the roi of rti€¦ · white paper | hp/central logic patient flow roi solution hospital size 200...

The ROI of RTIHospitals are using real-time intelligence (RTI) to improve patient flow—for a healthier bottom line.

Table of contents

3 Increasing capacity—without expansion

3 Payback potential

4 Building a business case•Addedeffectivecapacity•Increasedrevenue•Reductioninhospital-acquiredinfectionrate•Recoupingthelostopportunity:Under-billing

6 The costs of doing nothing•Operationalconsequences•Lackoftimelybusinessintelligence•Negativesideeffects

7 Putting patient flow into practice•KPIs:Metricsofsuccess•Mappingworkflows•Goingdigital,end-to-end

9 Reducing initial—and ongoing—investment

9 Getting started•Buildingthebusinesscase•Flexiblefinancing

10 Learn more•AboutHP•AboutCentralLogic•AboutIntel

Whitepaper|HP/CentralLogicPatientFlowROISolution

3|December,2012

Rx: Efficiency

Hospitalsareunderextraordinarypressuretoimproveefficiency.

Expandingpatientpopulations,staffshortages,andchanginghealthcareregulationsaredrivinghospitalsacrosstheUnitedStatestomakebetteruseoftheirexistingresources.

Inarecentstudy,31percentofhospitalssaidtheyplantoimplementorupgradeapatientflowsolutiontoimproveefficiency.1

Withreal-timeinsightandvisibilityintopatientandbedstatus,hospitalscansignificantlyimprovequalityofcare,resourceutilization,andcontributionmargins.

Increasing capacity—without expansion

AHASolutionsandHospitalsinPursuitofExcellence(HPOE)definepatientflowasanenterprise-wide,circularprocessextendingfrompre-admissiontopost-dischargecarethat“ensuresthatallinthemultidisciplinarypatientteam(nurses,physicians,therapists,etc.)havetoolstoassessreal-timestatusandhavetheabilitytomakereal-timeupdates.”2

Asphysicalexpansionbecomesalessfeasibleoptionformosthospitals,manyareinvestinginrealtimepatientflowsolutionssimplytomakebetteruseofthecapacitytheyalreadyhave.

“Efficiencyimprovementsarebyfarthemostsignificantdriverforproviderorganizationinvestmentsinpatientflowsolutions,”saysCapSiteResearchDirector,BrendanFitzGerald.“Morespecifically,healthcareprovidersarefocusedonimprovingbedturnaroundtimesandreducingpatientwaittimes.”3

Bymatchingpatientneedstoavailablephysicalresourcesinreal-time,hospitalscanimprovetheutilizationofinpatientbedsandlimitedresourcesinotherareas,suchastheemergencydepartment(ED).Nationally,theEDaccountsfornearly70%ofallhospitaladmissionsandEDvisitsaregrowingatarateof1.9%peryear—twicetherateofpopulationgrowth.4Today,nearlyhalfofEDsreportoperatingatorabovecapacity,and9outof10hospitalsreportholdingor“boarding”admittedpatientsintheEDwhiletheyawaitinpatientbeds.5

Payback potential

Evensmallimprovementsinbedturnovertimeincreaseeffectivebedcapacity,deliveringimmediatepayback.What’smore,mosthospitalscaneasilycalculatetheimpactoffasterturnoverandshorteraveragelength-of-stay(LOS)oneffectivecapacity—andassignadollarvalueforeachadditional“bed”gained,intermsofadditionalrevenueand/orcapitalexpensecost-avoidance.

Butthepotentialreturnoninvestmentintheabilitytocapture,access,andsharereal-timeinformationaboutpatientandbedstatusacrossmulti-disciplinaryteamscangofarbeyondaddingeffectivecapacity.

1 SourceCapSite2012U.S.PatientFlowStudy.2 SourceAHASolutionsandHospitalsinPursuitofExcellence(HPOE).“ResultsandReportofthe2012PatientFlowChallengesAssessment:HospitalsConsiderPatientFlowEssentialtoCareandCompetitiveness.”2012

3 SourceCapsitepressrelease:“31%ofU.S.HospitalsPlantoInvestinPatientFlowSolutions.”Nov2012:http://capsite.com/news/press-releases/31-of-u-s-hospitals-plan-to-invest-in-patient-flow-solutions/

4 SourceNationaltrendsinEmergencyDepartmentOccupancy,2001to2008:EffectofInpatientAdmissionsVersusEmergencyDepartmentPracticeIntensity.AnnalsofEmergencyMedicine.Volume60,No.6:Dec2012:http://www.ncbi.nlm.nih.gov/pubmed/22727201

5 SourceAgencyforHealthcareResearch&Quality(AHRQ):http://www.ahrq.gov/qual/ptflow/ptflow1.htm

Whitepaper|HP/CentralLogicPatientFlowROISolution

Simpler,moreaffordable,and“friendlier”digitalandmobiletechnologiesaremakingitpracticalforhospitalstoprovidestaffwithquickandeasyanytime-anywhereaccesstoreal-timeinformationthatenablesthemtodeliverbettercareandmakebetteruseofallhospitalresources,includingtheirowntime.

At the highest level, the return on real-time intelligence stimulates both:

•Lowercosts-throughbetterutilizationofallresources(transport,beds,equipment,facilities,professionalstaff,etc.)

•Increasedrevenueandreimbursement- byenablingmorecarewiththesameresources

A breakdown of potential “hard” and “soft” benefits includes:

•Addedcapacitywithoutcapitalexpense-throughshorteraverageLOS,fasterturnoverofexistingcapacity,andless“bedhiding”fromdelayedupdatingofavailability

•Betterclinicaloutcomes-byimprovingtimelinessofdefinitivecarethroughfaster,moreaccuratematchingofpatientswiththerightbed,intherightunit,withtherightlevelofnursingcare,diagnostics,specialists,andtreatments

•Betterpatientexperience/HCAHPSratings–byreducingwaittimesandcoordinatingservices,reflectedinHospitalConsumerAssessmentofHealthcareProvidersSystems(HCAHPS)surveys

•Improvedstaffproductivity-bycuttingthetimeteams(Admissions,Transport,Emergency,Transfer,Nursing,EnvironmentalServices(EVS))spendentering,lookingfor,andsharingdataandminimizing“workqueueing”

•ShorteraverageLOS-throughproactivelymanagedrightlevelofcareandfaster,morecoordinatedturnover(e.g.,transfer,discharge,EVS)processes

•Decreasedpatientleakage-tootherfacilitiesduetopoorvisibilityintoavailability

•Fewerreadmissions–throughbetterplannedandcoordinateddischargeprocesses

•Reducedorfewerpenalties-fewernon-reimburseddaysandpenaltiesfornegativeoutcomes,suchasMedicare/Medicaidreimbursementpenaltiesforexcessivereadmissionofpatientsinlessthan30days

•Reducedrisk/liability–throughbetterdefinition,coordinationandoversightofstandardsandprocedures,(e.g.,MRSAcontrol,negativeairflowforTB)

•Improvedproductivity–asskillednursingandotherprofessionalteamsspendlesstimesearchingfor,entering,updatingandcorrectinginformation.Also,real-timevisibilityintoavailableresourcesandworklistsenablealltypesofstafftoplananddotheirworkmoreefficiently.

Building a business case

Assumethatahospitalthatisablethroughproactivereal-timepatientflowintelligence(e.g.,faster,informeddecisionsaboutpatientplacementfromtransfer,admission,andinternaltransport,tobetterdischargeplanning)toreduceitsaverageLOS.AccordingtoastudyconductedbyTheHealthCareAdvisoryBoard,anaverage500-bedhospitalthatreducesLOSby0.25daysisequivalenttoadding20newbedstothefacility[Table1].6

Added effective capacity

BylookingatapossiblereductioninLOS,thehospitalcouldestimatethepotentialforadditionaleffectivebedsgainedpermonthwithoutanycapitalinvestmentinphysicalexpansion.

4|December,2012

6 Source MaximizingHospitalCapacity.Areport issuedbytheHealthCareBoardofTheAdvisory BoardCompany.2002.DataassumesinitialLOS

(LOSBefore)of5.2days,85percentoccupancy.

Whitepaper|HP/CentralLogicPatientFlowROISolution

Formula:

Hospital Size x Occupancy Rate = Y

LOSBefore – LOS reduction = LOSAfter

(LOSAfter x Y) ÷ LOSBefore = Z

Z – Y = Effective Beds Gained

Table 1. “Effective”bedsGainedperMonthfromLOSReduction6

Increased revenue

ThehospitalcouldalsouseitsLOSreductiontoestimatethenumberofadditionalpatientseachbedcouldaccommodatepermonth—andfromthat,thenumberofadditionaladmissionspermonth.Multiplyingbythehospital’saveragenetprofitperpatient,thehospitalthencouldestimatetheROIpermonththroughreducedLOS.

Reduction in hospital-acquired infection rate

Thebusinesscasecouldalsotakeintoconsiderationthepotentialreductionincomplicationsthroughbetterpatientflowmanagement(e.g.,improvedcommunication,coordination,andoversightofstandardsandproceduresforpatientplacementandtransfers).Theabilitytoreducehospital-acquiredinfection(HAI)ratesbysomepercent,forexample,canbemultipliedbythenumberofpatientsandnetprofitperpatienttocomeupwithapotentialsavingsinmonthlyrevenues.

5|December,2012

6 Source MaximizingHospitalCapacity.Areport issuedbytheHealthCareBoardofTheAdvisory BoardCompany.2002.DataassumesinitialLOS

(LOSBefore)of5.2days,85percentoccupancy.

Whitepaper|HP/CentralLogicPatientFlowROISolution

Hospital Size 200 Beds

300 Beds

400 Beds

500 Beds

600 Beds

LOS Reduction ---------- Effective Beds Gained Per Month -------------

0.25 day 8 12 16 20 25

0.50 day 16 25 33 41 49

0.75 day 25 37 49 61 74

1.00 day 33 49 65 82 98

1.25 day 41 61 82 102 123

1.50 day 49 74 98 123 147

Formula A:

30 Days/Month ÷ LOSAfter = # Patients/Month per available Bed

# Patients/Month per Available Bed x # Effective Beds Gained = # Additional Admits/Month

# Additional Admits/Month x $ Avg. Net Profit/Patient = $ Additional Profit/Month

$ Additional Profit/Month = A

Formula B:

Hospital Size x # Patients/Month per Bed x Hospital’s Rate of HAI = # HAI cases/month

# HAI Cases/Month x % HAI Reduction = # Fewer HAI Cases/Month

# Fewer HAI Cases/Month x $Avg. Net Profit/Patient = $ Additional Profit/Month

$ Additional Profit/Month = B

Recouping the lost opportunity: Under-billing

Abusinesscasecanalsobebuiltestimatingtheimpactofimprovedpatientflowmanagementonpatientflowerrors,suchasamiscategorizationofinpatientsas“observationstatus,”resultinginunder-billing.Tofactoronamonthlybasis,ahospitalcouldmultiplytheaveragenumberofmiscategorizationspermonthmultipliedbytheaveragelossofrevenueduetounder-billing.

CategoriesofpotentialsavingsfromeffectivepatientflowmanagementcanquicklyaddupasdepictedinTable2.

Table 2.TotalRevenuePotential

Note: Use values calculated from Formulas A, B, and C, respectively.

The costs of doing nothing

Investmentinnewreal-timepatientplacementsystemsneedtobeweighedagainstthecostsofcontinuingwiththestatusquo.Inarecentnationalsurveyofhospitalprofessionals,60.9percentcitedbadcommunicationasthenumberonereasonforpoorpatientflow,29percentlackofdatavisibility,andtheremaining10percent,poorpatientengagement.7

Operational consequences

Manyhospitalscontinuetorelyonmostlymanualpatientflowprocesses,includinghand-writtenupdatesonwhiteboards,hand-carriedpapernotes,andphonecallsand/orphysicalmeetings,severaltimesaday,inwhichflowcoordinatorsandnursesfromeachfloorshareinformationandupdatesonpatients,resourceavailability,andexpectedevents.

Despitetheseconsiderableefforts,informationissimplyneverup-to-date.What’smore,likearunnerwhomissesthebatonhandoffinarelay,anyunexpectedchangeintheflowsequence—apostponedpatientdischarge,asurgeinemergencyadmissions,abackupintelemetry,radiologyorsurgery—setsoffachainreactionofinterdependentconsequences,asstaffstruggletocorrectandcommunicateinformationandre-aligntasksandplans.

Somehospitalshaveattemptedtoaugmentmanualpatientflowprocesseswithinformationfromotherapplications.Acommonpracticeistotryto“piggyback”patientflowonthe“Admission/Discharge/Transfer”(ADT)system.AlthoughADTcanprovidenearreal-timeinformationregardingpatientlocation,itdoeslittletoidentifywherevacanciesorbacklogsexist,andtheinterfaceisnotuser-friendly.

6|December,2012

Whitepaper|HP/CentralLogicPatientFlowROISolution

Monthly Annual

Increased bed capacity $A $Ax12

Improved clinical outcomes $B $Bx12

Decreased non-reimbursable days $C $Cx12

Total $SUMA:C $(SUMA:C)x12

7 Source2012PatientFlowChallengesAssessment,aspresentedbyAHAonJanuary12,2012http://wm.yourcall.com/AHA/AHA_Longe_011211.wmv

Formula C:

# Recaptured Inpatients x $Delta between Inpatient and Observation Patient Net Revenue = $/Day

$/Day x 30 Days/Month = $ROI /Month

$ROI/Month = C

Lack of timely business intelligence

Suchsystemslackanypredictivecapabilitytohelpprofessionalstaffanticipateeventsoridentifytrends.Similarly,forhospitalexecutivesseekingtoimprovecapacitymanagementorpatientflow,gainingaccesstorelevantinformationhastypicallymeanthiringanoutsideconsultantoraddingtotheburdenofalready-busyprofessionalstocollectandenterinformationintospreadsheets.Again,despiteconsiderableeffort,informationremainedfragmentedandnottimelyenoughtoaffectmeaningfulchangeinanykindofproactivemanner.Instead,problemsoftenonlybecomevisibleduringacrisis,suchasabedshortageorERboarding.

Negative side effects

A340-bedhospitalthathasthreemedical-surgicalunits,andtreatsnearly16,000inpatientsperyearestimatedthelostrevenueconsequencesofpoorpatientflowtobe$3.1millionayear,dueprimarilyto:8

•Heightenedoccurrenceofredhours•Delayedadmission•Divertedpatients•Unsatisfiedpatients

Putting patient flow into practice

Forallitsbenefits,successfulimplementationofenterprise-widepatientflowmanagementrequirescarefulanalysisandplanning.

Somehealthsystemschoosetostartsmallandgrowsolutionsovertime.ICUs,surgery,andemergencydepartmentsarefrequentlyselectedtopilotpatientflowsystemstohelpmanagetheirunpredictable,fluctuatingdemandovertime.Limitingflowmanagementtoonedepartmentinitiallycanhelpeasetheimplementationbyallowingteamstofocus,gainhands-onexperience,andmeasureincrementalresults.

Before embarking on any patient flow management project, organizations should:

•Buildthebusinesscase.Whatmetricswillbetrackedtogaugesuccess?Howdotheytranslatetoreturnoninvestment?

•Gainexecutivesponsorship.Whohastheauthoritytoreview,approve,anddriveprogressacrossorganizations?

•Involvekeystakeholders.Getinputfromalluserstodefinerequiredfeaturesandcapabilitiesandreviewandrationalizeworkflow.

•EngageITtodefineinfrastructure,integration,operationalandsupportrequirements.HowwillthepatientflowsysteminteractwithADT,electronichealthcarerecords(EHR)andotherapplications?

•Revieworganizationalandskillrequirements.Doreportingstructuresstandinthewayofeffectiveworkflow?Whichuserswillrequirewhattraining?

•Developandgetsign-offonadetailedprojectimplementationplan.Whatarethekeytasksandmilestones?Whowillmanagewhataspectsoftheproject?Howwillrolloutbemanaged?

7|December,2012

8 SourcePatientFlowImprovementsEliminateAmbulanceDiversionsandReduceWaitingTimesforInpatientBeds.AgencyforHealthcareResearchandQuality.US.DepartmentofHealth&HumanServices.http://www.innovations.ahrq.gov/content.aspx?id=2491

Whitepaper|HP/CentralLogicPatientFlowROISolution

KPIs: Metrics of success

Akeyfactorinbuildingabusinesscaseandprojectdefinitionisdetermininghowtomeasuresuccess.Hospitalsshouldidentifyandmeasurekeyperformanceindicators(KPIs)thatcontributetomeetingtheirkeyobjectives.Assuch,eachhospitalneedstodetermineitsownKPIs,howtheywillbeweighted,andwhatperformanceimprovementsarerealistic.Thequarterlybenchmarksofcarereport,providedbyTheCentersforMedicare&MedicateServices(CMS)showshowsimilar-sizedhospitalsperforminareassuchasLOSandEDmetricsforspecificclinicalconditions,suchasacutemyocardialinfarction,coronaryarterydisease,andstroke.9ArecentstudybyalargeacademiccenteroffersanexampleofhowKPIstranslateintodollars.Forexample,theydemonstratedhowa1-hourreductioninEDboardingtimewouldcontributemorethan$9,000ofadditionalrevenuebyreducingambulancediversionandthenumberofpatientswholeftwithoutbeingseen.10

Mapping workflows

Visio-basedworkflowsareaneffectivewaytodocument,review,andrationalizecomplex,interdependentprocesses.Theycanbeusedtomapoutahospital’scurrentsystem,identifyportsofentrysuchastheED,catheterlab,orsomeotherportal,andconnectallstopsandstepsinthecareflow—includingbedswithdifferentlevelsofcareandtransportationfrompoint-to-point.Theyalsoallowuserstoaddormodifyelementseasily,asneedschange.

Somepatientflowsolutionsprovidecustomizablepredefinedworkflowtemplatesasastartingpoint,alongwiththeflexibilitytoadapteasilytoteamorhospital-definedrequirements.Rules-basedenginescanalsohelpguidestaffthroughthedevelopmentofworkflowsthatmatchspecificoperations.

Going digital, end-to-end

Visio-basedworkflowsareaneffectivewaytodocument,review,andrationalizecomplex,interdependentprocesses.

Themostcriticalaspectofpatientflowtransformationistheabilitytoprovideeveryoneonthepatientcareteamwithreal-time,“at-their-fingertips”informationtheyneedtomakepatientplacementdecisions.

Newdigital,touch-enabled,Web-enabled,andmobiletechnologiesmakeanend-to-enddigitalsystemnotonlypossible,butaffordableandeasy-to-use.Nursesstationsthatpreviouslyreliedonmanualentriesonwhiteboardscannowbeequippedwithinteractivedigitalwallboardsthatdisplaypatientinformationderivedfromthepatientflowsystem.Bedandpatientstatuscanbesecurelyupdatedbyauthorizedmembersofthemulti-disciplinarycareteam,usingsecuremobiledevicesanywhereinthehospital.

Theresultisbetterinformationaboutupstreamdemandwithreal-timeinformationfromadmissions,ED,telemetrybeds,surgeryandICU;betterinformationatthepointofpatientcare;andbetterinformationdownstreamforphysicaloroccupationaltherapy,transport,anddischarge.

Anall-digitalcapacitymanagementsystemwithreal-timevisibility,automaticcaptureandanalysisofdata,andeasyinformationaccessandsharingacrossthemulti-disciplinaryteamfromanywhereinthenetworkisthefoundationforcriticalfunctionality,including:

Real-time tracking of patients:

•Atadmission•Throughinternaltransfers•Atdischarges

Real-time visibility into resource availability:

•Beds•Diagnosticequipment•Treatmentfacilities•Snapshotviewsbymulti-disciplinaryteamacrossunits,floors,andtheentirehospitalsystem

8|December,2012

9 SourceQualityNetBenchmarksofCare:https://www.qualitynet.org/dcs/ContentServer?c=Page&pagename=QnetPublic%2FPage%2FQnetTier2&cid=1228768205297

10 SourcePinesJM,BattRJ,HiltonJA,TerwieschC.Thefinancialconsequencesoflostdemandandreducingboardinginhospitalemergencydepartments.AnnEmergMed;2011Oct;58(4):331-40.

Whitepaper|HP/CentralLogicPatientFlowROISolution

Ease-of-Use:

•Automatedworkflows•Automaticallygeneratedworklists•Automaticallygeneratedreports•At-a-glancedashboardviewsofperformancemetrics,withdrill-downtodetails•Real-timeemailalertswhenhospital-definedparametersareexceeded•Predictiveintelligencetools•EasyintegrationwithADT/EMRsystems

Reducing initial—and ongoing—investment

Together,Intel,HP,andCentralLogichelphospitalstakeadvantageofthelatestWebandtouch-enabledtechnologieswithcustomizableturnkeysolutionsandconsulting,installation,configuration,training,andsupportservicesthatreducethetime,cost,andcomplexityofimplementingreal-timepatientflowmanagement.

These solutions integrate:

•CentralLogicsuiteofpatientflowmanagementsoftwareIntuitive,Web-enabled,softwaresuiteprovidessecure,real-timedatavisibility,communication,tracking,andupdatingofpatientandbedstatus,predictiveavailabilitytools,andcustomizabletemplatesandrules-basedtoolsthatmakeiteasytoautomateanyworkflow.Theproductportfolioextendsfromtransport,admittingandtransfer,bedandcapacitymanagementtopatientplacementdischarge,andreadmissionavoidance.

•HPDigitalSignageDisplays,HPTouchSmart™PCs,andHPElitePad™mobiledevicesCentralLogicsoftwareonHPsystemsmakesiteasyforauthorizedpersonneltoquicklyandsecurelyaccessandupdatepatientandbedinformationusinginteractivedigitaldisplaysandawiderangeoftouch-enabledsystemsandmobiledevicesateverypointofpatientcare.

•3rd-generationIntel®Core™vPro™processortechnologyHPhealthcaresystemstakeadvantageofadvancedIntelprocessortechnologyinnovations,whichbuildsecurity,self-maintenance,dataencryption,andotherfunctionalityintothechipsetandothersystemhardware,wheretheyarelessvulnerabletohackers,computerviruses,computerworms,andotherthreats.

Getting started

Building the business case

CentralLogicconsultantsandauthorizedHPHealthcareSpecialistpartnersbringextensiveexpertiseandexperienceindigitalpatientflowsolutions.Weworkwithyouandyourstafftohelpassesscurrentcapacity,staffing,processesandworkflows;identifyopportunities;andbuildthebusinesscaseforinvestinginreal-timeintelligenceforbettercapacitymanagementandpatientflow.

Flexible financing

HPFinancialServicescanhelpyoutobegintotakeadvantageofend-to-enddigitalbedmanagementinyourhospitaltoday—withminimalimpacttocashflow.HPfinancingspecialiststakealifecycleapproachthathelpsyoutoconsidernotjustinitialpurchase,buttotalcost-of-ownershiptodevelopfinancingthatmakessenseforyourorganization.

9|December,2012

Whitepaper|HP/CentralLogicPatientFlowROISolution

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About HP

Asatrustedsupplierofinformationtechnologysolutionstohospitals,clinics,andmedicalpracticesaroundtheworld,HPisuniquelyequippedtosupportend-to-endpatientflowsolutionsinmajormedicalcenters,communityhospitals,andsmallcarecenters.TheHPHealthcareAllianceprogramcombinesofferingsfromindependentsoftwarevendorswithhardwarefromHPtodeliverintegrated,tailored,andtestedsolutionsthatwork.

Learn more about HP Healthcare solutions at: hp.com/go/healthcare

About Central LogicCentralLogicisthehealthcareindustry’sleadingproviderofinnovativepatientflowsoftwareandconsultativeexpertise.Thecompany’ssolutionshavetransformedpatienttransferprocessesforsomeoftheUnitedStates’mostrespectedmedicalsystemsandhospitals.CentralLogicworkscollaborativelywithphysicians,administrators,andstafftodesignanddeliverpatientflowsolutionsthatincreasepatientthroughput,whileconservinginternalresources.

Learn about Central Logic patient flow solutions at: centrallogic.com/solutions

About IntelWhereinformationandcaremeet:HPsolutionspoweredbytheIntel®vProprocessorfamilydeliversmart,long-lastingperformance.AdvancedandindustrystandardtechnologiesfromIntelhelpenablecoordinated,customizedcarebycontributingtothecreationofaninteroperablehealthITinfrastructure.

Learn about Intel and healthcare at: intel.com/about/companyinfo/healthcare/index.htm

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©2012Hewlett-PackardDevelopmentCompany,L.P.Theinformationcontainedhereinissubjecttochangewithoutnotice.TheonlywarrantiesforHPproductsand

servicesaresetforthintheexpresswarrantystatementsaccompanyingsuchproductsandservices.Nothinghereinshouldbeconstruedasconstitutinganadditional

warranty.HPshallnotbeliablefortechnicaloreditorialerrorsoromissionscontainedherein.Intel,theIntellogo,IntelCore,CoreInside,IntelvPro,vProInside,and

XeonaretrademarksofIntelCorporationintheU.S.and/orothercountries.

CentralLogicisaregisteredtrademarkandCoreisatrademarkofCentralLogic,Inc.

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Whitepaper|HP/CentralLogicPatientFlowROISolution