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CareGroup Electromagnetic Compatibility Management

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3 Hospitals and 3,000 Physicians. Beth Israel Deaconess Medical Center ... Placed 16th on the Information Week 500. BETH ISRAEL DEACONESS. MEDICAL CENTER ... – PowerPoint PPT presentation

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Title: CareGroup Electromagnetic Compatibility Management


1
CareGroup Electromagnetic Compatibility
Management
2
CareGroup
  • Boston Metro Area
  • 3 Hospitals and 3,000 Physicians
  • Beth Israel Deaconess Medical Center
  • Major Teaching Affiliate of Harvard Med
  • 1.2B Annual Revenue
  • 1,000,000 Patients
  • Placed 16th on the Information Week 500

3
Risks and Rewards
The USAs most popular drug could cause.
  • hepatotoxicity
  • myelosuppression
  • hypoglycemia
  • hypothermia
  • GI bleeding
  • pancreatitis
  • nephrotoxicity
  • pneumonitis
  • rash

4
Nomogram
Severe
Moderate
Asymptomatic
Serum (mg/dl)
0 12 24 36
48 Hours since ingestion
5
Benefits
  • Clinical providers life increasingly mobile
  • Valuable amenity for patients and their families
  • Institutional cost savings

6
Situation
  • 1999
  • No policy
  • Lack of knowledge
  • No central point of coordination
  • Uncontrolled use
  • Opportunities knocking
  • Demands for service
  • Prohibition impractical

7
Conference of Experts
The New England HealthCare Engineers Society Inc.
8
Topics
  • EMI Impact, sources, and management
  • Shielding
  • Spectrum Management
  • Power Control Management
  • Medical Center Case Studies

9
Shielding
  • Coupling Pathway blocking
  • International Electrotechnical Commission (IEC
    60601-1-2)
  • USA medical device manufacturers
  • New construction
  • Preventive maintenance

10
Power Management
  • Electrical field strength (Power, Distance, Gain)
  • Factor of power, distance, and antenna gain
  • Influenced by absorption, reflection, etc.
  • Desired power levels 200 mW or less
  • In-building service
  • 1 Meter Rule
  • Consider both AP and client

11
Frequency Management
  • Unlicensed and licensed spectrum
  • Internal and external sources
  • ISM bands (Wireless LAN, Bluetooth, and others)
  • Frequency manager
  • Wireless Medical Telemetry Service (WMTS)

12
Outcome
  • Knowledge Improvement
  • EMI risks are real
  • No single prescription
  • EMI risks are manageable
  • AAMI TIR No. 18-1997
  • Radio Manager
  • Immunity Standards
  • WMTS Benefits

13
CareGroup EMC Program
  • Policy based on AAMI TIR No. 18-1997
  • Awareness, assessment, management and risk
    mitigation
  • Clinical Engineering Lead Group
  • EMC Coordinator assigned
  • Review and approval before introducing RF source
  • Wireless device standoff distances

14
CareGroup EMC Program
  • Incident reporting and
  • handling procedures
  • Adhoc RF immunity testing
  • program (ANSI C63.18)
  • Employee, patient, and visitor education
  • New or replacement equipment meets or exceeds
    ISO/IEC RF immunity standards
  • New or replacement biomedical telemetry in WMTS
    spectrum

15
Other Lessons Learned
  • Societal issues with wireless use
  • In-building wireless
  • Public/Patients
  • Color Coding
  • Power settings
  • Wireless Security
  • Rogue unit detection
  • Tylenol Example

16
Typical Uses
  • Wireless LAN
  • Physician Order Entry
  • Emergency Department
  • Isolation Unit
  • In-building wireless voice
  • Blackberry devices
  • Wireless point-to-point
  • RFID or RTLS

17
THE ENDJPowers_at_caregroup.harvard.edu
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