SD / Amb Care Script 2015
PLEASE EMAIL pfrisch@ihassociation.org with any suggested changes
Contents
Updated Mar 24, 2015 ..............................................................................................................................3
Scenario ........................................................................................................................................................3
Introduction:..................................................................................................................................................3
Stepdown Bed ...............................................................................................................................................3
SD1 Wireless Communications (Intelligent InSites/Stanley/Vocera) ....................................................3
SD2 Environmental Monitoring (Extreme Networks, Intelligent Insites] .....................................................3
SD3 Embedded RTLS Solution (Zebra) ..........................................................................................................4
SD4 EMR ........................................................................................................................................................4
SD5 Bedside Workstation (HID, Zebra).........................................................................................................4
SD6 Bed Description (Hill-Rom, Critical Alerts) ............................................................................................4
SD7 Dome Light (Critical Alerts) ....................................................................................................................5
SD8 In Room Wristband Replacement (Sunquest/ Zebra) ...........................................................................5
SD9 Mobile Medication System (Carefusion) ...............................................................................................6
SD10 Physiological Monitoring: (Draeger) ....................................................................................................6
SD11 Connectivity: (Nuvon)..........................................................................................................................6
SD12 Draw Labs (Zebra) ...............................................................................................................................7
SD13 Eliminating Transfusion Errors and Increasing Efficiencies (Sunquest) ..............................................9
SD14 Interactive Patient System (Skylight) ................................................... Error! Bookmark not defined.
SD15 Meal Ordering (CBORD) .......................................................................................................................9
SD16 Alerts (Critical Alerts) ....................................................................................................................... 10
SD17 Infusion System (BBraun) ..................................................................... Error! Bookmark not defined.
SD18 Nurse call Pump Integration (Ascom) .................................................. Error! Bookmark not defined.
SD19 Interactive Patient System – Discharge (Skylight) ............................................................................ 10
SD20 Print Prescriptions: (Zebra) .............................................................................................................. 12
SD21 Environmental Services. (Stanley) .................................................................................................... 12
SD22 Equipment Shrinkage (Stanley) ......................................................................................................... 12
Ambulatory Care: ....................................................................................................................................... 13
AC1 Workstation (HID, Zebra) ................................................................................................................... 13
1
SD / Amb Care Script 2015
PLEASE EMAIL pfrisch@ihassociation.org with any suggested changes
AC2 Embedded RTLS Solution (Intelligent Insites) .................................................................................... 14
Scenario: ..................................................................................................................................................... 14
AC3 Self-Rooming, Patient Status, and Provider Workload Application (Intelligent InSites)................... 14
AC4 Draw Labs (Zebra) .............................................................................................................................. 14
AC6 Medication Management & Administration (Carefusion Pyxis) ....................................................... 15
AC7 Business Intelligence - Room Occupancy Reporting ........................................................................... 16
(Intelligent InSites) ..................................................................................................................................... 16
AC8 Communications and Information Delivery (Extension Health ) ........... Error! Bookmark not defined.
Closing Statement: ..................................................................................................................................... 17
2
SD / Amb Care Script 2015
PLEASE EMAIL pfrisch@ihassociation.org with any suggested changes
Updated Mar 25, 2015
Scenario
Name:
Walter Zickler
Age:
70
Condition: Congestive Heart
(Actor 1 starts outside the door to the room, Actor 2 starts by the bedside)(Actor 1
walks into the room as soon as the script starts)
Introduction:
Hello, welcome to the Step – Down Ambulatory Care area of the Intelligent Hospital. This
room represents two distinct environments; a typical step down area which provides an
intermediate level of for patients between the intensive care and a normally staffed in-patient
area; and an ambulatory care area providing consultation, treatment or intervention
delivered on a out-patient basis. These areas rely on a combination of medical technologies
for treatment delivery, patient care as well as workflow optimization and process validation.
Stepdown Bed
SD1 Wireless Communications (Intelligent InSites/Stanley/Vocera)
These areas utilize a robust network and wireless infrastructure, coupled with real
operational Intelligence from multiple RTLS / RFID systems with integrations including
several modalities of communication and visualization that provide rapid enterprise level
interaction as observed on the large screen or a hand held device. (Actors point to large
screen, hold up tablet and Zebra Motorola phone) In addition all clinicians utilize VoIP
communications devices, enabling staff to staff communications with integration to the
hospital phone system supporting incoming and outgoing calls. [Actor holds up the Vocera
badge around neck]
Streamlined communication improves patient care and throughput, making every minute
count. The ability to quickly and easily communicate puts patients back at the center of care
while improving efficiencies throughout the care process.
SD2 Environmental Monitoring (Extreme Networks, Intelligent Insites]
The Intelligent Hospital also continuously monitors environmental conditions of devices, such
as freezers as well as the building itself, including temperature, and humidity. Enabled by the
robust network and wireless infrastructure we can visualize environmental conditions via a
dashboard throughout the hospital.
3
SD / Amb Care Script 2015
PLEASE EMAIL pfrisch@ihassociation.org with any suggested changes
SD3 Embedded RTLS Solution (Zebra)
Vital to providing effective patient care includes the management of resources, supplies,
devices, and staff. Embedded RTLS solutions visibility to all aspects of healthcare including
patient, specimen, medication, asset, and staff. This unique identification enables global
tracking throughout the institution. At any moment in time the equipment management
system can use this location information to ensure that lean workflow is being followed to
reduce the critical time wasted when finding needed devices. RFID analytics report on
equipment and device movements, enabling discussions on device quantity, distribution and
optimal par levels. Equipment and supplies can be automatically re-ordered from the floor
when inventories fall below defined thresholds (Actor points to the display).
SD4 EMR
Scenario: CHF Monitoring:
The ambulatory area is currently managing to patients, a 70 yr old man, Walter Zickler who
has been undergoing treatment for Congestive Heart Failure. Over the last 9 months he has
been undergoing home monitoring of vital signs including weight, BP, Pulse Rate and data has
been collecting using a portable home monitoring system from his instrumented iHome.
The nurse calls the patient at home to check in. During the routine check of vitals and teleweigh-in (home monitoring information), the nurse realizes that the patient has gained well
over 4 lbs. overnight and his diastolic blood pressure has risen 10 mmHg. The nurse confirms
that the patient varied from his routine over the weekend. The patient was at a family
gathering the day before and may have had some food not on his recommended diet and was
standing for many hours.
Walter Zickler is asked to go to the ED or out patient clinic, where physician completes a
check-up, admits the patient into the Step Down cardiac unit and orders the patient be placed
on monitoring, orders several tests, including labs, CXR, ECG and Echo). (Extension Health)
(Actor points to the Phone).
SD6 Bed Description (Hill-Rom, Critical Alert)
Mr Zickler lies in an instrumented smart bed providing a secure dynamic environment
capable of monitoring patient weight, as well as, wheels, side rail status, and patient
communications integrating with Nurse Call System.
The nurse call system enables workflow optimization starting from an initial patient request
through fulfillment. A centralized unit clerk answers call request using patient name, triages
4
SD / Amb Care Script 2015
PLEASE EMAIL pfrisch@ihassociation.org with any suggested changes
call based on request type and forwards the message to the correct nurse via her device of
choice. The system enables full reporting on entire workflow.
SD5 Bedside Workstation (HID, Zebra)
This room is equipped with a bedside PC patient station, which can be either wall mounted or
a hand held tablet Actor 1 holds up the tablet and scrolls through, showing the audience what
is on it) providing an alternative to the computer on wheels implementations. This PC is
capable of running all hospital applications and provides the clinician bedside access to
clinical applications such as the EMR, , PAC’S, Lab data, cardiology management, or supporting
applications such as RTLS mapping and overall real time patient information aggregator.
The workstation also integrates with bar code scanners, and printer to support the processes
focused on patient centric identification and association, such as medication administration
and laboratory processes.
Proving security to patient sensitive information is achieve utilizing One Time Password
security into cloud applications leveraging your ID Badge and NFC communication protocol
with a single tap of the card. The innovative technology card both generates and sends a One
Time Password without the inconvenience of re-entry. (Actor picks up the tablet and taps
their ID badge to the tablet – screen shot of the authentication application).
Once the nurse is assigned to our patient she uses mobile device to associate and assign
herself to our patient. This ensures that all relevant information and communications will be
forwarded to her. (Extension Health)
(Actor points to the Zebra Phone).
SD7 Dome Light (Critical Alerts)
Based on his condition the nurse additionally classifies him as a potential fall risk,
requiring observation and monitoring. (Actor points out dome light to audience)
SD8 In Room Wristband Replacement (Sunquest/ Zebra)
While setting up the patient, placing him on oxygen and attempting to take his vitals the nurse
realizes that his wristband ID was damaged and unusable requiring a new wristband to be
generated. A replacement is easily generated in the room by accessing and confirming the
patient’s medical record and using the room based printer generating a replacement
wristband. (actor presses button and wristband comes from the printer). The wristbands
5
SD / Amb Care Script 2015
PLEASE EMAIL pfrisch@ihassociation.org with any suggested changes
are the unique identifier and scanned prior to any medication administration, sample draw, or
clinical procedure.
Wristbands can be barcode, passive RFID or both and as in this case an active RFID is also
added to enable patient tracking throughout the institution.
AC 8: Staff Communications and Information Delivery (Extension Health)
The nurse takes the patients vital signs and notifies the physician. A few minutes later, the Dr.
arrives at the patient's bedside to do a complete physical exam. Prior to entering the room,
the physician is able to review the results from the diagnostic tests from admission orders.
Reviewing the patient tests, symptoms and current vital signs he orders a Cardiology consult.
At this point the nurse also receives a low priority text message about changing a shift with a
colleague. See Screen shot but the priority of the message demotes that the noise is
suppressed and there is no interruption in the clinical workflow.
(Actor points to the Phone).
Upon consult, a physician order is written for the patient to be placed on ECG telemetry and
provide a low dose IV Natrecor, 0.005 μg/kg/min without bolus, prior to considering
Milrinone treatment.
SD10 Physiological Monitoring: (Draeger)
Telemetry provides continuous monitoring to enable a comprehensive assessment
of the patients condition. In the Intelligent Hospital Mr. Zickler’s physiological
parameters are monitored using wi-fi based telemetry, archived and visualized on
the telemetry pack and at the nursing station, or central monitoring or war room.
SD11 Connectivity: (Nuvon)
Using a connectivity solution medical device data is archived and available
anywhere inside or out of the hospital. Bed data from multiple sources can be
integrated into a rules engine to alert and provide analytics vital to the patient’s
treatment. platform designed by the Hospital.
As an example, patient distress has traditionally focused on pulse-oximetry
measured oxygen saturation. However, studies have shown that blood oxygen does
not react as quickly to signs of imminent distress in patients, and measurements of
end-tidal carbon dioxide are a better indicator of problems occurring in opioiddependent patients. Monitoring of patients such as Walter can include etCO2
which provides remote visual notifications as to changes in the measurements of
6
SD / Amb Care Script 2015
PLEASE EMAIL pfrisch@ihassociation.org with any suggested changes
etCO2 and other vitals parameters collected through connected medical devices so
that notifications of potential issues can be communicated to nursing and other
clinical staff via
AC 8a: Staff Communications and Information Delivery (Extension Health)
During the course of the patient care the Nurse is able to securely communicate via text to all
physicians involved in the care of Me Zickler including the Cardiologist and the attending
physician to a private text conversation. The patient weight is calculated and sent directly
from the instrumented bed to the patient demographics content within Engage Mobile. The
Cardiologist receives the text message on his mobile application (Zebra) along with the
patient contextual information including demographics, weight, and diagnosis. The
Cardiologist is able to see the text and the associated patient information. In addition is able
to review retrospective waveforms from a mobile application.
SD 12a: ePrescribing HID
According to DEA requirements, to write a schedule II-V prescription on-line the
physician needs to be identity proofed and bound to a certified credential. Within the
EHR module, two factors of authentication must be presented. You need to prove you
are who you say you are. The prescriber can do any one of the following supported
methods:
[Actor#1: Holds up ID Badge, inserts it into desktop reader, types four digit PIN 1234]
Insert their ID credential for presentation of their digital certificate, and add PIN.
[Slide 2: Screen shot: Identity accepted]
OR, the prescriber can initiate a One-Time-Password from the certified credential,
types in six numbers. 123456
[Actor#1: Holds up ID Badge, types six digit PIN 123456]
[Slide 3: Screen shot: Identity accepted]
OR, the prescriber can use a biometric that matches the issuer profile.
[Actor#1: Holds places index finger on the sensor]
[Slide 4: Screen shot: Identity accepted]
[Slide 5: Prescription successfully sent to the Pharmacy]
Again, any ONE of these three authentication methods meets DEA requirements. Twofactor authentication when E-Prescribing for all drugs increases security and improves
both the physician and patient’s experience.
SD12 Draw Labs (Zebra)
7
SD / Amb Care Script 2015
PLEASE EMAIL pfrisch@ihassociation.org with any suggested changes
As a follow-up, the physician has ordered hemoglobin and hematocrit labs. The nurse uses a barcodebased sample collection system to positively identify the patient by scanning their armband. The
nurse then prints the vial labels directly at the bedside, ensuring that all of the draw samples are
accounted for and associated with the patient, minimizing the chance of mislabeling errors.
(Actor/Actress - scan patient wristband, output label, scan affix label, scan vial, scan own badge.) The
drawn samples can be delivered quickly to the laboratory using the institution’s pneumatic tube
system. The labeled samples are loaded into RFID containers, ensuring accuracy and the chain of
custody from the bedside to the laboratory, in addition to establishing the unique identifier to
accurately document results into the patient record.
SD9a: Mobile Medicaiton Dispensing (Emerson)
Medications dispensed from the Medication System are placed into the drawer specified for
Mrs Millhouse. After the nurse has dispensed all of Mrs. Millhouse’s medications, she would
securely transport them to the patient’s bedside in the intelligent Mobile Medication
Workstation. Patient drawers are assigned using the HL7 ADT
(Admission/Discharge/Transfer) transactional data from the HIS, eliminating time consuming
and error-prone manual drawer labeling. Once at the bedside, the individually locking,
patient-specific drawers can be opened by scanning the patient ID barcode. The configurable,
time-based access controls reduce the risk of medication administration at an incorrect time
and aids in pharmacy reconciliation for unused medications. Centralized, web-based console
provides access to reports while allowing for Active Directory-compatible user management,
fleet management and system setup.
SD17 Infusion System (BBraun)
The Intelligent Hospital has deployed an advanced infusion system operating
wirelessly with interoperability with the EHR system. This integration helps to
close the safety loop in the medication administration process by associating the
pharmacy validated order with the patient, the medication, the IV pump and the
patient record using bar code medication administration technology. The nurse
can scan barcodes on the patient ID, the medication and the smart pump to initiate
the population of order information from the EHR to the pump . With this
integrated system, the ordered infusion settings automatically populate on the
pump screen, eliminating manual programming steps and decreasing opportunities
for error. Running infusion status is also sent from the infusion system to the EHR
to promote more timely, accurate and complete clinical documentation in addition
to enabling infusion surveillance through the EHR system.
SD18 Nurse call Pump Integration (Critical Alert)
8
SD / Amb Care Script 2015
PLEASE EMAIL pfrisch@ihassociation.org with any suggested changes
Before setting up the pump, the nurse plugs the cable from the IV pump into the
nurse call system. (Actor either depresses button at bed or IV pump) This allows a
secondary annunciation of pump alarms to go directly to the nurse call system,
which then directs the alarm to the assigned staff. Rapid intervention to IV pump
alarms, whether due to infusion completion, or interruption, decreases the
potential for adverse events, increasing patient safety. When the pump goes into
alarm, it is indicated with the dome light, staff console, and the care teams handfree staff communication badge. (Point to dome light and hold up vocera badge)
For the purposes of demonstration, we will fast-forward to the next day. Walter’s
condition has improved and she is ready to be sent home.. The discharge process
was initiated after the physician entered the discharge orders.
AC8b: Alert Notification (Extension Health)
While reviewing the patients information the nurse receives the alert notification from the lab
system with the test results and uses her phone to review the results. (Zebra)
(Actor points to the Phone).
SD13 Eliminating Transfusion Errors and Increasing Efficiencies (Sunquest)
In this case, the laboratory results confirmed low hemoglobin so the physician ordered blood
to be transfused. Transfusion Manager is used to positively identify the patient and ensure
the correct blood is given to the patient. The Nurse scans the patient’s armband and carries
out positive patient identification. Using the same device, the nurse also scans the unit of
blood. The match is confirmed, and the patient is given the blood transfusion. (Actor – goes
through the scanning process)
SD15 Meal Ordering (CBORD)
To improve efficiency and enhance the patient experience, the hospital uses an integrated
web-based mobile meal ordering application for entry of patient and guest meal selections for
either on-demand room service or a tray line meal service. (Actor picks up tablet)The
application interfaces with the hospital’s CPOE providing real time diet order and allergy
information along with clinical tools to ensure that all foods served are appropriate and meet
the patient’s needs. To help ensure patient safety, the staff member is automatically alerted
that Walter is a diabetic who requires insulin, and that she is allergic to peanuts. (Hold up
tablet to audience and show the alert that is sent to the tablet) The system automatically
tracks and displays carbohydrate totals compared to her prescribed diet goals reinforcing the
hospital’s patient education initiatives. (Actor switches through the screens on the HP Elite
9
SD / Amb Care Script 2015
PLEASE EMAIL pfrisch@ihassociation.org with any suggested changes
tablet) Once the meal order is placed, tray tracking information automatically displays on
monitors at the nursing unit to facilitate communication with nursing for a pre-meal blood
glucose check. (Actor puts down the tablet and brings over the tray of food to Walter) When
the tray arrives on the floor, foodservice staff delivers the tray, updates the tray monitoring
system using the smart phone or handheld to confirm the delivery and set a tray pickup
reminder so dirty trays won’t spoil your patient experience. Upon retrieving the tray, the host
records the patient’s actual food intake using a mobile device which provides valuable
nutrition information for the hospital’s multi-disciplinary Malnutrition Initiative. Screening
for malnutrition at admission and monitoring patient intake helps reduce complications,
shorten length of stay and prevent readmissions.
SD16 Alerts (Critical Alerts)
Mr Zickler realizes he needs to go to the rest room and presses the patient call
button. The call is then sent to the staff worn communication badge, rings the staff
console, and lights the dome light. (Point to dome light and staff console)
Before the staff can respond Mr Zickler attempts to go to the bath room on her own
triggering bed exit alerts to the central station and to the staff phone. (Actor puts
the rails down which will trigger the alarm, Puts rails back up to cancel the alarms)
The staff responds immediately to prevent the patient fall. The nurse system
automatically cancels the bed exit alarm and corresponding indicators. (Actor
point to dome light)
The nurse requires assistance in getting Walter to the bathroom, back into bed and
stabilized. The nurse can issue a request for assistance on the nurse call system.
The nurse activates the fall risk notification on the dome light from the work flow
station, indicating to all staff on the unit that this patient is a fall risk. (Actor presses
workflow buttons for assistance).
SD 16 a Patient Discharge Good to Go (Vocera):
Several days later the nurse is preparing to discharge Mr Zickler. The nurse pulls out an
iPhone (or other Apple device, TBD) and informs the patient that she will be recording the
discharge instructions, and this will be available to them and their family members for replay,
along with other resources about their diagnosis and follow up treatment plan. The nurse
goes through the discharge instructions, and provides the patient with their personalized link
and instructions for accessing the instructions when they return home. The nurse can also
set-up a quick reminder to the patient and or their family member with these instructions via
10
SD / Amb Care Script 2015
PLEASE EMAIL pfrisch@ihassociation.org with any suggested changes
email or SMS. The nurse then uses integrated secure messaging and voice application to call
for transport to escort the patient out of the hospital.(show VCS home screen).
SD 16b: Discharge Profile Vivify
The Discharge order and diagnoses in the EMR have generated a patient profile with
appropriate care plans for this patient, and an alert to the Care Transitions Team to bring a kit
for this patient to continue remote care at home. (Patient receives kit from Care Transitions
nurse and is shown how to use tablet, input PIN, and view videos and answer survey
questions.)
A complex chronic or high risk patient in the hospital is given a kit to use at home upon
discharge for Remote Patient Monitoring; this solution is used by patients of all ages, even up
to 92. During her stay, the patient can watch educational videos about their condition,
upcoming tests and procedures, and medications (patient watches video for medication).
Upon discharge, care transitions are eased as all providers have access to the same post
discharge patient data through the CareGiver Portal and can collaborate via virtual visits with
the patient within 2 days of discharge as a qualifier for reimbursable Transitional Care
Management Services. These mHealth capabilities are an enabling factor to improve patient
engagement, satisfaction and outcomes while reducing the overall cost of care.
SD14 & SD19 Interactive Patient System – Education & Discharge (Skylight)
Edited Mar 28
To ensure a high degree of patient satisfaction, the use of an interactive patient system
enables the patient to view her personalized electronic whiteboard. Through integration
with the hospital’s ADT system, the patient has access to a snapshot of her care team, pain
management tools, and other information necessary to help orient the patient during their
stay. [Skylight_SD14_stay] (Actor picks up pillow speaker and scrolls through the screens as
if they were teaching Samantha how to use the system, pointing out stuff on the screen as
they go along)
Samantha can easily view all her prescribed health education [Skylight_SD14Education]
including orientation and safety, fall prevention, discharge planning, and conditionspecific
education
based
on
integration
with
the
hospital
order
system [Skylight_SD14_System] Viewing of patient education is automatically documented
into the patient’s health record through integration with the hospital’s EMR system
[Skylight_SD14_EMR System] The interactive patient system engages Samantha in her
care, empowering and connecting her to her care team.
11
SD / Amb Care Script 2015
PLEASE EMAIL pfrisch@ihassociation.org with any suggested changes
As Mrs. Millhouse prepares for discharge, Samantha again uses the Interactive Patient
Systems to access the different services available to her including the ability to fill
prescriptions by way of the on-site retail pharmacy. [Skylight_SD19 _Pharmacy_Page1]
[Skylight_SD19 _Pharmacy_Page2], [Skylight_SD19 _Pharmacy_B Page1], [Skylight_SD19
_Pharmacy_B Page2], [Skylight_SD19 _Pharmacy_C]
Skylight also displays the needed steps for a patient about to be discharged should include
transportation and discharge instructions, [Skylight_SD19_instructions] e.g. diet and
medication instructions. There is also a Discharge Readiness progress bar visible at the
bottom of the About Me tab. [Skylight_SD19_About Me tab] This tracks the information in
the Discharge Checklist feature.
SD20 Print Prescriptions: (Zebra)
Before being discharged prescriptions can be printed directly in the room and
provided to Lauren’s as part of her discharge packet.
SD21 Environmental Services. (Stanley)
The nurse will remove the telemetry pack and IV access so that the patient can get
dressed. In a few minutes, Mrs. Millhouse and Molly will be going home to
recuperate. Once they have left the room the nurse takes the laundry and pushes
the button from the nurse call labeled DC, for discharge. (actor presses the large
button on the RFID tag on the wall, and points to the monitor as the room changes
color, and then presses the small button on the same tag to reset the color between
presentations). This will send a message to Environmental Services to request that
the room be cleaned. Room status changes–from soiled, available and occupied–are
indicated on the map with a visual color change.
SD22 Equipment Shrinkage (Stanley)
A common occurrence during clean-up processes, portable medical devices or
otherwise valuable inventory is misplaced or discarded. In the Intelligent
Hospital™, devices incorporate an RFID tag, and the laundry chute houses an RFID
transmitter – receiver. This creates a choke point that identifies inventory passing
through the chute, preventing valuable assets from accidentally being discarded by
triggering various notification modalities. As you can see, the clinician placed the
12
SD / Amb Care Script 2015
PLEASE EMAIL pfrisch@ihassociation.org with any suggested changes
telemetry box on the bed, (Actor puts pack on bed deliberately) which became
entangled with the linens. (Tangles it with the sheets and throws it through the
laundry chute) Inadvertently it was discarded with the sheets down the laundry
chute. The nurse call station receives an alert from the RFID system. This choke
point level of device tracking enables improved loss management and inventory
shrinkage.
Patient Demographics:
Lauren Black
Female, 39 years old
Pre-op patient in ambulatory surgery center
Pre-op kit we are pulling
• Midazolam 2mg/2mL injection
• Glycopyrrolate 1mg/5mL injection
• CeFAZolin 1gm / 0.9% NS 250 mL
Ambulatory Care:
Providing the continuum of care in the outpatient setting requires the environment to establish a
seamless integration of data enabling the review of past patient information. Enabled by the robust
network and wireless infrastructure establishing continuity between all areas of the hospital.
In addition the out-patient setting relies on many of the same technologies for clinical care, treatment
or follow-up, but requires increases focuses on the optimization of workflow, patient throughput and
satisfaction.
•
CeFAZolin 1gm / 0.9% NS 250 mL
AC1 Workstation (HID, Zebra)
Part of the continuity is established through the networked bedside PC patient workstation (
Actor 1 holds up the tablet and scrolls through, showing the audience what is on it) This PC
securely interfaces to all hospital applications and provides the clinician bedside access to
clinical applications such as the EMR, , PAC’S, Lab data, cardiology management. One Time
Password security into cloud applications leverages staff ID Badges and NFC communication
protocol with a single tap of the card. The innovative technology card both generates and
sends a One Time Password without the inconvenience of re-entry. (Actor picks up the tablet
and taps their ID badge to the tablet – screen shot of the authentication application).
13
SD / Amb Care Script 2015
PLEASE EMAIL pfrisch@ihassociation.org with any suggested changes
AC2 Embedded RTLS Solution (Intelligent Insites)
Vital to providing effective patient care on an ambulatory setting is the ability to track staff
and patients and have visibility in to their activities. Embedded RTLS solutions enable all
devices, staff and patients to be tracked globally throughout the institution. At any moment
staff are able to see where their patients are, which staff has seen them, and who needs to see
them. Additionally this visibility ensures that lean workflow is being followed to reduce the
critical time wasted when patients are waiting for care. Analytics report on the different
aspects of the patient visit include who they interacted with and for long as well as any waits
they may have had.(Actor points to the display).
Scenario:
Thirty five old Lauren Black is scheduled for her oncology visit at the Intelligent
Hospitals Oncology Outpatient Clinic after being diagnosed with a malignant
brain tumor. She will be receiving her chemotherapy treatment. Julia’s
appointment was prescheduled and she is to report to the Harbor Falls Medical
Center at 8:00 a.m. Lauren is accompanied by her husband John.
As Lauren Black arrives at the Registration Desk she is greeted by the Patient
Service Representative and issued an RTLS badge.
AC3 Self-Rooming, Patient Status, and Provider Workload Application
(Intelligent InSites)
The Patient Service Representative reviews room status and locates an available
room on the RTLS clinic map and tells to proceed to the Room 9. The Patient
Service Representative takes her husband cell phone number to receive updates
about Lauren’s visit while she waits for her in the coffee shop. Room status is
automatically changed once Lauren is brought to the room. The nurse is
notified to go to Room 9 to draw Lauren’s blood
AC4 Draw Labs (Zebra)
14
SD / Amb Care Script 2015
PLEASE EMAIL pfrisch@ihassociation.org with any suggested changes
The hospital bar code based sample collection system, scans Julia’s wristband
and prints sample vial labels directly at the drawing site. This ensures that all
the drawn samples are verified and associated with the correct patient
minimizing the chance of mislabeling errors. (scan patient wristband, output
label, scan affix label, scan vial, scan own badge
The nurse continues the assessment, take her height, weight, and vital signs.
After finishing the initial assessment, the nurse leaves the room and the
oncologist is notified to proceed to the patient room. (Notification received on
mobile device)
The oncologist sees the change in the patient status and quickly proceeds to the
Room 9 to conduct the physical exam and review the laboratory results.
Lauren’s lab results showed that she made the CBC count and can proceed with
the chemo infusion.
AC6 Amb Care Medication Dispensing Solution (Carefusion )
As you’re aware, healthcare doesn’t stop at the four walls of the acute care hospital anymore.
In order to provide the best care for patients, hospitals are pushing care to Ambulatory
centers to ensure that patients get the kind of care they need in the setting that’s most
appropriate. Extending the medication management continuum from the Acute Care
Pharmacy to Ambulatory settings is a challenge for health systems, specifically with respect to
space limitations and security concerns.
[Screen shot: (1) Visual with challenges of medication management in Ambulatory setting.]
Solutions now exist to help answer these challenges in an automated medication management
process. For example, it has a flexible, expandable form factor that leverages existing
available space. It also leverages the same secure med storage solutions as the acute care
facilities to stock and manage medications, enabling secure, closed-loop chain of custody to
the point of delivery. In addition, it uses the IT infrastructure and HIT systems of their
associated acute care facilities.
[Screen shot: (2) Visual with benefits of available solution.]
15
SD / Amb Care Script 2015
PLEASE EMAIL pfrisch@ihassociation.org with any suggested changes
Here, we have a pre-op patient, Lauren Black, in our ambulatory surgery center, whose nurse
will be placing a line for surgery.
[Screen shot: (3) Visual with patient scenario]
The nurse is going to pull a pre-op kit that has three medications in it.
The nurse accesses the system with their user name and BioID or password, selects the
patient and selects that kit.
[Actor: Nurse stands next to station and places finger on bio-ID, pretends to type on keyboard
and touches screen).
[Screen shot: (4) Show Patient screen, (5) then Selected Meds screen.]
The drawers and pockets would begin to open, one at a time, allowing the nurse to safely
remove the medications their patient needs.
This solution uses the same secure storage pockets across the health the system. These
pockets can be filled at the hospital- where the main medications are purchased and stockedand securely transported to this ancillary location as needed, helping health systems better
manage medication inventories. As the pockets open and provide access only to the
medication requested, the nurse can be sure they are accessing the correct medication for
their patient, protecting medication safety.
[Screen shot: (6) Medication transport, (7) Nurse access.]
[Actor: Holds up CUBIE pocket. Points to drawers on Mini.]
One of the medications is accessed from the secure refrigerator, where the Nurse removes an
IV bag. As the storage space is closed, a drug-specific IV label is automatically printed, as
configured by pharmacy for this medication at this location.
[Actor: Nurse picks up label by printer, pretends to put on IV bag, shows IV bag already labeled.]
[Screen shot: (8) Show image with drug-specific IV label, (9) image of labeled IV bag.]
The nurse is now ready to prepare Lauren for her procedure, enabled by a safe, secure
medication management solution, focused on the ancillary care space and supported by the
health care system.
AC7 Business Intelligence - Room Occupancy Reporting (Intelligent InSites)
16
SD / Amb Care Script 2015
PLEASE EMAIL pfrisch@ihassociation.org with any suggested changes
The next day, the Process Improvement Department reviews operational
performance data to identify improvement opportunities in the ambulatory
environment. The Room Occupancy reports identify the percentage of time that the
exam room is occupied by a patient and also the percentage of time the exam room has
a patient and provider/clinic staff in the room together. You can use this information
to improve your patient workflow and staff efficiency (point to monitor, 3 screen
shots)
Closing Statement:
This concludes the demonstration within this area, which I hope highlighted how
the integration of these different technologies and applications, enhance patient
care and safety, optimize staff workflow, and assist the inventory and supply
management. Please visit the other rooms in the Intelligent Hospital™ to find out
how the other patients fair, pick-up the Ambulatory Care Tour Handout and visit
our sponsors in the Pavilion kiosks to learn more about these dynamic
technologies.
Thank you.
17