I crossed over to the dark-side of nursing … also affectionately known as “HIT”. It was during my years working as a clinical systems analyst that everything I thought I knew about med-surg floors made me realize that I had no concept of what it was to walk in their shoes and understand what their workflow was all about.

The nurses who worked on the med-surg unit were taking care of a complex, diverse group of patients with varying degrees of acuity; more times than not, without the assistance or extra set of helping hands of a patient care tech, because the patient care tech was in a room with a confused geriatric patient who couldn’t be left alone. I watched these nurses document on napkins, scrubs and sometimes bed sheets all while taking phone calls from different doctors and receiving orders. Additionally, they were working with social services, the hospice nurse and every other visitor who decided to stop them in the hall and ask about their loved ones. I remember thinking, who signs up for this gig? To say the least, I was humbled by their dedication.

The big picture of this is that “floor” nurses are the ones in need of technology to complement their workflow and not impede it. Technology should not be seen as “big brother” watching over their shoulders, but as an extra set of eyes to help them do what they do best: take care of patients.

Interestingly enough, though, med-surg units are typically that last areas to be thought of for medical device integration. Walk into any critical care area and you’ll likely see monitors feeding to a central station that, in turn, feeds directly to an EMR. Ventilators are cutting edge and their data is flowing to the EMR, as well. Conversely, walk onto a med-surg unit and you’ll likely observe nurses with tattoos of vital signs up and down their arms, or on scraps of paper that they will later transcribe. Their patients’ data is just as important as the patients sitting in the critical care unit or ER, right?

So, here’s an interesting thought to ponder: Typically, there are more med-surg beds in a facility than ER beds and critical care beds combined; therefore, there are more med-surg nurses working at any given time than there are in all the other areas put together. The med-surg areas are the backbone of the hospital. As a general cultural oddity, why is it that these areas are the last to get connected? Why are they not seen as mission critical like other areas of the hospital?

I’d like to hear your opinion as to why this is the case and how we can change this thought process.

Read More

Tags: Medical Device Connectivity, Nurses, Nursing Stories, Clinical, Med-Surg

Oh, how times have changed… or have they?

Posted by Michelle Grate, RN MSN CPHIMS on Sep 19, 2014 @ 09:00 AM

chart_ring_binder_cart_rack_carstens_first_healthcareI stumbled upon an interesting statement recently, "The immediate availability of a patient's chart record means greater convenience to the nurse, the attending physician, the intern and the hospital administrator. Not only is there a marked saving in time, but greater accuracy is secured in clinical records when the chart and chart holder are easily accessible." Sounds like many of the conversations we hear today about electronic documentation. But the source of this statement may surprise you: it is from a series of articles in The Modern Hospital, circa October, 19221! Looks like the theme of immediate availability of a patient's record has been around for a long time and for the same reasons.

This has put me in a bit of a nostalgic mood. Recently I was doing some work at a hospital and I glanced fondly at the good ol' chart rack. It has always been an integral piece in our arsenal of nursing tools. Although they may be a little different from one hospital to another – some are square, some are round, some have wheels, and some sit on a desk – they are all basically the same. Even today with all the electronic documentation and EHRs, they can still be seen doing their humble job on the nursing units, albeit a little thinner than they used to be. I have many memories of pulling up the chart rack to my spot at the nursing desk and doing my documentation for the day, hour, shift or whenever I got the chance.

But I digress, so back to the subject of immediate availability. If you have been a reader of our blog posts, you are already aware that we are advocates of immediate availability of patient's vital signs in the electronic record. Our goal is to help make that possible for any med/surg environment.   We can help you collect vitals directly from most spot check monitors and transmit them along with additional documentation to the electronic record in near real time. This isn't future availability, it is available now. And apparently it still helps with the age old theme of "immediate availability of a patient's chart record".

Does your facility still have chart racks?
What is in them?
Do you think they will ever go completely away?

 

[1] The Modern Hospital (Vol. XIX, p. Adv. 105). (1922). Chicago: The Modern Hospital Publishing.

 

Image credits: Franklin Mills Co.

Read More

Tags: Nurses, Clinical Documentation, ThrowBack

The Documentation Paradox in Med-Surg

Posted by Susan Niemeier, RN BSN MHA on Sep 17, 2014 @ 11:44 AM

The med-surg unit is an operationally intense care environment with typically two out of three hospitalized patients residing in this area. The acuity of patients in this setting is escalating, along with rising co-morbidities and patient age. In parallel, the hospital's patient population is shifting more toward outpatient care, increasing the number of short-stay patients. Short-stay patients are those who stay in the hospital for approximately 23 hours or less and are then discharged to go home. Often, these patients are placed in med-surg units and require a heightened level of observation to assess for subtle changes in their condition. As acuity increases, so do the number of devices at the bedside, along with the requirements for entering data into a patient's record.

Despite these conditions the nurse-to-patient ratio in med-surg units has not changed. This results in more work and immeasurable stress. Add to that the regulatory, legal and hospital compliance efforts for higher degrees of documentation, as well as pressure to discharge patients as soon as possible, and you can see that there is a "perfect storm" of increased workflow requirements that could lead to errors putting patients at risk.  

The environment wherein med-surg nurses work has become incredibly complex and demanding. The result is that they must provide increased effort, energy, and attention just to perform their normal, daily activities. Many are close to the breaking point; they simply cannot take on any more work or responsibility without significantly impacting patient care.

One responsibility that steals substantial time from patient care is documentation. The increasing complexity of patients seen in the med-surg unit means that nurses are constantly moving (between one and five miles during a typical 10-hour shift), making decisions on the fly, and multitasking, all of which takes a high toll on performance and work processes.1 Given all this, nurses view documentation as a lower priority item on their list, choosing to document in batch mode when they have a few minutes rather than in the real time.

In fact, studies find that it takes between two to twelve hours after collecting data from patients' monitors before nurses enter it into medical record. The manual entry of data leads to error rates as high as 17%.2 Yet documentation is taking up an increasing amount of nursing time, with studies finding that 35% of a nurse's time is spent on documentation (147 minutes in a 10-hour shift), while less than 20% is spent on patient care and education, and just 7% on assessment and surveillance.3

The focus on quality in today's healthcare environment means the EMR must be fully integrated into clinical care and decision making. Among the benefits when used properly, for instance, are better decisions and better coordinated care. With physician order entry, physicians need an ‘information rich' record with real-time data. Ancillary departments such as respiratory, physical, occupational and speech therapy also require access to an up-to-date medical record so they may immediately know a patient's state. Such information is equally important for pharmacy, infection control and discharge planning.

However, while EMRs can bring numerous benefits to the hospital environment and improve patient care, they are impractical and even dangerous if the data is not accurate, timely, and complete. So, therein lies the paradox: much of the data entered into an EMR is on the shoulders of med-surg nurses. Yet med-surg nurses are forced to place this task towards the bottom of their list because of their patient care priorities.

The current system relies on the nurse to function as a "human bridge" between medical devices and the EMR. The med-surg unit is no exception. Med-surg nurses capture patient data throughout the day from a number of devices, manually writing the data on a clipboard, sticky pads, paper towels or even alcohol wipes. At a later time during the shift, they key the data into each of their patients' electronic record. The danger of this approach is the increased likelihood of errors and potential for omissions. Moreover, valuable time slips by - time during which critical decisions are made based on data that could be hours old. Just as important, all of this activity of capturing data from various bedside devices and manually keying it into a record takes the clinicians away from direct patient care and surveillance, which can affect outcomes. Very simply, under the current system, clinicians doing both clinical documentation and patient assessment simultaneously is ... well ... incompatible, to put it lightly.  

There are solutions to this "human bridge" problem that can remove the nurse as the "middleman". There is increased focus on the automation of clinical documentation, that is:  the electronic transfer of data from a medical device to the EMR, and other clinical systems. The integration of data in med-surg is even more critical as the patient acuity rises along with the number of number of bedside devices to assist in monitoring. Due to the fundamental nature of vital signs, devices that take these measurements are typically among the first to be targeted for automation. Integration, however, is not limited to devices measuring vital signs. Other types of devices that can be integrated in med-surg include (but not limited to) scales, smart beds, infusion pumps, etc. By not having to record and transcribe information into the EMR, a considerable amount of time can be saved. And, automating the collection of data ensures that all desired information is accurately collected. This eliminates the possibility of accidentally omitting essential data during documentation. Recording patient data at a higher frequency allows for catching subtle changes in a patient status much sooner. 

In an environment where information is recorded automatically into the patient's record, there is no need for a physician and the interdisciplinary team to wait on the med-surg nurse to complete rounds and transcribe the data.

In the end, bringing a flexible, documentation automation system into med-surg can help reinvest nursing time to direct patient-care activities, improve nursing productivity and satisfaction, enhance the completeness of the medical record, and ultimately, improve the delivery of safe, high quality care.

My question to you is, why do hospitals choose not to automate device documentation in med-surg when the evidence is clear?

 

References

1) Potter P, Boxerman S, Wolf L, et al. Mapping the nursing process. J Nurs Adm. 2004; 34(2):101-109

2) Wager KA, et al. Comparison of the Quality and Timeliness of Vital Signs Data During a Multi-Phase EHR Implementation Computers in Nursing. CIN: Computers, Informatics, Nursing. 2010; 38(4):205-212

3) Hendrich A, Chow M, Skierczynski B, Zhenqiang L. A 36 hospital time and motion study: How do medical-surgical nurses spend their time? The Permanente Journal. 2008;12(3):25-34

 

Originally posted on ADVANCE Healthcare POV Blog.

Read More

Tags: Medical Device Connectivity, Patient Care, Medical Device Integration, Nurses, Clinical Documentation, Med-Surg, Low Acuity

Time. It’s What Med-Surg Nurses Need Most to Care for Patients

Posted by Cyndi Coyne, RN on Aug 27, 2014 @ 11:01 AM

Join-MDI-in-MedSurg-webinarI read an article a few weeks ago that truly blew me away. It first caught my attention in Becker’s Hospital Review, but I have since seen it appear in other publications, such as the Wall Street Journal. It was about bringing nurses back to the bedside. You may be thinking “Isn’t that where they are already?” But here’s the big surprise. The article was about Novant Health in North Carolina and their initiative to free-up nurses so they can spend more time doing what they do best: taking care of patients.

It all began when hospital leaders wanted to know how much time nurses actually spent in patient rooms during a 12 hour shift. What they found was shocking to me, at first. It was only 2 ½-3 hours! They weren’t alone; other healthcare organizations had similar findings. Still, that really floored me! But then I recalled when I was a bedside nurse and I have to admit, considering the nurse/patient ratios and all the activities involved in caring for the average med-surg patient, 2 ½-3 hours sounds about right. I often commented that although it may have taken me five minutes to complete a task, it took more than twice as long to gather the supplies … sometimes having to call or even go to another department … then round up a co-worker to provide an extra set of hands, and afterwards, of course, document it all. With shorter patient stays, quicker patient turnover, and older, sicker patients, med-surg nurses are really squeezed.

Novant decided to do something about it and set an ambitious goal—70% of nurses’ time (or 8.5 hours of a 12 hour shift) spent in patient rooms. To develop a plan to accomplish this, they gathered a group of 40 nurses from across their healthcare system. Wisely, they engaged their own experienced nurses to brainstorm solutions instead of hiring an outside consulting group to swoop in, do a big study, and then dictate a plan of action. The nurses studied process flow and discovered the top activities that pulled them away from the bedside: hunting for supplies, tracking down medications, filling out paperwork, and looking for test results.

The battle plan they developed involved implementing a care team approach that called for LPNs, CNAs, pharmacy techs, and other support staff, to rally around the RN to ensure all of a patient’s needs would be addressed. This included some adjustments in each person’s role so that each team member functions to the full extent of their training and licensing.

In addition, they relocated supplies either in or closer to patient rooms; brought medications to the point-of-care; and implemented an EMR with physician order entry, along with a computer workstation in each patient room. This was all aimed at reducing the required steps in caring for the patient along with documenting that care. Bringing everything the patient needs to the point of care—what a revolutionary idea!

Integral to this strategy was automating the capture of medical device data, which freed-up the clinician from the manual process of entering data into the patient record; not to mention increasing the accuracy of the data, as well. It’s an essential tool that allows nurses more time to focus on the most important part of their job—the patient.

Research proves the more time nurses spend at the bedside, the fewer patient falls, the fewer medication errors, the higher the patient satisfaction rates, and the lower the infection rates. Furthermore, nursing satisfaction also increases, leading to lower nurse turnover. Med-surg units are the backbone of any hospital. Easing the workload of this vital group can only lead to good things.

Oh, and by the way, Novant reached their goal. Nurses are now spending 72% of their time in patients’ rooms allowing them to not only care for their patients, but also keep patients and their families better informed regarding post-hospital care, ways to improve their health, and the prevention of subsequent hospitalizations. Very impressive Novant! Bravo!

How much time do you think nurses at your hospital are engaged in direct patient care?
What measures have been instituted in your organization to increase nurses’ time at the bedside?

We're Discussing MDI in Med-Surg Today at 2:00pm EDT!

Read More

Tags: Medical Device Connectivity, Medical Device Integration, Nurses, Medical Device Information System, Med-Surg

Med-surg and device integration: Why not?

Posted by Susan Niemeier, RN BSN MHA on Aug 21, 2014 @ 03:11 PM

Webinar

  • Med-surg is a demanding, operationally intense care environment. The majority of a hospital’s patients are located in med-surg and generally, the unit provides most of its revenue. In fact, med-surg is described as the hospital’s “backbone”, and it can be argued that it is the most important department in an acute care facility.

  • Med-surg nursing units have the highest nursing turnover rate (>24%) compared to other nursing departments. Without intervention, med-surg will turn over their nursing staff every four years. The cost of turnover is two times the annual salary for this position, averaging around $100,000 per nurse. This has a profound impact on hospitals’ margins.

  • Med-surg units drive patient satisfaction opinions. Nurses cite work pressure and loss of control as the most common predictor of organizational work dissatisfaction. Med-surg nursing units are the last area in which patient’s reside and often the area that has the greatest impact on their perception of care. Consider the impact on measuring patient satisfaction through HCAHPS, which enables comparisons to be made across hospitals.

 

So, why talk med-surg and device integration? The frontline clinicians who work on the med-surg unit represent an essential and costly resource. Maximizing their effectiveness and efficiency is critical to hospital operations and the promotion of safe patient care, which is precisely what medical device integration is designed to do. I hope the data points above express the importance of supporting med-surg clinicians with the tools they need to do their job.

 

Register To Learn More

Expanding Medical Device Integration to Med-Surg 

Wednesday August 27, 2014, @ 2pm - 3pm ET 

Susan Niemeier MHA, RN, Chief Nursing Officer at Capsule

Register Here.

 

 

Read More

Tags: Medical Device Connectivity, Medical Device Integration, Medical Device Information System, Med-Surg

Safety First - Are You Automating Your Medical Device Data?

Posted by Halley Cooksey, RN on Aug 13, 2014 @ 12:59 PM

ID-100247920When I grew up, safety equipment like bike helmets and seat belts were few and far between. Some of the best memories from my childhood are of sitting in the back of my parent’s station wagon with my sisters untethered to either our seats… or to electronic devices. We passed the time by playing license plate bingo and trying to get truck drivers to beep their horns.

Fast forward 20 years, and the thought of allowing a child into a car without a seat belt, let alone in the “wayback” of a station wagon... err, a SUV... would land a parent on a DFACS (Department of Family and Child Services) watch list. The impetus behind these changes was research. Research found that when children are placed in the backseat of a car, and securely fastened, their chances of survival are greatly improved if they are involved in a car accident.

Nursing practice has followed suit. As a nurse, it is our duty to ensure that we provide the safest care to the patients we serve. Clinical, nursing-driven research has laid the foundation for what is considered to be “best practices” to support us in achieving that goal. But, what if those best practices aren’t enough?

I read an article last week that stated that in 2013, an estimated 440,000 patients died due to medical errors. That’s four times the population of my hometown! As nurses, what can we do to help decrease those errors? How can we be the driving force that saves one of those lives?

Sending data automatically from medical devices at a patient’s bedside into the medical record and other information systems, like clinical decision support, is a good first step in supporting the reduction of those errors.

Have you conducted any studies at your facility that have shown improvement in patient care when documentation is automated?

Let me know your thoughts! Share your story!

Read More

Tags: Medical Device Connectivity, Medical Device Integration, Patient Safety, Nurses, Medical Device Information System, Medical Device Data

Timing is Everything - Especially with Vital Signs!

Posted by Michelle Grate, RN MSN CPHIMS on Aug 08, 2014 @ 12:25 PM

ID-10044848The age old saying, “timing is everything,” still rings true today with Clinical Decision Support (CDS). The most effective time to present a CDS alert is immediately at the point-of-care. But how effective is an alert if the data triggering it is entered hours after the actual event?

To achieve the greatest benefit from CDS, data needs to be entered in near real-time. This is why automated documentation of vital signs is essential, even with periodic vitals collection.

We have long tried to achieve the ideal scenario of real-time bedside documentation, but incorporating the necessary workflow is difficult. While many facilities have deployed auto documentation for continuous monitoring in the ICU or the OR, the med/surg environment, or any location where periodic vital signs collection is performed, is often overlooked or not evaluated for automating documentation.

But why? This is an important environment that can benefit by enhancing CDS with automated periodic vital signs collection.

For example, early detection of a patient’s declining condition in the med/surg environment can lead to early intervention and prevent untoward events. CDS is an essential element in early detection and vital signs are a key component of many CDS rules. When vital signs are not entered into the electronic record for minutes or even hours after they are taken, the opportunity to maximize the benefits of early detection is lost.

It is as simple as this: the sooner data is entered, the sooner the CDS rule can trigger an alert and the sooner the patient can benefit. All of this will help lead to better outcomes.

The med/surg environment should be the patient's next stop in a hospital before going home, not back to the ICU or to another critical care area. Maximize the benefits of CDS with automated vital signs documentation at the point-of-care. Capsule's SmartLinx Chart Xpress™ works with a variety of spot check monitors and sends validated vital signs to information systems in near real-time.

 

Do you have automated vital signs documentation with your periodic monitoring locations?
What are some other benefits you see to automating this workflow?
Read More

Tags: Medical Device Integration, Alarms and Alerts, Medical Device Information System, Medical Device Data, Med-Surg, Low Acuity

Subscribe

Request a medical device
integration demonstration
demo-request
Capsule Tech, Inc.
300 Brickstone Square, Suite 203
Andover, MA 01810
+1 (978) 482-2300
www.capsuletech.com


Capsule Technologie
9B Villa Pierre GINIER
75018, Paris, France
+33 1 84 17 12 00
www.capsuletech.fr