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Intelligent Hospital™ OR Script 2015

Revised: Updated March 28 2015 PHF

Table of ContentsUse Cases to be added:........................................................................................................................................................... 3Introduction:................................................................................................................................................................................ 3OR1 Staff Identification: (Sponsor to be Determined).............................................................................................3OR2 OR Platform Infrastructure: (Skytron).................................................................................................................... 4OR3 Temperature and Humidity Monitoring (Pending Sponsor)..........................................................................4OR4 Integrated Management System (Extreme Networks)....................................................................................4OR5 Environmental Metrics (Planned Removal).........................................................................................................4“Pre-op” Preparation:.............................................................................................................................................................. 5OR15 Case Supply Management Integrated with ORIS (Omnicell)..................................................................5OR9 Surgical Tray (Cardinal)................................................................................................................................................ 5

Cardinal Health....................................................................................................................................................................... 5Start Procedure Patient Ready:............................................................................................................................................. 5OR6 Nurse Call communication and workflow utilization (ASCOM).....................................................................5OR7 Wireless Communications ( Vocera)......................................................................................................................5

Ascom/Vocera........................................................................................................................................................................ 5OR10 RFID Personnel Tracking (Sponsor to be Determined)..............................................................................6OR11 Wireless Messaging (Vocera).................................................................................................................................. 6OR8 Information System (TBD / Sunquest / Skytron)...................................................................................................6Or12 Central Line Kit (Cardinal) (Update required supplies Dr Landa)..............................................................6

Cardinal Health....................................................................................................................................................................... 6Or13 RFID Tagged Equipment (Intelligent Insites) Should be with Hospira !!...................................................7OR14 Infusion Pump: (Hospira)..........................................................................................................................................7

Hospira...................................................................................................................................................................................... 7OR16 Anesthesia Delivery System (Drager)..............................................................................................................8OR17 Anesthesia Workstation and Narcotic Control in OR (Omnicell Codonics)..............................................8

..................................................................................................................................................................................................... 8OR18 Capnography monitoring in OR: (Nuvon **).................................................................................................8OR19 Remote Collaboration Platform (Intouch Health)........................................................................................9

Intouch Health........................................................................................................................................................................ 9OR 19 A: Sample Collection Positive ID: (Sunquest).........................................................................................9Positive/Accurate Patient Identification and Container Labeling using Mobile Specimen Collection System....................................................................................................................................................................................... 9

OR20 Pneumatic Tube System (Swisslog)................................................................................................................10Swisslog.................................................................................................................................................................................. 10

OR21 Family Notification (ASCOM).......................................................................................................................... 10Ascom..................................................................................................................................................................................... 10

OR22 Usage Capture Station (Cardinal)..................................................................................................................10Cardinal Health.................................................................................................................................................................... 10

1 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


OR 22a Eliminating Transfusion Errors and Increasing Efficiencies using Sunquest Transfusion Manager (Sunquest **)................................................................................................................................................... 11

OR23 Housekeeping Update (ASCOM)....................................................................................................................11Ascom..................................................................................................................................................................................... 11

OR24 Surgical Instrument Management..................................................................................................................11Cardinal Health.................................................................................................................................................................... 11

OR25 Track Low Value Assets...................................................................................................................................... 11DeRoyal.................................................................................................................................................................................. 11DeRoyal: Automated Usage Capture of OR Materials..........................................................................................12

Conclusion.................................................................................................................................................................................. 12Business Intelligence - Room Utilization Reporting (Intelligent Insites)..............................................................12

Intelligent InSites................................................................................................................................................................ 12



Revised: Updated March 28 2015 PHF

Name: Robert GrantAge: 62 years Condition: 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 28As 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



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), Updated Mar 31The Intelligent Hospital OR suite is equipped with solutions for centralized temperature and humidity which utilizes Bluetooth Low Energy and Wi-Fi tags for 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. Emails 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. (Actor Points to Screenshot 2 “Temp Alert”.

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

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 16During 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 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 24During 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)



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



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.


Hospira User, 03/24/15,

Display image Plum360_1






(Actor mocks veryifying the onscreen order by tracing it with their finger, the mocks pressing Start button on device – do not actually press)

This IV Clinical Integration solution enables infusion pumps to be Auto-Programmed from the Barcode Medication Administration system, ensuring 5 Rights administration of pharmacy-verified orders. Device starts/stops, alarms, and events can also be Auto-Documented to EMR. Interoperability can enhance hospitals’ ability to reduce medication errors, increase efficiency, and avoid preventable costs.

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 Auto-Documentation 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.



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 A-Check 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 4Anesthesiologist scans vial with barcode scanner. Machine records medication and reports use to the system. (scanning vial)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


Carefusion User, 03/15/15,

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Screen shot (4)CareFusion_OR15a_provides.png


Screen shot (3)CareFusion_OR15a_Through.png


Screen shot (2)CareFusion_OR15a_With.png


Screen shot (1)CareFusion_OR15a_In.png


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) April 3

The real time management of IV bolus injections at the point of administration enables an enhanced surgeon workflow. Innovative medication management solution for IV bolus injections, help manage the risk of medication errors and improve documentation accuracy.

With this System, a clinician can:

Automatically identify the IV injectable drug name and concentration before an injection, which may help manage the risk of inadvertent substitution (syringe swap) errors.

Perform real-time drug allergy checks that help manage the risk of allergy-related medication errors by pulling in allergy information from the patient’s EMR and notifying the physician prior to administration.

Measure the cumulative dose being administered to a patient during an injection, which may help identify and manage possible accidental dose errors.

Wirelessly send captured information on drug/dose/time directly into the patient’s electronic medical record (EMR) following an injection, which reduces manual documentation efforts and improves accuracy.

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.

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 6The 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 2812 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


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.

(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 14During 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 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.

ConclusionThe 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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