How to Automate Norav Medical

Norav makes the machine that writes the trace

Norav Medical sells the equipment that produces the trace, and has done since 1993. The catalogue is hardware first: resting ECG, stress ECG, Holter ECG, ambulatory blood pressure monitoring, spirometry, a telemetry system for cardiac rehabilitation, and the electrodes, cables and triggers that go with them.

Around the hardware sits NEMS-Web, the ECG management system, which puts every modality into one database that any authorised workstation can open, installed locally or in the cloud. A resting ECG taken in a clinic room, a stress test from the treadmill, a Holter recording made in a patient's living room and a rehabilitation telemetry session all end up in the same record for the same person.

The places this runs are not all hospitals. Primary care rooms, emergency departments, cardiology clinics, cardiac rehabilitation gyms, telemedicine services and research sites use the same equipment, and the smaller the site, the more likely the person who runs the ECG also owns it.

The recorder goes home with the patient and stops being visible

A Holter recorder is equipment worth real money that a clinic hands to a member of the public and asks them to bring back. Most come back. The ones that do not are noticed weeks later, when nobody remembers who had it.

That is the shape of the whole estate. Electrodes, batteries, patient cables and lead wires are consumables bought from distributors, and a rehabilitation session cannot start without them. Every device has a safety test and a calibration date, tracked by biomedical engineering or by an outside service company on their system rather than yours. A device gets a field safety notice. A recorder needs a firmware update.

Then the recordings themselves. Some sites send Holter studies to an outside over-read service and wait. A research site uploads ECGs to a sponsor's core laboratory and waits to hear whether they were accepted.

None of this is cardiology. All of it decides whether the cardiology can be done tomorrow.

NEMS-Web already collects every modality in one database

Norav has put a good deal of the routine into the software, and a service should use all of it before adding anything.

NEMS-Web holds resting, stress, Holter, ambulatory blood pressure, telemetry and spirometry studies in one database, reachable from any authorised workstation, which is the difference between a multi-site service and six separate ones. It carries alerts and notifications so technicians and physicians hear about pending tests, abnormal results and events that need attention rather than finding them on a list. Interoperability is standards-based, with HL7, DICOM and GDT into the EHR or HIS and PDF export for everything else, so a trace reaches the patient's chart without anyone printing it. The system installs in the cloud or locally, which matters when a rehabilitation gym and a hospital want the same records under different network rules.

All of that acts on studies, patients and devices the software already knows about.

The distributor's order page is not one of those. Nor is the service company's job list, the manufacturer's safety notice page or the over-read provider's portal. Each has a login and somebody who is meant to check it.

Recorders, electrodes and service dates managed as one fleet

A fleet becomes manageable the moment somebody counts it every day.

Every Holter recorder that went out matched against what has come back, with the ones overdue named alongside the patient and the issue date, so a chase happens in week one rather than at the annual stocktake. Electrode, battery and lead wire stock read off each distributor's site with what is on order and what has actually shipped, because a rehabilitation session that cannot start is a supply problem found too late.

Safety test and calibration dates read from the service company's own system, sorted by which device falls out of date first. Manufacturer safety notices and firmware updates checked as they publish, matched against the model numbers actually in the cupboard. Holter studies sent out for over-read tracked out and back, so a report that never returned is visible rather than assumed. Research uploads confirmed as accepted by the sponsor's core laboratory.

An integration would add nothing here. A page gets opened and the answer goes onto a list.

In a clinical service the boundary holds regardless. This gathers, compares and flags. It reads no trace and makes no clinical judgement, and anything that would change a patient record or reach a patient waits for a qualified person to check and send.

A missing recorder is found by looking, not by remembering

So is an expired calibration, a stock-out, and a report that never came back. All of it is somebody logging in somewhere and reading carefully, which is a job description rather than a skill.

WebRun is an agent that works a real Chrome browser, signed in the way your staff sign in. It opens the distributor's site, the service company's system, the manufacturer's notice page or the over-read portal, reads what is on the screen, and brings the answer back with the dates attached.

It runs on your schedule in your own private environment, sessions are not shared between tools, and a workflow can be restricted to a named list of domains. You can watch a run and stop it part way through.

Every workflow below names what it opens and what it returns.