Providing Healthcare Without Boundaries
Debra Sloane
Healthcare Lead – Emerging Markets
Cisco Expo - June 2011
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Imperatives and Technology Alignment
Cisco Connected Clinic
Cisco Connected Hospital
Cisco Health Presence
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Rising Care Costs
Access to care
Quality of Care
Delivery
• Staffing shortages
• Specialist and GP distribution
• Growing patient loads
• Lack of proper IT support
• Underserved areas
• Inefficient health delivery
processes
• Lack of Interoperability
• Lack of standard tools and
single patient view
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• Lack of Decision Support at
point of care
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Which of the Following Are the Greatest Problems in
Providing Health Services to Citizens in Your
Country Today?
Source: Princeton Survey Research Associates International, 2010
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How Much Potential Do the Following Telehealth Approaches Have To Improve
Health Services in Your Country Within the Next Five Years?
Source: Princeton Survey Research Associates International, 2010
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How Viable Would These National Programs Be in Your Country?
Source: Princeton Survey Research Associates International, 2010
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H1N1 Creates Panic
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A bundled solution providing collaboration opportunities with remote caregivers/agencies
to improve local care :
MGN Services such as Switching, Routing,
Wireless, Transport Optimization, Security,
Collaboration, and Local Storage
Connectivity to the Connected Health
A Ecosystem enabling (1) Medical Collaboration;
N (2) EHR Availability; (3) Disease Reporting;
D and (4) Imaging Services
Delivered via
Business Model
Managed Services
Enterprise
Cloud
No IT Expertise Need
Clinic Purchase
Healthcare—aaS
No Upfront Investments
SmartNet Contract
Pay per Use
OpEx not CapEx
© 2011
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Scale Out and In
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• A ―main‖ hospital has the imperative
to connect to clinics that serve the
same population
• The requirements are basic clinic
connectivity to provide a collaboration
and/or scheduling option between the
main hospital and clinics; eventually
adding EHR
Managed
Services
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• A single government agency
potentially requires:
Disease reporting/surveillance
e-Health record roll-out
Digital imaging roll-out
• The requirement with basic
connectivity in place is to add more
capabilities with ISR and UCS
Managed
Services
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Enterprise
Cloud
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• A national government needs to
establish nationwide connectivity
for all clinics and hospitals
• The required architecture should
be based on the nationwide health
delivery and/or payment model
Managed
Services
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Cloud
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BUSINESS
VALUE:
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Health
Collaboration
Electronic
Health
Records
Disease
Surveillance
Imaging
Services
• Opportunity for remote clinics to collaborate
• Ability to add relevant application software only as required
• Remote management promotes health workers ability to focus on patients
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A connected hospital must be considered by definition a
collaborative organization : all actions should trigger a related
follow-up activity or procedure. Time is an unforgiving asset in the
hospital: Inefficient processes produce wasted time for busy staff
and can produce medical errors.
Baseline connectivity provides system-to-system, system-to-human,
and human-to-human communication.
Always-on communication and collaboration enables expertise
availability anywhere anytime to provide quality care to the patient.
Further, mobile access brings patient data to point of care.
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Connectivity enhances delivery of care
CLINICAL SYSTEMS
EMR
Patient registration
Physician Order system
Patient Tracking and Monitoring
Emergency e-monitoring
Caregiver search
RIS
PACS
Online operating room
Lab management system
Pharmacy Management system
Ambulance management
Telemedicine/ Tele Care
BEDSIDE SERVICES
Nurse Call Systems
Patient Data
Digital Signage
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STAFF EFFICIENCY
Hospital Portals
Communication & Collaboration
Video Conference and Telephony
Workflow Management
INTELLIGENT BUILDING
Video Surveillance
Access management
BACK OFFICE & HOSPITAL
EFFICIENCY
Device Tracking.
Paying system
E-procurement
Contact Center
External portal
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Event
What happens
Benefits
Tech Infrastructure
Patient is
admitted
into hospital
Availability of bed is checked, bed
reserved, patient date updated,
location tag installed on patient, staff
alerted to start procedures.
All workflows are set to
automate procedures, to
optimize care.
RFID tag
MSE
WiFi
HL7
CUCM
IP Phones
Patient is
transported
to room
Aid is notified for patient transport,
locates wheel chair via interface to
location tracking, Patient journey is
automatically tracked.
Automated notification
process for transporting
patients eliminates patient
and staff waiting times .
Patient tracking guarantees
safety.
WiFi
MSE
RFID Tag
CUCM
WiFi IP Phone
LDAP
Patient
receives
preliminary
consultation
Patient record is checked (allergies,
available lab results, scans, previous
medical issues, …)
Single patient data view is
created pulling medical info
from all systems in the
hospital system (local,
regional, national)
IHE middleware
VPN
ISR G2
UCS [Express]
Patient
scheduled
for scan.
Doctor authenticate into RIS ,
scanner availability is checked,
reservation is made, specialist is
alerted, RIS record is created.
System integration enables
workflow automation and
real-time notifications,
accelerating the scan cycle.
WiFi
AAA
CUCM
CIUS
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Event
What happens
Benefits
Tech Infrastructure
Scan is
performed
Patient scan is created and made
available for diagnosis. Specialists is
alerted. Modality is immediately
available for next scan.
Image is created, securely
and quickly transported for
review. Workflow involves
alerts to involved staff.
Image is stored.
DC
Load Balancer
WAAS
DICOM routing
Gigabit switching
QoS
CUCM
Lab analysis
are
requested
Doctor enters requests for analysis .
Lab is notified to start procedures.
Doctors is notified when lab result is
ready.
Optimize response cycle.
WiFi
CIUS
CUCM
IP Phone
Diagnosis is
reviewed by
care team.
A team is dynamically created to
collaborate around the image, and
deliver a diagnosis. Team is created
according to presence information,
specialties. Collaboration is remote
with full audio/video/ image sharing
capabilities.
Experts can easily
collaborate to produce the
highest quality diagnosis
Presence
CUCM
Webex
TP
CUVA
PACS
Surgery is
requested
Availability of operating room is
checked, room is reserved together
with available surgeon and staff,
Team is alerted.
Workflow automation for
surgery procedure enhance
care process quality and
minimize errors.
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CUCM
HL7middleware
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Event
What happens
Benefits
Tech Infrastructure
Patient is
transported
to the
operating
room.
Aid is notified for patient
transportation, Entrance of patient
into room is detected, Patient Record
is automatically fetched and shown
on LCD screen (reason for surgery,
scan image, operation histories,
allergies, …)
Patient journey is always
under control, every event
triggers specific actions to
guarantee highest quality of
care. Complete patient
information display
eliminates errors.
WiFi
MSE
RFID Tag
CUCM
WiFi IP Phone
DMS
MDES
Patients
starts
surgery
recovery
phase
Patient conditions are monitored by
connected biomedical devices, fixed
or mobile. ICU staff is alerted if vitals
signs goes off boundaries. Patient
can also trigger intervention of nurse.
Automation of Biomedical
device connectivity
simplifies IT operations and
guarantees for optimal
working conditions, ICU
staff are supported by
automated alerts to
optimize productivity and
quality of recovery.
BioMed NAC
WiFi
QoS
CUCM
Nurse Connect
Drugs are
ordered
Doctor inputs request for specific
drugs. Pharmacy receives order.
Patient record is checked for counter
indications and updated. Staff is
alerted when drugs are available.
Optimize pharmacy cycle.
WiFi
CIUS
CUCM
IP Phone
Increase bed turnover.
CUCM
Patient is
discharged.
Patient can go home, cleaning staff
is alerted to set up the bed/room for
patient, status is updated.
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Network Services
Reliable Efficient
Connectivity
Policy
User Services
Dynamically Linking
Users, Devices, and
Applications
Mobility, Video,
Workplace Experience
on a Common Fabric
Experience
Integration
Virtualized Devices and
Resources, Anytime,
Anywhere
Consolidated Data, Video,
Energy, Automation
Cisco Medical Grade Network
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Acute Care Campus Environment
North Access 1
Core
Clinical
Workstation
802.11
n AP
NAM
Network
Analysis
Module
NAC
Server
South Access 1
Distribution
Nx 10G
Si
CT / MR
Si
Si
Si
Access
Patient
Monitor
South Access 2
Si
Si
CoW
802.11
n AP
Si
North Access 2
Wireless
LAN
Controller(s)
Access
Core
VPN
Tunnel
Remote Clinician
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Intrusion
Prevention
System
Distribution
An Optimized
Network
Architecture for
the Connected
Hospital
Si
Public
WAN
Data Center
Private
WAN
WAN Edge
Remote Ambulatory Care
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• South Africa: Khayelitsha Hospital
Cisco Medical Grade Network
Provide care efficiencies and collaboration opportunities
• Brazil: Institute of Trauma and Orthopedics
Cisco Medical Grade Network
Telepresence for external collaboration
Unified communications and video for internal collaboration
• Poland: John Paul II Hospital
Cisco Medical Grade Network
Telepresence for real-time training on surgeries
Integration of patient health record on secure wLAN
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Access
Productivity
Efficiency
NEW
OLD
NEW
OLD
NEW
OLD
Service
the
Patientcomes
goes totothe
patient.
The
best
possible
service and waits.
expert sees the patient,
even if the patient is far
away.
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More
patient
encounters,
less
Caregiver
time
lost between
in-between
time,
broader
patient encounters, limited
geographical coverage.
Patients
can of
access
routine
Heavy use
emergency
and
specialty
medical
care
rooms and overburdened
using offsite
clinics in urban
systems.
and rural areas.
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Sharing
Using the network as a platform, the Cisco Health Presence solution combines video, audio,
and patient medical data to create an environment similar to what most people experience
when they visit their doctor or health specialist.
Patient in a remote area needs
to see a doctor
Local health worker places
patient at Cisco Health
Presence unit
Health worker places
call to a remote doctor with a
single touch
Medical devices
provide vitals which are
uploaded into a patient record
Remote doctor sees patient
using video. Both patient and
doctor view data from medical
devices.
 Increased convenience and access to healthcare for patients
Business
value
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 Optimizes the use of scarce health resources while containing costs and
offering a live, ―face-to-face visit‖ experience
 Offers the ability to augment and optimize the capacity to train and reach
remote health workers
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Cisco
TelePresence and
Tandberg
for a realistic face-toface experience
Cisco®
Vitals Software
for secure session
management,
transmission of medical
data, and viewing of
electronic medical
record (EMR)
Cisco Session
Management Application
for interoperability with
Cisco Unified Communications,
enabling intelligent routing and
management & one-touch
dialing
Components
Medical Devices
AMD-2500 General
Examination Camera
AMD-3700 Telephonic
Stethoscope
AMD-2015
ENT Scope
Welch Allyn Spot Vital
Signs Lxi
(blood pressure, temperature,
pulse rate, pulse oximetry)
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• Mayo Clinic
Cardiology
• Ascension Hospital
Neurology – Cardiology
• St Josephs
Behavioral Health/ER
(ATT)
• Stanford
Dermatology
• Apollo Hospitals
General Care
• Jordan Health Initiative
General Care
• Cisco on Cisco
Corporate Clinics
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www.cisco.com/go/healthcare
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