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SD / Amb Care Script 2015 PLEASE EMAIL [email protected] with any suggested changes Contents Updated Mar 19, 2015 .............................................................................................................................. 3 Scenario ........................................................................................................................................................ 3 Introduction: ................................................................................................................................................. 3 Stepdown Bed ............................................................................................................................................... 3 SD1 Wireless Communications (Intelligent InSites/Stanley/Vocera) .................................................... 3 SD2 Environmental Monitoring (Extreme Networks, Intelligent Insites] .................................................... 4 SD3 Embedded RTLS Solution (Zebra) ......................................................................................................... 4 SD4 EMR ........................................................................................................................................................ 4 SD5 Bedside Workstation (HID, Zebra) ........................................................................................................ 5 SD6 Bed Description (Hill-Rom, Critical Alerts) ............................................................................................ 5 SD7 Dome Light (Critical Alerts) .................................................................................................................... 6 SD8 In Room Wristband Replacement (Sunquest/ Zebra)........................................................................... 6 SD9 Mobile Medication System (Carefusion) .............................................................................................. 6 SD10 Physiological Monitoring: (Draeger) .................................................................................................... 6 SD11 Connectivity: (Nuvon) ......................................................................................................................... 7 SD12 Draw Labs (Zebra) ............................................................................................................................... 7 SD13 Eliminating Transfusion Errors and Increasing Efficiencies (Sunquest) .............................................. 7 SD14 Interactive Patient System (Skylight) .................................................................................................. 8 SD15 Meal Ordering (CBORD) ....................................................................................................................... 9 SD16 Alerts (Critical Alerts) .......................................................................................................................... 9 SD17 Infusion System (BBraun) ................................................................................................................. 10 SD18 Nurse call Pump Integration (Ascom) ............................................................................................... 10 SD19 Interactive Patient System – Discharge (Skylight) ............................................................................ 11 SD20 Print Prescriptions: (Zebra) ............................................................................................................... 11 SD21 Environmental Services. (Stanley) .................................................................................................... 11 SD22 Equipment Shrinkage (Stanley) ......................................................................................................... 12 Ambulatory Care: ........................................................................................................................................ 12 AC1 Workstation (HID, Zebra) .................................................................................................................... 12 1 SD / Amb Care Script 2015 PLEASE EMAIL [email protected] with any suggested changes AC2 Embedded RTLS Solution (Intelligent Insites) ..................................................................................... 13 Scenario: ..................................................................................................................................................... 13 AC3 Self-Rooming, Patient Status, and Provider Workload Application (Intelligent InSites) ................... 14 AC4 Draw Labs (Zebra) ............................................................................................................................... 14 AC6 Medication Management & Administration (Carefusion Pyxis) ........................................................ 15 AC7 Business Intelligence - Room Occupancy Reporting ........................................................................... 15 (Intelligent InSites) ...................................................................................................................................... 15 AC8 Communications and Information Delivery (Extension Health ) ........................................................ 15 Closing Statement: ...................................................................................................................................... 17 2 SD / Amb Care Script 2015 PLEASE EMAIL [email protected] with any suggested changes Updated Mar 19, 2015 Scenario Name: Samantha Millhouse Age: 26 Condition: awake, stable and has minor visible injuries. She had a brief loss of consciousness, significant laceration over the parietal bone, concussion Diabetic (Actor 1 starts outside the door to the room, Actor 2 starts by the bedside)(Actor 1 walks into the room as soon as the script starts) Introduction: Hello, welcome to the Step – Down Ambulatory Care area of the Intelligent Hospital. This room represents two distinct environments; a typical step down area which provides an intermediate level of for patients between the intensive care and a normally staffed in-patient area; and an ambulatory care area providing consultation, treatment or intervention delivered on a out-patient basis. These areas rely on a combination of medical technologies for treatment delivery, patient care as well as workflow optimization and process validation. Stepdown Bed SD1 Wireless Communications (Intelligent InSites/Stanley/Vocera) These areas utilize a robust network and wireless infrastructure, coupled with real 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 hand held device. (Actors point to large screen, hold up tablet and iphone) In addition all clinicians utilize VoIP communications devices, enabling staff to staff communications with integration to the hospital phone system supporting incoming and outgoing calls. [Actor holds up the Vocera pendant around neck] 3 SD / Amb Care Script 2015 PLEASE EMAIL [email protected] with any suggested changes Streamlined communication improves patient care and throughput, making every minute count. The ability to quickly and easily communicate puts patients back at the center of care while improving efficiencies throughout the care process. SD2 Environmental Monitoring (Extreme Networks, Intelligent Insites] The Intelligent Hospital also continuously monitors environmental conditions of devices, such as freezers as well as the building itself, including temperature, and humidity. Enabled by the robust network and wireless infrastructure we can visualize environmental conditions via a dashboard throughout the hospital. SD3 Embedded RTLS Solution (Zebra) Vital to providing effective patient care includes the management of resources, supplies, devices, and staff. Embedded RTLS solutions visibility to all aspects of healthcare including patient, specimen, medication, asset, and staff. This unique identification enables global tracking throughout the institution. At any moment in time the equipment management system can use this location information to ensure that lean workflow is being followed to reduce the critical time wasted when finding needed devices. RFID analytics report on equipment and device movements, enabling discussions on device quantity, distribution and optimal par levels. Equipment and supplies can be automatically re-ordered from the floor when inventories fall below defined thresholds (Actor points to the display). SD4 EMR We pick up the scenario in the Step Down, where Samantha Millhouse a 29 year old female was admitted from the ED a victim of an automobile collision and admitted for observation. Mrs. Millhouse is awake with multiple minor injuries including bruises, abrasions and is in pain. Samantha suffered a concussion and is also a diabetic. Since data can be seamlessly shared in through the hospital electronic medical record, accessing and reviewing clinical information from the assessments made during ambulance transit and in the ED, as well as imaging and medical history from their primary physician are readily available enabling nurses to quickly develop a treatment plan for Samantha. Actor points to the bedside display mounted and taps Imaging tab 4 SD / Amb Care Script 2015 PLEASE EMAIL [email protected] with any suggested changes and presents an X-Ray, taps personal history tab and presents a graph of sugar levels history. SD5 Bedside Workstation (HID, Zebra) This room is equipped with a bedside PC patient station, which can be either wall mounted or a hand held tablet Actor 1 holds up the tablet and scrolls through, showing the audience what is on it) providing an alternative to the computer on wheels implementations. This PC is capable of running all hospital applications and provides the clinician bedside access to clinical applications such as the EMR, , PAC’S, Lab data, cardiology management, or supporting applications such as RTLS mapping and overall real time patient information aggregator. The workstation also integrates with bar code scanners, and printer to support the processes focused on patient centric identification and association, such as medication administration and laboratory processes. Proving you are who you say you are, by utilizing One Time Password security into cloud applications can be accomplished leveraging your ID Badge and NFC communication protocol with a single tap of the card. The innovative technology card both generates and sends a One Time Password without the inconvenience of re-entry. (Actor picks up the tablet and taps their ID badge to the tablet – screen shot of the authentication application). SD6 Bed Description (Hill-Rom, Critical Alerts) Mrs. Millhouse lies in an instrumented smart bed providing a secure dynamic environment capable of monitoring patient weight, as well as, wheels, side rail status, and patient communications integrating with Nurse Call System. The nurse call system enables workflow optimization starting from an initial patient request through fulfillment. A centralized unit clerk answers call request using patient name, triages call based on request type and forwards the message to the correct nurse via her device of choice. The system enables full reporting on entire workflow. (Actor 2 makes her way outside the door and waits for the hand hygiene segment 5 SD / Amb Care Script 2015 PLEASE EMAIL [email protected] with any suggested changes SD7 Dome Light (Critical Alerts) Based on her condition the nurse additionally classifies her as a potential fall risk, requiring observation and monitoring. (Actor points out dome light to audience) SD8 In Room Wristband Replacement (Sunquest/ Zebra) During the rounding the nurse also realized that the patient wristband was damaged and unusable requiring a new wristband to be generated. A replacement is easily generated in the room by accessing and confirming the patient’s medical record and using the room based printer generating a replacement wristband. (actor presses button and wristband comes from the printer). The wristbands are the unique identifier and scanned prior to any medication administration, sample draw, or clinical procedure. Wristbands can be barcode, passive RFID or both and as in this case an active RFID is also added to enable patient tracking throughout the institution. SD9 Mobile Medication System (Carefusion) The nurse now confirms patient identification, using the wristband, and the bedside medication tracking system checks physician medication orders The mobile mediation system streamlines medication tracking and transport by communicating seamlessly with the Automated Dispensing Cabinets. Clinicians are able to capture patient information from these dispensing systems, eliminating redundant data entry, allowing them to stock their system in advance with the patient specific ordered medications. The label is scanned by the barcode scanner on the mobile medication workstation to enable the administration of patient specific medications to comply with the five rights of patient administration at the bedside. In the event that other medications are required they can be rapidly prepared and delivered to the bedside. SD10 Physiological Monitoring: (Draeger) Traditionally patients in the Step Down vital signs spot checked at 4 hour intervals. In the Intelligent Hospital Mrs. Millhouse’s physiological parameters can continuously monitored using wi-fi telemetry visualized at the nursing station, of central monitoring or war room. 6 SD / Amb Care Script 2015 PLEASE EMAIL [email protected] with any suggested changes SD11 Connectivity: (Nuvon) Using a connectivity solution medical device data is archived and available anywhere inside or out of the hospital. Bed data from multiple sources can be integrated into a rules engine to alert and provide analytics vital to the patient’s treatment. platform designed by the Hospital. As an example, pain management is a common practice especially in postoperative patients. Some patients, particularly those who have sleep apnea or have difficulty tolerating anesthesia, can have difficulty with post-operative analgesics, particularly opioids. Measures for patient distress have traditionally focused on pulse-oximetry measured oxygen saturation. However, studies have shown that blood oxygen does not react as quickly to signs of imminent distress in patients, and measurements of end-tidal carbon dioxide are a better indicator of problems occurring in opioid-dependent patients. Monitoring of patients such as Samantha can include etCO2 which provides remote visual notifications as to changes in the measurements of etCO2 and other vitals parameters collected through connected medical devices so that notifications of potential issues can be communicated to nursing and other clinical staff. SD12 Draw Labs (Zebra) As a follow-up the physician has ordered a hemoglobin and hemocrit labs. The hospital uses a bar code based sample collection system, scanning the patient’s wristband and printing sample vial labels directly at the bedside. This ensures that all the drawn samples are verified and associated with the correct patient minimizing the chance of mislabeling errors. (scan patient wristband, output label, scan affix label, scan vial, scan own badge The drawn samples can be rapidly delivery to the laboratory using the institution pneumatic tube system. The labeled sampled are loaded into RFID couple containers ensuring accuracy and the chain of custody from the bedside to the laboratory, as well as establishing the unique identifier to accurately document results into the patient record. SD13 Eliminating Transfusion Errors and Increasing Efficiencies (Sunquest) In this case the laboratory results confirmed a low hemoglobin and the physician ordered a blood to be transfused. Transfusion Manager is used to positively identify patient and ensure the correct blood is given to the patient. The Nurse scans the patient ID and carries out positive patient identification. Using the 7 SD / Amb Care Script 2015 PLEASE EMAIL [email protected] with any suggested changes same device, a unit of blood is scanned. The match is confirmed, and the patient is given the blood transfusion. (Actor – goes through the scanning process) SD14 Interactive Patient System (Skylight) To ensure a high degree of patient satisfaction, the use of an interactive patient system enables the patient to view her personalized electronic whiteboard. Through integration with the hospital’s ADT system, Samantha has access to a snapshot of her care team, pain management tools, and other information necessary to help orient the patient during their stay. (Actor picks up pillow speaker and scrolls through the screens as if they were teaching Samantha how to use the system, pointing out stuff on the screen as they go along) Samantha can easily view all her prescribed health education including orientation and safety, fall prevention, discharge planning, and condition-specific education based on integration with the hospital order system. Viewing of patient education is automatically documented into the patient’s health record through integration with the hospital’s EMR system. The interactive patient system engages Samantha in her care, empowering and connecting her to her care team. Actions: Will Need to water this down !!!!!!! From the Main Menu, actor selects “ABOUT ME” On the About Me/Electronic Whiteboard screen, actor pretends to speak to the patient, pointing to the screen, explaining the electronic whiteboard to the patient Actor then selects “TEACH ME”, navigates down to “To-Do’s”, then confirms patient identity by selecting “Confirm” As actor scrolls down through the videos listed on the screen, actor pretends to explain the To-Do list to the patient Actor scrolls down and selects “Fall Prevention” Select “Play Video” Automatically launches 5 second video clip Automatically displays survey question after the video Actor turns to the patient as if asking for a response to the survey question and selects “NO” (that the patient does not have further questions) Automatically goes back to “To-Do’s” screen 8 SD / Amb Care Script 2015 PLEASE EMAIL [email protected] with any suggested changes SD15 Meal Ordering (CBORD) To improve efficiency and enhance the patient experience, the hospital also uses an integrated web-based mobile meal ordering application accessible from the web browser on the mobile tablet or bedside device to support staff-assisted entry of patient and guest meal selections for either on-demand room service or a tray line meal service. (Actor picks up tablet)The application interfaces with the hospital’s CPOE providing real time diet order and allergy information along with clinical tools to ensure that all foods served are appropriate and meet the patient’s needs. To help ensure patient safety, the staff member is automatically alerted that Samantha is a diabetic who requires insulin, and that she is allergic to peanuts. (Hold up tablet to audience and show the alert that is sent to the tablet) The system then automatically tracks and displays carbohydrate totals compared to her prescribed diet goals reinforcing the hospital’s patient education initiatives. (Actor switches through the screens on the HP Elite tablet) Once the meal order is placed, tray tracking information automatically displays on monitors at the nursing unit or central monitoring area to facilitate communication with nursing for a pre-meal blood glucose check. (Actor puts down the tablet and brings over the tray of food to Samantha) When the tray arrives on the floor, foodservice staff delivers the tray and updates the tray tracking system using the smart phone or handheld to confirm the delivery. SD16 Alerts (Critical Alerts) Mrs. Millhouse realizes she needs to go to the rest room and presses the patient call button. The call is then sent to the staff worn communication badge, rings the staff console, and lights the dome light. (Point to dome light and staff console) Before the staff can respond Mrs Millhouse attempts to go to the bath room on her own triggering bed exit alerts to the central station and to the staff phone. (Actor puts the rails down which will trigger the alarm, Puts rails back up to cancel the alarms) The staff responds immediately to prevent the patient fall. The nurse system automatically cancels the bed exit alarm and corresponding indicators. (Actor point to dome light) 9 SD / Amb Care Script 2015 PLEASE EMAIL [email protected] with any suggested changes The nurse confirms Mrs. Millhouse is in danger of a fall and requires assistance in getting her to the bathroom, back into bed and stabilized. The nurse can issue a request for assistance on the nurse call system. The nurse activates the fall risk notification on the dome light from the work flow station, indicating to all staff on the unit that this patient is a fall risk. (Actor presses workflow buttons for assistance). SD17 Infusion System (BBraun) The Intelligent Hospital has deployed an advanced infusion system operating wirelessly with interoperability with the EHR system. This integration helps to close the safety loop in the medication administration process by associating the pharmacy validated order with the patient, the medication, the IV pump and the patient record using bar code medication administration technology. The nurse can scan barcodes on the patient ID, the medication and the smart pump to initiate the population of order information from the EHR to the pump . With this integrated system, the ordered infusion settings automatically populate on the pump screen, eliminating manual programming steps and decreasing opportunities for error. Running infusion status is also sent from the infusion system to the EHR to promote more timely, accurate and complete clinical documentation in addition to enabling infusion surveillance through the EHR system. SD18 Nurse call Pump Integration (Ascom) Before setting up the pump, the nurse plugs the cable from the IV pump into the nurse call system. (Actor either depresses button at bed or IV pump) This allows a secondary annunciation of pump alarms to go directly to the nurse call system, which then directs the alarm to the assigned staff. Rapid intervention to IV pump alarms, whether due to infusion completion, or interruption, decreases the potential for adverse events, increasing patient safety. When the pump goes into alarm, it is indicated with the dome light, staff console, and the staff communication badge. (Point to dome light and hold up vocera badge) For the purposes of demonstration, we will fast-forward to the next day. Samantha’s condition has improved and she is ready to be sent home.. The discharge process was initiated after the physician entered the discharge orders. 10 SD / Amb Care Script 2015 PLEASE EMAIL [email protected] with any suggested changes Lab Results returned The hemoglobin and hemocrit tests that were drawn earlier are returned by the lab to the EMR and then pulled into the nurse’s visual tablet display in near realtime. The nurse glances at the visual display on her tablet, noting the yellow lab icon representing an abnormal lab result. (Actor points to the tablet display) She clicks on the icon, revealing the patient’s test results, then on the abnormal lab in question. Based on the result, she decides to notify the physician by pushing the actual lab result to the attending physician using an integrated, HIPAA-secure texting application. The physician receives the text message on his Smartphone, authenticates into the application and sees the relevant patient information along with the test result. The physician then sends a secure text order to the nurse to order B12, TSH, and peripheral, eliminating the need for a verbal order and saving time communicating. SD19 Interactive Patient System – Discharge (Skylight) As Mrs. Millhouse prepares for discharge, Samantha again uses the Interactive Patient Systems to access the different services available to her including the ability to fill prescriptions by way of the on-site retail pharmacy. Actions: Actor selects “ASSIST ME” Then scrolls down to “Leaving Hospital” From the “Leaving Hospital” menu, actor scrolls down to “Fill Prescriptions” Then selects “YES” (that the patient would like to fill their prescriptions now) SD20 Print Prescriptions: (Zebra) Prescriptions can be printed directly in the room and provided to Samantha as part of her discharge packet. SD21 Environmental Services. (Stanley) 11 SD / Amb Care Script 2015 PLEASE EMAIL [email protected] with any suggested changes The nurse will remove the telemetry pack and IV access so that the patient can get dressed. In a few minutes, Mrs. Millhouse and Molly will be going home to recuperate. Once they have left the room the nurse takes the laundry and pushes the button from the nurse call labeled DC, for discharge. (actor presses the large button on the RFID tag on the wall, and points to the monitor as the room changes color, and then presses the small button on the same tag to reset the color between presentations). This will send a message to Environmental Services to request that the room be cleaned. Room status changes–from soiled, available and occupied– are indicated on the map with a visual color change. SD22 Equipment Shrinkage (Stanley) A common occurrence during clean-up processes, portable medical devices or otherwise valuable inventory is misplaced or discarded. In the Intelligent Hospital™, devices incorporate an RFID tag, and the laundry chute houses an RFID transmitter – receiver. This creates a choke point that identifies inventory passing through the chute, preventing valuable assets from accidentally being discarded by triggering various notification modalities. As you can see, the clinician placed the telemetry box on the bed, (Actor puts pack on bed deliberately) which became entangled with the linens. (Tangles it with the sheets and throws it through the laundry chute) Inadvertently it was discarded with the sheets down the laundry chute. The nurse call station receives an alert from the RFID system. This choke point level of device tracking enables improved loss management and inventory shrinkage. Ambulatory Care: Providing the continuum of care in the outpatient setting requires the environment to establish a seamless integration of data enabling the review of past patient information to information. The outpatient setting relies on many of the same technologies for clinical care, treatment or follow-up, focuses on the optimization of workflow, patient throughput and satisfaction. AC1 Workstation (HID, Zebra) 12 SD / Amb Care Script 2015 PLEASE EMAIL [email protected] with any suggested changes The Ambulatory Care area is equipped with a bedside PC patient workstation which can be either wall mounted or a hand held tablet ( Actor 1 holds up the tablet and scrolls through, showing the audience what is on it) providing an alternative to the computer on wheels implementations. This PC interfaces to all hospital applications and provides the clinician bedside access to clinical applications such as the EMR, , PAC’S, Lab data, cardiology management. Ensuring the integrity of the patient information relies on a One Time Password security into cloud applications can be accomplished leveraging your ID Badge and NFC communication protocol with a single tap of the card. The innovative technology card both generates and sends a One Time Password without the inconvenience of re-entry. (Actor picks up the tablet and taps their ID badge to the tablet – screen shot of the authentication application). AC2 Embedded RTLS Solution (Intelligent Insites) Vital to providing effective patient care both in-patient and out is the management of workflow and management of resources, supplies, devices, and staff. Embedded RTLS solutions enable all devices, staff and patients to be tracked globally throughout the institution. At any moment in time the equipment management system can use this location information to ensure that lean workflow is being followed to reduce the critical time wasted when finding needed devices. RFID analytics report on equipment and device movements, enabling discussions on device quantity, distribution and optimal par levels. Equipment and supplies can be automatically re-ordered from the floor when inventories fall below defined thresholds (Actor points to the display). Scenario: The ambulatory area is currently managing to patients, a 70 yr old man, Walter Zickler who has been undergoing treatment for Congestive Heart Failure. Over the last 9 months he has been undergoing home monitoring of vital signs including weight, BP, Pulse Rate and data has been collecting using a portable home monitoring system and a 35 year old Julia Smith who is scheduled for her oncology visit after being diagnosed with a malignant brain tumor. She will be receiving her chemotherapy treatment. Julia’s appointment was prescheduled and she is to report to the Intelligent Hospital at 8:00 a.m. In the case of Walter Zickler, the nurse calls the patient at home instrumented an iHome to check in. During the routine check of vitals and tele-weigh-in (home monitoring information), the nurse realizes that the patient has gained well over 4 lbs. overnight and his diastolic blood pressure has risen 10 mmHg. Over the last 9 months he has been undergoing home monitoring of vital signs including weight, BP, Pulse Rate and data has been collecting using a portable home monitoring system 13 The nurse asks the patient if his routine SD / Amb Care Script 2015 PLEASE EMAIL [email protected] with any suggested changes differed and was at a family gathering the day before and may have had some food not on his recommended diet. The nurse recommends that the patient come to the ambulatory care clinic for additional tests and monitoring. As Julia Smith arrives at the Registration Desk where and is greeted by the Patient Service Representative and issued an RTLS badge. The Patient Service Representative locates an available room and tells to proceed to the Room 9. The Patient Service Representative takes her husband cell phone number to receive updates about Julia’s visit while she waits for her in the coffee shop across in the cli AC3 Self-Rooming, Patient Status, and Provider Workload Application (Intelligent InSites) The desk attendant reviews the room status or availability and assigned the patient to room. Room status is automatically changed once Julia is brought to the room. The nurse is notified to go to Room 9 to draw Julia's blood AC4 Draw Labs (Zebra) The hospital bar code based sample collection system, scans Julia’s wristband and prints sample vial labels directly at the drawing site. This ensures that all the drawn samples are verified and associated with the correct patient minimizing the chance of mislabeling errors. (scan patient wristband, output label, scan affix label, scan vial, scan own badge The nurse continues the assessment, take her height, weight, and vital signs. After finishing the initial assessment, the nurse leaves the room and the oncologist is notified to proceed to the patient room. (Notification received on mobile device) The oncologist sees the change in the patient status and quickly proceeds to the Room 9 to conduct the physical exam and review the laboratory results. Julia's lab results showed that she made the CBC count and can be seen in the Infusion Center to receive her Chemo. 14 SD / Amb Care Script 2015 PLEASE EMAIL [email protected] with any suggested changes AC6 Medication Management & Administration (Carefusion Pyxis) Managing the entire patient care continuum, delivering patient care doesn’t stop with a patient discharge. Treatment centers depend on a compact, high-efficiency medication management system for the non-acute, ambulatory settings. The system leverages and integrates with hospital’s medication management platform and Enterprise Server communicating over the hospital’s IT infrastructure. AC7 Business Intelligence - Room Occupancy Reporting (Intelligent InSites) The next day, the Process Improvement Department reviews operational performance data to identify improvement opportunities in the ambulatory environment. The Room Occupancy reports identify the percentage of time that the exam room is occupied by a patient and also the percentage of time the exam room has a patient and provider/clinic staff in the room together. You can use this information to improve your patient workflow and staff efficiency (point to monitor, 3 screen shots) As Walter Zickler arrives, he is similarly registered and provided an RTLS badge and assign to a treatment and the RTLS systems indicates that he is ready to be seen. The physician performs a check-up and admits the patient into a Step Down area as was described and orders several tests including labs, CXR, ECG and Echo. Once the patient is assigned a room, he placed on oxygen and ECG and Pulse oximetry monitored. The nurse is assigned to our patient and they use engage mobile device) to assign themselves to our patient. (Extension Health) The nurse takes the patients vital signs and hangs a low dose IV Natrecor, 0.005 μg/kg/min without bolus, and prior to considering Milrinone treatment. (B. Braun) AC8 Communications and Information Delivery (Extension Health ) A few minutes later, the Dr. arrives at the patient's bedside to do a complete physical exam. Prior to entering the room, the physician is able to review the results from the diagnostic tests from admission orders. Reviewing the patient tests, symptoms and current vital signs 15 SD / Amb Care Script 2015 PLEASE EMAIL [email protected] with any suggested changes he orders a Cardiology consult. Upon consult, a physician order is written for the pt. to be transferred to an ECG telemetry unit for continuous monitoring to better understand the overall patient condition. The Med/Surg Nurse is able to securely communicate via text to all physicians. Adding both the Cardiologist and the attending physician to a private text conversation. The patient weight is calculated and sent directly from the bed to the patient demographics content. The Cardiologist receives the text message on his mobile application (Vocera, Ascom, Motorola or other) along with the patient contextual information, Demographics, weight, Diagnosis, etc. The Cardiologist is able to see the text and the associated patient information. In addition, he may also be able to review retrospective waveforms from a mobile application.) While the physician is review in the patient vitals and ECG over the last several hours, the nurse receives the alert notification from the lab system with the test results. She heads to the computer to review the lab results. Now the Patient begins experiencing chest-pain and uses the Nurse call platform (Critical Alert) to notify staff of his changing condition. The nurse texts the Cardiologist and a short time later, the nurse sees the order on her Mobile device changing the patients' medication. At this point the nurse also receives a low priority text message about changing a shift with a colleague. See Screen shot but the priority of the message demotes that the noise is suppressed and there is no interruption in the clinical workflow. The exchange of critical information to and from the patient point of care enhances the patients overall care and experience and optimizes the effectiveness workflow of the clinical staff. Actor instructions: Nurse/physician using a mobile device to send review alarms/alerts/orders and send/respond to text message. We will have devices available but we should use the Motorola pivot which is the best and most viable "Smartphone" use case from a sponsor. 16 SD / Amb Care Script 2015 PLEASE EMAIL [email protected] with any suggested changes Closing Statement: This concludes the demonstration within this area, which I hope highlighted how the integration of these different technologies and applications, enhance patient care and safety, optimize staff workflow, and assist the inventory and supply management. Please visit the other rooms in the Intelligent Hospital™ to find out how the other patients fair, pick-up the Ambulatory Care Tour Handout and visit our sponsors in the Pavilion kiosks to learn more about these dynamic technologies. Thank you. 17