Blog - Mobile Aspects

5 Steps To a Lean Hospital

February 10, 2011Nick Klein Big Data Clinical Documentation Cost Reduction Hospital Finance Hospital IT Hospital Management Operational Efficiency The Business of Surgery

The main guiding principle to Lean Healthcare enabled through technology is to create the right value for our patients, colleagues, physicians and organization as a whole with minimum effort. Simply put, work smarter, not harder and with a value driven sense of purpose. Everyone should be aware of how their part ties into the organization as a whole.

Below are the 5 steps in lean methodology which can be applied to many of your hospitals challenges:

Identify Value – Take a hard look at your organization and assign priorities. What do you value most? (Patient Safety and Quality should always top this list) What departments, Supplies, Medical Devices or workflows have the largest impact on hospital costs, revenues, patient safety and quality.

Value Stream Mapping – The value stream map illustrates the process required to produce the service. Each process step should be categorized as either value-added, non-value-added but necessary, or non-value added waste.

Create Flow – The services offered should be designed to be robustly interwoven and handed off from one step to another. The goal here is for process to be predictable and enabling; minimal waits and queuing; no rework.

Establish Pull – Ideally supplies will only be reordered if current inventory is used (or lost due to waste), as opposed to a “push” strategy where orders are pushed out based on a time frame and volume which has been projected (estimated).

Achieve Perfection – Perfection would be nice. Realistically the goal is to be gathering enough data and have processes in place to achieve an atmosphere of continuous improvement

Lean Resource Management Tip #1: How To Get 4X More Value Out of Your Value Analysis Team

January 26, 2011Nick Klein Big Data Clinical Documentation Cost Reduction Hospital Finance Hospital IT Hospital Management Operational Efficiency The Business of Surgery

A Value over Volume Approach

Most Healthcare organizations non-salary expense initiatives are focused on lowering the price of the products, services and technologies that they are purchasing.

However a word of caution, you are working harder and receiving much less than some of your peers are.

It seems our industry has always been so focused on price that we have forgotten about VALUE. Continuously fighting, reaching and stretching to shave dollars and cents off of “blanket” supply purchases while ignoring the low hanging fruit which is ripe with sweet returns. The challenge lies in helping your hospitals value analysis or “lean” team find those fruits which will deliver a significant boost to your organizations revenue cycle.

The 80/20 Rule

With so many different services, supplies and medical equipment present under one healthcare providers roof and limited human resources available to drive lean results, it is critical that we focus our efforts on the the correct areas. Thus using the Pareto Principle (80-20 rule) as a guide will quickly lead you to see that the majority of your costs can be found in only a few areas spread over several different types of supplies. Closer inspection will reveal that the vast majority of a hospital’s supply spend is in the following three areas: Operating Rooms, Cardiology and Radiology. Not surprisingly the highest dollar value items such as: drug eluding stents, balloons, pacemakers and catheters can be found in these service lines.

Ultimately these high dollar value items make up only 20% of your total inventory volume, but represent 80% of your costs. So focus on extracting every last bit of value from those crucial 20% and you will see your Value Analysis team will be able to produce returns up to 4X what could be done with the same amount of effort on the larger volume of supplies.

Some more food for thought

While the 80-20 rule makes it is easy to see why focusing our resource management initiatives on the most expensive supplies first is a logical starting point, it alone doesn’t do justice to the impact these medical devices provide.

When looking for value Consider the following:

Chargeability: The cost of losing one $1000 stent is not the same as losing one thousand $1 gauze bandages. The cost associated with (loss/expiration/missed charge) the stent does not take into account the lost opportunity for revenue generated through reimbursement. So in reality, value = the cost of the item + the opportunity cost of losing that item.

On Shelf Expiration: Many of these items have expiration dates which end up arriving before the device can be used.
On Shelf Investment Capital: Lastly it is worth noting that inefficiencies created through bulk ordering of these higher priced items can be damaging as well. On hand inventory costs quickly skyrocket leading to hundreds of thousands of dollars in wasted capital which could be further invested into the Hospital.

How RFID Will Prevent The Next Endoscope Infection Crisis

January 20, 2011Nick Klein Infection Control Managing Endoscopes Patient Safety

“10 veterans test positive for hepatitis after colonoscopies” – USA Today

A headline such as the one above appearing in a 2009 USA Today article is a major loss for everyone involved. Unfortunately the trend of recent endoscope infection scares is on the rise after hospitals in Escondido, California and Hennepin County, MN had to publicly notify thousands of patients that they may have been exposed to a virus such as hepatitis or HIV.

What started as a failure to follow proper HLD reprocessing guidelines quickly turned into an operational and public relations nightmare for the hospitals. Because of manual documentation, tracking and reprocessing workflows which produce scattered and innacurate data needed to identify the exact patients exposed to the endoscope, the organizations were required to provide blood tests for each patient who may have been at risk.

Whats so difficult about cleaning a flexible endoscope?

To begin with there are many steps in the process as can be seen in the flexible endoscope cleaning and disinfection guide assembled by the SGNA , leading to a greater risk for one to be missed or intentionally skipped.
Second, there is very little accountability created by current endoscope storage and High Level Disinfection (HLD) processes within GI labs. Scopes can be found hanging in unlocked cabinets while clinicians manually document the steps they have completed.
Lastly there are no checks and balances built into the workflow to insure that scopes which have not been properly cleaned cant be used in a procedure.

The Solution: Red Alerts and a movement to “Complete Endoscope Use Cycle Management”

While providing barcode based tracking systems or locking down the endoscope storage room can help improve your current process, the goal now is to use one system to track every scope from the time its removed from the cabinet through the case, into each stage of reprocessing and finally back into the cabinet itself. The ability to gather all of this data in one place allows Mobile Aspects iRIScope solution to keep each scope under surveillance and know whether a potentially infected endoscope was returned as cleaned.

The secured storage unit will then light up red as seen in this featured video while simultaneously pushing out an alert to the GI Lab supervisor. This mitigates the risk of having an improperly disinfected scope be returned to a cabinet (where it can compromise other scopes) and then used in another procedure. Because we can effectively trace the use of that scope back to the exact patient it was used on, as well as the staff member responsible for it there is no longer the need to scare thousands of people who had recently been tested.

Have you reviewed your endoscope disinfecting processes recently?

The Paradigm Shift in Perioperative Nursing

January 12, 2011Nick Klein Managing Endoscopes Operating Rooms

Consider the jobs of a heart surgeon and a perioperative nurse who can be found standing side by side…

Both share a common goal: Saving Lives

Both work in a very hectic environment: The Operating Room

Both handle some of the most expensive and most technologically advanced medical devices available …

The Healthcare Resource Management Paradigm Shift: From Data Gatherer to Data Analyzer

It is in these medical devices that one can find the irony of healthcare. That is we have advanced technology to a point where we can diagnose a patient using microscopic cameras and unblock an artery with a drug coated stent, but yet we store and track these items in largely neanderthal ways. Pen and paper documentation, manual inventory counts and unsecured storage are the unfortunate realities a perioperative nurse has to deal with. As a result time, money and a whole lot of effort is wasted ultimately putting healthcare providers in a financial bind.

Recently however this has begun to change as supply automation systems using barcode and RFID technologies are becoming more prevalent within hospitals. This trend toward using technology to not only improve the ability of the surgeon to operate, but also support the nurses and hospital itself in the care delivery process signals a major shift in the job responsibilities of perioperative clinicians.

Using the term “Data gatherer to data analyzer” or “Paradigm Shift” is nothing more than a fancy way of saying there job responsibilities will change for the better. Here’s a look at how some notoriously troublesome processes for staff within surgical units across the country and how they are being shaped by technology.

Documenting procedures using pen, paper and charge stickers: While some organizations have made minor improvements using Manual Technologies (Barcode based solutions), it is clear that RFID is the most effective way to capture this information at the point of use.

Physically counting on hand inventory: Will be a thing of the past as an accurate, real time view will be available from your desktop. (Ex. pictured above)

Frantically searching shelves for the exact size device a doctor requests will now be as simple as keying in a search of the product description and instantly being able to see the exact location and quantity on hand

Ultimately these automation technologies signal a shift in focus from simply making sure the correct supplies are available when the doctor needs them to a focus on increasing the quality and efficiency of the care we deliver.

Memorial Springfield Selects Mobile Aspects for Tissue Tracking And JCAHO Compliance Solutions

December 8, 2010Nick Klein Operating Rooms Regulatory Compliance The Business of Surgery Tissue Management

PITTSBURGH, PA – December 8, 2010 – Mobile Aspects announced today that the Memorial Medical Center located in Springfield IL, has selected Mobile Aspects iRISecure Tissue Tracking solution. The system provides secure storage for implantable human tissue utilized in surgical procedures the technology also automates the activity logging and JCAHO compliance workflows required of clinicians.

“This computerized system is much more efficient and effective compared to the manual process that was previously in place resulting in improved patient safety. The technology will make all aspects of tissue storage and tracking less time consuming to staff and will assist the department in meeting all regulatory agency requirements. We are all very excited at Memorial as we continue our mission to improve the health of the people and communities we serve.”
– Memorial Medical Center
The key to the system is its ability to track tissue from the time of acquisition through its implant. Providing item level detail such as expiration date, product, lot and serial number as well as linking this information to the clinician, procedure and patient involved with the tissue. By accurately collecting and storing this entire set of data digitally healthcare providers can leverage Mobile Aspects web based reporting system iRISweb to review usage details of every tissue in the event of a recall or compliance inspection. On top of the benefits to safety and compliance, the end result is a major reduction in time required for clinicians to be manually recording each step.

About Mobile Aspects
Mobile Aspects, Inc. of Pittsburgh, Pa., is a healthcare supply and data management company focused on delivering clinical process improvement using RFID and other advanced automation technologies to streamline clinician workflows for interventional and surgical specialty care providers. By eliminating manual processes through clinician-friendly, simple workflow solutions that acquire rich data sets and implement process controls, Mobile Aspects solutions increase safety, improve clinical outcomes and enhance efficiency and transparency in clinical processes that support interventional care delivery. Mobile Aspects has been certified under the ISO 9001:2008 Quality Standard, a Quality Management System standard developed by the International Organization for Standardization (ISO). Mobile Aspects can be found on the web at https://www.mobileaspects.com.

Massachusetts General Hospital Achieves Results with Mobile Aspects Integrated RFID Supply Cabinets

November 3, 2010Nick Klein Clinical Documentation Hospital Finance Hospital Management Operational Efficiency Radiology Revenue Cycle The Business of Surgery

Mobile Aspects RFID TechnologyIncreases Charge Capture by 25% and Reduces Inventory Stock-Outs At Massachusetts General Hospital

PITTSBURGH, PA – November 3, 2010 – Mobile Aspects announced today that Massachusetts General Hospital (MGH) has fully implemented its radio frequency identification (RFID) enabled supply automation system to store, track, and manage medical devices and supplies used for neuro interventional procedures in the IR division within the Department of Radiology. The system known as iRISupply™, uses passive RFID technology and real-time data management to automate clinician workflows and streamline communication processes for product storage, tracking, and supply chain management.

The department implemented the supply automation technology in 2009 to manage the storage and utilization of high cost implantable devices such as coils, stents and catheters. Through a six month post-implementation analysis, the organization realized an increase in charge capture accuracy of nearly 25% by tracking the use of the high cost items through the Mobile Aspects technology. In addition, clinical supply chain processes were optimized to decrease the occurrence of special requisitions by 50% through the avoidance of stock-outs and rush orders. The total benefits realized by the organization approaches nearly $1 million annually.

“We are pleased to be able to partner with an organization as prestigious as MGH to provide a solution that creates a highly automated and accurate approach in managing their interventional devices and supplies,” shared Suneil Mandava, President and CEO of Mobile Aspects. “More importantly, we are excited to have them realize measurable operational improvements in their charge capture accuracy and clinical supply chain efficiency to justify their investment in our technology.”

About Mobile Aspects

Mobile Aspects, Inc. of Pittsburgh, Pa., is a healthcare technology supplier focused on delivering clinical process improvement systems using RFID and other advanced automation technologies for interventional and surgical specialty care providers. By eliminating manual processes through clinician-friendly, simple workflow solutions that acquire rich data sets and implement process controls, Mobile Aspects solutions increase safety, improve clinical outcomes and enhance efficiency and transparency in clinical processes that support interventional care delivery. Mobile Aspects has been certified under the ISO 9001:2008 Quality Standard, a Quality Management System standard developed by the International Organization for Standardization (ISO). Mobile Aspects can be found on the web at www.mobileaspects.com.

Are buttons pushing your buttons?

October 26, 2010Nick Klein Cath Lab Hospital IT Operating Rooms Radiology Supply Chain The Business of Surgery

Anyone who has worked within a hospital, specifically in perioperative services knows that healthcare providers have a habit for using “sticky” things to capture data. Whether its removing a sticker off a product and placing it on a “charge sheet”, putting the sticker on our own lab coat to record later or even using post it notes to remind employees to follow procedures… “sticky” things work best. Seems kind of Neanderthal in our technology driven world doesn’t it? But this is simply human beings at there finest, solving problems and attempting to make their lives easier, after all how else are they supposed to capture the information that drive hospital revenues, budgets and decision making? (more…)

Dealing with rising medical device recalls

August 31, 2010Nick Klein Patient Safety Regulatory Compliance The Business of Surgery

Recently another class 1 medical device recall has surfaced involving cardiovascular products from St. Jude Medical. As class 1 recalls are reserved for cases with a “reasonable probability that use of the product will cause serious adverse health consequences or death“ it is certainly a priority for healthcare providers to be able to locate and remove these items from their shelves immediately. Even more important is quickly identifying any patients that may have received the device and taking the appropriate next steps to mitigate safety concerns.

While this type of recall notification is concerning, unfortunately it is not surprising. The trend of increasing device recalls seems to be skyrocketing upwards in the past few years. According to the ECRI Institute, in 2009 alone the FDA recalled over 2,000 devices with potential safety defects and the number of yearly recalls has grown by nearly 400% since 2001.

While the rising number of recalls is a concern, an equally pressing issue is many hospitals’ inability to efficiently find and remove the defective units from their shelves before being used. Secondly, devices are often implanted in patients before a recall occurs or the provider is made aware of the recall thus making it the hospital’s responsibility to notify the patient that a faulty product was used.

Studies have shown that manual documentation and procedure logging practices pose severe risks to quality and safety of care in the event of a recall. With as many as 10% of recalled products overlooked and left on shelves, many hospitals are turning to information technology to more accurately track these devices. A great white paper further details the safety issues and excessive labor costs created as a result of manual practices for the locating and removing of recalled medical devices.

Specifically, RFID based storage and tracking systems such as Mobile Aspects iRISupply are well suited to overcome these challenges. By capturing item level information with each product including the exact location of the product as well as automatically associating the device to the patient who received it, device recalls no longer need to be inaccurate and time consuming processes.

The continued adoption of HIT systems is more apparent than ever as care providers struggle to keep pace with the rising number of recalls and procedures involving new implantable technologies.

Mobile Aspects customers save $2M annually by eliminating expiration costs

August 21, 2010Nick Klein Cath Lab Cost Reduction Hospital Finance Operating Rooms Operational Efficiency Radiology The Business of Surgery

It’s estimated that clients using Mobile Aspects supply management technologies are reducing waste in healthcare delivery by eliminating nearly $2 million annually in inventory expiration costs. In an environment where ongoing cost pressures are forcing care providers to maximize efficiency, these cost reductions are creating significant value.

In the brief video aside, a Mobile Aspects engineer highlights how Mobile Aspects iRISupply technology helps care providers reduce inventory expiration costs.

Three primary features discussed in the video include:

The use of RFID technology to enable item-level tracking of inventory – including expiration date
Secured storage and tracking of expiration dates for items kept within on-hand inventory
Automated notifications and reports to identify inventory items scheduled to expire

A detailed case study of how one hospital was able to reduce its product expiration costs by $250,000 annually is available here.

Leveraging Supply Chain Leadership to Build Organizational Advantages 3) Value Analysis

August 18, 2010Nick Klein Hospital Finance Supply Chain The Business of Surgery

As we continue our overview of AHRMM’s roundtable discussion it is becoming more evident that members of the supply chain have the unique ability to make significant contributions to organizational cost reduction goals. One way of doing this is through an emphasis on value analysis. Value analysis and standardization committees are being increasingly used to address supply cost containment.

Key to these committees is multidisciplinary representation including CFO’s, medical staff, risk managers along with supply chain professionals. However having the right people is only the first step, it is just as essential to equip these groups with timely and accurate data around supply utilization.

When equipped with the right data, members of these groups are positioned to drive immediate results by:

1. Optimizing on hand inventory and PAR levels
2. Standardizing and managing physician preference items
3. Increase procedure profitability by projecting costs compared to reimbursements

Mobile Aspects supply management technology couples accurate, real-time data with intuitive reporting and analysis tools. With this information, supply chain professionals receive a transparent view of supply utilization patterns. As an example, the aging report pictured above provides a view of how efficiently inventory is being used. Access to this data allows decision makers the ability to slice the data down to item location and usage by case levels. New York Presbyterian Hospital is just one example of how data provided by Mobile Aspects iRISupply system can be used to achieve cost reductions. Within Cardiothoracic Surgery the organization was able to reduce on hand inventory levels, saving $230,000 by adjusting par levels and optimizing purchase patterns.

As economic pressures to make healthcare more sustainable continue to mount care providers are beginning to implement supply chain strategies targeted at creating value. Mobile Aspects has made it a priority to provide healthcare organizations the data and tools necessary to manage their costs and align in their goals to create value through heightened supply chain management.

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