confidential © 2008 radianse all rights reserved revolutionizing the delivery of quality healthcare...
TRANSCRIPT
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Confidential © 2008 Radianse All Rights Reserved
Revolutionizing the Delivery of Quality Healthcare through Automation
AIDC 100October 15, 2008
Manuel Lowenhaupt, MD
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Confidential © 2008 Radianse All Rights Reserved
“Even small healthcare institutions are complex, barely manageable places… large healthcare institutions may be the most complex organizations in human history.”
Peter Drucker
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Confidential © 2008 Radianse All Rights Reserved
The Price of Progress
Life Expectancy• 9 year increase from 1960 - 2000
Infant Mortality
Clinical breakthroughs
We’ve made a lot of progress. . . But progress comes at a cost
Source:1. OECD High Perfoming Health Sudy
• 5x reduction from 1960 - 2000
• Heart disease, Cancer, Stroke• Minimally invasive procedures• Improved diagnostics• Promise of genomics • Expenditure doubled as % of GDP over past 30 years
• 120-200% growth in Pharma spend over past 10 years
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Confidential © 2008 Radianse All Rights Reserved
Fragmented systems not delivering on Quality and Access
Emerging Crisis – Quality and Access
• Baby boomers/aging demographics will accentuate these problems
• Sustainability is provoking system level responses to policy, structure and delivery
• There is a shared sense of emerging ‘crisis’
Adverse events 16.6% of hospital
admissions 51% preventable Sub-Optimal Access “Access Block” Increasing surgical
listsRising Costs Funding for
hospitals Wage increase
Adverse events ~ 50-100K deaths p.a. US$17-29Bn p.a. cost
due to preventable event
Sub-optimal Access More than half of low-
wage earners lack coverage1
Rising Costs 13.9% of GDP
Adverse events NHS:- 850,000
events each yearSub-optimal Access 1 million people on
waiting listsRising Costs Grown by 4% per
annum since 1990
Common Challenges
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Confidential © 2008 Radianse All Rights Reserved
Identification of Leading Performance Provider Trends
K. Increased Private / Public Sector Collaboration
High Level Trends / Characteristics of the High Performing Provider Market
C. Initiation of Broad-Based Health System Reform
D. Shifting Care Delivery Models
B. Increasing Influence of Consumers/Patients
E. Improved Patient Flow / Demand Management
I. Consolidation /Outsourcing of Provider Back-Office
F. Evolving Roles and Skills of Clinicians
H. Increase Investment and Effective Utilisation of Clinical IT
A. Evolution of Science, Medicine and Technology to Improve Treatment and Access
J. Improved Visibility, Reporting and Management of KPIs
G. Effective Leadership and Culture Change
Trend HypothesesTrend Hypotheses
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Confidential © 2008 Radianse All Rights Reserved
Overarching Trend - Patient Centricity
Acute Facility(eg Nursing Home, Rehab, etc)
Primary Care Primary Care
Illustrative Patient Journey
Co
mm
un
ity
Co
mm
un
ity
Patient
EHR
GP ‘a’ Diagn ‘y’
Nurse ‘a’ Clinician ‘x’
Patient
ED Dr ‘a’ Surgeon ‘y’
Nurse ‘x’
Physio ‘x’
Patient
Rehab ‘a’ Clinician ‘c’
Nurse ‘s’ Physio ‘z’
Patient
GP ‘a’ Clinician ‘y’
Nurse ‘a’ Nurse ‘b’
Post-Acute Facility
Diagn ‘a’
• Prevention of disease. • Information sharing (clinical
and administrative) to improve health care quality, access and affordability.
• EHR available ‘anywhere, anytime’.
• Alignment of governments, companies, charities and non-governmental organisations
• Early detection and treatment of ‘high risk’ / chronic illness to reduce acute illness.
Concepts of Patient Centricity …
• Treatment by the most appropriate Health Channels (eg outpatient, hospital inpatient, etc)
• New ‘patient centric’ care models.• Comprehensive treatment of the
whole person, rather than ‘silo treatment’ by individual specialties.
• Clinical service streaming across setting
• Removal of ‘data silos’. Health information exchange securely enabled by technology advances.
• Hospital discharge pathways articulated
• Interconnection of acute & post acute clinicians
• Automated filing and archiving of claims upon discharge.
• Discharge summaries / notifications for all relevant clinicians.
• Continuous information sharing amongst appropriate personnel facilitated by EHR.
• Automated ‘home monitoring’ - IT systems / people / processes to promote healthy living and reduce re-admission.
“Systematizing” the Patient Journey
Structure ProcessOrientation Information
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Confidential © 2008 Radianse All Rights Reserved
Clinician/Ward
Patient
Emerg.
Acute Inpatient
Nursing Home
RehabElective
InpatientAmbulat.
Inpatient
Ambulat.
Primary Care
Primary Care
Co
mm
un
ity
Co
mm
un
ity
Post- Acute Care
The Patient Journey
• Regional referral networks• Coordination through Contact Centres• Waiting list management/ theatre utilisation• Patient flow protocols• Real time KPI’s and escalation
End to End Patient and Demand Management
End to End Patient and Demand Management
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Confidential © 2008 Radianse All Rights Reserved
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Confidential © 2008 Radianse All Rights Reserved
Radianse System
Ethernet LANHospital standard
Receivers
Server
Active-RFID tags transmit at 433MHz to provide accurate location & low- cost, easy to wear tags
Receivers send data to the server via LAN or WiFi leveraging existing network infrastructure
WiFi Access Point
Web-based Applications
Web-based application are available over standard browsers
Copyright © 2006 , Radianse, Inc. All rights reserved. Feedback to
Detailed View for ED
Orders & Labs
>>
>>
Exam 1 J ohnson, Mike Smith, Samuel TriagedM – 46Y J ones, Susan 11:05 Chest Pain
Exam 4 Fredrick, J ohn Rueter, Charles Triaged M – 64Y J ones, Susan 10:12 Headache
Room 2 Cummins, Debora Smith, Samuel Waiting for Admit F – 31Y J ones, Susan 11:01 Trauma
3/11/07 11:13
Prospective Patient Flow Manager tm
Bed
2
1
4
Room 3 Smith, Samuel Waiting for Admit F – 31Y J ones, Susan 11:01 Trauma 4
Room 4 Cummins, Debora Rueter, Charles Waiting for Admit F – 31Y J ones, Susan 11:01 Trauma 4
Room 5 Cummins, Debora Smith, Samuel Waiting for Admit F – 31Y J ones, Susan 11:01 Trauma 4
Room 6 Smith, Samuel J ones, Susan
4
ED StatusPatient Name
Gender - Age
Complaint
Nurse
Triage Level
Physician
Arrival Time
EKGCTXray Resp CBC
UASMAC EnzyABGCoag
C20
Sput
EKGCTXray Resp CBC
UASMAC EnzyABGCoag
C20
Sput
EKGCTXray Resp CBC
UASMAC EnzyABGCoag
C20
Sput
EKGCTXray Resp CBC
UASMAC EnzyABGCoag
C20
Sput
EKGCTXray Resp CBC
UASMAC EnzyABGCoag
C20
Sput
EKGCTXray Resp CBC
UASMAC EnzyABGCoag
C20
Sput
EKGCTXray Resp CBC
UASMAC EnzyABGCoag
C20
Sput
EKG
EKG
EKG
EKG
Xray
Xray
CBC
CBC
CBC
Group by: None All ,Show for: All
Update
Copyright © 2006 , Radianse, Inc. All rights reserved. Feedback to
Detailed View for ED
Orders & Labs
>>
>>
>>
>>
Exam 1 J ohnson, Mike Smith, Samuel TriagedM – 46Y J ones, Susan 11:05 Chest Pain
Exam 4 Fredrick, J ohn Rueter, Charles Triaged M – 64Y J ones, Susan 10:12 Headache
Room 2 Cummins, Debora Smith, Samuel Waiting for Admit F – 31Y J ones, Susan 11:01 Trauma
3/11/07 11:13
Prospective Patient Flow Manager tm
Bed
2
1
4
Room 3 Smith, Samuel Waiting for Admit F – 31Y J ones, Susan 11:01 Trauma 4
Room 4 Cummins, Debora Rueter, Charles Waiting for Admit F – 31Y J ones, Susan 11:01 Trauma 4
Room 5 Cummins, Debora Smith, Samuel Waiting for Admit F – 31Y J ones, Susan 11:01 Trauma 4
Room 6 Smith, Samuel J ones, Susan
4
ED StatusPatient Name
Gender - Age
Complaint
Nurse
Triage Level
Physician
Arrival Time
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKG
EKGEKG
EKGEKG
EKGEKG
XrayXray
XrayXray
CBCCBC
CBCCBC
CBCCBC
Group by: None All ,Show for: All
UpdateUpdate
Location resolver calculates location & populates database All information is
available via intranet, SMS, paging or XML
ID Tags
Ethernet LANHospital standard
Receivers
Server
Active-RFID tags transmit at 433MHz to provide accurate location & low- cost, easy to wear tags
Receivers send data to the server via LAN or WiFi leveraging existing network infrastructure
WiFi Access Point
Web-based Applications
Web-based application are available over standard browsers
Copyright © 2006 , Radianse, Inc. All rights reserved. Feedback to
Detailed View for ED
Orders & Labs
>>
>>
Exam 1 J ohnson, Mike Smith, Samuel TriagedM – 46Y J ones, Susan 11:05 Chest Pain
Exam 4 Fredrick, J ohn Rueter, Charles Triaged M – 64Y J ones, Susan 10:12 Headache
Room 2 Cummins, Debora Smith, Samuel Waiting for Admit F – 31Y J ones, Susan 11:01 Trauma
3/11/07 11:13
Prospective Patient Flow Manager tm
Bed
2
1
4
Room 3 Smith, Samuel Waiting for Admit F – 31Y J ones, Susan 11:01 Trauma 4
Room 4 Cummins, Debora Rueter, Charles Waiting for Admit F – 31Y J ones, Susan 11:01 Trauma 4
Room 5 Cummins, Debora Smith, Samuel Waiting for Admit F – 31Y J ones, Susan 11:01 Trauma 4
Room 6 Smith, Samuel J ones, Susan
4
ED StatusPatient Name
Gender - Age
Complaint
Nurse
Triage Level
Physician
Arrival Time
EKGCTXray Resp CBC
UASMAC EnzyABGCoag
C20
Sput
EKGCTXray Resp CBC
UASMAC EnzyABGCoag
C20
Sput
EKGCTXray Resp CBC
UASMAC EnzyABGCoag
C20
Sput
EKGCTXray Resp CBC
UASMAC EnzyABGCoag
C20
Sput
EKGCTXray Resp CBC
UASMAC EnzyABGCoag
C20
Sput
EKGCTXray Resp CBC
UASMAC EnzyABGCoag
C20
Sput
EKGCTXray Resp CBC
UASMAC EnzyABGCoag
C20
Sput
EKG
EKG
EKG
EKG
Xray
Xray
CBC
CBC
CBC
Group by: None All ,Show for: All
Update
Copyright © 2006 , Radianse, Inc. All rights reserved. Feedback to
Detailed View for ED
Orders & Labs
>>
>>
>>
>>
Exam 1 J ohnson, Mike Smith, Samuel TriagedM – 46Y J ones, Susan 11:05 Chest Pain
Exam 4 Fredrick, J ohn Rueter, Charles Triaged M – 64Y J ones, Susan 10:12 Headache
Room 2 Cummins, Debora Smith, Samuel Waiting for Admit F – 31Y J ones, Susan 11:01 Trauma
3/11/07 11:13
Prospective Patient Flow Manager tm
Bed
2
1
4
Room 3 Smith, Samuel Waiting for Admit F – 31Y J ones, Susan 11:01 Trauma 4
Room 4 Cummins, Debora Rueter, Charles Waiting for Admit F – 31Y J ones, Susan 11:01 Trauma 4
Room 5 Cummins, Debora Smith, Samuel Waiting for Admit F – 31Y J ones, Susan 11:01 Trauma 4
Room 6 Smith, Samuel J ones, Susan
4
ED StatusPatient Name
Gender - Age
Complaint
Nurse
Triage Level
Physician
Arrival Time
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKG
EKGEKG
EKGEKG
EKGEKG
XrayXray
XrayXray
CBCCBC
CBCCBC
CBCCBC
Group by: None All ,Show for: All
UpdateUpdate
Location resolver calculates location & populates database All information is
available via intranet, SMS, paging or XML
ID Tags
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Confidential © 2008 Radianse All Rights Reserved
Orders
Lab
Schedule
ADT
Outcomes
Financial
Quality
Efficiency
Equipment StaffPatients
Radianse Context Engine
Copyright © 2006 , Radianse, Inc. All rights reserved. Feedback to
Detailed View for ED
Orders & Labs
>>>>
>>>>
Exam 1 J ohnson, Mike Smith, Samuel TriagedM – 46Y J ones, Susan 11:05 Chest Pain
Exam 4 Fredrick, J ohn Rueter, Charles Triaged M – 64Y J ones, Susan 10:12 Headache
Room 2 Cummins, Debora Smith, Samuel Waiting for Admit F – 31Y J ones, Susan 11:01 Trauma
3/11/07 11:13
Prospective Patient Flow Manager tm
Bed
2
1
4
Room 3 Smith, Samuel Waiting for Admit F – 31Y J ones, Susan 11:01 Trauma 4
Room 4 Cummins, Debora Rueter, Charles Waiting for Admit F – 31Y J ones, Susan 11:01 Trauma 4
Room 5 Cummins, Debora Smith, Samuel Waiting for Admit F – 31Y J ones, Susan 11:01 Trauma 4
Room 6 Smith, Samuel J ones, Susan
4
ED StatusPatient Name
Gender - Age
Complaint
Nurse
Triage Level
Physician
Arrival Time
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKG
EKGEKG
EKGEKG
EKGEKG
XrayXray
XrayXray
XrayXray
CBCCBC
CBCCBC
CBCCBC
CBCCBC
Group by: None All ,Show for: All
UpdateUpdate
Asset Management Patient Flow & Logistics Clinical Effectiveness10:00 D
14:00 D
14:30 D
11:30 B10:42 O
363368373376378380382
07/07/07 11:3007/07/07 14:0007/07/0707/07/07 13:00
388 07/07/07 10:00
10:00 D
13:00 D0:30 B0:30 B0:30 B
PTPT
XRXR OROR
Radianse Applications
Benchmarking/Operational and Clinical Analytics
Radianse Solution Set
… …
… …
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Confidential © 2008 Radianse All Rights Reserved
401 403 405 407 409
402 404 406 408 410
Room-level Accuracy With Radianse
• 433 MHz (UHF band)• Set aside by FCC• Decades of UHF medical use• No interference with other
equipment or systems• Excellent indoor properties• Excellent body worn properties
Confidential © 2008 Radianse All Rights Reserved.
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Confidential © 2008 Radianse All Rights Reserved
Room-level Accuracy
EquipmentPeople
EDUNIT
Waiting
Reception
Triage
Triage
Tre
atm
ent
Tre
atm
ent
Treatment
Treatment
Waiting
Reception
Triage
Triage
Tre
atm
ent
Tre
atm
ent
Treatment
Treatment
? ?
Nursing Station Patient Room
Dirty Utility
Clean UtilityPatient Room
Patient Room
Patient Room
Nursing Station Patient Room
Dirty Utility
Clean UtilityPatient Room
Patient Room
Patient Room
In the ED In the unit … versus …Waiting for triageTriaged Being treatedWaiting for transfer
… versus …Clean & availableDirty Being used
Exciter problem
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Interference-free Operation
“ISM equipment is concentrated in the 2400 MHz band. Equipment operating in this band will suffer from reduced throughput and interference degradation if too many systems are expected to share this very popular slice of spectrum.”
Healthcare Facility MeasurementsA Case Study: Radio Frequency Site Survey, Spectrum Analysis, and Measurements in the Hospital By Mark Gibson
Radianse WiFi
Measured Spectrum Utilization in Hospitals
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Real-time Location Technologies
Low support cost
Standard infrastructure
Secure RF network
Interference free operation
Disposable patient tag
Operates with ID tag covered/blocked
Long battery life with fast update
Small, light ID Tags
Room-level accuracy
InfraredUltrasoundZigbeeWiFiRadianse
Line-of-sight2.4GHz433MHzTECHNOLOGY COMPARISON
× × ×
× × ×
×
× × ×
×
× ×
× × ×
×
× × ×
× ×
?
Pra
ctic
al P
eop
le T
rack
ing
Inst
all &
Su
pp
ort
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Confidential © 2008 Radianse All Rights Reserved
Find Application
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15:49 –Room dirty
Dirty Msg to housekeeping & supervisor
In process Available
Radianse msg: 3 East, Room 387 available
Msg to bed coordinator
Key
15:49 –Room dirty
Dirty Msg to housekeeping & supervisor
In process Available
Radianse msg: 3 East, Room 387 available
Msg to bed coordinator
Key
Patient Flow Application
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Confidential © 2008 Radianse All Rights Reserved Copyright © 2007 , Radianse, Inc. All rights reserved. Feedback to
Detailed View for ED
Orders & Labs
>>
>>
Exam 1 J ohnson, Mike Smith, Samuel M – 46Y J ones, Susan 11:05 Head laceration
Exam 4 Fredrick, J ohn Rueter, Charles Triaged M – 64Y J ones, Susan 10:12 Flu symptoms
Room 2 Weinberg, Sally Smith, Samuel Being Treated F – 43Y West, Patty 11:21
Left-side numbness Thrombolytic administered
2/11/08 12:13
Radianse Reveal tm
Bed
2
1
4
Room 3 Doe, J ane Smith, Samuel Being Treated F – 18Y J ones, Susan 11:01
Chest Pain Late for Cath Lab4
Room 4 Cummins, Debora Rueter, Charles Being treated F – 31Y West, Patty 11:01 Bloody Stool
Room 5 J ones, Ted Smith, Samuel Being treated M – 27Y Martin, Kelly 10:37 Trauma 4
Room 6 Smith, Samuel Martin, Kelly
4
ED StatusPatient Name
Gender - Age
Complaint
Nurse
Triage Level
Physician
Arrival Time
EKGCTXray Resp CBC
UASMAC EnzyABGCoag
C20
Sput
EKGCTXray Resp CBC
UASMAC EnzyABGCoag
C20
Sput
EKGCTXray Resp CBC
UASMAC EnzyABGCoag
C20
Sput
EKGCTXray Resp CBC
UASMAC EnzyABGCoag
C20
Sput
EKGCTXray Resp CBC
UASMAC EnzyABGCoag
C20
Sput
EKGCTXray Resp CBC
UASMAC EnzyABGCoag
C20
Sput
EKGCTXray Resp CBC
UASMAC EnzyABGCoag
C20
Sput
EKG
EKG
CBC
CBC
Group by: None All ,Show for: All
Update
Waiting for TriageBeing TriagedWaiting for ED BedWaiting for DoctorWaiting for DoctorBeing Treated XrayWaiting for ED room
2
CT
ABG
Copyright © 2007 , Radianse, Inc. All rights reserved. Feedback to
Detailed View for ED
Orders & Labs
>>
>>
>>
>>
Exam 1 J ohnson, Mike Smith, Samuel M – 46Y J ones, Susan 11:05 Head laceration
Exam 4 Fredrick, J ohn Rueter, Charles Triaged M – 64Y J ones, Susan 10:12 Flu symptoms
Room 2 Weinberg, Sally Smith, Samuel Being Treated F – 43Y West, Patty 11:21
Left-side numbness Thrombolytic administered
2/11/08 12:13
Radianse Reveal tm
Bed
2
1
4
Room 3 Doe, J ane Smith, Samuel Being Treated F – 18Y J ones, Susan 11:01
Chest Pain Late for Cath Lab4
Room 4 Cummins, Debora Rueter, Charles Being treated F – 31Y West, Patty 11:01 Bloody Stool
Room 5 J ones, Ted Smith, Samuel Being treated M – 27Y Martin, Kelly 10:37 Trauma 4
Room 6 Smith, Samuel Martin, Kelly
4
ED StatusPatient Name
Gender - Age
Complaint
Nurse
Triage Level
Physician
Arrival Time
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKG
EKGEKG
CBCCBC
CBCCBC
Group by: None All ,Show for: All
UpdateUpdate
Waiting for TriageBeing TriagedWaiting for ED BedWaiting for DoctorWaiting for DoctorBeing Treated XrayXrayWaiting for ED room
2
CTCT
ABGABG
Whiteboard Application
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Confidential © 2008 Radianse All Rights Reserved
Clinical EffectivenessRadianse managed workflow
Target door-to-balloon time = n minutesPatient arrives with chest pain
Registered & paired with Radianse ID tag
Arrival time and patient location captured
MI protocol initiated, alerts cath lab team
Assets for cath lab are automatically inventoried
Doctor located & alerted to cath lab
Auto match of right patient, equipment, staff & device made in cath lab
Interventionist performs procedure
Copyright © 2006 , Radianse, Inc. All rights reserved. Feedback to
Detailed View for ED
Orders & Labs
>>>>
>>>>
Exam 1 J ohnson, Mike Smith, Samuel TriagedM – 46Y J ones, Susan 11:05 Chest Pain
Exam 4 Fredrick, J ohn Rueter, Charles Triaged M – 64Y J ones, Susan 10:12 Headache
Room 2 Cummins, Debora Smith, Samuel Waiting for Admit F – 31Y J ones, Susan 11:01 Trauma
3/11/07 11:13
Prospective Patient Flow Manager tm
Bed
2
1
4
Room 3 Smith, Samuel Waiting for Admit F – 31Y J ones, Susan 11:01 Trauma 4
Room 4 Cummins, Debora Rueter, Charles Waiting for Admit F – 31Y J ones, Susan 11:01 Trauma 4
Room 5 Cummins, Debora Smith, Samuel Waiting for Admit F – 31Y J ones, Susan 11:01 Trauma 4
Room 6 Smith, Samuel J ones, Susan
4
ED StatusPatient Name
Gender - Age
Complaint
Nurse
Triage Level
Physician
Arrival Time
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKG
EKGEKG
EKGEKG
EKGEKG
XrayXray
XrayXray
XrayXray
CBCCBC
CBCCBC
CBCCBC
CBCCBC
Group by: None All ,Show for: All
UpdateUpdate
Family-centric view of progress & timeliness of careCopyright © 2006 , Radianse, Inc. All rights reserved. Feedback to
Detailed View for ED
Orders & Labs
>>>>
>>>>
Exam 1 J ohnson, Mike Smith, Samuel TriagedM – 46Y J ones, Susan 11:05 Chest Pain
Exam 4 Fredrick, J ohn Rueter, Charles Triaged M – 64Y J ones, Susan 10:12 Headache
Room 2 Cummins, Debora Smith, Samuel Waiting for Admit F – 31Y J ones, Susan 11:01 Trauma
3/11/07 11:13
Prospective Patient Flow Manager tm
Bed
2
1
4
Room 3 Smith, Samuel Waiting for Admit F – 31Y J ones, Susan 11:01 Trauma 4
Room 4 Cummins, Debora Rueter, Charles Waiting for Admit F – 31Y J ones, Susan 11:01 Trauma 4
Room 5 Cummins, Debora Smith, Samuel Waiting for Admit F – 31Y J ones, Susan 11:01 Trauma 4
Room 6 Smith, Samuel J ones, Susan
4
ED StatusPatient Name
Gender - Age
Complaint
Nurse
Triage Level
Physician
Arrival Time
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKGCTCTXrayXray RespResp CBCCBC
UAUASMACSMAC EnzyEnzyABGABGCoagCoag
C20C20
SputSput
EKGEKG
EKGEKG
EKGEKG
EKGEKG
XrayXray
XrayXray
XrayXray
CBCCBC
CBCCBC
CBCCBC
CBCCBC
Group by: None All ,Show for: All
UpdateUpdate
Time in minutes
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Confidential © 2008 Radianse All Rights Reserved
Benchmarking & Analysis
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Confidential © 2008 Radianse All Rights Reserved
Information Technology DepartmentCopyright 2007. All rights Reserved 29
Delay in Minutes: ADT vs. RFIDDelay in Minutes: ADT vs. RFID
• 67% greater than 20 minutes– 35% > 20-40 minutes
– 23% 40-120 minutes
– 9% >120 minutes
Mount Sinai Bed Turn-Around Time
Customer challenge • Excessive time from discharge to new admission• Prolonged turn-around times with ED congestion
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Confidential © 2008 Radianse All Rights Reserved
• Before (measured): Weekday (mode): 45 min Weekend (mode): 60 min Range: 15 -> 525 min
• Tracking towards: Weekday (mode): 35 min (20%) Weekend (mode): 45 min (25%) Range: 15 -> 500 min
Providence HospitalBed Management and Turnover
Customer challenge • ED diversions, wait times, left-without-being-seen• Multiple phone calls to coordinate patient placement
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Confidential © 2008 Radianse All Rights Reserved
• Real-time tracking of equipment, patients and staff – “OR of the Future”
• 40% improvement in OR throughput• Billing for Anesthesia time• “Zone of Patient Safety”
– “Office of the Future”– Performance Improvement – workflow studies
• Stroke pathway adherence• Needle localization for breast-biopsy
Customer challenge • Difficult to monitor, complex care processes • Provider information overload• Limited resources leading to delays in care
Massachusetts General HospitalComplex Care Delivery
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Confidential © 2008 Radianse All Rights Reserved
Multi-Site StudyHow Med/Surg Nurses Spend Their Time
• 37 hospitals participated with 21,955 hrs of data collected
• 801 nurses participated in Radianse study track
Simulation analysis with spaghetti diagram
Results: Accurately quantified
nursing workflow and activities
Identified waste and variation in actions and movement
Provided metrics for nurses and unit performance improvement
Customer challenge • Identify nurse work patterns to develop both architectural & workflow improvements
• Provide opportunities for more patient interaction time
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Confidential © 2008 Radianse All Rights Reserved
Predictable & Sustainable Results
Process Support
Pre
dic
tab
ility
an
d
Su
sta
inab
ility
of
Res
ult
s
None Automated, Transparent& Seamless
Low
Inco
nsis
ten
tH
igh
Manual Input
TraditionalProcess
Improvement
Process Support
Pre
dic
tab
ility
an
d
Su
sta
inab
ility
of
Res
ult
s
None Automated, Transparent& Seamless
Low
Inco
nsis
ten
tH
igh
Manual Input
TraditionalProcess
Improvement IS
Typical process improvement
Radianse based improvement
• Objective data• Measurable results• Ongoing measurement
& support