Excellence i Q lit
                                                                       E ll       in Quality




© 2008...
Digital Hospital in Practice
    g        p
  High Value Asset Tracking
        for Healthcare
          Diane Beattie
Int...
London Health Sciences Centre

One of Canada’s largest teaching
                    g          g
hospitals
Three campus si...
St. Joseph’s Health Care,
          L d
          London
Ambulatory care, mental health,
            y
rehabilitation, com...
Governance Overview
LHSC and SJHC Structure
– A shared CEO – Cliff Nordal
– Integrated Vice Presidents and Senior
  Medica...
London Health Sciences Centre and
 St J
 St. Joseph’s H lth C
          h’ Health Care, L d
                          Lond...
We Believe Enabling Technology
                  g         gy

 Provides care givers a g
                g       greater s...
We Believe Enabling Technology

  Enhances timely collaboration
  among caregivers
  Access to clinical information is
  e...
Our EPR Definition




                                                                                                   ...
What is a Digital Hospital or
      H lth S t
      Health System
Enables the Organization to leverage its
potential for d...
So What Do Care Givers
     Thi k and W t
     Think d Want
Understand the “Art f the P
U d t d th “A t of th Possible”
  ...
Architectural             Business             IT
Assessment
                          Day 1 AM         Day 2 AM
Workshop ...
Digital Hospital
I f
Infrastructure W k h
               Workshops
 Focus on:
1) Business goals and objectives
2) E
   Eng...
Key Elements of HPGM for ITSA
     Based on stakeholder participation
     Organized as a set of four
     fundamental vie...
HPGM for ITSA Summary
                           y
The HP approach for the DHI solution
architecture is:
– Based on stakeh...
Why We Chose RFID First?
 Becoming a mainstream technology for
           g                   gy
 logistics operations
 As...
The RFID Opportunity
Asset loss 15% or greater
Asset utilization currently 35-40%
Equipment search times of 30
minutes or ...
Principles for the Project
Solve a real problem
             p
– Ability to locate not just any infusion pump, but
  the r...
Principles for the Project
Leverage existing assets
– Citywide wireless network infrastructure
  in all clinical locations...
Project Goals
Clinical/Medical Staff
 – E h
   Enhance patient care th
             ti t       through rapid l
           ...
Solution Partners
HP
– Project management, relationship with
  Cisco and LHSC/SJHC
Cisco
Ci
– LHSC and SJHC network infras...
Implementation Overview
All technology proven in a test
environment prior to implementation
200 pumps tagged
      p p    ...
Project Milestones
Spring 2008
– Wireless network modifications,
  including migration to Lightweight
  Wireless Access Po...
Project Milestones
Summer 2008
– Tagging of infusion pumps
– Creating of training literature
– Stakeholder communication a...
Solution Architecture
     AeroScout
    MobileView
      bl
          4.0




  Location Engine




 Wi-Fi
Network




Wi...
Device Tagging
Device Tagging
Device Tagging
Coverage – 2nd Floor
    CCTC and PCCU
Filtering Searches


Can search by:
– Name (Department,
– BME number))
– Category
– Status
– Location
– Group
Tag Button Configuration
Primary (large) button press
 – Press once to set pump status to IN USE
Primary (large) button lo...
Feedback
“It's a great step in the right
 It s
direction”
“I know it's not perfect y , but it
                 p       yet...
Benefits and ROI
                                             Direct Benefits
                                            ...
Implementation Challenges
 Technical
 – Removal of IPX traffic from the wireless
   network; affected all notebook images,...
Implementation Challenges
 People and Change

 – Communication and training for all staff
   who handle a pump

 – Staff f...
What Did We Learn
Working together is a daily
experience
Projects have to be driven by
    j                       y
busin...
What Did We Learn
People Perspectives
– Find an effective means of communicating with
  clinical staff; email isn't necess...
Lessons Learned
Project Perspectives
   j        p
– Allow time to recalibrate in the middle of the
  Implementation. Wire...
Next Steps
Evaluate RFID expansion to other
devices and areas
Link asset tracking to other
                    g
initiativ...
Future RFID Healthcare Ideas
 Real-time                                              Workflow &
             Equipment    ...
Technology for better business and health outcomes
Aeroscout Canada
Aeroscout Canada
Aeroscout Canada
Aeroscout Canada
Aeroscout Canada
Aeroscout Canada
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Aeroscout Canada

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Aeroscout Canada

  1. 1. Excellence i Q lit E ll in Quality © 2008 Hewlett-Packard Development Company, L.P. The information contained herein is subject to change without notice
  2. 2. Digital Hospital in Practice g p High Value Asset Tracking for Healthcare Diane Beattie Integrated VP Health Information and CIO
  3. 3. London Health Sciences Centre One of Canada’s largest teaching g g hospitals Three campus sites Over 10,000 staff members Annual patient care activity – 795,700 outpatients visits – 146,600 emergency visits – 40 000 admissions 40,000 Patient information stored on 7 million visits
  4. 4. St. Joseph’s Health Care, L d London Ambulatory care, mental health, y rehabilitation, complex care, veterans care, long term care Five sites Over 5,100 staff members Annual patient care activity – 479,000 outpatients visits – 25,418 day surgeries – 47 600 annual urgent care visits 47,600 Patient information stored on one million individuals
  5. 5. Governance Overview LHSC and SJHC Structure – A shared CEO – Cliff Nordal – Integrated Vice Presidents and Senior Medical Directors – Citywide departments • London Laboratory Services Group (LLSG), Healthcare Materials Management Services (HMMS) – Integrated departments • Information Management, Biomedical Engineering – Individual departments • Finance, Human Resources
  6. 6. London Health Sciences Centre and St J St. Joseph’s H lth C h’ Health Care, L d London Provide majority of acute and ambulatory j y y services for approximately 1.5 million patients Affiliated with the University of Western Ontario and more than 30 other educational institutions London’s largest employer g y Home to Lawson Health Research Institute and CSTAR
  7. 7. We Believe Enabling Technology g gy Provides care givers a g g greater sense of control in workplace Creates an aura of an “enlightened organization” Reduces “non value” repetitive work Leads to more timely patient care decisions Mitigates “errors” and “hassle factor”
  8. 8. We Believe Enabling Technology Enhances timely collaboration among caregivers Access to clinical information is enhanced Facilitates the multiple care transactions that are always in motion Moves us closer to offering High Tech: High Touch care
  9. 9. Our EPR Definition Integration Family Physician - Partially Complete Home Regional Regional Care Hospitals p Community Hospitals I LTC Facilities Services S i LTC Facilities formation CPOE Clinical - Focus Clinical Decision Transf Documentation Support Management Chronic Orders Reporting Disease Pharmacy Foundation Automation Electronic Mngmt Blood Peri-Operative ED Patient We are here Signature Si t PACS Bank Care Tracking - Revise and Radiology, Chart Chart Patient Notes Nuclear Chart General Dictation Med Deficiency Coding & Tracking Patient Registration Upgrade & PowerChart Pathology Lab CIHI Scheduling Transcription Abstracting
  10. 10. What is a Digital Hospital or H lth S t Health System Enables the Organization to leverage its potential for delivering hi h quality care t ti l f d li i higher lit in increasingly efficient ways though the use of IT and process redesign Relies on technology as an integral and fundamental part of its business strategy Goes beyond advanced clinical systems and includes additional integration between IT medical, communication and b t di l i ti d building technologies to create a real-time information environment
  11. 11. So What Do Care Givers Thi k and W t Think d Want Understand the “Art f the P U d t d th “A t of th Possible” ibl ” Needs to be aligned with their strategic initiatives and drivers They need to be engaged in the process
  12. 12. Architectural Business IT Assessment Day 1 AM Day 2 AM Workshop p Introduction Recap Format Strategic Business Technical View View Wrap-up Wrap-up Day 1 PM Day 2 PM Recap Recap Tactical Functional Implementation View View Wrap-up Wrap up Wrap-up Wrap up
  13. 13. Digital Hospital I f Infrastructure W k h Workshops Focus on: 1) Business goals and objectives 2) E Engagement in th P i iti ti of t i the Prioritization f required functions 3) Develop a high level solution and validate the implications 4) Create an implementation roadmap that is aligned with the priorities identified in 1 and 2 above
  14. 14. Key Elements of HPGM for ITSA Based on stakeholder participation Organized as a set of four fundamental views Expressed as principles, models, and standards Business view Functional view Technical Stakeholders view Principles Standards Implementation Models view
  15. 15. HPGM for ITSA Summary y The HP approach for the DHI solution architecture is: – Based on stakeholder participation – Organized as a set of four fundamental views – Motivated by key business Business view drivers, goals, and metrics – Expressed as a set of p p principles, p , Functional models, and standards view – Linked to actions to ensure timely Technical p g progress view – Supported by an extensible framework Implementation of methods, tools, and techniques view
  16. 16. Why We Chose RFID First? Becoming a mainstream technology for g gy logistics operations Asset location and tracking – People (eg. Infants, elderly, staff) – Equipment Identification – Positive identification of patient, staff, medications State monitoring – Environmental conditions (eg. Temperature, humidity)
  17. 17. The RFID Opportunity Asset loss 15% or greater Asset utilization currently 35-40% Equipment search times of 30 minutes or greater Productivity loss for Biomedical Engineering for preventative maintenance due to equipment being in use se Labour costs for environmental monitoring Inventory management
  18. 18. Principles for the Project Solve a real problem p – Ability to locate not just any infusion pump, but the right infusion pump – Predictable sizing of fleet replacement Engage Clinical Staff Maximize the deliverables – Enhanced wireless network – Multidimensional expansion • More assets within the same footprint • More locations to track the same assets
  19. 19. Principles for the Project Leverage existing assets – Citywide wireless network infrastructure in all clinical locations – PCs and thin clients located within the target locations – Fleet of infusion pumps used within Paediatrics environment – Partnerships with Hewlett Packard and p Cisco Systems
  20. 20. Project Goals Clinical/Medical Staff – E h Enhance patient care th ti t through rapid l h id location of ti f equipment • Goal: location of the right device in less than 2 minutes 100% of the time for clinical users Biomedical Engineering – Quickly locate broken equipment and support preventative maintenance efficiencies – Reduced time to locate devices by Biomedical Engineering staff Hospital Operations – Fleet rightsizing • Device utilization to be calculated using busy/idle statistics gathered as part of the trial • Equipment movement patterns to be reviewed
  21. 21. Solution Partners HP – Project management, relationship with Cisco and LHSC/SJHC Cisco Ci – LHSC and SJHC network infrastructure is Cisco-based – Relationship to Aeroscout Aeroscout – Industry leadership position, relationship with Cisco
  22. 22. Implementation Overview All technology proven in a test environment prior to implementation 200 pumps tagged p p gg Pilot ran for five weeks 45 minute training for clinical staff staff, Biomedical engineering, help desk personnel User feedback solicited using vendor-supplied rewards; Tim’s cards and an iPod raffle
  23. 23. Project Milestones Spring 2008 – Wireless network modifications, including migration to Lightweight Wireless Access Point Protocol, addition access points to support location services, removal of IPX , routing, introduction of location appliance
  24. 24. Project Milestones Summer 2008 – Tagging of infusion pumps – Creating of training literature – Stakeholder communication and training – Implementation p – Gathering of user feedback – Measurement of project deliverables against plan – Development of calculator to determine future expansion costs
  25. 25. Solution Architecture AeroScout MobileView bl 4.0 Location Engine Wi-Fi Network Wi-Fi Tags, clients, integrated sensors
  26. 26. Device Tagging
  27. 27. Device Tagging
  28. 28. Device Tagging
  29. 29. Coverage – 2nd Floor CCTC and PCCU
  30. 30. Filtering Searches Can search by: – Name (Department, – BME number)) – Category – Status – Location – Group
  31. 31. Tag Button Configuration Primary (large) button press – Press once to set pump status to IN USE Primary (large) button long press – Press and hold for 5 seconds to set pump status to AVAILABLE Secondary (small) button long press – Press and hold for 5 seconds to set pump status to REQUIRES MAINTENANCE Using the buttons will help you locate “available” pumps – the system is only as g y good as the users using it!! Primary Secondary
  32. 32. Feedback “It's a great step in the right It s direction” “I know it's not perfect y , but it p yet, seems pretty good” “We should tag harder-to-find g devices, pumps aren't that hard to find” “We need to make sure everyone uses the buttons on the tags, not everyone i ” is”
  33. 33. Benefits and ROI Direct Benefits and ROI Reduced Capital & Regulatory Improved Increase Revenues Operational Expenses p p p Compliance Quality of Care y Reduce purchase of p Increase regulatory g y Reduced safetyy Increased patient p new equipment compliance rates incidents throughput Reduce rental costs Reduce staff time Reduced wait times Increased capacity of Reduce shrinkage spent on manual Increased staff time critical departments y Staff efficiency searching, logging with patients (OR/ER) and monitoring Increased staff procedures productivity
  34. 34. Implementation Challenges Technical – Removal of IPX traffic from the wireless network; affected all notebook images, Workstations on Wheels – Repositioning of existing Access Points; confusion with contractors on coverage service vs. location-based service – Tag quality; we may have received a bad batch – Location accuracy; assets shown on the wrong side of external walls – Quality of maps when drilling down on a large scale map; room numbers unreadable
  35. 35. Implementation Challenges People and Change – Communication and training for all staff who handle a pump – Staff forgetting to push the “busy” indicator button on the tag while pump in use – Staff claiming “ownership” of the device
  36. 36. What Did We Learn Working together is a daily experience Projects have to be driven by j y business needs not I.T. Circle back – Implementation is just the beginning Communicate, communicate, communicate – Change management is key Strong partnerships
  37. 37. What Did We Learn People Perspectives – Find an effective means of communicating with clinical staff; email isn't necessarily the best – Education and training for end users is essential – Get everyone on board quickly. Show the benefit of the system and get everyone comfortable with the system so they can focus on their jobs and find pumps quickly – Budget the correct amount of time for project staff to dedicate to a project; Don’t layer on top of other project and support activities – Determine early adopter areas and have project team and stakeholders sign off prior to implementation
  38. 38. Lessons Learned Project Perspectives j p – Allow time to recalibrate in the middle of the Implementation. Wireless isn't an exact science. Environmental factors may impact y p progress (traffic flow, building construction, materials, liquids, etc.) – Take special care of tag location and mounting p g g methods on assets. Make them easy to use for staff pressing tag buttons to change status – Allow budget and time for p p training of g proper g technical/project staff
  39. 39. Next Steps Evaluate RFID expansion to other devices and areas Link asset tracking to other g initiatives such as positive patient identification Leverage expanded wireless infrastructure on other projects such as SSmartPhone i Ph integration, i reduction of pager requirements
  40. 40. Future RFID Healthcare Ideas Real-time Workflow & Equipment Temperature T t Patient & Asset Resource Maintenance Monitoring Staff Safety Management Management
  41. 41. Technology for better business and health outcomes
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