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Aeroscout Canada


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  • 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. Digital Hospital in Practice g p High Value Asset Tracking for Healthcare Diane Beattie Integrated VP Health Information and CIO
  • 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. 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. Solution Architecture AeroScout MobileView bl 4.0 Location Engine Wi-Fi Network Wi-Fi Tags, clients, integrated sensors
  • 26. Device Tagging
  • 27. Device Tagging
  • 28. Device Tagging
  • 29. Coverage – 2nd Floor CCTC and PCCU
  • 30. Filtering Searches Can search by: – Name (Department, – BME number)) – Category – Status – Location – Group
  • 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. 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. 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. 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. 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. 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. 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. 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. 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. Future RFID Healthcare Ideas Real-time Workflow & Equipment Temperature T t Patient & Asset Resource Maintenance Monitoring Staff Safety Management Management
  • 41. Technology for better business and health outcomes