VA Real Time Location System (RTLS) Overview Zack Smith, MS

Transcription

1 VA Real Time Location System (RTLS) Overview Zack Smith, MS VISN 1 RTLS Program Manager, VHA RTLS Asset Tracking Co-Chair Andrew J. Mazotas, MS, PMP Clinical Engineer, National VHA RTLS PMO 5 Nov 2014 NESCE Healthcare Symposium v

2 Agenda Overview Applications Asset Tracking Cath Lab Supply Management Sterile Processing Workflow Temperature Monitoring Governance and Deployment

3 Veterans Affairs To care for him who shall have borne the battle and for his widow and his orphan. Abraham Lincoln

4 VA RTLS Goals Healthcare Efficiency Transformational Initiative Improve Patient Care Improve Staff Efficiency Improve Staff Satisfaction Optimize Inventory and Equipment Improve Managerial Decision Support Supplies Patients Medical Equipment Staff

5 VA Organization Veterans Integrated Service Networks (VISNs) Largest direct care healthcare system in U.S. 8.3M+ Veterans cared for each year 152 Medical Centers 1400 Other Facilities $5.6B+ of Medical Technology RTLS Infrastructure with multiple applications to be deployed VA-wide Dec 2012 Dec 2017

6 Healthcare RTLS Use Cases - Examples Asset Tracking Bed Management Biological Implants Blood Bank Dietary Workflow Emergency Department Workflow EMS Workflow Hand Hygiene Hard Copy Records Tracking Non-Biological Implants Organ Tracking Transplants Outpatient Care Patient Workflow Pathology Specimens Patient Elopement and Wandering Patient Fall Notification Pharmaceuticals Primary Care Patient Workflow Research Sterile Processing Workflow Supplies Tracking Surgical Sponges Surgical Workflow Transfer Center Workflow Vehicles Many more

7 RTLS: Example Use Case Variance Niche Solutions in Single Hospital Mobile Assets Active Wi-Fi + IR Immobile Assets Passive UHF Cath Lab Supplies - Passive HF Instruments - 2D Barcodes OR Staff/Patients Active 900MHz + Ultrasound Hand Hygiene Staff Active 433MHz + LF Long Term Care Ultra Wide Band Example Issues Redundant Costly Interactions difficult 7

8 RTLS: Lack of Interoperability 433MHz Access Point Vendor A IR Beacon Vendor A IR Beacon Vendor B 900MHz Access Point Vendor B Tag 1 Tag 2 8

9 VA RTLS Overview RTLS = Real Time Location System RTLS Active Tag Here it is! Veterans Affairs Applications Base Asset Tracking (AT) Cath Lab Supply Management (CL) Temperature Monitoring (TM) Sterile Processing Workflow (SPW) Developing Emergency Dept. Workflow (EDW) Hand Hygiene (HH) Patient Elopement and Wandering (PEW) Surgical Workflow (SW)

10 VA RTLS Overview National Data Repository GUI/ Database Readers Tags/badges/ markings

11 VA RTLS System Model 1) Tags 2) Location Sensors 3) Location Engine 4) Middleware 5) Applications Location Sensor Communication Tag Communication Ranging Techniques Tag, Location Sensor, Location Engine Management User Interface Technology Exciters/ Beacons Telemetry Position Algorithms Location Data Management Business Rules Interrogators Pushbuttons Batteries Handhelds Middleware Integration Application Integration Alerts/Actions In Development with IEEE

12 RTLS Conceptual Data Model Tracking Transaction = Item and Location association over Date/Time Business Rules Communications Operations Item Output Location Associations RTLS Tag Sense Sensor In Development with IEEE

13 RTLS: What to do with the data? Real Time Current Item Location Correlated status Business Rules/Communications Retrospective Workflow analysis to improve business processes Predictive 13

14 RTLS Asset Tracking (AT)

15 AT: Components Software Intelligent InSites (+ AEMS/MERS Interface) OATSystems Active Hardware CenTrak Tags CenTrak Supplemental Hardware Passive Hardware Vizinex + Emerson and Cuming Tags Impinj + Motorola Portals Motorola Handhelds 15

16 RTLS Asset Tagging Standard Tag Type (Active, Passive, N/A) By Equipment Type (e.g. Infusion Pump) 2,838 Equipment Types Minimal National Standard (may be exceeded) Default to Active unless: Bolted to Ground, Impedes Function, Non-Clinical Tool, Too Small, Vehicle 16

17 RTLS: Blended Technology Example Passive Tags Scanner Portals Network Active Tags Wireless Servers Exciter Justin Cooke, VHA

18 AT: Technology Overview Wi-Fi 900MHz Sensory Infrastructure VA Network Servers Active Tags Infrared Low Frequency Workstations Exciters/Beacons 18

19 AT: Software 19

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21 RTLS Wi-Fi in Practice Location in RTLS Actual Location 21

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23 Room Level 23

24 RTLS: Accuracy Assessment Locating Precisely 10m 5m 1m Room Beacon Position A Position B 24

25 Asset Tracking Bed/Bay Level Accuracy Clinical-Grade Locating Certainty-based accuracy at the room-, bed-, bayand chair-level Gen2IR Virtual Wall

26 AT: Infrastructure Components Device Photo Purpose Power Gen2IR Monitor - Room-level ~4 years Battery Gen2IR Virtual Wall - Bed-level location / Room Level ~2.5 years Battery Low Frequency Exciter - Chair-level location - Egress detection ~2 years Battery 900MHz Star WiFi Access Point - Coordinates w/ Virtual Walls - Alternate to Wi-Fi - Zone coverage; lowresolution locating PoE Wired

27 Asset Tracking Multimode technology Location Sensing / Communication WiFi 900 MHz Also used as supplemental 4 Technologies Supplemental Excitation Gen2IR (Infrared) Low Frequency 27

28 Light Bulb: An Illuminating Standard Edison Screw (standard)

29 RTLS Supplemental Hardware Standard Accuracy By Room Type (e.g. ICU Bay) By Application (e.g. Sterile Processing Workflow) Defines minimal broad initial implementation Enables multiple RTLS Applications

30 AT: Asset Status Pump RTLS Status Available In Use Location correlates to Status Clean Utility Patient Room Dirty Utility Pump A101 A102 A103 Dirty Was it really In Use or In Patient Care Area? More data Output from device Association of Patient and Device 30

31 RTLS Temperature Monitoring (TM) v

32 TM: Components Software Intelligent InSites (+ AEMS/MERS interface) Active Hardware CenTrak Temperature Tags CenTrak Temperature and Humidity Tags

33 TM: Technology Overview Wi-Fi VA Network 900MHz Servers Active Temperature Tags Sensory Infrastructure Indicates the flow of information from tag to user Workstations w/ InSites Software 33

34 TM: Tags Manufacturer: CenTrak NIST traceable calibration 0.75C standard accuracy (0.5C typical) Leverages Wi-Fi or 900 MHz Instant button initiated measurement On board storage of data Multi year battery life Configurable reporting rates Low battery condition alerting Dimensions: 1.6 x 2.5 x 0.7 inches Battery: 1/2 AA Li battery Equipment Environmental Single Probe Options: -20C to 50C -100C to -20C -200C to -100C Temp Temp + Humidity

35 RTLS Cath Lab Supply Management (CL) v

36 CL: Components Software Intelligent InSites (+ GIP, CART-CL, Patient and Hemodynamics Interfaces) Wavemark Passive Hardware Wavemark Tags Wavemark Smart Cabinets Wavemark XPOS Wavemark Tagging Station

37 CL: Smart Cabinets Locking Door Standing Bin Mobile Cabinet Hanging Cabinet Standard 5-shelf HF-D1500 (shelf and hanging) 80 in (w/ wheels) x 44.5 in x 21in HFS in (w/ wheels) x 44.5 in x 21 in HFM in (w/ wheels) x 52 in x 31 in 8 Hr Battery HFH in (w/ wheels) x 44.5 in x 21 in HF in (w/ wheels) x 44.5 in x 21 in Requirements (other than Mobile) Power: Standard 110 Volt AC, 15 Amp socket (200 Watt maximum cabinet power) Data: RJ45 Ethernet data jack required. 37

38 CL: Passive Tags Manufacturer: Wavemark Standard: ISO Operating frequency: HF MHz Standard Square Tag Dimensions: 1.69 x 1.69 Used for most tagging Spine Tag Dimensions: 1.5 x 2.0 Used for foil packaging Hanging Tag Dimensions: 1.75 x 2.38 x.5 Used for hanging products

39 RTLS Sterile Processing Workflow (SPW) v

40 SPW: Components Software Intelligent InSites Censitrac (ITS) Instrument Tracking System (ITS) 2D Matrix Stencils Workstations Marking Stations Handheld scanners Printers Other Hardware Being Explored Active and Passive Tags Passive Portals and Handhelds Active Supplemental

41 Governance and Deployment v

42 Veterans Integrated Service Networks (VISNs)

43 VA RTLS Governance National, VISN, and Local Programs: VA RTLS RTLS Committee Application Workgroups Asset Tracking Sterile Processing Workflow Cath Lab Supplies Temperature Monitoring Developing Applications PM Workgroups Risk Change Control Education and Communication

44 VISN RTLS Program Phases Enhancement Projects Program Initiation Pre- Procurement Facility Projects Operations & Maintenance Pre-Site Assessment Site Assessment Pre-Implementation Design Implementation Planning Implementation Acceptance Testing Training Project Close

45 VISN Implementation Facility Kickoff Facility Close-out Facility A Facility B Facility C Facility D Facility E Facility F Facility G Task Order Award Period of Performance (PoP) Contract Close

46 National Schedule Acquisition Schedule FY12 FY13 Technology demonstrations: V10, V11 V1, V5, V8 (ITS), V17, V19, V21, V23 (Phase 1), CMOP (Phase 1), National Data Center (NDC), ESE, NDR FY14 V20, V22, V3 (Phase 1), V6, V16, V23 (Phase 2), CMOP (Phase 2) FY15 V3 (Phase 2), V7, V8, V15, V18, CMOP (Phase 3), optional pilots FY16 V2, V4, V9, V12, optional pilots

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