Blog - Mobile Aspects

How To Use Predictive Analytics In The Hospital Supply Chain

September 12, 2019Sri Mandava Big Data Cost Reduction Hospital Finance Hospital IT Hospital Management Operational Efficiency Supply Chain The Business of Surgery

Many hospitals still rely on manual processes or antiquated technologies for managing their expensive supplies and implants. The concept of predictive analytics and artificial intelligence (AI) in their supply chains may seem like a remote possibility, but this doesn’t necessarily have to be the case.

Advances in hospital supply chain technologies over the last decade have now made it possible for hospitals to realize the benefits of predictive analytics in inventory management. Real-time data gathering technologies, such as RFID-enabled smart cabinets, can help hospitals gather the data needed to harness the incredible power of AI and predictive analytics. As this article by Chris Luoma at Health Data Management explains:

“Properly managing inventory levels is a challenge. In fact, many hospitals still cling to the “more is better” mindset when it comes to supplies. More inventory on hand reduces the risk of running out, ensuring the highest possible care can be delivered to patients at all times. However, excess supply drives up costs and increases waste for those products that expire before use.

Just-in-time (JIT) delivery is one way hospitals combat overstock and waste. Although it requires quite a bit of manpower to execute, JIT delivery is a highly efficient system, well suited for the regular course of business. However, if there is a disruption, such as a natural disaster or flu outbreak, JIT is less efficient and costs can soar.

As more data becomes available through increased levels of automation, supply chain teams can use predictive analytics to better forecast demand. Synthesizing historical and real-time data from multiple systems will enable teams to gain insight into case mixes, anticipate the types of cases that are likely to come through the door, and the supplies required to support those cases.

Moreover, predictive analytics will enable more intelligent, data-informed decisions throughout the entire delivery process. With better planning, a distributor can understand what a provider needs to stock. Manufacturers can use that data to see what needs to be produced, including the raw materials. This will let the industry reduce excess capacity from delivery systems, and ultimately reduce risk.”

Read the entire article here: How predictive analytics will impact the supply chain in the 2020s

In order to better compete in the 2020s, hospitals will have to find ways to reduce waste throughout the system, including within the supply chain. Predictive analytics will bring the promise of increased efficiency and reduced waste to those hospitals and health systems that pursue its benefits. However, a key challenge will be ensuring a reliable, real-time view of all supplies and their usage trends so artificial intelligence can make the proper conclusions. A system like iRISupply marries hospital inventory management software with RFID cabinets to provide a just-in-time system for managing key supplies and implants. This AI-ready software will also arm you with the data you need to make the best re-ordering and stocking decisions possible. iRISupply will not only provide you with the usage data and reports you need, but will take it one step further and provide actionable recommendations about which products are overstocked, understocked or that can even be eliminated altogether. Mobile Aspects supply chain experts will also sit down with you quarterly as part of a best-in-class customer success program to discuss strategies to optimize your inventory mix and review the data behind those suggestions. By closely managing PAR levels and setting up interfaces for automatic re-ordering, the twin problems of stock-outs and bloated inventories can be successfully and sustainably eliminated.

How To Link Patient Outcomes To Medical Devices Using UDI

September 10, 2019Sri Mandava Big Data Clinical Documentation Hospital IT Hospital Management Operational Efficiency Regulatory Compliance Supply Chain The Business of Surgery

The United States Food & Drug Administration (FDA) is touting the benefits of tying unique device identifiers (UDIs) on medical devices to patient outcomes via electronic medical records. UDIs have been a long-term dream for many in healthcare, who view the ability to track and trace medical devices using unique item-level codes as a true game changer for patient safety and documentation quality.

By utilizing UDIs on a wide scale for the first time, the FDA is hoping to not only improve the ease of patient safety recalls but also to study the post-market effects of devices on patient outcomes. This article from Greg Slabodkin at Health Data Management elaborates:

“A medical device may ultimately get approved and—as it is used in a larger population—we understand its benefits but also potential concerns and may need to pull that device from the market,” Amy Abernethy, MD, FDA’s principal deputy commissioner and acting CIO, told last week’s Interoperability Forum, held by the Office of the National Coordinator for Health IT.

“One way to do that is to have the universal device identifier available in the electronic health record and now have the universal device identifier start to be linked to patient outcomes,” said Abernethy.

The Global Unique Device Identification Database, which is publicly available, contains key device identification information submitted to the FDA about medical devices. Currently, the GUDID database contains more than 2 million device records and enables patients and healthcare providers to download information about their devices.

However, the FDA is working with ONC, the Centers for Medicare and Medicaid Services and the National Library of Medicine on improving the accuracy of device-related adverse event reporting and expediting the resolution of device-related problems, according to Abernethy.

“I believe interoperability is key to all types of processes going forward—including the interoperability from the electronic health record—and that this is a place where FDA and ONC can continue to collaborate and work together,” she added.

In the next couple of months, the FDA will release a plan to modernize the agency’s technology infrastructure, including interfaces with stakeholders, Abernethy said.

She made the case that modernized, active surveillance that utilizes real-world data is the future of medical device safety signal detection and is one of the agency’s main priorities.”

Read the entire article here: FDA sees benefits of linking universal device IDs to EHRs

With data accuracy around implants and medical supplies a constant source of frustration for hospitals and the FDA, the roll-out of UDIs will bring a sea change to the healthcare system. To make sure you’re ready for the UDI roll-out, consider a system like iRISupply that targets the procedural areas of a hospital, where hospitals spend and make 50% of their dollars. The system is UDI-ready and gives all the anticipated benefits of UDI today by using RFID technology to track supplies down to the item-level. The software will arm your hospital with the data you need to make inventory optimization and patient safety decisions that will provide a large and sustainable ROI to your hospital. The system also links implants and supplies used in procedures automatically to your EMR via a direct two-way interface.

FDA Presses Industry To Use Duodenoscopes With Disposable Components

September 3, 2019Sri Mandava Hospital Management Infection Control Managing Endoscopes Patient Safety Regulatory Compliance

The United States Food and Drug Administration (FDA) has begun its effort to move the US healthcare industry to use duodenoscopes with disposable components, such as end caps. The effort is being made to reduce the incidences of superbug transmissions through inadequately reprocessed duodenoscopes that have been reported in recent years.

The FDA is urging healthcare facilities to end their use of duodenoscopes with rigid end caps from the major manufacturers Olympus, Pentax and Fujifilm. Their view is that using disposable end caps can remove one variable from reprocessing that has proven difficult to properly disinfect for some facilities. A recent article by Conor Hale at Fierce Biotech continues:

“..the FDA is urging duodenoscopes be designed with single-use caps that eliminate the need for reprocessing and allow improved access to the device’s interior for cleaning. The first duodenoscope with a disposable plastic end cap, Pentax’s ED34-i10T, was cleared in September 2017; Fujifilm has since received clearance for a similar model.

For the future, the agency recommends the industry move toward fully disposable duodenoscopes once they become available.

“We recognize that a full transition away from conventional duodenoscopes to innovative models will take time and immediate transition is not possible for all health care facilities due to cost and market availability,” Jeff Shuren, director of the FDA’s Center for Devices and Radiological Health, said in an agency statement.

“This is why we’re communicating with health care facilities now—so they can begin developing a transition plan to replace conventional duodenoscopes—and those facilities that are purchasing duodenoscopes with fixed endcaps can invest in the newer, innovative models,” Shuren said. “We are also encouraging the manufacturers of these duodenoscope models to assist health care facilities with their transition plans.”

Though the overall risk of transmitting infections through reused duodenoscopes is relatively low, continuing reports of contamination have caused the agency to act, he added. Earlier this year, the FDA reported new surveillance data tracking infection rates linked to reprocessed devices from Olympus, Fujifilm and Pentax.

In April, the agency disclosed that 5.4% of samples tested positive for what it describes as “high concern” organisms—such as Escherichia coli or the bacteria related to staph infections—up from 3% detailed in a safety communication in December 2018.

According to the FDA, flexible duodenoscopes are used in more than 500,000 endoscopic procedures a year, including in the diagnosis of the pancreas and bile ducts. Reprocessing procedures can take hundreds of steps to remove bodily tissues and fluids as well as microorganisms.

“Information from postmarket surveillance human factors studies indicate that many steps in the reprocessing instructions cannot be reliably followed by health care facilities,” the agency said, referring to real-world studies required of Olympus, Fujifilm and Pentax, adding that users frequently had difficulty understanding and completing the manufacturers’ instructions.

Going forward, the FDA is ordering new postmarket studies of devices with disposable end caps to ensure the feature makes reprocessing instructions easier to follow and lowers contamination rates. The agency requested that real-world contamination rates be included in product labeling once those studies are completed.

“We are collaborating with the FDA and are supportive of their recommendation of a gradual transition to duodenoscopes with disposable components,” an Olympus representative said in a statement to FierceMedTech. “Accordingly, we are diligently working on development of a disposable endcap duodenoscope and anticipate filing our submission to the FDA as soon as possible.”

The FDA is not making any changes to the approval status of currently cleared devices and said that it believes the continued availability of fixed end cap devices is in the best interest of the public health at this time.”

Read the entire article here: Too tough to clean: FDA urges industry transition to disposable duodenoscopes

While the transition from rigid end caps, to disposable end caps to potentially fully disposable duodenoscopes takes place, hospitals must make sure that their staff is following the proper protocols each and every time a duodenoscope is reprocessed. Systems such as iRIScope can display the proper workflow for reprocessing duodenoscopes and document the process automatically. Any breaches of protocol can be alerted in real-time to protect patients and identify which staff members need additional training on reprocessing techniques. You owe it to your staff and your patients to offer everyone the peace of mind that duodenoscopes and all other flexible endoscopes are being properly reprocessed every single time.

How To Create A Culture Of Safety Across A Growing Health System

September 3, 2019Sri Mandava Hospital IT Hospital Management Infection Control Joint Commission Managing Endoscopes Patient Safety Regulatory Compliance Tissue Management

Hospitals continue to fight the trends of declining reimbursements and increasing expenses with a multi-pronged attack. One of the favorite tools of larger health systems that are staving off shrinking margins is hospital consolidation. The idea goes that as more hospitals are brought into the health system, efficiencies can be gained by sending less profitable procedures to lower cost settings and consolidating the highest margin procedures at the flagship hospital(s). With all of the changes going on in health care, one fact will remain the same – hospital consolidation is here to stay.

One of the operational challenges of growing a health system is making sure that the same standard of care is reached regardless of the setting. This means that the best practices learned from the flagship hospitals need to be carried out at community hospitals and surgery centers that are built or brought into the fold. While simple in theory, this has been a nagging challenge to health systems in practice.

To create a culture of safety, health systems must not only spend the time and money to properly train staff, they must also invest in the right technologies. While staff can be trained in all the safest practices, how can you ensure that staff are following them when no one is watching? One possible solution is to use software for documentation and tracking.

For example, some of the top hospitals in the country use RFID-based tracking and documentation software from Mobile Aspects to ensure Joint Commission standards are consistently met in their tissue, endoscopy and blood operations. Using this software, health systems are able to define their best practices and enforce them using tracking software. Health systems define the workflows that they want their employees to follow, then Mobile Aspects encodes these workflows into the tracking software to ensure a consistent, repeatable process. When protocols are breached, employees are immediately alerted about skipped or incomplete steps for immediate correction. Managers are also sent reports that allow them to identify employees who make repeated errors so that they can be given additional education.

With all of the uncertainty that hospital consolidation brings to both the acquiring health system and the acquired hospital, make it a priority to introduce automation to ensure consistent practices are followed throughout the health system. This will bring you one step closer to a true culture of safety by making sure employees are following best practices every single time.

Mayo Clinic Physician Reiterates Need To Focus On Safe Endoscope Reprocessing

August 15, 2019Sri Mandava Hospital Management Infection Control Managing Endoscopes Patient Safety Regulatory Compliance

Hospitals continue to focus on duodenoscopes and their successful reprocessing in order to reduce the incidence of superbug breakouts related to endoscopes. The primary concern that hospitals have to address regarding duodenoscope reprocessing revolves around some of the manual components of disinfecting these devices.

Bret T. Petersen, MD of the Mayo Clinic in Rochester, Minnesota recently spoke with Healio regarding some of the current updates around duodenoscope reprocessing, and endoscope reprocessing in general. Dr. Petersen pointed out that while endoscope-related outbreaks have declined over the past year, they are still a persistent risk for hospitals and ambulatory centers performing endoscopic procedures. Dr. Petersen also discussed some of the key updates on reprocessing best practices:

“Since 2015, much of our field has been focused on the need to attend to adequate endoscope reprocessing to avoid further outbreaks like those we’ve seen in multiple major centers from duodenoscopes,” Petersen told Healio Gastroenterology and Liver Disease. “The advice at the present time hasn’t changed greatly, in that we’re still emphasizing the importance of attending to pre-cleaning, cleaning, high-level disinfection, adequate drying and appropriate storage.”

Petersen said the manual components remain weak points in the process, as well as adequate drying after high-level disinfection. However, although outbreaks still occur, overall incidence has been in decline.

FDA oversight remains the most active current issue, Petersen said, with a focus on post-market surveillance studies. Two duodenoscope companies have completed their studies and are awaiting a compilation of all their data, and data from the third company should be ready by the end of the year.

“All of them are, unfortunately showing persistent levels of contamination,” Petersen said. “This brings to play the importance of single-use devices, including colonoscopes and duodenoscopes, which are very close to the marketplace.”

Read the entire article and view the accompanying video here: VIDEO: Focus remains on safe endoscope reprocessing

With all the protocols that endoscope techs and sterile processing staff must follow to properly high level disinfect every scope, hospitals and ambulatory centers must put in the proper checks and balances to make sure scopes are reprocessed properly every single time. While supervisors can spot check and catch a certain percentage of these errors, it’s not feasible to keep a pair of eyes on staff 24×7. This is where a scope tracking system, such as iRIScope from Mobile Aspects, can come into play. The system’s built in artificial intelligence analyzes all reprocessing steps in real-time to assess whether critical steps are missed. The system can then send immediate alerts to supervisors, and even display alerts on storage cabinets to warn end-users not to use any potentially poorly reprocessed endoscopes. While staff can be trained ad infinitum, all employees are prone to occasional mistakes. Help mitigate this risk with a smart tracking system like iRIScope and you could potentially save patients’ lives.

How To Increase Endoscope Reprocessing Protocol Adherence With Technology

August 8, 2019Sri Mandava Hospital Management Infection Control Joint Commission Managing Endoscopes Patient Safety Regulatory Compliance

Flexible endoscopes have been the source of many superbug breakouts over the past decade. In order to protect your facility from the patient safety and legal nightmares that superbug breakouts lead to, you need to make sure that your staff is following your standard operating procedures for reprocessing endoscopes every single time.

Even the best trained staff members can make mistakes when they come under high-pressure situations. So how can you make sure that you catch any of these mistakes when they occur and what can you do to prevent them from happening in the first place? As this article from Cynthia Saver at OR Manager discusses:

“Policies and procedures. Policies and procedures should be specific, sufficient, and congruent with current guidelines, [Scott Lucas of ECRI Institute] says. If they aren’t, they should be revised. Lucas adds that it’s best to have separate policies for instruments and endoscopes because each category has unique needs. He advises reviewing and updating policies on a regular basis and whenever any new equipment is added.

Compliance. Sometimes the best policies and procedures aren’t followed because of pressures such as time constraints. To assess for compliance, the team can review reprocessing logs for completeness, check biological indicator and test procedures and results, and conduct audits.

“It’s good to use peers to conduct some of the audits,” Lucas says. For example, staff can check a percentage of trays for proper processing. Supervisors can conduct random audits at various points in the processing cycle. Some instrument tracking systems may make it possible to link trays to the specific patients on whom they were used.

Staffing. Lucas says the team should ask, “Where are the bottlenecks?” because staff may cut corners in these situations. Bottlenecks may occur during a specific shift or in a specific point in the reprocessing cycle, such as the manual cleaning station.

It’s also important to assess staffing levels, what percentage of staff are from agencies, whether staff have had sufficient training, and how long it takes for staff to clean an instrument. (If cleaning takes a long time, it may be necessary to change the technique so that the instrument is still clean, but the time is reduced.) Lucas recommends that organizations commit to having an SPD supervisor on each shift to support staff and manage problems that arise.”

Read the entire article here: ‘Coming clean’ in the SPD requires collaboration and competency–Part 2

With all the protocols that endoscope techs and sterile processing staff must follow to properly high level disinfect every scope, certain steps may be skipped from time to time. While supervisors can spot check and catch a certain percentage of these errors, it’s not feasible to keep a pair of eyes on staff 24×7. This is where a scope tracking system, such as iRIScope from Mobile Aspects, can come into play. The system’s built in artificial intelligence analyzes all reprocessing steps in real-time to assess whether critical steps are missed. The system can then send immediate alerts to supervisors, and even display alerts on storage cabinets to warn end-users not to use any potentially poorly reprocessed endoscopes. While staff can be trained ad infinitum, all employees are prone to occasional mistakes. Help mitigate this risk with a smart tracking system like iRIScope and you could potentially save patients’ lives.

How To Create Accountability With RFID Technology

August 1, 2019Sri Mandava Hospital Finance Hospital Management Operational Efficiency Supply Chain The Business of Surgery

The procedural areas of hospitals, including the Cath and EP Labs, Interventional Radiology and the Operating Rooms, typically go through tens of millions of dollars per year in expensive implants and supplies. With so many different individuals – from reps, to techs, to nurses, to physicians – touching those expensive supplies, what can hospitals do to make sure that individuals are being held accountable for making good decisions with these expensive assets?

Whether with good or bad intentions, staff will inevitably make poor decisions from time-to-time with your expensive supplies and implants that could be costing your hospital hundreds of thousands or millions of dollars per year. These poor decisions can result in such outcomes as unnecessarily expired inventory, poorly documented or undocumented item use, supply loss or shrinkage, frequent stock-outs and bloated inventories.

Just like any other industry, hospitals must hold their employees accountable for financial decisions that affect their bottom line. The case may even be even more acute in healthcare, where razor-thin margins can be impacted by a small improvement or drop in supply management practices.

In order to introduce employee accountability into supply management decisions, many hospitals have turned to RFID technology. Using RFID tags to track items and a series of sensors to read them at various locations throughout a campus can give hospitals visibility into their expensive supplies that can’t be had through manual or semi-manual (e.g. bar-code, push-button) processes.

The foremost way that RFID technology can increase accountability is by keeping a perpetually accurate count of items on hand. With RFID cabinet systems, such as iRISupply from Mobile Aspects, eyeballing inventory to find expiring items or to calculate re-order levels become a thing of the past. The RFID technology replaces all antiquated inventory management systems with a real-time inventory count that can be as accurate as 99% ˗ which is 15% higher than typical experiences with manually intensive systems such as bar-codes, push-buttons or eyeballing. With this technology in place, on-hand inventory counts become much more accurate and product expirations can be reduced or even eliminated.

RFID cabinet systems like iRISupply also keep your expensive supplies and implants behind closed doors. This simple idea can have an outsized effect on your bottom-line. Because employees and reps now know that all of their inventory transactions are being recorded by the RFID cabinets automatically, they tend to act more responsibly with their decisions. For example, if items aren’t use in a procedure, employees will be more likely to return it to the cabinets than to dispose of it because they know the unused item can be traced back to them. Small psychological “nudges” like these can save your hospital untold amounts of wasted spend. Push-button or bar-code based systems open up your hospital to undocumented shrinkage that RFID technology can eliminate.

Another way RFID technology such as iRISupply can help increase accountability is by keeping accurate data about inventory usage. Built-in data analytics arm you with the data you need to make the best re-ordering and stocking decisions possible. iRISupply will not only provide you with the usage data and reports you need, but will take it one step further and provide actionable recommendations about which products are overstocked, understocked or that can even be eliminated altogether. Mobile Aspects supply chain experts will also sit down with you quarterly as part of a best-in-class customer success program to discuss strategies to optimize your inventory mix and review the data behind those suggestions. By closely managing PAR levels and setting up interfaces for automatic re-ordering, supply management practices can be greatly improved.

How RFID Can Streamline Your Hospital’s Supply Chain

July 25, 2019Sri Mandava Cost Reduction Hospital Finance Hospital Management Operational Efficiency Supply Chain The Business of Surgery

With hospitals turning over every cushion to find new ways to reduce costs without sacrificing quality of care, RFID technology is coming up more often as a worthwhile technology to consider in order to save millions of dollars per year. One of the most effective use cases for RFID technology in healthcare is to track expensive supplies and implants used in the PeriOperative environments of hospitals.

With so much waste in the healthcare supply chain, RFID technology can help by bringing an Internet of Things (IOT) approach to expensive assets in hospitals. Every PeriOperative area of a hospital has numerous supplies and implants that cost anywhere between $500 to $50,000, and can add up to hundreds of thousands or millions of dollars in on-hand inventory. Some of these products are moving at rapid velocities, while others are sitting on the shelf until they expire and are replenished. With so much happening in these busy surgical areas, it’s understandable that employees are unaware of the money being wasted on supplies. After all, they’re too busy keeping an eye on patients, where they should be – not on their supplies. That’s why RFID technology can add so much value to these busy areas, since they can keep an “eye” on these expensive supplies 24×7.

Having a second pair of eyes on your expensive inventory can yield numerous benefits to your hospital’s supply chain. This article by Meeta Ramnani at Enterprise Talk discusses three primary benefits of RFID/IoT technology in a hospital setting:

“Developing a holistic view of the supply chain

Hospitals can leverage IoT to enable data analytics with their cloud-based, system-wide inventory management. This can help connect products and processes with their actual cost. Experts opine that now healthcare supply chain is not just about manufacturing, transporting and distributing products; to properly evaluate the value chain it has to be viewed holistically and encompass the direct as well as the indirect costs. This type of system-wide valuation demands a lot of data that can be collected, visualized, aggregated, and acted upon.

Improve the efficiency of clinical staff

According to the Cardinal Health Supply Chain Survey that included responses of 600,000 medical professionals in the US, 42% of professionals believe that supply chain work takes time away from patient care. Almost 45% of frontline providers also said that the manual supply chain tasks even has a “somewhat” or “very” negative impact on patient care. IoT’s connectivity and data-sharing capabilities can be used to free the frontline staff from such inventory-related burdens. Experts advise using the advanced product-tracking technologies as well as the automated systems to help alleviate the stress of supply chain tasks and get the clinicians back to their patients.

IoT to improve accuracy, speed, as well as spend

Experts consider the healthcare supply chain as a strategic asset that has the potential to yield significant financial savings. They believe that IoT is key to propelling that change. Doctors, nurses, and surgeons have a considerable stake in improving the supply chain operations. An overwhelming 94% of the medical professionals that were surveyed identify the correlation between supply chain management and financial success.

These clinicians look at the benefits of improving the hospital supply chain, which includes appropriately balancing inventory levels to match usage patterns, freeing up capital, reducing and adequately managing product expirations, and reducing patient risk to improve the accuracy and speed of supply chain management.

Data generated from IoT connectivity provides visibility across the organization enabling proper management of consignment, product and workflow standardization, and accurate clinical documentation across entire enterprises.”

Read the full article at: 3 Ways to Leverage IoT in the Healthcare Supply Chain

One company that leverages IoT technology to bring a more transparent supply chain to hospitals is Mobile Aspects. Their iRISupply solution collects real-time data around supply and implant usage with RFID technology and provides actionable insights to help with vendor negotiations, on-hand inventory levels and owned-consigned item mix. Powerful data analytics included with the software give specific recommendations on which items to reduce or eliminate, and which items should be owned vs. consigned, leading to millions of dollars in cost-savings opportunities. The system is also completely interoperable with Epic, Cerner and other EMR vendors, helping to drive powerful insights by looking across your clinical systems. These cost-savings opportunities can help hospitals increase their margins and could contribute tens of millions of dollars to their bottom line.

Oregon Health & Science University Implements Endoscope Tracking Software As An Investment In Patient Safety

July 18, 2019Sri Mandava Clinical Documentation Hospital Management Infection Control Joint Commission Managing Endoscopes Operational Efficiency Patient Safety Regulatory Compliance

Oregon Health & Science University (OHSU) implemented the iRIScope endoscope tracking system from Mobile Aspects to help automate the documentation of reprocessing and storage practices for endoscopes in its new Center for Health & Healing Building 2(CHH2).

As the only academic health center in the state, OHSU is where personalized patient care is combined with the latest treatments and therapies to deliver a quality of healthcare not available anywhere else in Oregon. Nationally, OHSU is the only health system in Oregon to be recognized in US News and World Report’s Best Hospitals list. The academic medical center is on the verge of opening its new, state-of-the-art CHH2 building. The new 15 story facility hosts an ambulatory hospital and research building.

Mobile Aspects was approached by OHSU to help address specific workflow and traceability challenges that the new CHH2 building would bring to the Endoscopy department.

Stepping Up to the Challenge

OHSU identified a need to ensure all infection control protocols for flexible endoscopes are adhered to closely in their new CHH2 Building. This new health care facility offers complex surgery and interventional procedures as well as clinical space for the Knight Cancer Institute and clinical space for the Digestive Health Center and Perioperative Medicine Clinic. Adding to the infection control challenge is the fact that space constraints forced OHSU to centralize scope reprocessing in the Sterile Processing department one floor above the new GI procedural unit. Many regulations surround the handling and cleaning protocols for flexible endoscopes, which become very difficult to manage when you add in to the mix moving them from floor to floor and from one group of technicians to another. OHSU needed a way to ensure each necessary step of the endoscope lifecycle was followed, tracked, reported on and (if necessary) alerted should a breach in protocol occur.

“Our new CHH2 building presented us with challenges that required us to evaluate several potential solutions from the ground up. With the loss of the direct visualization of the endoscope cleaning process, we quickly identified a need to use technology to help us manage and track our scopes effectively,” said Lisa Newman, Nurse Manager of the Endoscopy Unit at the Portland-based hospital.

The sheer size of the new space, and the reality that scopes would be reprocessed on a different floor than the procedure rooms, made solving infection control issues for endoscopes a challenge. OHSU has partnered with Mobile Aspects to adapt its iRIScope endoscope management system to the CHH2 environment. The goal of working with Mobile Aspects and iRIScope is to minimize any potential breaches in endoscope reprocessing protocol and to enable immediate notifications should a breach occur.

A Collaborative Approach To Ensuring Automation Success

OHSU’s Endoscopy staff worked closely with Mobile Aspects staff to identify key steps of the scope management workflows that they wanted to be tracked. With scope utilization and reprocessing in CHH2 spread across multiple floors, one of the key infection control protocols most at risk was the time requirement for used scopes to return to the Sterile Processing Department for reprocessing. Mobile Aspects was able to tailor the workflows in iRIScope to match OHSU’s standard operating procedures. With this intelligence embedded in the software, iRIScope can help ensure OHSU’s adherence to its infection control protocols around time requirements for the reprocessing cycle to begin after each procedure.

Another new requirement introduced by the CHH2 building was the need to ensure endoscopes are transported in an efficient manner between the two floors where endoscopes are used and reprocessed. The timely reprocessing of endoscopes in this multiple floor layout requires scopes to be quickly loaded and unloaded onto elevators as they’re being transported between floors. iRIScope was programmed to record scopes that are being loaded on an elevator so that technicians can be made aware of scopes arriving on their floor in real-time to minimize delays in the reprocessing cycle.

Several other steps of the reprocessing cycle, such as manual cleaning, leak tests and Automated Endoscope Reprocessor transactions, are also being tracked in iRIScope. With this tracking in place, artificial intelligence within the software can detect if any steps of a reprocessing cycle are skipped in real-time.

“The Mobile Aspects implementation team were able to build, test and implement all the specific changes we asked for in a timely manner. They were onsite for go-live and continued to make improvements to the system post go-live,” added Lisa Newman. “They have worked closely with our team to identify the places where we anticipate challenges in following our protocols and have put checks in the software to make sure we’re made aware of any breaches in real-time.”

Real-Time Alerts and Notifications

With artificial intelligence within iRIScope constantly monitoring endoscopes and their path along their usage lifecycle, several real-time alerts and notifications have been enabled to alert staff and eliminate any breaches of infection control protocols. For example, if the time limit to get from the bedside to Sterile Processing exceeds the internal limit for any scopes, staff are immediately notified so that they can remediate the situation per hospital protocols.

Endoscopes are also constantly being monitored by the software to ensure that they undergo all key steps of reprocessing before being returned to iRIScope’s clean storage cabinets. If any endoscope is returned to clean storage without successfully completing all key steps of the reprocessing cycle, real-time email alerts are sent to notify administrators of the scopes and their location so they can be reprocessed again as required by their infection control protocols.

iRIScope has also been integrated with one of the hospital’s internal communication systems to allow for immediate action by certain team members. For the notifications to technicians that endoscopes are ready for pick-up in the elevators, iRIScope sends alerts through the hospital’s Vocera pagers so that staff can react efficiently and continue the reprocessing cycle.

Ready To Launch

With iRIScope in place, OHSU has a system that will change as endoscope reprocessing protocols change. Any updates to infection control procedures can be mirrored within iRIScope to ensure that they are always tracking and adhering to their standard operating procedures. Additionally, the wealth of data that iRIScope collects will allow OHSU’s GI department to optimize its business operations. They will have data showing them which scope models are most and least used so they can re-balance their scope inventory as needed. They will also know which endoscopes are most often sent for repair so that they can put in procedures to reduce costly damages. Perhaps most importantly, they can track how efficiently each step of the reprocessing cycle is being completed so they can work to reduce bottlenecks and identify specific individuals who may need more training.

OHSU is pleased with the implementation of a technology which provides useful data on an essential function of their new Endoscopy Unit – flexible endoscope cleaning. “I think it is important that we don’t just track scope location, but also how we are doing with the cleaning process. By having real-time alerts to a breach in standard protocols we can remove that scope from service before it touches a patient,” said Lisa Newman. “With all of the complexity that is inherent to the endoscope reprocessing cycle, using a sophisticated tool like IRIScope will help us keep up with the ever-changing procedures and protocols and to ensure our scopes are being reprocessed properly every single time so that we can keep our patients safe. The bottom line is that it’s an investment in patient safety.”

Leading Heart Hospital Expands Use Of Supply Automation System From Mobile Aspects To Increase Efficiencies

July 11, 2019Sri Mandava Cost Reduction Hospital Finance Hospital Management Operating Rooms Operational Efficiency Supply Chain The Business of Surgery

A leading heart hospital in Texas has expanded its use of a leading supply automation technology to reduce costs and increase efficiencies in its Operating Rooms (ORs). The hospital has been regarded as one of the top cardiology focused hospitals in the state of Texas since it opened over a decade ago. The hospital has been using iRISupply RFID cabinets and inventory management software from Mobile Aspects in its Cardiac Catheterization (Cath) Labs and Electrophysiology (EP) Labs successfully for over 10 years. The system has been providing automation of the supplies and implants that the Cath and EP labs have been using by interfacing with the electronic medical record and materials management systems at the hospital. By reducing the amount of manual inventory work, including eyeballing of inventory and creating order reports, the hospital has been able to save dozens of hours per week on managing inventory, and instead has spent that time on patient care.

Expanding into the ORs

After experiencing nearly a decade of success in the Cath Labs and EP Labs, the hospital turned their attention to supply and implant management issues which had been becoming more of a distraction in their ORs. The ORs had been experiencing periodic stock-outs of key implants and supplies, especially those with high velocity, that were affecting their efficiency. They were also spending a lot of employee labor managing and reconciling inventory levels to keep their implants and supplies at adequate levels.

All of this was happening even with another inventory management system from Omnicell in place. With the push button-based cabinets running in the ORs and iRISupply RFID cabinets running in the Cath and EP Labs, the hospital was able to see the benefits of each system side-by-side. iRISupply was recognized as the system that could bring more efficient supply and implant management to the ORs.

The hospital’s CEO noted that they have achieved a sustainable $300,000 reduction in inventory levels using the data from iRISupply in the Cath and EP Labs, and they hope to have similar success in the ORs. The hospital’s Service Line Director is also looking forward to spending more of his time on developing the hospital’s business. The increase in automation that iRISupply is bringing to the ORs will allow him to re-direct the disproportionate amount of time he currently spends assisting with supply and implant management issues.

As the Service Line Director mentioned after the recent installation, “If you have service lines that stock out of key supplies and you are manually controlling inventory with high cost overruns, this is a great system to help you solve your challenges.”

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