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Analytics and workflow improvement the big stories at RSNA

By Jerry Zeidenberg

CHICAGO – Some of the most interesting and significant product announcements at the recent RSNA conference, held in December, weren’t about the traditional imaging modalities, like CT and MRI. Instead, they involved eye-popping improvements in process management and analytics.

Agfa HealthCare, for example, was the talk of the McCormick Place convention centre with its new TrackStar, a system that combines RFID tags with analytics. A new generation of tiny, battery-powered tags can be attached to everything that moves through hospital – medical devices, surgical equipment, staff and patients.

As in other RFID systems, you can then find out where everything is at any time. It’s all tracked on a visual floor plan of the hospital, and a Google-like search for various items shows where they are throughout the hospital. This has all been done before in RFID systems, but what’s new is the combination with business intelligence and analytics. TrackStar also measures who is doing what, and how long things are taking to be accomplished.

“You can see, in real-time, that one room is taking 60 minutes to perform tests, while another is doing the job in 45 minutes,” commented Jim Thornhill, Agfa HealthCare’s North American director of service marketing. “You can then find out why one is faster than another, so you can improve patient flow in the hospital.”

Tiny tags can be attached to all surgical equipment, including sponges, so that nothing is ever left inside a patient – which is a real problem in healthcare today, despite the efforts made by OR physicians and nurses using checklists. The miniscule tags are already commonplace in the retail industry – Walmart and others have been using them to track inventory and analyze business trends.

Agfa demonstrated a nifty application for hand-washing compliance at their booth, showing how the system is alerted when a person washes their hands at a particular station. Andy Hind, vice president at Agfa HealthCare, demonstrated by walking over to a Purell dispenser and washing up. The system recognized the tag he was wearing, and the episode immediately showed up on the computer screen 20 metres away.

The real-time system can be used enterprise-wide, showing who is washing their hands after meeting with patients, and who is not. “No care-giver will want to be seen as not washing his or her hands,” commented Thornhill. “Because they know stats are being collected, they’re more likely to wash their hands. It’s self modifying behaviour.”

Thornhill commented on the seriousness of hand-washing in hospitals. “We know there’s only 10 percent to 36 percent compliance with hand-washing in hospitals. At the same time, there are an estimated 200,000 deaths a year because of hospital-acquired infections.”

Not only can you chart which individuals are best – or worst – at hand-washing, you can also see which departments are most compliant. Setting up competitions for the highest compliance rates is an effective way of boosting hand-washing in a good-natured way, giving bragging rights to the high-achievers.

Agfa has partnered with American RFID Solutions, a leader in the field, to create the new solution. Testing has been under way at Resurrection Surgery Center, in Chicago.

TrackStar can visually show the location of equipment, patients and staff, all in real-time. That’s a useful tool for locating clinicians in an emergency situation; it is also helpful for finding needed equipment – like pumps and wheelchairs.

It can graphically slice and dice all kinds of information, showing how a patient spent his or her day. “You can track and trace how long the patient was in different places,” said Thornhill, who showed the length-of-stay for a patient in a coronary care unit, ER, geriatics, physiotherapy and psychiatry.

The system can also monitor bed turnarounds; the system can notify staff as soon as a bed is vacated, so it can be readied for the next patient. “It’s based on real-time events, not when a staff person remembers to make a phone call,” said Thornhill.

TrackStar can be used as a performance monitoring system – it shows by department and staff member who is spending the most of least time with patients. Management can decide whether that’s a good thing, or whether improvements are necessary.

You can also establish a ‘patient frustration index’, showing the wait times for various tests and procedures, by department and caregiver. “You can then say to various caregivers, everyone else is doing it in 10 minutes, and you’re doing it in 30. Why?”

Also on the analytics front, ABS Systems of Toronto, demonstrated its business intelligence solution for radiology and cardiology departments at RSNA ‘13.

ABS has a long history in business intelligence, and for the past five years has provided Toronto’s University Health Network and its joint imaging department partners at Mount Sinai Hospital and Women’s College Hospital with its analytics solution.

“We’ve developed an easy-to-use analytics system,” said Oren Chervinsky, executive VP of ABS. “Doctors didn’t go to medical school to learn analytics, so we’ve created a very intuitive system for them.”

The system provides basic reporting, with some 20 pre-defined reports. It also has more advanced features, like time-series analysis, cross tabs and correlations, enabling doctors and administrators to quickly spot problem areas.

“They can see if there’s a bottleneck in one room as opposed to another,” said Chervinsky, or whether one site at a hospital is performing better than another. “But the software also helps them figure out what to do next. Even more importantly, it helps them solve problems like, ‘why am I spending more in one room than in another’.”

According to Chervinsky, the software allows users to find answers in minutes. That compares with the days or weeks that are often needed to analyze trends in hospitals. What’s more, he says the system is much easier to use than BI systems that are traditionally used in hospitals and other organizations.

ABS recently scored a big win by signing a contract with Alberta AIM (a multistakeholder organization in Alberta); the Toronto company will provide its solution to the Alberta healthcare quality improvement program, so that healthcare teams can analyze how they deliver care and make improvements accordingly.

A contract with hospitals in northern Ontario is also on the horizon; ABS will soon supply a number of hospitals in northern Ontario with a business intelligence system for their shared information system. Chervinsky noted that ABS has created a special version of its solution, one that has been tailored to the needs of the northern hospitals.

He observed that the next big wave in BI for healthcare won’t be technological, as powerful algorithms and concepts already exist. Instead, it will involve the benefits derived from comparing practices and outcomes across multiple sites. “You can then compare what’s being done and attain a set of best practices,” he said.

M*modal, a large dictation and transcription company based in Franklin, Tenn., demonstrated recent innovations in adding intelligence to D/T. In particular, it’s offering a new version of its radiology product with analytics, quality-improvement and workflow capabilities, said chief scientist Dr. Juergen Fritsch.

For example, “A side-panel [on the screen] presents additional information that comes from the EMR and other sources, including oncology and pathology,” said Dr. Fritsch. In this way, the radiologist can see what happens to the patient as he or she continues his or her journey through the hospital.

“A radiologist often doesn’t know whether his diagnosis was right,” he said. “This shows whether he was right or wrong, and enables him to score himself. It’s a feedback loop that results in a smarter worker.” M*modal won a huge D/T contract in Canada at the end of 2012; it was the winning bidder on a deal to supply all of the health authorities in British Columbia’s lower mainland with its solution. The cloud-based system was selected as the sole dictation platform to be used by 10,000 physicians in 38 hospitals and medical centres.

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