G3 syst tech draft pdf


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G3 syst tech draft pdf

  1. 1.     G3 System Technologies (G3ST)                                                       Eddie Tapper PO Box 7070 Kansas City, MO 64113 816200-6557 etapper@kcdesignbuild.com
  2. 2. Table of Contents Executive Summary ...................................................................... 1-3 Business Description and Vision ..................................................... 4 Description of the Products and Services ................................... 4-5 Definition of Market and Analysis .....................................................5 Organization and Management ........................................................ 6 Marketing and Sales Strategy .......................................................... 6 Additional Benefits ........................................................................... 6 G3ST Solutions ............................................................................. 7-9
  3. 3. Executive Summary       Phase 1 Phase 2 Phase 3 - G3 Electronic Triage G3 Information Validation G3 Offsite Technologies This business plan will briefly outline the development of a system that will assist in saving lives, provide better healthcare and insure that our environments are as safe as possible.   Information is essential to insuring the positive outcome of individuals experiencing a medical emergency. Unfortunately many of the healthcare providers have no way of knowing how an injury may have occurred or what the conditions were at the time of injury. Gathering the right information at the right time is not currently possible but may be possible in the near future using G3 technologies.   Example: A car accident occurs involving 4 cars and 10 individuals, all with injuries. Ambulances arrive at the scene but the paramedics cannot treat all the injured at once so standard triage of patients occurs with all attempts made to care for the most injured first. The patients are transported to area hospitals where they are healed to the best of the doctor’s and nurses’ ability and then the patients are sent home to finish healing.   A Better Example: A car accident occurs involving 4 cars and 10 individuals, all with injuries. Ambulances arrive at the scene but the paramedics cannot treat all the injured at once so standard triage of patients occurs with all attempts made to care for the most injured first.   PHASE 1 – G3 ELECTRONIC TRIAGE   The ambulance driver “deputizes” four passersby who have been trained in the G3 systems which could be taught with CPR courses. The passersby obtain a G3 package from inside of the ambulance. These would contain a touch pad, ear piece and wired / wireless connectors which will monitor the vitals and status of each of the patients from an offsite location.   The touch pads are wirelessly connected to either receivers located throughout the G3 wired community or to the ambulance which then transmits the information via satellite or wireless connection.   Since the connection to the offsite doctors/nurses can be two-way communication, the nurses may ask the injured person questions regarding who they are, how they are feeling, what their medical history is and who they should contact to inform of the accident. The one-on-one connection can also be calming and reassuring to an injured person. After connecting the injured to the touch pad the deputized passerby will also   Page 1
  4. 4. raise and rotate the touch pad 360 degrees to fully video the current status of the accident scene and provide offsite medical personnel with critical facts related to the injuries. If directed by offsite personnel the passerby can also take specific images of the injuries or other relevant information and provide stabilizing and shock reducing care.   Offsite personnel will have the ability to hear, see and monitor the patient and accident scene. They can also communicate directly to the paramedics to assist in the triage of the injured and inform the paramedic if an patient has a change in condition. If required, additional doctors, surgeons or specialists may be electronically tied into the accident scene from anywhere in the world to give assistance in determining care. In addition to the medical personnel having two way contact, family members may be tied in to the conversation to assist in providing background medical histories and translating if required. Hearing a loved one’s voice may also be calming. The connection to the injured also assists in directing the relative to the appropriate hospital and if other situations must be managed for instance picking up children from school.   PHASE 2 – G3 INFORMATION VALIDATION   Information from all touchpads as well as a 360 degree videos from the ambulance are downloaded and available to assist in determining the cause of the accident. This information may be shared with a wide variety of entities. Roadway designers may view the information to determine if a section of road is inherently dangerous and should be redesigned to be safer. Accidents nationwide could be analyzed to determine the safest possible way to design roadways. Car designers may view the data to better understand how vehicles react to impact and how the forces of the impact are inflicted on the passengers inside the cars. Safer cars can designs can result.   Healthcare providers can review the information to gather better data on how the injuries occurred and what the best course of action may be. Doctors currently do not know how accidents occurred and how the trauma was inflicted especially if the injured are unconscious or if the sheer number of injuries cloud the paramedics dissemination of information to hospital staff.   The touchpad may continue to be assigned to the patient while they are in the hospital all the while recording every minute of care (electronic, video and audio), who did what, what medications were given and when as well as the constant monitoring of vitals. This information is continuously relayed to a central storage facility where it can be monitored and reviewed. On-call doctors and specialists may access the stored information and real time information to better ascertain actual condition of the patient and immediately direct on-site personnel. Insurance companies could also access information to determine fault. The combination of multiple cameras should allow for a virtual accident scene which can be viewed in real time or at a later date.   Page 2
  5. 5. PHASE 3 – G3 OFFSITE TECHNOLOGIES   The touchpads can then be assigned to healing individuals when they leave the hospital so current health status and information can be transmitted back to the central storage unit where it is monitored every second of every day. Recording and transmission of electronic, video and audio information can be triggered by a change in condition or other event. Offsite personnel can connect with individuals to find out if they are ok or are having a health emergency. Monitoring of all vitals, confirmation of the taking of medication and recommended care and immediate assistance in case of emergency all will contribute the fastest recovery possible.   G3 locations can also be set up throughout the city to allow individuals to connect to medical or emergency personnel. The individual’s medical history may be viewed in conjunction to current condition and the patient’s primary medical caregiver may be electronically informed and tied in.   This concept can be expanded to monitor injured individuals after either man-made or natural disasters. Medical assistance and expertise from all over the world may be focused and directed to assist in major disasters or events relieving immediate healthcare providers from becoming overwhelmed. If individuals are already tied into G3 systems then locating them and communicating with them can be possible, ie under a building or other inaccessible location. In wartime soldiers may be equipped with G3 systems to assist in the coordination of efforts, saving lives and the ability to learn from the analysis G3 information detailing successes and errors.   G3ST provides information in real time or for review at a later date that will save lives and promote safer environments. Offsite medical personnel will instantly be able to virtually tour an accident site, ascertain the most critically injured, direct onsite medical personnel, monitor the vitals of the injured in real time and most importantly have the ability to understand what happened, how it happened and when it happened. All of these will contribute to making the best decisions in treating the injured and promoting the fastest and most complete recovery.   Kansas City Missouri and Kansas are in a historically unique position to develop and implement G3ST, a revolutionary system of delivering medical care due to the following: 1. G3 Fiber Network 2. Advanced Hospitals and Research Facilities 3. Preeminent Medical Staff 4. Integrated Ambulance and First Responder Network 5. Market Leading Medical Software, GPS and Communications Companies 6. Strong Entrepreneurial Support System and Spirit 7. Educated and Highly Productive Workforce   Page 3
  6. 6. Business Description and Vision   G3ST’s vision is to evolve and grow into an entity that can serve the entire Kansas City Metropolitan Area quickly and expand to other G3 markets as soon as they become available. This escalation would be a challenge for any new company with limited resources. The formation of a health services public private partnership (PPP) may be the best option to leverage the purchasing power, funding sources and oversight of a government agency with the innovation and cost control of private companies.   Although initially started as a private entity G3ST may transform into a PPP which would be owned by a public / private partnership including the Cities of Kansas City, Missouri and Kansas City, Kansas along with the private sector health, technology, software and manufacturing companies who have a vested interest in working together to provide core competencies in operations, technology, funding and technical expertise.   Health service PPPs have increasing been relied upon by many communities as a viable alternative in developing new healthcare infrastructure. As detailed in Build and Beyond: The (r)evolution of Healthcare PPPs published by Health Research Institute “PPPs can evolve to bend the cost curve. Across the globe, these partnerships are being crafted to make government and private industry more accountable for maintaining each nation’s most precious national resource: the health of its citizens”.     Description of the Products and Services   Tablet / smart phone hardware G3ST software will run on multiple tablet and smart phone platforms including G3 Tablets and Apple iPads. Emergency personnel tablets will meet the FDA Quality Systems (QA) Regulation / Medical Device Good Manufacturing Practices (CGMP Practices) to reduce the potential for pathogen transmission and reduce the potential for human use error through clear input/output guidelines. Human Factor Engineering will be implemented in both G3ST hardware and software. Wireless monitoring devices and A/V connections may be single use.   Network Software The network and standalone software for G3ST will include upload and download encryption and will additionally meet all current HIPPA security requirements.   A “light” version of G3ST is planned for consumer download which will allow consumers to upload medical histories, monitor vitals through connected/wireless devices and transfer information to and from medical providers. Emergency personnel will have the ability to upload G3ST Light essential data from the consumer’s device   Page 4
  7. 7. Data Repository G3ST is currently reviewing available data repository options and the requirement for dispersing medical data across regional lines. If possible local data repositories on the Kansas City G3 High Speed Fiber Network will be utilized and / or developed. Cloud computing through systems similar to G3 Health, The Direct Project and Microsoft Healthvault are also under consideration.   Data Subscriptions Encrypted data management, dissemination and privacy controls will follow all applicable local, state, federal and international rules and regulations. Data subscription access will be tiered controlling what information is available to whom and for what purpose. Examples of available data requests may include:  First responders training may include actual virtual accident scenes  A drug company would like to know how patients respond to their drug.  An insurance company would like to better understand what happened to cause an accident  Traffic designers would like to understand why a specific intersection has so many accidents  A university would like information to determine how specific events  Automotive companies may want to know how their car responds to impacts in certain weather conditions       Definition of the Market and Market Analysis   The American Hospital Associations listing of 5,795 registered hospitals includes 944,277 staffed beds admitting 37,479,709 patients who had received over $726,671,229,000 of care in 2009. This market represents a significant portion and focus of the G3ST Market. This however does not however include the 48,384 ambulance vehicles manned by 840,669 EMS personnel working for 15,276 ambulance services or the approximately 800,000 police officers who currently serve communities throughout the US and would also benefit from G3ST services.   Beyond the current medical and first responder fields a new supporting industry is potentially available. This industry will not only provide additional jobs for the hardware manufacturing and sales, software development, sales and logistical support but also a new virtual G3 based emergency medical network of the best doctors, nurses, specialists, tacticians and first responder support systems. Patients will literally receive the best health care the world can offer at a significantly reduced cost.   Page 5
  8. 8. Organization and Management   G3ST is in a research and development stage. The ownership and management of G3ST will be primarily divided among the communities and businesses that assist in its development and implementation who will also share in the financial benefits of the venture. Initially businesses and organization wishing to participate would be encouraged to locate offices in Kansas City and by doing so creating job opportunities in Missouri and Kansas.   It is the intention of G3ST that those organizations that assist in the development and testing of the systems will receive long term benefit. For example if the Kansas City MAST ambulance service is instrumental in the development of G3 (G3 Emergency Triage) then MAST would receive residual income if the system was implemented in Taipei.     Marketing and Sales Strategy   Given the collaborative infrastructure consisting of both public and private institutions that must be created in order to develop G3ST, the enlistment of a public relations/marketing firm with broad experience in the health care and information technology sectors, is essential for success in bringing together the experts, key service providers and other stakeholders necessary to move the project forward. This firm would be tasked with branding, creation of presentation materials, market research and focus groups, and convening of the local leadership in all relevant sectors required for development and implementation of G3ST. They would also be responsible for the public messaging and media relations throughout the development process. At the point of implementation, the firm would then guide a marketing consortium comprised of all participating institutions so as to leverage the consumer marketing expertise of the local healthcare providers at the point G3ST begins to serve the public.       Additional Benefits   G3ST data and resources will lead to an unprecedented amount of medical information that could benefit researchers for years to come and spin off educational, business and social service opportunities we cannot even comprehend today.   G3ST could become a stepping stone in the development of a health care delivery system that is primarily owned by the general public and incentivizes the best and brightest businesses to continue to develop the highest quality service at the most economical rate.   Page 6
  9. 9. G3ST Solutions   The success of G3ST is dependent on the ability of the system to solve current problems, increase the level of health care and reduce the cost to provide that care. Our research has identified specific industry problems which have been documented in peer reviewed publications. Here is a brief synopsis of a few of those problems and how we are positioned to solve them.     1. Overcoming Pre-hospital Communication Errors   “Problems with communications are a frequent source of disaster scene and triage errors in small MCIs. In a study of pre-hospital triage and EMS communication performance, prospective data from resource physicians and retrospective data from tape recorded pre-hospital conversations were collected for 45 consecutive MCIs over a 9-month period.1 Most of the MCIs were motor vehicle accidents and most patients were treated at a level 1 trauma center. Frequent errors included having multiple communicators on site (38%), misidentifying the number of victims (56%), and having unclear information for the resource physician (43%). Only 38% of events had pre-hospital triage information that was deemed entirely appropriate.” Communication: The Indispensable Part of Emergency Medical Services The Norman Wood Bridge Incident: A Turning Point Michael J. Reinhart, D.O., F.A.C.E.P. Sr. V.P. & C.F.O., Lancaster Emergency Associates Ronald D. Baier, E.M.T.-P EMS/Communications Center Manager, Lancaster General Hospital   G3ST allows direct communication between patients and the treating nurses and physicians. Emergency personnel will be able to see, speak to, monitor and evaluate patients anywhere from anywhere. If questions occur after the accident or if additional training is necessary the emergency scene may be replayed virtually.     2. Overcoming Emergency Room Communication Errors   “This study observed the communication patterns of 20 staff members in the pediatric and adult ED areas of a regional hospital trauma center over the course of 39 hours (including day and evening shifts). Most communication was face-to-face, short (less than 1 minute to 3 minutes), and frequent (an average of 49 communication events per hour). However, the frequency, duration, and mode of communication differed among ED providers. For example, paramedics and triage nurses didn't communicate often with ED attending doctors. This suggests that the attending doctors received most patient handoff information secondhand.” "Emergency department communication links and patterns." Annals of Emergency Medicine Fairbanks, R.J., Bisantz, A.M., and Sunm, M. (2007, October).   “Conclusion: Academic EDs present unique challenges to effective communication. In our study, the physician patient encounter was brief and lacking in important health information. Provision of patient centered care in academic EDs will require more provider education and significant system support.” Resuscitating the Physician-Patient Relationship: Emergency Department Communications in an Academic Medical Center   Page 7
  10. 10. G3ST allows doctors and specialists to quickly review all the patient’s information directly through still photos, videos and audio, date stamped and indexed. All medications and the provider of those medications would be time/date scanned into the system with notifications of possible drug interactions and dose level, frequency or allergy checking. A low frequency reader (RFID 125kHz) within the G3ST hardware will monitor the medical employee badges to identify who assisted in the care of the patient and the standard patient monitoring devices can be coupled with EKG Units, Glucose Analyzers, Blood Analyzers, Infusion Pumps, Ventilators or any other monitoring devices to allow a overlay of patient response to medication or assistance.     3. Overcoming Patient Transfer Communication Errors   “During an episode of disease or period of care, a patient can potentially be treated by a number of health-care practitioners and specialists in multiple settings, including primary care, specialized outpatient care, emergency care, surgical care, intensive care, and rehabilitation. Additionally, patients will often move between areas of diagnosis, treatment, and care on a regular basis and may encounter three shifts of staff each day—introducing a safety risk to the patient at each interval. The hand-over (or hand-off) communication between units and between and amongst care teams might not include all the essential information, or information may be misunderstood. These gaps in communication can cause serious breakdowns in the continuity of care, inappropriate treatment, and potential harm to the patient. Breakdown in communication was the leading root cause of sentinel events reported to the Joint Commission in the United States of America between 1995 and 2006 (1) and one USA malpractice insurance agency’s single most common root cause factor leading to claims resulting from patient transfer (2). Of the 25 000 to 30 000 preventable adverse events that led to permanent disability in Australia, 11% were due to communication issues, in contrast to 6% due to inadequate skill levels of practitioners (3). Hand-over communication relates to the process of passing patientspecific information from one caregiver to another, from one team of caregivers to the next, or from caregivers to the patient and family for the purpose of ensuring patient care continuity and safety (4). Hand-over communication also relates to the transfer of information from one type of health-care organization to another, or from the health-care organization to the patient’s home. Information shared usually consists of the patient’s current condition, recent changes in condition, ongoing treatment and possible changes or complications that might occur. Patient care hand-overs occur in many settings across the continuum of care, including admission from primary care, physician sign-out to a covering physician, nursing change-of-shift reporting, nursing report on patient transfer between units or facilities, anaesthesiology reports to postanaesthesia recovery room staff, emergency department communication with staff at a receiving facility during a patient’s transfer, and discharge of the patient back home or to another facility.” World Health Organization Patient Safety Solutions volume 1, solution 3 | May 2007   G3ST will be the patient’s healthcare navigator, advocate and early warning system. If appropriate the patient may review educational videos or documents that will assist the patient in understanding what is needed, why and what the potential risks are. Schedules for medications, procedures and patient involvement will alert the patient when specific medications must be taken and if exercise is needed keep track thru GPS of distances walked. If the patient’s vital signs extend beyond set limits they are informed and the medical staff is notified of where the patient is and what assistance   Page 8
  11. 11. may be needed. G3ST may also open up direct audio and video communication between the patient and the care giver.   Physicians may access individual patient’s history and have a clear understanding of the patient’s current and historical status even before physically meeting the patient. Since vitals are monitored before, during and after every drug or procedure occurs the physician may gain significant knowledge on the best course of action. The Physician’s G3ST portal will deliver emergency notifications, full records, prognosis and scans both offsite and onsite. On call doctors will have unprecedented information to draw upon to make informed recommendations and directives.     4. Overcoming Discharge Communication Errors   “Being discharged from the hospital can be dangerous. A classic study found that nearly 20% of patients experience adverse events within 3 weeks of discharge, nearly three-quarters of which could have been prevented or ameliorated. … Systematic problems in care transitions are at the root of most adverse events that arise after discharge. Discontinuity between inpatient and outpatient providers is common, and studies have shown that traditional communication systems (such as the dictated discharge summary) generally fail to reach outpatient providers in a timely fashion and often lack essential information. Patients frequently receive new medications or have medications changed during hospitalizations. Lack of medication reconciliation results in the potential for inadvertent medication discrepancies and adverse drug events—particularly for patients with low health literacy, or those prescribed high-risk medications or complex medication regimens.” Adverse Events after Hospital Discharge Agency for Healthcare Research US Department of Health & Human Services   If appropriate G3ST may monitor patients condition, medications and directives informing both the patient and medical personnel of a change in condition or missed medication. Patient information will be delivered in whatever language or ability level required insuring complete understanding and participation.   Page 9