Using RFID Technology to Improve the Efficiency and Effectiveness of Healthcare Delivery

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Using RFID Technology to Improve the Efficiency
and Effectiveness of Healthcare Delivery
Administration Process Improvement Track

• Michael Dereszynski, Microsoft
• Henry Tenarvitz, Versus

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Uncovering the Benefits of Microsoft RFID
Infrastructure for Healthcare

• Michael Dereszynski
• Senior Consultant
• Healthcare and Life Science

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What is RFID ?

• Radio Frequency Identification (RFID) is a method
  of remotely storing and retrieving data using
  devices called RFID tags and RFID Readers
• RFID is an enabling technology with the potential
  to simplify processes
• Tags can be read in bulk
• Tags can be read without line of sight
  restrictions
• Data can be stored and retrieved from the tag
  automatically with a Reader
• Tags can be write once read many (WORM) or
  rewritable
• Other sensors can be combined with RFID

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General Business Benefits

• Improved Operational Efficiency
• Shipping/Receiving, warehouse management
• Total Supply Chain Visibility
• Inventory movement from warehouse to final
  destination
• Inventory Control
• Shrinkage management
• Security
• Asset tracking

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Business Benefits (Healthcare Specific)

• Providers
• Asset management
• Patient Tracking (RFID bands)
• Pharmaceutical
• Manufacturing logistics benefits
• Distribution electronic pedigree

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Examples (Providers)

• Surgichip used in hospital operating rooms
• An RFID asset tracking system enables the staff
  to locate a piece of tagged equipment by using a
  PC.
• Tagged surgical instruments are monitored for
  location and their maintenance schedule.
• Staff and patients be located easily due to the
  tagged bracelets that they wear.

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Examples (Pharmaceutical)

• Starting in December 2005, Pfizer has started
  affixing RFID tags to all U.S. shipments of
  Viagra in order to counter fake pills.
• Sensitech has introduced an RFID-enabled device,
  ColdStream Plant to Shelf (PTS), which monitors
  container temperature.

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Microsoft RFID Goals

• Encourage widespread RFID adoption
• Scalable, deployable, extensible infrastructure
• Standards based (EPC and ISO)
• Broad device support
• Application enablement
• Lowest TCO
• Build an RFID infrastructure that enables
• Compliance
• Automation
• Business process transformation

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Microsoft Product Strategy and Positioning

• Strategy Make RFID a pervasive technology with
  Windows Server Systems as preferred platform for
  RFID-based solutions
• Positioning Microsoft RFID Infrastructure is a
  robust, extensible platform with open APIs and
  tools to cost effectively build vertical
  solutions and configure intelligent event driven
  processes. It is an integrated platform that will
  enable customers and partners to capture sensor
  data through almost any device, translate the
  data into meaningful events and utilize it in
  line of business applications and custom solutions

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Partner Centric Approach

• Enable the event driven enterprise with
  intelligence at the edge
• Develop core platform components to support RFID
  applications and solutions
• RFID enable selective Microsoft Business Solutions

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Real Time Enterprise Platform a functional view
Application Solutions
Real Time Enterprise/Point Apps
Batch Oriented Enterprise Apps
ServicesLayer
Open, standard based interfaces
Enterprise, ContentSolutions
Product InfoResolutionLook-up
Business Process Mgmt
Analytics, Reports and Notifications
Event MgmtLayer
Events and Workflow Management Events, Messages,
Business Rules
Data Collection Mgmt Layer
Data Collection and Management Collection,
Storage, Smoothing, Filtering, Aggregation
Device Interfaces, Management
DevicesLayer
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Platform Architecture

• EPCIS
• ONS

BizTalk Server
Partner Solutions
MBS
Solutions
Designers, Tools Adapters
RFID Services OM / APIs

RFID Engine Runtime
RFID Runtime

EPCIS GDS
Microsoft RFID Services
Config Store
Rules Engine
Reader Management
Device Service Provider Interface (DSPI)
Extended Provider
Custom Providers
EPC Provider
Reader with Extensions
EPC Reader
Device 1
Device n
.
Hardware
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Key Value Propositions

• Abstraction of Device handling
• Discovery, configuration, communication, and
  management
• Rich RFID event processing model
• Design, store, deploy and manage RFID Processes
• Reduce data noise and increase data relevancy
• Rules Engine for Filters, Alerts and
  Transformations
• English like vocabularies for rule creation /
  modification by business user
• Inference based generation of events Ex
  Internal Movements
• Robust framework to support agile processes
• Rules provide dynamic policy morphing
• Hot-swap of Readers Processes
• Support for transactional execution and failover
  semantics
• Base set of tools for lifecycle management
• Device, Process and Server Management

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Key Value Propositions

• Pluggable architecture for customizable
  components
• Security
• Role based access to RFID Processes Devices
• Management, Monitoring Tracking
• Performance and Scalability
• Large volumes of irregular event streams
• Distributed deployment architecture
• Edge vs. Central processing transparent to end
  user
• Integration with BizTalk
• RFID events as BizTalk messages to build closed
  loop RFID aware business processes
• Standards
• Stack will support RP, RM, ALE, and ePCIS across
  multiple

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Partner Ecosystem

• Independent Software Vendors / System Integrators
• Real time Business Analytics
• RFID Enabled Business Apps / Solutions across
  multiple verticals
• Integration of MS RFID Services into existing
  applications via BizTalk platform
• 3rd party RFID component-ware
• do for RFID what ASP.Net did for web development!
• Vertical specific tools for creating managing
  RFID processes
• Simulation, Auditing, Monitoring Tuning
  solutions
• Independent Hardware Vendors
• Device Providers Simulators for existing
  devices and new device types
• Surface Device innovation to higher layers WSD
  and CE

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Our Commitment

• We are committed to RFID and will build a
  scalable, reliable platform for solutions and
  applications.
• Positive momentum with a large number of
  customers across all industries
• TAP program for customers / partners
• Currently in Beta 1, Beta 2 expected later this
  year

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Resources

• Microsoft RFID News
• http//www.microsoft.com/business/rfidlanding.mspx
  
• RFID Gazette/Healthcare
• http//www.rfidgazette.org/healthcare/index.html
• Microsoft Healthcare Industry Site
• http//www.microsoft.com/industry/healthcare/defau
  lt.mspx
• Michael Dereszynski - michael.dereszynski_at_microsof
  t.com

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• Active RFID-IR can reduce overcrowding and
  improve healthcare delivery in the ED
• Henry Tenarvitz
• President

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Patient Throughput

• GAO Report on Hospital EDshttp//www.gao.gov/new.
  items/d03460.pdf
• Overcrowding Indicators
• Diversion Divert EMS away
• Boarding Admits waiting for a bed
• LWBS (Left without Being Seen) Registered /
  triaged then left due to extended wait

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GAO Report ED Overcrowding
Percent of Hospitals reporting Over Capacity
EDs http//www.gao.gov/new.items/d03460.pdf
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Using VIS Active RFID-IRTo Increase ED Throughput

• Identify Treatment Milestones
• Cyclic patient care steps used in Your ED
• Define Processes
• RFID Events that monitor the Milestone Completion
• Automate adjacent applications
• RFID Event Distribution
• Find Everything in real-time

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Leverage Active RFID / IR to Improve Healthcare
Delivery in the ED and other Departments
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Active RFID-IR Personnel Tag

• Real time (3-5 second) location of Doctors,
  Nurses and Patients accessible on your Intranet
• Small, lightweight
• Coin cell battery
• Call button
• ID card clip

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Active RFID-IR Equipment Tag

• Real time (3-5 second) location of medical
  equipment accessible on your Intranet
• Small, lightweight
• Coin cell battery
• Motion sensor

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Patient Milestone / RFID Event Associations
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Clinical Applications

• Patient Flow Manager
• Enhance service/minimize wait times
• Monitor room status
• Monitor patient progress
• Streamline patient throughput in the ED and OR
• Automate patient milestones based on location
  e.g., waiting room, lab, recovery
• Automatic data entry of doctor and nurse
  assignments
• Real-time department overview of activity/load
  level

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Clinical Applications

• Staff follower
• Detects presence of staff in patients treatment
  area
• Reduces manual entry/action
• Registers caregiver in in TA
• Cancels pending patient calls
• Accurate time stamp of who, when, what room, with
  whom, and for how long
• Button may be programmed as desired (typically
  for Assistance call)

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Medical Equipment Mgmt.

• Reduce search time (hard dollar savings)
• Reduce rental purchases
• Manage inventory more efficiently and increase
  utilization
• Reduce wait time of critical equipment to
  patients
• Decrease in liability concerns over lost or
  misplaced charts/files
• Streamline preventive maintenance (PM)
• Enhance security of mobile assets
• Enhances liability protection for grievance
  issues

NOTE Five to fifteen percent of hospital
inventory is written off each year - Frost
Sullivan
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Back Room Applications

• The VIS Rules Engine allows you to create and
  edit message rules or conditions on-the-fly
• For example, when a patient waits more than 20
  minutes in an exam room before seeing a doctor,
  send pager message to ED Manager

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Security Alarms
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Real World ROIs

• Memorial Health System
• Albert Einstein MC
• Christiana Care
• University of Rochester MC

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Memorial Health System

• Increase in cash collections at all facilities
• by 60 at Memorials largest facility
• Decrease in patient throughput times at all 6
  facilities
• Adult Treat and Release 15 22
• Adult Treat and Admit 33 39
• Pediatric Treat and Release 36 38
• Improved capability to handle peak time / staffing

Memorial Health System Includes Five Hospitals
and Urgent Care Center 250,000 ED visits a year
system wide

• Soft Dollars
• Increased bedside time
• Improved communication with Ancillary Support
  Staff

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Applying the Numbers

• Example of estimated ROI with VIS Patient Flow
  Management at a medium/large facility

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Albert Einstein MC

• Diversion rate plummeted to 39.9 hours/month from
  223 hours/month average
• Annual loss of 9M turned into 12M profit in two
  years

Albert Einstein Medical Center 65,0000 ED visits
per year average 200 patients a day
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Christiana Care

• Due to improved throughput Christiana reduced the
  number of patients left without being seen by 3
  projecting payback within first 6 months
• Decreased walkouts by over 3
• Projected increase in revenue based on retention
  of these ED visits 600,000/per year

Christiana Care Health System Includes two
hospitals with over 1100 beds 132,000 ED visits
a year system-wide
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University of Rochester MC

• Sandra Schneider MD FACEP
• Professor and Chair Emergency Medicine
• WRG Patient Throughput Conference
• Strong Memorial ED 90,000 visits/yr
• 2003 3477 hours diversion (40 of the time)
• 2004 1585 hours diversion (18 of the time)
• Diversion 3000 in revenue / hour
• 2004 Additional Revenue 5,676,000

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VIS IntegrationExpands the benefit of RFID-IR
NOTE Versus uses HL7 for both inbound and
outbound messages
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VIS System Architecture
VIS Client Applications And SQL Reports
HL7 Transaction Engine (i.e. Cloverleaf)
Application Layer
Windows Integrations Partners (VIS OCX)
VIS HL7 (Windows Service)
VIS Rules Engine (Windows service)
Middleware Layer
VIS Transaction Engine (Windows service)
IR/RF Sensory Network
IR/RF
Active RFID
Passive RFID
802.11
Other
Hardware Layer
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VIS One System A host of applications a
multitude of benefits
Staff CIS Automation Nurse Call
Biomedical Equipment Management
OperatingRoom
OutpatientClinic
Emergency Department
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References

• GAO Report on Hospital EDs
• http//www.gao.gov/new.items/d03460.pdf
• Defense Medical Logistics Standards Support
• http//www.tricare.osd.mil/dmlss/downloads/RFI-Ver
  sus-Update-13-Dec-05.ppt
• Ms. Nafizwe Palmer, System Administrator,
  Clinical Informatics npalmer_at_mhs.net
• Ms. Melita Howell, Project Manager IT, Texas
  Childrens Hospital mjhowell_at_texaschildrenshospita
  l.org
• Versus Technology website www.versustech.com
• Henry Tenarvitz henry_at_versustech.com

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Thank You