“The Intelligent Hospital” Adaptive Information Management Paul, H. Frisch, PhD. FHIMSS Attending Department of Medical Physics Chief, Biomedical Physics & Engineering Memorial Sloan-Kettering Cancer Center. New York, NY Dec 8-11, 2013 , Washington DC mHealth Summit
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“The Intelligent Hospital” Adaptive Information Management
“The Intelligent Hospital” Adaptive Information Management . mHealth Summit. Dec 8-11 , 2013 , Washington DC . Paul, H. Frisch, PhD. FHIMSS Attending Department of Medical Physics Chief, Biomedical Physics & Engineering Memorial Sloan-Kettering Cancer Center. New York, NY. Toilet - PowerPoint PPT Presentation
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“The Intelligent Hospital”Adaptive Information Management
Paul, H. Frisch, PhD. FHIMSSAttending Department of Medical Physics Chief, Biomedical Physics & Engineering
Memorial Sloan-Kettering Cancer Center. New York, NY
Dec 8-11, 2013 , Washington DC mHealth Summit
PhysiologicData Manager
(Connectivity)
Directed Communications
Nurse CallApplication Server
VentilatorManagementApplication
PhysiologicalMonitoring
Pump Medication
Management
Hospital GatewayRTLS
Hospital Backbone
Alarm & Physiologic Data Manager
Nurse Hands Free Wireless Devices
Intelligent Hospital
CISCOAccess Point
Outside of RoomDome Indicator
Patient Station
Toilet Emergency
Code Blue
Router
Room HUB
Hub
(Emergin)
(Vocera)
RFID
Room Level Devices
Medication Administration
Sample Collection RTLS EMR
Archiving
Objective: Design of an Integrated Intelligent Hospital
Increased Data Accuracy & Availability Electronic Medical Records Shared Medical Device Interconnectivity and Integration Global View of the Patient / Unit
Rapid Information Dissemination & Response Physiological Data Alarm Event Management Advanced Communication Platforms (PDA, iPhone, etc.) Location Content
Enhanced Error Checking & Validation Identification & Association Location Content Correct Information
Optimization of Workflow & Resource Management
Hospital Environment
OR Acute Care (ICU) Emergency
Department General Patient Care
Areas Outpatient Specialty Areas
Radiology Radiation Oncology Cardiology Suite
Pharmacy Central Supply War Room Data Center Biomedical
Engineering Information
Technology
Patient Treatment & Care
Supporting Operations
Real Time Information DeliveryDemographicsStatus , ETA Field AssessmentAllergiesPhysiological Data
Patient Staff Ratio 4:1 64 Critical Alarms / HourCritical Event Every 11 minutes
Average Alarms Per Bed Per Shift
Connentivity & Point of Care Information Delivery
Handheld IP Phone Alarms Delivery Staff to Staff Communications
Handheld PCCan access all Hospital Applications Pagers
Dynamic Identification and Association
Equipment to Patient
Pharmaceutical
Frisch, P.H., Miodownik, S., Booth, P., Carragee, P., Dowling, M., Patient Centric Identification and Association. IEEE Engineering in Medicine and Biology Society, Proceedings of the 31th International Conference. 2009: 1722-5
Medical Devices & Systems Physiological Monitoring Bernoulli Ventilator Management Infusion Pump Systems Nurse Call
Alarm Management & Data Distribution Critical Alarms to the Point of Care Staff to Staff Communications
Medication Administration Sample Collection Electronic Medical Record
Active RFID Bar CodesPassive RFID
Processor
Applications
IdentificationAssociationData
RTLS, Network Clients, ADT, etc.
User Interface
Institutional RTLS Solution
• Item Level Identification• Shelf level Tracking• Validation of Supplies Check Expiration Serial #, Lot #• Update Inventory
Surgical Applications - Retained Objects: • 1 in 5,000 open cavity surgeries result in a retained object• 40% of surgical cases are open cavity• 70% of retained objects are sponges
Ascension Health, Scott Lambert, Lead Partner, Engagements & Prototypes Transformational Development, 2008 Midwest Chapter HIMSS
• 764 Medicare incidents in 2006
• Tray Development • Validate Surgical Tray Content Before & After Procedure• Validate Sponge Counts• Confirm Cleaning & Sterilization Processes
• Utilization & Availability of Devices & Supplies
Workflow Metrics & Analytics
10:19 10:33 10:48 11:02 11:16 11:31 11:450
0.1
Tag #12Patient Alice Smith June 18, 2012
Registration
Check outFellow
RN
Room
MD
The Patient ExperienceWorkflow Metrics
Cautions & Considerations Lack of Strategic Vision & Planning ROI Based on Institutional Plan
Not Application Specific Network Impact Interference (EMI) Regulatory Issues Business Intelligence Management Application Development Simulation / Test Environment
Simulation Laboratory
Duplicates Environment of Care Infrastructure Devices Applications
Enables Test & Evaluation Upgrades to Infrastructure Wireless Network / AP’s Device Upgrades Application Changes New Technologies