RFID In Healthcare
Saint Michael s Medical Center Established by the Franciscan Sisters of the Poor in 1867 Premier teaching and research institution Serving a diverse, Medicare/Medicaid population Catholic Health East affiliation July 2008 $250M+ Investment to transform into Destination Medical Center
SMMC Background US World News Report : Best Hospital in NJ for Diabetes and Endocrine Disorders First Robotic-Arm assisted orthopedic surgery First medical institution in NJ to perform open-heart surgery First medical institution in NJ to develop a cardiac catheterization program Major teaching affiliate of : Seton Hall University School of Graduate medical Education New England College of Osteopathic Medicine Saint George s University School of Medicine in Grenada
SMMC Stats Area Admissions Patient Days Med/Surg 13700 66500 Critical Care 290 9700 Pediatrics 70 160 Behavior Health/Detox 2100 11000 Payor % of SMMC Revenue Medicare/Medicare HMO 47% Medicaid 15% Self-Pay 16% Commercial 16% Other 6% FTE 2009 1633
SMMC Specialty Care 357-bed regional tertiary care, teaching, and research center in Newark, NJ, a member of Catholic Health East Acute Care 309 ICU 30 Psych Beds 21 OR Rooms 10 Specialty services The Heart and Vascular Institute The Regional Cancer Center Connie Dwyer Breast Center DaVinci Robot
Bio-Med at at SMMC Responsibilities at 3 Campuses : St. Michael s Medical Center (Newark) St. James Satellite Center (Ironbound) Urgicare, prenatal clinic, behavioral health services Columbus Satellite Center (North Ward) Urgicare, prenatal clinic Equipment managed 4000+ total pieces of equipment 2500+ mobile pieces of equipment Staff managed by Director 2 Technicians 1 Coordinator Outsource /Contractors on time and material work for specialty equipment such as anesthesia, ventilators, ultrasound, radiology, etc
Bio-Med Challenges Improve clinical workflow and productivity Reduce amount of time spent by clinicians and bio-med technicians searching for equipment Constant reduction in staff Understand equipment utilization information Should we rent equipment and if so for how long? How much should we buy/rent How can we find lease/rented equipment? Ensure extended rental equipment is properly maintained
Hospital Benefits for an Ability to locate equipment for improved PM management and compliance with JCAHO and other regulatory agencies Decreased capital and rental equipment expenses as a result of usage tracking Ability to quickly locate equipment involved in a recall or product notification Eliminates asset hoarding and decreases clutter RTLS Solution
Hospital Benefits for an RTLS Solution Ability to identify equipment that is waiting to be picked up for cleaning, as well as location of equipment ready for patient use Ability to identify when equipment/patient enters an unauthorized area or leaves the hospital premises. Staff can take action immediately and record results Improved patient safety Increased patient and staff satisfaction
Initial Asset Tracking Deployment Requirements Find assets for PM or warranty or product recall work Alert if asset is leaving the building Alert if asset is entering an unauthorized area Alert if asset is in hallway or room more than a predefined time interval Alert for minimum/maximum number of assets detected (too many dirty pumps in soiled utility or not enough clean pumps available in clean utility room)
Initial Asset Tracking Deployment Requirements Alert if asset detected in room and then moved to another room without going to decontamination area Asset utilization report Asset location history Lease equipment location and report (feeding pumps, anti-embolism boots) Warranty equipment location and report
Future Deployment Requirements Track Wheelchairs and Stretchers Hospital Security for patient elopement Specialty beds for specific areas ED optimization workflow analysis Cath lab tracking for Stemi-90 (EKG to balloon) Temperature Monitoring with alerts Staff Tracking
Solution Information Gathering Process Visits to vendor booths at HIMMS and AAMI Reviewed various publications and analyst reports Vendor solution in-depth reviews and demos : Queralt (Active RFID) RadarFind (Active 900Mhz RFID) Aeroscout (Active 802.11 RFID) IBM/Sonitor (Active Ultrasound Technology) Considered Zigbee Selected to pursue with 2 vendors : RadarFind and IBM/Sonitor
Queralt Evaluation Not suitable for Healthcare Not a real time solution Mostly access/security
Aeroscout Evaluation Pros : Use WiFi network Tag form factors Cons : SMMC WiFi network would be stressed IT support required Possible RF interference
RadarFind Evaluation Pros : Easy to install with electrical outlet plug-ins Deployed in CHE Hospital (Our Lady of Lourdes) Cons : SMMC Outlets are generally scarce and position low positioned behind beds with metal frames Possible RF interference
Sonitor/IBM Evaluation Pros : Uses LAN (WiFi or Ethernet) Minimal network bandwidth impact Does not interfere with Hospital RF Room and sub-room level location accuracy Ability to integrate other sensor solutions Cons : IT support required Network/LAN support/wifi or POE
Wireless Infrastructure vs Wired POE Technology Pros Cons WiFi Ease of deploying sensors The hospital Wi-Fi, security protocols etc. could involve some work, and requires full cooperation from hospital IT/Wi-Fi infrastructure management. If the Wi-Fi network communication is not solid, then the sensor communication performance could be compromised Most Wi-Fi networks' performance are subject to risk of change/deterioration over time. Needs separate 110V power outlet access within 10 ft from HDR. POE Available in most hospitals No issues/risks with network communication or power source (POE) Solid consistent communications performance Cost and time for Ethernet/POE drop installation if drops are not available
RTLS ROI Use Case Assessing labor savings Pre and post implementation survey Nursing & Bio-Med Assessing capital equipment savings
Project Timeline Ongoing Project Management Conduct Project Kick-Off Meeting Conduct Requirements Validation (Use Cases / Asset Tagging) Develop Solution Architecture/Design Prepare Site - IBM Prepare Site - SMMC Install Software / Test System Perform Inventory Verification, Data Cleansing, Data Import Tag Assets - SMMC/IBM Develop Reports and Interfaces Conduct Training Implement RTLS System Conduct Final Project Meeting Provide Post-Live First Level Support Start : May, 2010 End : Aug, 2010
Lessons Learned Get a solution there sooner Over purchased - is there a need? 450+ IV pumps 100 new beds
Next Steps Finish deployment Gather metrics Save money, improve productivity Publish results!
Thank You! Maria Agostinho Director, Biomedical Engineering Saint Michaels Medical Center, Inc a member of Catholic Health East phone (973) 887 5592 fax (973) 877-5696 mariaa@smmcnj.org