improving operations & the delivery of care …improving operations & the delivery of care...

IMPROVING OPERATIONS & THE DELIVERY OF CARE

THROUGH THE REAL-TIME HEALTHCARE SYSTEM

JOE PLESHEK, TERSO SOLUTIONS. INC.

Contents

Introducti on

What is RTHS and How Do We Get There?

The Work Has Already Begun at Terso

Will Healthcare Buy Into the Retail ROI?

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Introducti onThe U.S. spends a startling $3 trillion a year on healthcare, or nearly 18 percent of its GDP. The expenditure is so great that, on it’s own, U.S. healthcare costs are the fi ft h largest economy in the world, just ahead of the United Kingdom.

On a per capita basis, U.S. consumers spend $8,745 per person on healthcare, about $2,500 more than Norway, the second highest spender on a per capita basis. France, by comparison, spends just over $4,000. (1)

The high price of healthcare isn’t the only issue. A 2013 report by the Journal of Pati ent Safety claims that as many as 440,000 pati ents who go to the hospital in the U.S. each year suff er some type of preventable harm that contributes to their death. Simply stated, spending more money on healthcare doesn’t result in higher quality.

In a day and age when ti meliness is criti cal to pati ent safety, care quality and operati onal effi ciencies, many healthcare providers waste copious amounts of ti me and resources to locate pati ents, staff and criti cal equipment like heart monitors and defi brilla-tors.

While many potenti al soluti ons exist, a Real-Time Healthcare System (RTHS) represents the most formidable change agent moving forward. RTHS disrupts the classic care delivery model by using real-ti me informati on and communicati ons to be more proacti ve and less reacti ve. They key aspect to the RTHS is situ-ati onal awareness -- or knowing where people (pati ents, clini-cians and care team members) and resources such as medical devices and wheelchairs are at all ti mes during the pati ent expe-rience. The concept of situati onal awareness involves sensing, collecti ng, analyzing and using state and event informati on -- or situati onal intelligence -- to improve operati ons and the delivery of care. (2)

Improving the Operati ons & Delivery of Care Through Real-Time Healthcare SystemBy Joe Pleshek Terso Soluti ons, Inc.

Terso Solutions, Inc. ©1

Situati onal Awareness is the Key

Real-ti me product visibility already exists in much of the retail supply chain, as retailers and manufacturers have the ability to view products as they travel through the supply chain and when they enter and exit the retail store. The same is largely true for some sectors within manufacturing, such as automoti ve and aerospace.

Although healthcare is a much more complicated industry, this can no longer be an excuse. With technologies available today there is no reason why the same situati onal awareness and real-ti me intelligence principles cannot be exercised, off ering high-level visibility into the enti re healthcare supply chain.

What is RTHS & How Do We Get There? The Internet of Things is receiving tremendous fanfare from nearly every single industry verti cal that sees an advantage of connecti ng their parti cular product to the Internet. By 2020, Gartner esti mates that 25 billion devices will be connected to the Internet, led by applicati ons in the uti lity, manufacturing and government sectors. In 2015, there were fewer than 5 billion connected devices.


Today, consumer goods like appliances and cars are of top focus in the IoT world. Connected applianc-es, for example, can communicate with manufac-turers and send an alert when a part is about to malfuncti on. Similarly, some appliance makers are already off ering NFC-enabled washing machines that allow consumers to operate the machine from afar and to download new clothing cycles as they are released.

While the opportuniti es are vast in the consumer sector, they are dwarfed by the industrial sector. Consumers typically own only one washing ma-chine and one refrigerator. A manufacturer of airplanes, however, owns millions of assets, and millions of parts, all of which will some day com-municate back to the cloud.

Healthcare, however, could represent the biggest jackpot for IoT. The average hospital stocks tens of thousands of inventory SKUs, plus operati ng assets. In additi on, 136 million people visit the ER each year, with another 125 million more receiving outpati ent care. (3) When you consider hundreds of millions of pati ents, staff , infrastructure and in-ventory, an IoT-enabled healthcare industry could represent billions of connected items.

The RTHS is the Internet of “Healthcare” Things. Imagine the possibiliti es that exist when all assets in a healthcare facility are connected, allowing for

bett er locati on, improved service and maintenance (equipment calibrati on, for example) and enabling doctors to monitor pati ents remotely.

Further sti ll, imagine the day when medical implant devices like hip replacements or heart valves carry RFID tags, allowing them to be tracked through the enti re supply chain. If a manufacturer of a $40 shirt gains value by tagging all of the shirts they ship to Macy’s, the value that medical device manufacturers can reap from tagging high-value products is likely tenfold.

Locati on-aware technologies such as RFID, RTLS and GPS are able to determine the geographi-cal positi on of a person or thing, and are vital to achieving a situati onal awareness environment. Aside from being able to track the exact locati on of a pati ent, a doctor, or an asset such as a heart pump, many of the same technologies can be used to monitor temperature, humidity, light, move-ment, low-batt ery situati ons and hygiene compli-ance in areas within Healthcare Delivery Organiza-ti ons (HDOs) that require close monitoring.

The RTHS uses up-to-date informati on to remove delays in the management and executi on of its crit-ical business processes. It provides visibility into important pati ent-related acti viti es and event data. It couples situati onal awareness informati on with informed pati ent context to sati sfy revenue, cost,


quality and pati ent experience expectati ons.

The road to achieving the Real-Time Healthcare System will be long and fi lled with detours. To-day, the healthcare value chain is unprepared to capitalize on the rich situati onal awareness and operati on intelligence surrounding the pati ent that is now possible. But there is a path forward.

Gartner Research suggests that healthcare provid-ers take these steps in order to begin the journey:

• Deploy locati on- and conditi on-sensing tech-nology in support of workfl ows and business processes that can benefi t from enhanced situati onal awareness

• Begin with wireless healthcare asset manage-ment, and progress to locati on- and condi-ti on-sensing technologies

• Implement consistent, enterprise-wide posi-ti ve pati ent identi fi cati on (PPID) as a founda-ti onal architectural component for situati onal awareness

• Create a road map to situati onal awareness by managing the technology evoluti on between IT and operati onal technology (OT)

The Work Has Already Begun at TersoThe good news is that Healthcare is beginning to adopt situati onal awareness technologies. It is esti mated that the global market for RFID in healthcare was $1.1 billion in 2012. (4) That fi gure is expected to grow to $3.3 billion by 2018, repre-senti ng growth of nearly 20 percent annually, as healthcare providers seek to increase profi tability by knowing where their assets are and by moving more pati ents through the system because of the increased effi ciencies that RFID and sensor tech-nology can provide.

The Internet of “Healthcare” Things or RTHS is poised to revoluti onize the enti re healthcare chain, from the birthing process (sensor-enabled belly bands worn by expectant mothers to monitor uter-ine contracti ons) to elderly care (sensor-enabled adult diapers) and everything in between. The Io”H”T will revoluti onize emergency medical care, allowing EMT’s to respond to emergencies faster while enabling enhanced pati ent care at the scene,

during transit and upon arrival at a hospital facility.

Terso’s sensor technology and JetStream™ RFID Cloud Platf orm are poised to play a criti cal role every step of the way in achieving an RTHS envi-ronment. Internet-enabled sensors that collect valuable data about pati ent conditi on or asset lo-cati on can all be aggregated in JetStream. By using this secure cloud-based tool, stakeholders across the enti re RTHS – including suppliers, distributors and healthcare providers – can leverage the data by integrati ng it into ERP, inventory management, EHS and BI systems.

Much of this sensor capability is already enabled on the connected cabinets that Terso produces, and will also be prevalent in mobile cases, kiosks, Ipads, and even stethoscopes that communicate back to the cloud and help doctors to arrive at faster medical conclusions.

Products like Terso’s RFID Mobile Case, for exam-ple, ensure that all the proper products required by EMT’s and fi rst responders are in stock when needed, while RFID-enabled storage cabinets already deployed by the thousands ensure that inventory is on-site when the pati ent arrives at a healthcare facility for further care.

JetStream ti es the enti re RTHS process together by enabling soft ware companies and enterprises to add distributed RFID capabiliti es quickly through simple programming interfaces. JetStream off ers a powerful toolset that makes integrati ng other soft ware systems with Terso’s RFID cabinets quick and easy.

Products like RFID-enabled refrigerators repre-sent a major part of that industry growth moving forward. At Terso Soluti ons, we have deployed our RFID-enabled refrigerator, freezer and storage cab-inets at over one thousand locati ons around the world, and we see strong demand for these units moving forward. This type of product line -- which provides strong track and trace ability stored safely in the cloud – ti es in very closely with the overall RTHS concept.

We’re excited to see the RTHS process starti ng to come to life before our own eyes. We are in the midst of launching a new program with Medtronic and our ti ssue tracking soft ware partners, Cham-


pion Medical and TrackCore, Inc., that will allow all three companies to share real ti me data through the JetStream platf orm.

Sharing data is the key to closing the loop on medical devices. Through JetStream, we can now track devices from the point of manufacture at Medtronic to the exact point of use at the hospi-tal. We can see products move through the enti re supply chain unti l they eventually show up on a pati ent’s electronic medical record. This ability rep-resents a giant leap in the medical devices sector. In this instance, Medtronic tags products at its manufacturing facility. At that point, all metadata associated with the product is stored in a shared database. When the product arrives at a hospital, it is already RFID tagged, making for a simple tran-siti on to one of Terso’s enclosures.

This new supply chain visibility enables Medtronic to know exactly when the product arrived, and the hospital knows it arrived through its inventory management soft ware. From there, Champion and TrackCore, Inc., document exactly who touched what ti ssue, and when, in additi on to tracking tem-perature and expirati on.

When a product is used in a case such as surgery, the hospital charts it in the pati ent’s electronic health record, which then communicates direct-ly back to the other platf orms. At this point, all parti es – the pati ent, the hospital and the manu-facturer -- know which item was used, off ering sig-nifi cant value all the way through the supply chain.

One East Coast hospital has already saved more than $300,000 by using the Champion UDI Tracker and Terso RFID soluti ons to track ti ssue. In this case, each piece of ti ssue is assigned a unique RFID tag and tracked via Terso’s RFID freezer/cabinet.

With the integrati on to JetStream, UDI Tracker knows when a nurse removes a product and which case it is used for. This hospital has seen signifi cant value through the integrated soluti on through reducti ons in expirati on and missing products, along with real ti me visibility which allowed them to right size inventory levels.

There are numerous other examples of hospitals that parti ally operate in a RTHS environment al-ready. For several years, the Disney Family Cancer


Center in California has used RFID to track pati ent move-ment through the facility. Sensor technology also makes sure that each room is at the pati ent’s recommended temperature, with the previously selected genre of music piped into the room. (5)

Will Healthcare Buy into the Retail ROI?When retailers fi rst began to pursue RFID, the ulti mate end-goal was to track cases and pallets of goods as they moved through the supply chain. Eventually, forward thinking retailers determined that the real value was in item-level tagging, and tracking the fl ow of goods at the store level. This philosophy initi ally led to large concerns about consumer privacy. Eventually, consumer-related apps like magic mirrors and RFID-enabled fi tti ng rooms helped consumers to gain a greater acceptance for the technology.

For healthcare, the ulti mate goal for situati onal awareness is omniscience – or the infi nite awareness and insight into the pati ent context and conditi on at any point in ti me. Like their predecessors in retail, healthcare CIOs may be skepti cal of this strategy, which may be impracti cal and un-achievable given strict privacy implicati ons in healthcare.

However, improvements in situati onal awareness, short of omniscience, can substanti ally improve operati onal effi ciency, outcomes and the pati ent experience. In retail, consumers became willing to sacrifi ce a certain amount of privacy in return for bett er customer service and mon-ey-saving promoti ons, such as sending an email to a mo-bile phone with a savings for a product they had bought before.

The Real Time Healthcare System is the future for Health-care in the U.S. and beyond. This system uses situati onal intelligence to improve decision making around pati ent care and hospital operati ons. It is able to sense the need for a change pro-acti vely and has the means to execute that change. It works to eliminate waste and latency, accelerate business processes, balance resources versus demand, improve care quality and pati ent experience. The ti me to develop a RTHS road-map is now. We cannot aff ord to wait.

1 - Organization for Economic Co-operation and Development

2 – Gartner Research

3 – Centers for Disease Control & Prevention

4 – Transparency Market Research

5 – RFID 24-7

improving operations & the delivery of care …improving operations & the delivery of care...

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