Intelligent Hospital™ OR Script 2015
Revised: Updated March 28 2015 PHF
Table of Contents
Use Cases to be added: ........................................................................................ Error! Bookmark not defined.
Introduction:........................................................................................................................................................................... 3
OR1 Staff Identification: (Sponsor to be Determined) ......................................................................................... 3
OR2 OR Platform Infrastructure: (Skytron) ................................................................................................................ 3
OR3 Temperature and Humidity Monitoring (Pending Sponsor) ....................................................................... 4
OR4 Integrated Management System (Extreme Networks) ................................................................................ 4
OR5 Environmental Metrics (Planned Removal) ....................................... Error! Bookmark not defined.
“Pre-op” Preparation: ......................................................................................................................................................... 5
OR15
Case Supply Management Integrated with ORIS (Omnicell) ............................................................... 5
OR9 Surgical Tray (Cardinal) ........................................................................................................................................... 6
Cardinal Health ................................................................................................... Error! Bookmark not defined.
Start Procedure Patient Ready: ........................................................................................................................................ 6
OR6 Nurse Call communication and workflow utilization (ASCOM) .................................................................. 6
OR7 Wireless Communications ( Vocera) .................................................................................................................. 7
Ascom/Vocera ..................................................................................................... Error! Bookmark not defined.
OR10
RFID Personnel Tracking (Sponsor to be Determined) .......................................................................... 7
OR11 Wireless Messaging (Vocera)................................................................ Error! Bookmark not defined.
OR8 Information System (TBD / Sunquest / Skytron) ............................................................................................... 8
Or12 Central Line Kit (Cardinal) (Update required supplies Dr Landa) .................Error! Bookmark not
defined.
Cardinal Health ................................................................................................... Error! Bookmark not defined.
Or13 RFID Tagged Equipment (Intelligent Insites) Should be with Hospira !!................................................. 8
OR14 Infusion Pump: (Hospira) ..................................................................................................................................... 8
Hospira .................................................................................................................. Error! Bookmark not defined.
OR16
Anesthesia Delivery System (Drager).......................................................................................................... 9
OR17 Anesthesia Workstation and Narcotic Control in OR (Omnicell Codonics)......................................... 10
................................................................................................................................. Error! Bookmark not defined.
OR18
Capnography monitoring in OR: (Nuvon **) .......................................................................................... 11
OR19
Remote Collaboration Platform (Intouch Health) ................................................................................. 12
Intouch Health..................................................................................................... Error! Bookmark not defined.
OR 19 A: Sample Collection Positive ID: (Sunquest) ................................................................................... 12
Positive/Accurate Patient Identification and Container Labeling using Mobile Specimen Collection
System .............................................................................................................................................................................. 12
OR20
Pneumatic Tube System (Swisslog) ........................................................................................................... 12
Swisslog ................................................................................................................. Error! Bookmark not defined.
OR21
Family Notification (ASCOM)...................................................................................................................... 13
Ascom .................................................................................................................... Error! Bookmark not defined.
OR22
Usage Capture Station (Cardinal) .............................................................................................................. 12
Cardinal Health ................................................................................................... Error! Bookmark not defined.
1
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reproduced or distributed without written consent from the RFID in Healthcare Consortium
Intelligent Hospital™ OR Script 2015
OR 22a Eliminating Transfusion Errors and Increasing Efficiencies using Sunquest Transfusion
Manager (Sunquest **) .............................................................................................................................................. 13
OR23
Housekeeping Update (ASCOM) ............................................................................................................... 14
Ascom .................................................................................................................... Error! Bookmark not defined.
OR24
Surgical Instrument Management .................................................. Error! Bookmark not defined.
Cardinal Health ................................................................................................... Error! Bookmark not defined.
OR25
Track Low Value Assets .................................................................................................................................... 5
DeRoyal ............................................................................................................................................................................... 5
DeRoyal: Automated Usage Capture of OR Materials ........................... Error! Bookmark not defined.
Conclusion ............................................................................................................................................................................ 14
Business Intelligence - Room Utilization Reporting (Intelligent Insites) ........................................................... 14
Intelligent InSites ................................................................................................ Error! Bookmark not defined.
2
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reproduced or distributed without written consent from the RFID in Healthcare Consortium
Intelligent Hospital™ OR Script 2015
Revised: Updated March 28 2015 PHF
Name:
Age:
Condition:
Robert Grant
62 years
Mid-sternal chest pain radiating to his left jaw
Aortic Stenosis
Type II Diabetes, Hypertension, Hypercholesterolemia, Obesity
Introduction:
Welcome to the Intelligent Hospital Pavilion Advanced Perioperative Suite developed by the Intelligent
Health Association. This advanced perioperative environment is supported through our partnerships with
industry leaders in perioperative and healthcare solutions. Through our collaborative efforts, we share
with you today a modern vision of an integrated OR environment that offers seamless connectivity and
communications. Both quality of care and patient safety are enhanced utilizing advanced clinical
applications and cutting edge medical devices, enabling unparalleled information access and real-time
clinical staff awareness. The clinical scenario that follows is integrated with other Intelligent Hospital
Pavilion departments, as you will find throughout your tour of our facility.
Patient Demographics
Allen Grant is a 62 year old male admitted through the ED who has undergone an emergency cardiac
catheterization and was discovered to have aortic stenosis requiring valve replacement as well as a coronary
bypass. Mr Allen a previous patient of the Intelligent Hospital has a documented history of type II Diabetes,
hypertension, hypercholesterolemia and obesity.
OR 01: ActivID Tap: NFC Tablet and Mobile Phone authentication with ID
Badge (HID Global)
As hospitals increase their dependence on mobile and wireless devices there becomes an
increasing requirement for heightened security to protect system access and patient specific
information. The Intelligent Hospital has implemented a two factor authentication process for
access to cloud-based or Microsoft ADFS services. Staff simply Tap their enabled ID Badge to any
Windows or Android phone or tablet verifying access authority.
OR1
Staff Identification & Workflow: (Stanley) Updated Mar 28
As you can see, I was automatically identified as I entered the room through my real-time location system
or RTLS, tag. (Actor 1 motions to the large screen when their picture appears) The OR unit combines a
robust network and wireless infrastructure coupled with real time 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 handheld device.
(Actors point to large screen, hold up Tablet)
In addition, the patient is wearing an RFID badge [The actor points to Patient’s RFID tag – on
wrist]. The patient flow tracking system monitors the location, status, interaction and
timestamps of patients, rooms and staff in the surgical services department. [Actor points to
wall monitor] This real-time data is captured and transformed into powerful visual analytics
3
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Intelligent Hospital™ OR Script 2015
that provide understanding of patient flow, procedure length and room availability—all
critical to ensuring effective care delivery in a timely manner. [Actor taps the iPad to flip
through the dashboards – changes on large monitor] The dashboards can show patient
location, procedure time, bay/room status in Preop, Intraop and PACU areas, allowing staff to
look “upstream” and “downstream” to improve communication and immediate decision
making to expedite room turnover, streamline case preparation and advance patient
throughput.
OR2 OR Platform Infrastructure: (Skytron)
Within this advanced OR suite, we find the foundation of a modern OR infrastructure. This hybrid surgical
environment has state-of-the-art Ultra-slide surgical tables and high intensity, advanced optic, LED surgical
lighting systems (Touch table and aim surgical lights onto surgical field). The integrated precision HD
camera system offers a brilliant view of the surgical field via the boom mounted video routing and control
platform (Walk over to Skyvision system and route camera to display 4). By utilizing the intuitive touch
interface, our Intelligent OR medical staff is able to display, share, and archive digital media and many other
clinical information sources effortlessly. (Touch the equipment boom) The OR is capable of routing surgical
video feeds and any visual display sources to other areas of the hospital for central planning and
monitoring. The OR platform integrates with a C-Arm X-ray imaging system enabling dynamic imaging to
be performed within the surgical field minimizing surgery time. These images are routed to the hospital
PACS system and available anywhere in the institution for consultation.
Additionally this hybrid OR is designed to support multiple surgical modalities and incorporates minimally
invasive surgical platform including a endoscopic devices, video camera, lights, insufflators, and scopes all
mounted on one of the booms to support advanced laparoscopy equipment and procedures (Stryker). The
OR also incorporates a surgical navigation systems enabling a fully integrated computer assisted surgery
solution.
A dedicated digital camera tracks instrumentation and provides tracking information to
endoscopes, fluoroscopes and surgical microscopes. (Stryker)
OR3 Temperature and Humidity Monitoring (AiRista)
The Intelligent Hospital OR suite is equipped with solutions for centralized temperature and humidity
monitoring coupled with the RFID systems providing event driven alerts to aid in the management of
regulation compliance and required reporting for the Joint Commission. [Tech points out temperature
and humidity modules) These real-time environmental conditions within the OR suites are fed to the OR
control area for automated limit monitoring which sends alarms or text messages to the
communication badges of designated parties if room temp and/or humidity nears ‘breach’ levels, (Actor
holds up badge) helping prevent patient care issues before they occur.
OR4 Integrated Management System (Extreme Networks)
A versatile array of modular switches supporting everything from an enterprise/campus
connectivity right up to cloud data centers. The system provides Terabit-class performance, high
availability and redundancy, our simple, scalable and intelligent switching and routing products as
required by the hospital. A integrated management system that provides wired/wireless
visibility and control from the IT data center enabling the IT organization to optimize the
efficiency of network operations
4
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Intelligent Hospital™ OR Script 2015
OR5 Hands-Free Communication (Vocera), Updated Mar 28
Intelligent communication solutions enable care team members to communicate and collaborate on their
device of choice; including a hands-free badge with the ability to provide vocal responses “Yes” or
“No” to accept or route calls. Hands-free Badges allow the care team focus on the patient and
delivering high quality care, while seamlessly connecting them to the right information and people.
OR 6: Real Time Schedule Optimization: (CreatAsoft)
Scheduling and management of OR operations is critical to provide an optimized utilization of the OR
resources. OR tracking utilizes RTLS technology coupled with real-time predictive analytics and
integrated optimization engine to maintain on-time procedure completion and increase operating
department efficiency. Dynamic real-time dashboards present dynamic schedule adherence
views comparing planned, actual and forecasted schedules along with real-time staff notifications.
This toolset empowers the OR department staff to proactively increase efficiency and reduce
scheduling delays.
Actor1 points to screenshot of alert identifying a proposed schedule changes that are projected to be
needed in the near-term for the OR. and directs Actor2 to take proactive measures to shift case
schedules and to begin room preparation the case schedule.
“Pre-op” Preparation:
OR6A OR Device Preparation, locating and tracking
(Borda Tech)
In preparation for the surgical procedure the OR’s required portable equipment complement is
gathered and setup for the specific case. The use of real time location system enables the required
devices to located. Using a hybrid system that multiple technologies combining NFC, UHF passive
RFID and active RFID to merged into a single platform, enables devices across the institution to
monitored across a wide base of applications. This system provides a seamless integration with
many OR systems providing real time availability, tracking and utilization to monitored and
dynamically determined.
OR25
Automated Usage Capture
DeRoyal * Update Mar 16
During the course of the procedure general supplies are tracked utilizing RFID / Barcode coupled Kiosks
strategically mounted within the Operating Room or available on movable stands. Required supplies are
scanned and associated to the patient eliminating the manual recording process which links or documents
supply utilization directly into electronic medical record, ERP & Financial systems. This information is
available in real-time and documented into the case file as the procedure case is closed.
The nurse will select the appropriate patient from a list of cases received from the OR IT Scheduling system
(nurse points towards the screen). RFID tagged supplies picked in preparation for the surgical procedure
5
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Intelligent Hospital™ OR Script 2015
are linked to the specific patient prior to entry into the OR. As the nurse opens the surgical supplies, the
wrappers or packaging is tossed into the cloud based Continuum Safe where the usage and other pertinent
information is confirmed. Any items that were not picked prior to the surgical procedure will also be
captured and linked to the patient by tossing the opened wrappers into the Safe. The nurse will also be
alerted to any expired item introduced into the surgical procedure. Usage information is automatically sent
the OR IT clinical record. Any items that were picked but not used in the procedure are scanned and
returned to stock for chain of custody and tracking purposes. (The nurse picks up a supply, opens the
package, content falls onto back table, wrapper is thrown away in the Continuum Safe (bin), and the nurse
will see that the item is now displayed on the screen.)
OR15
Case Supply Management Integrated with ORIS (Omnicell) **
Updated Mar 24
During the course of the procedure general supplies and implants are routinely required. General
supplies are associated to the patient’s case in the system prior to the procedure, requiring that
only additions or changes are documented during the procedure. (Start new case in OptiFlex SS).
Supply usage may be captured from a secured storage cabinet or from open supply storage
(product scanned into OptiFlex capturing product, serial and expiration). Information is sent to
hospital clinical documentation systems while inventory is automatically tracked.
Once the case is closed and the patient goes to recovery or is admitted for post-surgical care,
supply usage is also captured against the patient account. (Close case, view report) Data is
available for trends in case cost, items pulled and not used on cases, and items added to cases, as
well as supply usage for the entire patient encounter. (View case cost report)
OR9 Surgical Tray (Cardinal)
In preparation for surgery, materials management pulls up the digital preference card for the surgery
on a mobile platform (Prefcard_OR_CAH) interfaced with the ORIS system, which contains the master
OR schedule and related preference cards. (Actor pulls the preference card on his/her NCF-enabled
mobile device and shows it to audience)
The pick list includes an aortic heartvalve, surgical kit, tissue, and sutures. The RFID tagged surgical kit
and tissue are read using the NFC-enabled mobile device (Productscan_OR_CAH) which confirms the
item selection against the pick list. Materials Management proceeds to pick remaining medical supplies
from the 2-bin Kanban system and mark them as picked on the mobile device while placing items on
the case cart. (Actor picks remaining medical supplies and marks them as picked on the mobile device then places on case cart)
Start Procedure:
OR6 Nurse Call communication and workflow utilization (ASCOM)
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Intelligent Hospital™ OR Script 2015
Reliable and uninterrupted communication between patients and staff is vital within the OR environment.
Complementary systems such as RTLS, Patient Monitoring, LIS and Order Entry can be integrated to
effectively streamline information flow and improve response time.
In our clinical scenario using the workflow station, a notification has just been routed via the OR nurse call
system, (Actor points to the Nurse Call system) to the OR from the preop area (Presses ready for patient
button and starts the timer) indicating that Mr. Allen is ready to transferred to the OR.
OR7 & OR 11 Care Team Communication & Collaboration ( Vocera) **
Update Mar 6
Members of the care team can communicate with one another using their device of choice that best
addresses the clinical situation. For example, when hands-free communication is necessary, the care
team can communicate using voice communication on a hands-free Badge (motions to the badge,
presses button and places a call). When hands-free is not required, the care team can use an integrated
voice and secure messaging smartphone application to send a secure text messaging, leveraging
templates for instant and consistent communication both inside and outside of the hospital. (shows
nurse or doctor using a smartphone to send a chat message to other members of the care team).
OR10
RFID Personnel & Workflow Tracking (Zebra) ** Updated Mar 6, 28
As outlined the OR staff are wearing RFID tags (Point to and/or hold up your personnel RFID tag).
The Intelligent Hospital RFID asset and personnel tracking system enables improved surgical
environment awareness as to staff location and status, critical to ensuring effective care delivery
in a timely manner. (Point to the Big Screen View that displays milestones of Staff arrival) Should
any of the required personnel for the surgery not be present upon patient arrival, notification can
be sent to appropriate staff via the Mobility platform for escalation. Surgeon walks into the OR to
begin the case. The entrance of the surgeon into the OR suite marks a milestone “surgery in
progess” which is an accurate case start time. This start time could then be communicated
through the Surgical department as needed. Now that the patient has arrived in the OR the surgery
is ready to get underway. The anesthesiologist notes that the patient needs central line venous
access and has the nurse obtain the appropriate supplies including an IV pump and central line
supplies. <Sunquest for patient ID?> <Omnicell vs. Solstice for Central line kit> Find Equipment –
(Awarepoint)
Additionally RFID tagged equipment, such as IV pumps, are managed utilizing the hospitals RTLS
system. (Actor walks out of OR to get IV pump, Actor 1 will already be standing next to the
Awarepoint dashboard) <Notify awarepoint> We can see that the IV pump has been identified as
present in the OR on our equipment RTLS platform interface. (Actor points to the Awarepoint or
Dashboard ) The ability to track items throughout the facility results in dramatic improvements in
equipment utilization for our hospital. The OR staff is able to quickly prepare and deploy the vast
number of items needed for surgery thanks to our implementation of a robust inventory and
materials management RFID solution
7
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reproduced or distributed without written consent from the RFID in Healthcare Consortium
Intelligent Hospital™ OR Script 2015
OR8 Information System (TBD Skytron) screen shot
Upon notification of Mr. Allen’s readiness for surgery, the operating room staff uses the OR Information
system (TBD) as well as the electronic medical record (TBD) route the appropriate displays to the screens
within the OR to view and confirm perioperative data, other patient information). (Note: Screen / Video
Capture on the Skytron Boom)
OR13 RFID Tagged Equipment (Intelligent Insites, Hospira)
RFID tagged equipment such as IV pumps are managed utilizing the hospitals RTLS system. (Actor walks
out of OR to get IV pump, Actor 1 will already be standing next to the Intelligent Insites dashboard)
We can see that the IV pump has been identified as present in the OR on our equipment RTLS platform
interface. (Actor points to the Intelligent Insites Dashboard ) The ability to track items throughout the
facility results in dramatic improvements in equipment utilization for our hospital. The OR staff is able to
quickly prepare and deploy the vast number of items needed for surgery thanks to our implementation of a
robust inventory and materials management RFID solution
OR14 Infusion Pump: (Hospira)
The Intelligent Hospital has deployed an advanced infusion system operating wirelessly and with
interoperability to the EMR system. This Infusion pump has onboard safety software, including
drug-specific hard and soft dose limits, providing a defense for the patient to guard against an
incorrect dose or typo during infusion setup.
In the OR, pharmacy-verified physician orders are not always available. When no order is
available, infusion pumps can be pre-programmed with multiple protocols that allow clinicians to
quickly and correctly administer the IV medications most commonly used. If an order is available,
the infusion pump can be fully 5 Rights Auto-Programmed with the physician's order by scanning
the patient's wristband, the IV medication and the infusion pump with the clinical vendor's
Barcode Medication Administration handheld device.
In this case the order is available. The physician has ordered a Dopamine IV infusion (400 mg /
250 mL) at a dose of 5 mcg/kg/min. To ensure the complete 5 Rights administration of this
powerful medication the nurse first scans the patient wristband with the clinical vendor's Barcode
Medication Administration device to verify his identity, then, using the same device, scans the
barcoded IV medication, and finally scans a permanent barcode on the IV pump.
(Where indicated by script, Actor will use the wireless handheld Barcode Medication
Administration prop to scan the patient's wristband, scan the barcode of the IV medication
bag hanging on the IV pole, and then scan the barcode on the pump.)
These actions associate the patient, the IV medication and the infusion pump, and automatically
program the IV pump to the pharmacy verified, physician order. The nurse then verifies the order,
as displayed on the pump, and starts the device.
8
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reproduced or distributed without written consent from the RFID in Healthcare Consortium
Intelligent Hospital™ OR Script 2015
(Actor mocks veryifying the onscreen order by tracing it with their finger, the mocks pressing
Start button on device – do not actually press)
With this IV pump integration, not only is the device automatically programmed, but infusion data
is automatically documented to the patient's eMAR and I&O Flow sheet. This combination of Autoprogramming and Auto-documentation strengthens the clinician’s ability to enhance patient
safety, improve outcomes, and spend more time with patients thanks to a more efficient workflow
As anesthesia prepares the patient for surgery the perioperative antibiotics are administered.
These are taken from the drug dispensing cabinet and using the embedded bar code reader the
clinician scans the product GTIN or global trade item number.
On administration of the antibiotic, the patient will be scanned again, establishing the association
of the secondary drug to the patient. This validation scanning interfaces with the OR information
system and EMR, which confirm that the correct drug is dispensed and administered, providing
clinical decision support with drug-drug, drug-allergy, and five rights confirmation.
OR14A (Smiths Medical)
As Anesthesia prepares sedation medications for the patient’s surgery, a prefilled 20 mL syringe of
Propofol 10 mg/mL is removed from the drug dispensing cabinet, prepped for IV infusion, and
loaded onto the Medfusion® syringe infusion pump. Anesthesia scans the Propofol prefilled
syringe barcode and then scans the patient’s wristband, establishing the association of the drug to
the patient for Auto-Documentation in the EMR.
At the syringe pump, Anesthesia turns the pump on, selects the Quick Library Profile Anesthesia,
then selects the Drug Program Propofol 10 mg/mL, B-D 20 mL. On the next screen, Anesthesia
confirms the infusion parameters, including the patient weight of 75 kg and dose of 75
mcg/kg/min. Prior to beginning the infusion, Anesthesia programs in a Loading Dose of 4,000
mcg by selecting Options then Loading Dose, confirming the total loading dose and programming a
Loading Time of 10 seconds. The Start button is then selected and Begin Loading Dose Delivery is
accepted. After the Loading Dose completes, the infusion automatically begins at the dose of 75
mcg/kg/min. A few minutes into the infusion, Anesthesia titrates the dose to 100 mcg/kg/min by
selecting Change Dose on the syringe pump.
All the while, Anesthesia is able to view the infusion data in the EMR and complete infusion
documentation in just a short time with the use of Auto-Documentation. The syringe infusion
pump’s integration with the EMR not only provides increased efficiency with its AutoDocumentation of infusion data such as the dose, rate, or volume infused, it also provides clinical
decision support such as drug-drug, drug-allergy interaction checking.
9
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Intelligent Hospital™ OR Script 2015
OR15a: Anesthesia Medication Tray Management (Carefusion)*
Updated Mar 14
In the OR, many hospitals use anesthesia medication trays to distribute medication in addition to
automated cabinets. Anesthesia Check complements this approach using RFID-based technology.
With Anesthesia Check, the anesthesiologist passes an RFID tag that pharmacy has placed on the
medication vial in front of an RFID reader in the OR to print an ASA colored syringe label.
[Screen shot: (1) Show RFID makes meds trackable slide, (2) show vial to syringe slide]
[Actor: Pick up medication with tag on it, point to tag, take medication vial and pass it in front of ACheck unit]
Through a single tap of the RFID tag, the system will instantly update what was drawn, what was
administered and what was returned! That tap can even record what was administered in the
EMR eliminating the need for paper records.
[Screen shot: (3) Show to patient slide.]
[Actor: Pick up labeled syringe and tap it on A-Check unit]
And, it provides a safeguard against expired and recalled medications as well as syringe swaps
helping to increase patient safety. Anesthesia Check uses RFID to automatically track medications
from pharmacy to operating room and back. With RFID tracking, when meds move physically, they
also move virtually. Availability, use and waste are automatically recorded improving
accountability and saving time for anesthesiologists and pharmacists.
[Screen shot: (4) Show expired warning slide, (5) show waste slide]
OR16
Anesthesia Delivery System (Draeger)
(Walk over to the anesthesia machine and touch) The anesthesia team is supported by an advanced
anesthesia delivery system, integrating the latest in physiologic and vital signs monitoring. This advanced
system is interfaced with anesthesia specific analytics software to continuously analyze anesthesia related
perioperative data. The Anesthesia Information Management System (AIMS) delivers the perioperative
information anesthesia providers need – including data points from the physiological monitors facilitated
by monitor data aggregation systems to avoid redundant documentation. With unique workflow wizards
and an easy-to-use touch screen application, the system facilitates pre-op and intra-op documentation to
ensure provider focus remains on the patient. Utilizing the powerful interconnectivity features offered in
this modern anesthesia platform, we are able transmit data into the EHR achieving real time surgical care
documentation and provide a summary of all on-going procedures within the Intelligent hospital OR suites
as seen on the central monitor typically located in the anesthesia central monitoring location. (actor points
to the monitor) t
OR17 Anesthesia Workstation and Control in OR (Omnicell Codonics)
** Updated Mar 4
Anesthesiologist scans vial with barcode scanner. Machine records medication and reports use to the
system. (scanning vial)
10
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Intelligent Hospital™ OR Script 2015
The OR also includes an Anesthesia Workstation (AWS) that provides an automated system that
securely stores all the medications and supplies needed for a full day of cases in one convenient
place. The AWS aids in diversion control by providing visibility of high volume narcotic inventory
and dispensing transactions. Also, it automates reconciliation of controlled substances and
eliminates countbacks. The anesthesiologist removes fentanyl and scanning the vial in the Safe
Label System (Codonics) that simultaneously prints a color coded label, adjusts the inventory, and
charges the patient.
These systems focus on creating workflow efficiencies in the OR while enhancing patient safety
and increasing accuracy. Improving communication between systems and reducing redundant
tasks helps create an efficient OR environment.
OR 17a IV Bolus Injection Management (BD)
The real time management of IV bolus injections at the point of administration enables an
enhanced surgeon workflow. The system includes a Syringe Labeler which automatically prints
and applies barcode labels to the Luer tip of syringes for compatibility with the injection site. The
device also prints full-color syringe barrel labels based on Joint Commission, ASTM and ASA
labeling guidelines. A tablet PC that contains proprietary software to display injection
information, generate alerts, and transfer information wirelessly to a software application that
integrates with existing hospital information systems to transmit data to hospital records or
printers providing safety checks and documentation.
OR18
Connectivity / Capnography monitoring in OR: (Nuvon) **
Mar 6,28
(Note: Demonstration of physiologic value notifications displayed on iPad when thresholds are
exceeded using measurements obtained from patient in OR.)
All devices within the OR are integrated through the hospital’s Medical Device Integration (MDI)
connectivity solution (shown connected to the Draeger Perseus anesthesia machine) which
provides access to vital signs and other data from connected devices within the environment. In
addition to supporting the clinical needs of patient charting, access to medical device data
promotes remote monitoring of the vital signs of intra-operative patients. The MDI enables access
to much-needed data to assist anesthesia staff throughout the ongoing monitoring of multiple
cases through visual access to and notifications of trends and changes in vital signs measurements
that merit closer attention.
Examples of measures that are key to patient stability and care quality measured through the
anesthesia machine include respiration rate, tidal volume, end-tidal carbon dioxide and pulse
oximetry. Measurements of blood pressure and heart rate as well as four-channel
electroencephalography are increasingly during surgical procedures to assist in identifying
cardiovascular status as well as level of sedation. Real-time knowledge of these parameters can
help clinicians detect impending under- or over-sedation and respiratory depression, which
improves overall patient safety and patient outcome.
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Intelligent Hospital™ OR Script 2015
Start Procedure:
OR19
Remote Collaboration Platform (Intouch Health)
During the course of the procedure the surgeon identifies a pericardial mass. (Walk over to the Intouch
robot and touch) The remote presence surgical collaboration platform enables unprecedented reach and
expert consults between surgeons and specialists at distant locations. By merging of unique visualization
and telecommunications technologies, barriers of time and distance are eliminated. The pathologist is
able to peer into the surgical field and visualize a pericardial mass identified intraoperatively. Pathology
recommends biopsy of the mass.
OR 19 A: Sample Collection Positive ID: (Sunquest, Zebra), Mar 28
Specimen evaluation requires a sample to be provided to the laboratory for STAT pathologic
review. As samples are taken during surgery, they can be labeled within the OR with a thermal
printer that has a IEC 60601-1 medical grade power supply and medical grade plastics for easy
disinfectants. Within the OR the caregiver scans the patient’s armband to electronically confirm
positive patient identification prints bar coded labels and affixes them to specimen containers. The
containers are then sent directly to the laboratory, ensuring that the specimen containers are
correctly labeled and electronically tracked from the OR to receipt in the laboratory, preventing
any opportunity to mislabel a specimen, assign it to the incorrect patient, or lose a specimen.
(Actor/Actress uses handheld device to scan patient ID/identify patient. Using the same device,
they print bar coded labels and affix them to the specimen containers).
OR20
Pneumatic Tube System (Swisslog) ** Updated Mar 6
The hospital pneumatic tube system enables rapid delivery of samples from the OR to the appropriate
laboratory for review and analysis.
Pathology results are electronically delivered back to the OR
enabling the surgeon and pathologist to discuss and review the slides and determine the next
steps.
OR22
Usage Capture Station (Cardinal Health) Updated Mar 28
During the valve replacement portion of the procedure, the nurse walks over and starts a case
on the usage capture station (POUEncounter_OR_CAH) (WaveMark XPOS). (Actor walks over
to the Wavemark XPOS and starts new case). The ADT feed automatically populates both
procedure and patient information.
The smart cabinet solution delivers the benefit of shared visibility, efficient inventory
distribution, enhanced implant tracking, and improved regulatory compliance. Utilizing RFID
tagged inventory and cabinets with embedded RFID readers, simply removing items from the
cabinet enables advanced inventory management and supply control.
12
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Intelligent Hospital™ OR Script 2015
(The nurse walks over to the RFID Smart Cabinet) Using the RIFD Smart Cabinet an artificial
heart valve is retrieved and quickly waved past the usage capture station
(ExpirealertEncounter_OR_CAH) (XPOS). This system aids in tracking expired products and
will immediately identify this product to ensure it is not used. The staff is notified of the
expired product status through the touchscreen interface.
All products used during the procedure are “waved” using RFID or scanned using barcode for
complete usage capture (actor waves product box in front of box reader) and the information
is sent via interfaces to hospital information systems such as EMR, billing systems, MMIS and
core clinical documentation systems making the data available for subsequent analysis. This
action eliminates redundant data entry that can be error-prone.
Post procedure the surgical tech records using a mobile device
(prefcardoptimization_OR_CAH) items not used, wasted, and added on during the procedure to
allow for subsequent preference card analysis and optimization. [surgical tech taps on tablet to
simulate recording of actual procedure usage]
OR 9A Supply Management (Cardinal) Updated Mar 28
Later that day, the materials management staff member receives an alert on his mobile device
(alertexpire_OR_CAH) via Bluetooth from a nearby iBeacon indicating that a supply room
down the hallway has an expired item. This solution allows for proactive notification of staff
members based on proximity making efficient use of staff as they travel through the hospital
environment. [Actor picks up cell phone, taps on it, goes to supply shelf to investigate
situation] Seeing that the product has expired, materials management walks up to the shelf,
looks for the expired item it was alerted for and uses the phone to scan the item and returns it
to the manufacturer. (Actor then goes to metro shelf, scans phone and finds item that's
expired - Actor then scans item for return to manufacturer)
OR 22a Eliminating Transfusion Errors and Increasing Efficiencies using Sunquest
Transfusion Manager (Sunquest) ** Updated Mar 6, Mar 14
During the course of these surgical procedures, Robert Grant requires the transfusion of blood
products. Keeping patient safety at the forefront, the caregiver uses Transfusion Manager to
positively identify both Robert and the unit of blood to ensure he is the correct patient receiving
the correct blood product. This electronic match eliminated the need for a second nurse verifier
and for blood bank wristbands, saving resource time and money and providing a safer
environment for patients.
OR21
Family Notification (ASCOM)
Earlier in the scenario, a timer was set on the work flow station that the procedure was started on to
remind staff when to give the family an update. [Timer elapses and rings device, which actor should
silence]. As per the protocol of the Intelligent Hospital, the nurse updates the family. This notification
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reproduced or distributed without written consent from the RFID in Healthcare Consortium
Intelligent Hospital™ OR Script 2015
ensures compliance with family communication initiatives and results in improved satisfaction. The staff
member can then send the status update to the family member through an RTLS Badge Tag assigned to the
Patient’s Family. [At this point the actor will press a button on a tag they are carrying and points to the
Family member receiving the message-verbiage]. Since this is a portable device, the family member can
receive the status update while they move throughout the facility (TBD). This information can also be sent
to the large screen in the waiting room, which automatically updates with the patient information to allow
the family to see the progress. (TBD ) <actor to receive time out from ASCOM>
OR23
Housekeeping Update (ASCOM)
After the procedure is completed and the patient is transferred from the OR, housekeeping is made of
aware of a status update to the OR suite. The OR RTLS platform is able to automatically notify the
housekeeping staff that an OR cleaning and is needed. <ASCOM Via Nurse call workflow station or v>
OR24 Business Intelligence - Room Utilization Reporting (Intelligent
Insites)
The OR’s are continuously monitored to assess the OR performance, utilization status providing
metric to the optimize OR operations. The Room Utilization reporting dynamically identify the
percentage of time that the room is occupied by a patient and also the percentage of time the room
has a patient and provider/clinic staff in the room together. This information can be used to
improve your patient workflow and staff efficiency. (actor points to screen 3-5 different reports)
OR25 Virtual OR Education and Proctoring: (Hodei)
Right now somewhere, there is a surgeon meeting with a patient discussing an upcoming
procedure. Imagine if a surgeon could experience the impact of that procedure could be felt far
beyond the walls of that operating room and in real-time?
This innovative remote proctoring solution leverages wearable optical technology, proprietary
software, and integrated hardware to enable real-time proctoring and on-demand two-way
training communications. This solution enables a relevant and value-added remote
educational/learning experience that helps improve the quality, effectiveness, and efficiency
needed for delivering healthcare professional proctoring and training. FDA-manufacturer
agreements dictate that clinicians must undergo course training and then be supervised by a
proctor for a designated number of cases before being able to use the device independently.
With this new training tool surgeons being proctored ware an optical device with multiple feeds
streaming capabilities to send POV images and other information real-time to a proctor who can
be located anywhere in the world. The system enables the expert to see exactly what the trainee
sees and switch views to other data feeds (vitals, endoscope, fluoroscope, etc.) as he/she guides
and oversees the trainee adeptly through the procedure. These two-way audiovisual feed, the
proctor can talk directly to the trainee and even capture images being viewed, telestrate on those
images to make a point, and send those image back to the OR to be viewed by the trainee.
Conclusion
14
All contents copyright The RFID in Healthcare Consortium. ©2015. No part of this document may be
reproduced or distributed without written consent from the RFID in Healthcare Consortium
Intelligent Hospital™ OR Script 2015
The Intelligent Hospital Perioperative Team concludes this session with thanks to all of our dedicated
vendor partners for their collaboration in delivering to you this state-of-the-art vision of the enhanced
perioperative care delivery environment. Please follow this patient’s recovery in the Intelligent Medical
Home. Thank you all for your time and attention and please visit the other Intelligent Hospital Pickup the
OR Tour Guide and visit the kiosks in the Pavilion to learn more about these technologies.
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All contents copyright The RFID in Healthcare Consortium. ©2015. No part of this document may be
reproduced or distributed without written consent from the RFID in Healthcare Consortium