First feedback and master plan for a Real-Time Healthcare System (RTHS) orchestration platform

1. Real-Time
Healthcare System
Binon Jean-Pierre
Directeur des Technologies de
l'Information et des Communications
T:+32 (0)71 924 646
E: jean-pierre.binon@chu-charleroi.be

2. Agenda
I. ISPPC Presentation
II. RTHS in general
III. RTHS at ISPPC
IV. Examples of RTHS orchestration
V. FMU

3. I. ISPPC PRESENTATION

4. ISPPC
Intercommunale de Santé Publique du Pays de Charleroi
• A hospital sector and a non-hospital sector
• 1.374 beds
• 4.200 staff members and more than 400 doctors
• Includes 5 hospitals, polyclinics, retirement homes,
nurseries, children's and youth centers
• In total, 77 sites in the region of Charleroi

5. Real-time and mobility, both inside and outside our
sites, are essential because of our business and our
multi-site environment

6. II. RTHS IN GENERAL

7. « Real-time » and mobility

8. RTHS principles
Based on situational awareness to improve operational
efficiency and delivery of care :
– Collecting data from connected sensors
– Data analysis to identify relevant indicators and
trends
– Integration of results in information systems
– Use native capabilities of mobile devices to
provide immediate feedback to staff and patients

9. Geolocation
• Very important for situational awareness and
real-time process automation
• Indoor (Wifi) et Outdoor (GPS or LORA)
• Indoor :
– A floor precision of 4-5 m is enough. The key is to
avoid a floor level error
– Geofencing is enough to trigger I/O events

10. III. RTHS AT ISPPC

11. Master plan for a
global RTHS solution
• Enterprise RTHS orchestration platform perfectly integrated with our hospital
telecom solution and our electronic patient record
• Progressive deployment of IoHT solutions (Internet of « Healthcare » Things = IoT + IoMT)
• In and Ex Situ approach
• OT / IT Convergence
Robotic
HealthCare
HomeCare
Security
Building management
Flows optimization

12. Flows optimization
• Nurse call :
– Télévic
– Ascom
– Siemens
• Do button
• Aeroscout solution (Wifi tags) :
– Temperatures
– Distress and agression calls
– Geolocation of people and medical equipment
• Inter-site transport of blood and microbiological
samples
• Management of the fleet of professional vehicles
• Blood products distribution

13. Building management
• BMS (Building Management System) :
– Schneider
– Honeywell
• PLCs and dry contacts

14. Security
• Fire detection
• Access control
• Intrusion detection
• Camera
• IT alarms
• Mobilization campaigns (SACHA)

15. Multiple networks
• LAN :
– Wired
– Wifi
– 6LowPan
– Bluetooth (LBE)
– Beacon
– Zigbee
• LPWAN :
– Sigfox
– Lora
• Cellular :
– SMS
– 3G/4G
– LTE
– NB-IoT

16. Multiple protocols
• OT
– OPC / OPC UA
– Modbus
– Profibus
– ESPA 4.4.4 (and ESPAX)
• IT
– HTTP (REST)
– MQTT
– CoAP
– HL7
– DICOM

17. CMX/MSE of Cisco = Single repository for the
internal mapping used by all RTHS applications
Floor plans stored in Cisco Prime

18. RTHS orchestration platform
Key element of the Smart Digital Care Delivery
Nurse ESPA 4.4.4.
call
Fire ESPA 4.4.4. et SMS
alarm
ESPA 4.4.4. et SMTP
AXIS SMTP
camera
REST
DB
REST
REST
REST
HL7 and REST
EPR
COMMUNICATIONS
UNIFIED
SACHA
AEROSCOUT
ACTUATORS
IoT streaming
IoMT streaming
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BMS
CENTREON
Microservices
Google Maps, OpenWeatherMap,
HighCharts, CMX/MSE ...

19. Benefits
• The ability to couple older technologies with newer ones via
an RTHS orchestrator makes them more efficient. Nurse call
coupled with unified communication provides a next-
generation nurse call
• HiOT solutions are usually in silot. An RTHS orchestrator
converges different HiOT solutions to allow more
sophisticated processing

20. IV. EXAMPLES OF RTHS ORCHESTRATION

21. 1. TEMPERATURE MONITORING

22. Balance after 4 years
• More than 700 fridges and freezers monitored
• General improvement of quality
• The temperature monitoring allows :
• No losses: organ transplant, blood bags, reagents, drugs
and food
• Proactive maintenance
• Faulty equipment replacement on an objective basis
IoT perfectly integrated with unified communications
allows a very fast ROI.

23. 2. ALARM SERVER

24. Migration of traditional alarm servers
Progressive migration of our DAKS and OSCAR
servers (SIEMENS) to the SERVAL :
– Fire detection
– Nurse call
– BMS
– Access control

25. 3. INTER-SITE TRANSPORT OF BLOOD
AND MICROBIOLOGICAL SAMPLES

26. A single Laboratory of Clinical Biology at Marie Curie for all
our sites from where the need to transport all the blood and
microbiological samples to this site

27. Objectives
• Meet the requirements of the ISO 15189
accreditation standard for sample transport
time and compliance with a specific
temperature range
• Optimize the workflow

28. Sensors
Temperature and location between sites (Proximus) :
 LORA network
 EnCo platform and SeaaS (Sensor as a
Service) API package
Localisation intra-site :
 WIFI network
 Aeroscout Tag with RTLS and
geofencing features
 Real-time detection of I/O in a
laboratory of a site

29. Results
• Proactivity (alert) otherwise reactivity (alarm) in case
of problem :
• Voice notification to drivers via IVR – FMU
• Notification by email to laboratory officials in charge of inter-site
transport
• Decision on objective basis to exclude certain samples
• Traceability and history

30. Evolutions
Inter-site transport of :
– Pharmaceuticals
– Blood products
– MAP (Medically Assisted Procreation)
• IT becomes an active partner in support of certain scientific
activities of the hospital
• Intersite transport by drone? Cfr experience of the Swiss
multisite hospital Ente Ospedaliero Cantonale (EOC) which
introduced the use of a drone to transport medical samples
between two of its hospitals

31. Global view

32. Detail view

33. Reporting

34. 4. MANAGEMENT OF THE FLEET OF
PROFESSIONAL VEHICLES

35. Objectives
Manage the entire ISPPC vehicles fleet :
• Ambulance et Cramu
• Transport service
• Guarding
• Homes Branch
• Stretcher at VVG
• Cité de l'Enfance
• TIC
• Technical service
• Laboratory VVG
• Social service
A total of 75 vehicles

36. Specific objectives for ambulances
• Reduce the number of transports outsourced
• Calculate the waiting time for an intervention request
to inform the caller
• Send the nearest available ambulance to the area of
operation
• Better invoicing for the transport services carried out
on the basis of the waiting time at the place of
intervention and the distance traveled

37. Sensor
GPS tracker :
 Cellular network (3G/4G)
 Batch transfer of data to our on-
premise cloud
 Proximus Cockpit Platform for
SIM card management

38. Main features
• Real-time view of :
– All the positions of vehicles for a given service :
ambulances for example
– A complete route for a vehicle
• View of all stops and trips
• In case of an intervention request, calculation of
the distance and the duration of the trip for all
the vehicles in order to choose the best one

39. Real-Time view of all the vehicles

40. Complete route for a vehicle

41. Select the nearest available ambulance
to the area of operation

42. 5. BLOOD PRODUCTS DISTRIBUTION

43. Any blood product that has come out of the laboratory but
was not finally placed is eliminated

44. Objective
Recovery of unplaced blood products :
A blood product that has left the laboratory can be
recovered if it is not finally used provided that :
1. It has been kept permanently in a certain temperature range
2. The frigobox that contained it was not opened outside the
Laboratory
3. It returned to the laboratory within a certain time

45. Sensor
Temperature and Location within a site :
 WIFI network
 Aeroscout Tag with temperature,
RTLS and geofencing functions
 Real-time I/O detection of the
laboratory

46. Main features
• Real-time view of all the frigoboxs that have left the laboratory
• Automatic triggering of a timer as soon as a frigobox leaves the
laboratory and automatic shutdown on return to the laboratory
• Voice notification of the care unit concerned when a frigobox still in
the unit is approaching the maximum allowed time
• Association of a recovered blood product with a circuit

47. Expected results
• Reduction of waste in blood product
• Proactivity (alert) otherwise reactivity (alarm) in case of
temperature problem :
• Voice notification to nurses via IVR – IP tel / FMU
• Notification by email to laboratory officials in charge of inter-site transport
• Decision on objective basis to recover a blood product with
traceability and history

48. Real-time view of all the frigoboxs
that have left the laboratory

49. V. FMU

50. FMU = Fixe Mobile Unification
Unification of the enterprise fixed voice network
with the GSM mobile network

51. 1. ISPPC UNIFIED COMMUNICATIONS

52. Master Plan for a global
hospital Telecom solution
The unification of the fixed and mobile voice networks is the last step of our
Telecom Master Plan for a global hospital Telecom solution.
Fixed mobile unification
IoHT
Interactive TV et Digital Signage
Multimedia collaboration
Contact Center
Unified messaging
IP Telephony
IT Network

53. Global Telecom Architecture
VCS Expressway
SIP or H.323
Video Endpoints
Jabber
Guest
Internet
Spark
Proximus
SIP Trunk
Cube
GSM/FMU/PSTN

54. Generalization of single numbers
and SIP addressing
Key element that gives all its power to the FMU

55. FMU main benefits
• Transforms GSM into endpoint of our Unified Communication
solution with national coverage
• All medical staff and other mobile agents can be reached on a
single number: the fixed number of the company. Whether
they are on one of the sites of the intercommunal, on the road
to an emergency or traveling anywhere else in Belgium
• Possibility to restrict outgoing calls for certain equipment
which makes it possible to transform a GSM into a simple
DECT (gardener for example)

56. 2. APPLICATIONS

57. MARECHAL NEY SATELLITE SITE

58. Telephony scheme
Maréchal Ney small remote site

59. FMU benefits
• Integration of the small remotes sites into the
company's telephony via a unique dial plan
• Possibility to reach educators easily through a
single number even when they are outside the
building to allow children to play in the
playground

60. MOBILE TELEPHONY
IN CARE UNIT

61. Telephony scheme
Care unit

62. FMU benefits
• In case of trouble or maintenance of the Wifi network,
nurses in the care unit have always a operational mobile
"phone“
• It is especially interesting the night when there are fewer
nurses
• Longer battery life of a mobile phone compared to a mobile
IP phone

63. Thank you for your attention