Collaboration in the Cath Lab

Partnering two systems at Florida Hospital provides improved inventory management and charge capture

Florida Hospital has long been interested in applying information technology to internal processes. So when it came time to evaluate systems for its newly opened Ginsburg Tower, a 15-story cardiac tower that houses 440 new patient beds, as well as one of the largest emergency departments and cardiac catheterization labs in the country, it is no surprise that the use of RFID (radiofrequency identification) was at the top of the list. The appeal of RFID was primarily due to its hands-free nature and the accuracy of collected data, enabling a smooth clinical workflow and insight into making financial decisions. Its digital format meant it could be fed into existing information systems already in use in the cath lab. A project team, consisting of cardiology administration, supply chain management, IT project management and the clinical techs responsible for using the system, a technical analyst from the MIS Department, and a cardiology information systems technical liaison, was established. After extensive planning sessions on the needs of the lab and an evaluation of the available RFID solutions, including site visits to peer hospitals already effectively using RFID, Florida Hospital chose WaveMark CIMS™ (WaveMark, Inc., Littleton, MA), a real-time inventory management system used to track the flow of high-value physician preference items. In considering how technology could improve their processes, Florida Hospital brokered the concept of partnering WaveMark’s inventory management system with the Apollo Cardiovascular Information System (Lumedx, Oakland, CA), which was already in use in the cardiology suite. Combining real-time inventory management, and end–to-end cardiovascular information and imaging systems would enable Florida Hospital to streamline charge capture and patient billing to ensure that high-cost inventory is accurately accounted for throughout the healthcare supply chain. Instrumental to the success of the project was the willingness of Florida Hospital’s internal IT resource and the flexibility of WaveMark’s software architecture and technical team to work with Lumedx to develop a seamless interface to the Apollo Cardiovascular Information System. RFID for Real-time Inventory Management WaveMark CIMS uses RFID cabinets and point of service readers to collect information. The use of RFID in the process ensures accuracy and timeliness of captured information, with no time-consuming manual processes required. With WaveMark CIMS, Florida Hospital expects to achieve optimized inventory levels, cost-effective purchasing decisions, better management of product expirations and recalls, and improved charge capture. Cardiovascular Information System Ensures Accurate Patient Billing The Lumedx Apollo Cardiovascular Information System tracks product usage for specific patient events and procedures to enable accurate patient billing. In addition, by combining device usage with procedural data, the Apollo system provides a real-time look at clinical outcomes with various therapeutic devices, supporting quality improvement initiatives. The integration of the WaveMark CIMS and Apollo system will help Florida Hospital to reduce losses and improve charge capture of high-value specialty products. The Trial: Putting RFID to the test Putting RFID to work in the soon-to-be-opened, fast-paced cath lab was the goal at the onset. Florida Hospital did, however, choose to start in the electrophysiology (EP) lab, which provided a more controlled environment with a smaller footprint. “We knew there would be some process changes and we needed to get them worked out with the least amount of disruption,” said AJ Scarlato, technical analyst with Florida Hospital’s MIS Department. Working with WaveMark’s Hospital Services team and the hospital’s cardiology department, Scarlato facilitated the layout and form factors of RFID-enabled cabinets, along with the necessary network integration to support the real-time data feeds. Meanwhile, Cesar Santos of cardiology information systems assessed the impact of WaveMark CIMS on downstream systems where he identified and re-engineered impacted workflows, and communicated plans for change to end users and affected personnel. Once the RFID-enabled cabinets were in place, the tagging of product began. The RFID tags that are placed on the product packaging have a unique number recognized by the antenna in the RFID shelving. The antenna captures the item’s ID and transmits the information to a computer server managed by WaveMark. The database is refreshed every 18 minutes, and users can access the inventory data via a web browser at any time. User names and passwords ensure that data access is on a strictly need-to-know basis. The EP lab initially tracked 130 product models from 4 vendors and had 500 tagged items on the shelves. Having a dedicated WaveMark specialist on-site for the initial implementation to address any technical or workflow issues, and then unlimited access to that person via phone thereafter, was critical to its success. “We needed to get answers fast and having access to key personnel ensured we would not have to disrupt services while testing,” explained Scarlato. This person also spent time training the staff on the proper use of the system and how best to use the information that was now available. Testing continued on the tagging station — capturing new product information from the bar codes, associating it with the passive RFID tag that was placed on the product packaging and then registering that item into the system. Product was added, removed, used and returned to the shelves, with the system tracking its movement. Since this was a hosted solution, tracking network down time and cabinet reads were also completed with no issue. Integration of Inventory Data with the Patient Billing System Simultaneous to the testing of RFID in the EP lab was the collaboration of WaveMark and Lumedx to develop the interface to automatically pass information from WaveMark CIMS to Apollo, for the primary purpose of improving billing accuracy and timeliness of reimbursements. A representative from WaveMark and Apollo was assigned to the project, with the MIS director at Florida Hospital as project manager. The integration of the WaveMark and Lumedx systems will have an immediate, positive impact on the hospital’s bottom line. The new automated process starts with a simple wave of the product in front of a WaveMark RFID reader, at the point of use. This wave automatically captures the item details from the RFID tag on the product packaging and simultaneously enters the event in the electronic medical record, updates the on-hand inventory levels and creates a billing record for the encounter. Results After a successful trial in the EP lab and the smooth integration of the inventory and billing systems, the comprehensive solution was fully installed in the new Ginsberg Tower, with a 10-room cath/EP lab and shelled space for 5 additional OR-ready suites. As a result of the integration, Florida Hospital is already experiencing inventory optimization, reduced billing errors and streamlined workflow for front-end clinical staff. The use of RFID in the overall process ensures the accuracy and timeliness of captured information, with no manual intervention required. It has been a boost to the hospital as it offers better control over supply chain as well as improved accuracy in patient billing. At the same time, the streamlined workflow means clinicians can now spend more time on patient care, and less time on manually tracking inventory and product usage. The ultimate success of this endeavor was due to the collective work and dedication to patient care of the hospital and its chosen vendors. Collaboration truly has an impact on the quality of care. Sam Braga can be contacted at Sam.Braga@flhosp.org

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