Automated case management for the cath lab

A resourceful solution by

Resourceful knowledge Logi-D was originally created as a hospital supply chain consulting group with a research affiliation with the HEC Montréal business school. Our consulting and research experience has provided us with an in-depth understanding of dominant healthcare supply chain issues. Building on this experience, we continuously expand our knowledge by sourcing best practices, emerging technologies and leading standards across borders and industries, which has resulted in a comprehensive and resourceful knowledge base.

Resourceful ideasHowever, simply knowing the sector does not distinguish us from our peers. It is through our core competency of innovation that we connect the dots in new ways and convert our knowledge into resourceful solutions, just as we have transformed ourselves into a hospital logistics solutions integrator. We strongly believe that an end-to-end solution generates the best results, given the dynamics of the supply chain, and that the standard solutions available on the market today do not always solve the issues. It is with this in mind that we have developed our iD-SUITE, a unified solutions platform of best-of-breed solutions designed to interface easily to host applications.

Resourceful integrationOur CL CIRCUIT-iD solution fully integrates and automates all cath lab materials management processes, including charge capture. With the implementation of CL CIRCUIT-iD all processes are linked together to optimize your supply chain, from case picking to the updating the procedure item lists. CL CIRCUIT-iD also seamlessly integrates of all Logi-D’s solutions, including its internationally recognized 2BIN-iD replenishment system. This integration enables the sharing of a common database, which simplifies data maintenance and interfacing with host applications.

Resourceful benefits• Best of class case costing• Automated demand capture• Ongoing optimization of the procedure

item lists• Automation of initial building of the

procedure item list• Minimal clinical staff involvement• Automated charge capture integrated

into material management processes • Complete integration and visibility of

cath lab supply chain data flow• Interface capability to all external applications

Precise case costingThe CL CIRCUIT-iD solution delivers the most precise real-time case costing in the industry. All data related to supplies picked at the various stages of case preparation as well as during the procedure is captured with minimal human intervention.

Resourceful EMR linkageCL CIRCUIT-iD automatically makes the critical link between patients and supplies and has been designed to pass this information to the electronic medical records with no additional staff involvement required.

GS1 compatibleAmong others, our system is compatible with GS1 standards. It will read GTIN barcodes when available and uses GLNs when these are used for the management of product locations.

Patents pending : 2.565.934 — 2.645.696 — 12/327401 — 2.587.186 — 2.663.781 — 12/4280952 3

1. Plan the case

Management of the procedure item listDepending on the scheduling system being used, CL CIRCUIT-iD can host the procedure item lists, requiring only the electronic file of the scheduling application on an ongoing basis. CL CIRCUIT-iD can also receive procedure item list files from the clinical application, should you wish to maintain these lists in the clinical application. If your procedure item lists are still paper based, we offer support to automate their documentation within a fraction of the time usually required (please see Data cleansing section on page 13).

Product code

104

05/03/2009

Picking list

(12.35) Cataract surgery majorSurgeon: 15 Graham Rachel

Intervention: 102 Basket: 1

Number:

Alexandre GrahamPatient:

Description Qty Location Voice

Procedure:Interventio

102Procedure:

12.35

PlaceRFID

label here

þThree-Quarter sheet 110008 CSD/ A.2.1.P

þGaz sponges 2X2 12 ply 210001 CSD/ A.4.1.P

þLow adherent absorbent dressing 4X4 210002 CSD/ A.4.2.P

þTransparent dressing 4 X 4 3/4 310007 CSD/ A.6.1.P

þConvertors 110009 CSD/ A.12.1.P

oInstrument tray 1G10 CSD/ B.1

oSyringe with needle 3cc/ml 212005 Centre core/ A.8.1.P

oChloride injection USP 0.9% Sodium 112012 Centre core/ A.14.1.P

oSuture 1G2 Centre core/ A.10

oNurse gloves 1G1 Centre core/ A.4

oLens 1C1 Centre core/ B.1

Surgeon Procedure Patient

P P P

Resourceful inventory navigationAll standard (predictable) items are automatically added to the procedure cost record. The list specifying the items and quantities that need to be picked is displayed on a touch screen, along with their respective storage locations to optimize the picking process and ensure that the essential items are available.

2. Pick standard items

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Resourceful data capture The procedure cost record is updated as case-specific supplies are picked. Using a finger-held Bluetooth-enabled scanner, products are linked to a procedure when users scan either:• the product bin label, which contains an RFID

transponder, or,• the manufacturer’s barcode on the product’s packaging.

3. Add case-specific supplies Using to replenish supplies2BIN- D

At the heart of our solutions is our internationally-recognized 2BIN-iD replenishment system for the inventory management of most stock and non-stock items.

This solution has been designed to manage replenishment processes for the majority of items used in a range of hospital units, including the OR, cath lab, radiology and inpatient units. In the cath lab, the 2BIN-iD system is used to manage items that do not require item-level traceability.

Resourceful inventory management The Logi-D 2BIN-iD replenishment system is unique in that it gathers replenishment information from remote locations in real time without requiring any counting or data entry in the user department and requiring only limited involvement from clinical users. In essence, it automates replenishment and facilitates the control of inventory levels and stock rotation, thus preventing the expiration of products. Our 2BIN-iD solution also provides a selection of management reports, including optimization reports that suggest quotas based on actual consumption and replenishment time, a list of slow moving items, and a list of locations where any given item can be found to name just a few.

Using to replenish supplies2BIN- D

6 7

Resourceful item-level traceabilityThe consumption of high-value items requiring item-level traceability is recorded automatically for inventory management purposes. Such items are added to the procedure cost record, and ultimately the patient file, when their packaging is disposed of in the CC-iD intelligent receptacle located in the treatment room. In order to link supplies to the procedure, as the case begins, the employee initiates the receptacle through the kiosk. All item packaging subsequently disposed of in the CC-iD receptacle will automatically be associated with the procedure.

4. Add high value items

Consumption Checkpoint

Storage

Replenish items requiring unit-level traceability The following information on delivered supplies is captured by scanning the manufacturer’s barcode:• Manufacturer’s product number • Serial number or lot number• Expiry date

Data is transferred to CC-iD in real time. The application then automatically retrieves the following information from the hospital’s database:• Internal product number• Internal product description• Requesting department/specialty• Storage location

An RFID printer automatically prints a removable self-adhesive label that contains a unique RFID transponder. Pertinent product information is also printed on the label, including its storage location. The label is then affixed to the product packaging.

When delivered to the user department, the product is swiped in front of the 2BIN-iD board to update the CC-iD application database. This action records the time that the product was delivered to the user department and confirms that it is ready for use.

When the product is used and its packaging disposed of in the CC-iD intelligent receptacle in the clinical procedure room, the intelligent receptacle technology transmits the item’s unique identifier, recorded in the RFID transponder, to the CC-iD database. This registration creates a replenishment request transaction. The same information can also be transferred to other information systems, such as the patient file or billing application.

Conditioning

SN60WF210DAlcon

Intraocular lens 21.0D

Serial: 10855543073Lot:Expire on: Aug. 31 2013

Dept: ORRoom: 012Cabinet: ABin: 3

8 9

Product code

104

05/03/2009

Picking list

(12.35) Cataract surgery majorSurgeon: 15 Graham Rachel

Intervention: 102 Basket: 1

Number:

Alexandre GrahamPatient:

Description Qty Location Voice

Procedure:Interventio

102Procedure:

12.35

PlaceRFID

label here

þThree-Quarter sheet 110008 CSD/ A.2.1.P

þGaz sponges 2X2 12 ply 210001 CSD/ A.4.1.P

þLow adherent absorbent dressing 4X4 210002 CSD/ A.4.2.P

þTransparent dressing 4 X 4 3/4 310007 CSD/ A.6.1.P

þConvertors 110009 CSD/ A.12.1.P

oInstrument tray 1G10 CSD/ B.1

oSyringe with needle 3cc/ml 212005 Centre core/ A.8.1.P

oChloride injection USP 0.9% Sodium 112012 Centre core/ A.14.1.P

oSuture 1G2 Centre core/ A.10

oNurse gloves 1G1 Centre core/ A.4

oLens 1C1 Centre core/ B.1

Surgeon Procedure Patient

P P P

Plan the case

Pick standard items

Add case-specific supplies

Add high value items

Update1

2

4

3

Replenishment & charge captureCase-specific supplies are added to the case during the procedure by scanning either the location tag or the manufacturer’s barcode with a finger-held Bluetooth scanner. Specific supplies are replenished using the internationally recognized, industry-leading kanban practice, which reduces interruptions and costly stockouts and enables fast and easy demand capture without the need for manual inventory counts.

Resourceful inventory navigationThe standard (predictable) items are picked from a touch screen list of specified items, quantities and locations, which are based on the dynamic procedure item list that is continuously optimized.

Procedure item list managementAs a first step, a treatment or procedure is transferred to our CL CIRCUIT-iD system. This information may include the list of required supplies or simply the procedure/treatment reference number. This can be performed through an in-terface from the scheduling application or other clinical application, or it can be entered manually.

High value item captureThe consumption of items requiring item-level traceability is recorded automatically for inventory management, charge capture and patient file purposes when an item’s packaging is disposed of in the CC-iD intelligent receptacle. In order to link supplies to the procedure, the employee initiates the receptacle through the touch screen interface. When an empty package is subsequently placed in the intelligent receptacle, CC-iD performs the charge capture and triggers a replenishment request for the item.

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Surgeon X Surgeon I

Surgeon II

Surgeon III

Surgeon IV

Surgeon YSurgeon Z

Interface

Procedure A

Procedure B

Procedure C

Procedure D

Cath lab

Standard item 1

Standard item 2

Case-specific ite

m 1

Case-specific ite

m 2

Treatment room

Resourceful procedure item lists

Data cleansing and computerization of procedures items listsData cleansing and the computerization of procedure item lists are the foundation of efficient clinical specialty area supply chain and case costing processes. Such an initiative will ultimately allow case picking to be delegated to non-clinical personnel.

Procedure item lists are often incomplete or outdated, and manual updates of these lists can take several weeks, yield disappointing results, and delay the realization of significant gains.

The CL CIRCUIT-iD solution automates data collection and procedure item list management, which greatly reduces the involvement of clinical staff and project length and allows you to achieve your targeted objectives.

Logi-D offers the following support in organizing procedure item lists:

• Preparation of the procedure item list structure

• Definition of categories (standard or predictable vs. case-specific)

• Data collection support through RFID technology

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Resourceful project execution

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Simulation and consultingThe Logi-D TRIAX-iD consulting services represent a unique offering. Our consulting services focus on building hospital supply chain automation business cases through analysis and optimization. Reaching beyond our own proprietary solutions, we are committed to recommending and implementing only those solutions that bring the highest value to our clients’ specific context; we thus integrate leading practices from other vendors as needed.

For every project that we are involved in, we establish a detailed project plan and timeline to ensure that we meet our client’s specific needs and objectives.

Implementation servicesLogi-D has developed a unique methodology to implement its automation solutions. The principal phases include:

Pre-implementation: assessment of the existing situation, review and validation of the proposed processes, proposal of a detailed implementation plan, etc.

Implementation: coordination of the main steps of our implementation methodology, training, and coordination of meetings in order to maintain project focus and identify any corrective actions required immediately, etc.

Post-implementation: post-implementation results and compliance measurement as needed, remote monitoring of the systems, etc.

Case study - Cath Lab success story

Resourceful gainsA 650-bed hospital, which offers a wide range of diagnostic and treatment services and treats more than 700,000 patients annually, mandated Logi-D to implement its automated replenishment solution to improve the supply chain of the hospital’s cath lab.

The implemented solution included 2BIN-iD, CC-iD and CL CIRCUIT-iD. This set of solutions integrates and automates charge capture and replenishment processes for clinical specialty areas.

The project generated gains through inventory reduction, space savings, access to real-time statistics, a reduction in the time staff spend performing inventory-related tasks, and improved inventory management.

In addition to the anticipated gains, the project also generated the following:• 18% space savings• 40% increase in stock rotation within less than

8 months.

Furthermore, the unanticipated gains included a 28% reduction in cath lab storage equipment requirements, owing to the elimination of obsolete and unused items that came about in the data cleansing exercise. This exercise was part of the implementation process.

Based on the total estimated gains and investments, the calculated project payback period was within 1 year if only 32% of the gains identified were realized.

Inventory of consignment items: 15% reduction

Logistics processes: 78% reduction

Inventory of stock and non-stock items: 33% reduction

$1.67 MTotal gains for the cath lab over 5 years:

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