Sphere3® Introduces Trackit!™

Mismanagement of Assets utilization can cost hospital’s millions each year.

Sphere3®, the industry leader in medical device alarm and alert analytics and hospital alignment of medical device strategy, has partnered with TriVestige Consulting to provide Trackit!™ consulting services for RTLS selection, asset management, utilization, and staff workload.

Trackit!™ employs the core principles Sphere3 has used to help hospitals leverage existing technology, plan for new, and identify how to manage the data associated with the purchase. This vendor agnostic approach to market provides greater insight for hospitals in both the selection and application of best of bread products, and best practices processes.

"Our partnership with TriVestige brings cross industry expertise to our growing client base. Our focus is making the patient stay better. Providing the things they need in a timely manner not only improves patient perception but enhances their ability to heal faster. There are great products out there in both the software and hardware - our job is to make the process easier for the hospital" CEO, Kourtney Govro

TriVestige consulting has depth of knowledge into best practices in the distribution and logistics industry. Their expertise is in process optimization, automation, software, and robotics. They provide better throughput results, reduce staff workload, and decrease spending, resulting in millions saved.

"TriVestige is focused on building solid content with replicable processes and enhanced delivery of existing services. We are excited to bring these proven techniques to the healthcare market."

Contact us info@sphere3consulting.com

Workflow and Growth

I have found with a start up there are several rules – I think of them like the If / Then statements we use in developing our software.


The three that I have found to be critical are:

1. IF you don’t have enough Capital THEN you are hosed.

2. IF you don’t make the right relationships THEN you are hosed.

3. IF you don’t create replicatable processes where every move isn’t hinged on you THEN you are hosed.

The third item I noted is one of my favorites – hence the reason for writing the Sphere3 Workflow Tool aka our software program. I don’t like to do the same thing twice, and it kind of drives me nuts to watch someone else do repetitive processes. (Once I have figured out the puzzle you might as well garage sale it because it’s not like revisiting an old friend for me, it’s just dull.)   I think that’s why I like to look at workflow – while there are patterns there are also variables around those patterns keep things interesting.

I recently found a kindred spirit in this vein, Tony Marsico, CEO of PCTS. Tony stopped by our office on a recent trip to Kansas City to get the “Grand” tour. Tony has a graduate degree in documentation of complex processes and corporate training. (No, I didn’t make that up, and yes I did laugh when he told me.) Which makes him perfectly suited to run PCTS, a analytic software firm that provides business intelligence for hospitals via an RTLS system.   He is an investors dream with his ability to clearly document and communicate process back out to his team.

PCTS provides real time business intelligence for Operating Rooms and Emergency Departments with “air traffic control” like screens, mobile buttons, and integration to systems and medical records. The really interesting thing about their product is its ability to run workflow rules and associate them with other rules. (That’s an over simplified way of describing that) Breaking down processes to physical movements, allowing for interaction levels and not only the “time association stand point” such as “IF the RN is in the room for X period of Time THEN do XYZ” obtaining information from other systems to validate the entry and interaction with patient specific information. All of which I have seen in “Demo” mode.

As I have said before I usually don’t believe it until I see it and PCTS was gracious enough to take me on a site visit and let me watch their team in action at Cook’s Children’s Hospital. This was an asset tracking project, so not nearly as complex as the workflow in an Emergency Department or OR, but interesting and exciting. The team was incredible, and the processes appeared to provide real time value to staff.  Including the ability to better locate, identify, and collect recalled pumps and modules.

It’s important to note – while PCTS is dependent on RTLS they are NOT an RTLS company. However, they do provide RTLS products. Tony’s explanation made a lot of sense.   Analytics based on workflow using RTLS is not simple and the validity of the information is a direct correlation to the installation of the RTLS product.    His challenges, similar to many companies I have talked to, is who to hitch his wagon to. He is in need of companies who understand analytics, understand workflow, and understand the relationship to hardware. (That last point may sound “easy” but take it from the voice of experience it’s not)

My assessment – Tony Marsico is an Investors dream - he could "McDonalize" processes within a company.  He has also surrounded himself with good people - which I have found to be the key to building a successful people.  (Yes, that's my secret - I hire people smarter than me.)  He is driven, intelligent, and has an eye for creating better workflow inside his firm and outside.

Tony’s Most Recent Read: Inside the Tornado – which I read the following week and it was a really interesting read. (Note to audience: Just read the first couple of chapters and you will get the gist of the entire book)

Sphere3 celebrated our first birthday in May. Though there was no noted celebration there was a strange, we have arrived moment – meaning that the phone has been ringing a lot and business is definitely starting to move. That momentum has really increased my travel - which has noteably decreased the blog posts. Stay tuned there are good posts to come later this month: Chad West, CEO of Ascom Wireless and Todd Plesko, CEO of Extension

To Wash or Not to Wash....

Recently, I enjoyed a spirited conversation with Hill-Rom’s GM and Vice President, Mike Gallup. Mike is a former IBM consultant who has been tasked with creating an unstoppable force in the Hill-Rom HITS (Healthcare Information Technology Systems) Group. His goal is to systematically coordinate the design of applications, creation of partnerships, and integration of collaborative initiatives that will strategically confront the marketplace status quo.  He was gracious to share his thoughts and a new project that they are going to be launching soon.

Hill-Rom as written and developed a patent on hand washing that should cause the industry to sit up and take notice. Hospital infections are costly and many are preventable. Those two items are ear perking to people who focus on providing value to a hospital. Not to mention the pain and discomfort that they cause a patient, and potential additional infections throughout the hospital. The ability to decrease infection by a simple hand washing or sanitization is crucial. To put dollars to the thought, according to Hill-Rom MRSA infections can cost in excess of $200,000.

Hill-Rom approached the marketplace trying to identify a strategic partnership with an RTLS provider that could meet the system and software requirements developed in the patent. After much research they decided on Centrak. Centrak’s ability to get granular in the patient room allows for the proximity of the caregiver to the dispenser to be identified. It also detects the actual motion and interaction with the cleaner.

Sound a little like Star Trek? It’s not.

The concept is actually quite simple, but software and application is really brilliant. The motion sensor within the Centrak tag notices movement of the dispenser when it is touhed and the badges correlate the proximity of the caregiver. To “fool” it you would actually have to have a caregiver bump the dispenser on purpose and not clean their hands. This would seem to be a farfetched idea. I am not an expert on hand washing, by any means, but I would assume that a majority of the time that a caregiver didn’t wash their hands prior to interacting with a patient would be more out of forgetting, and not intentionally avoiding.

I see this as a brilliant tool. Since it’s a standalone system it could be tied into a number of different integration points to track the effectiveness, but also offer some proactive notifications to the caregiver or manager. While the application is not prime time at a facility today the system has made it through all of the Hill-Rom and Centrak’s internal testing. Mike’s projection is to have it live within the next three month.

Thanks again to Mike Gallup – www.hillrom.com I look forward to more spirited interactions about healthcare in the future.

Grady Health Systems Surgical Service Workflow

At HIMSS I had the opportunity to tour the Surgical Services area of Grady Health System in Atlanta. The visit was facilitated by Centrak and hosted by Hakan Iliken the Director of Anesthesia and Director of Process Improvement. Iliken was an exciting individual who shared his vast knowledge of process design which is rooted in his Industrial Engineering, Software Development, and CEO background. Iliken is in charge of making sure the technology applies and assists the caregivers, patients, and doctors throughout the day. What I found unique about Iliken was his ability to not only look at things through clinical glasses, but also examine it with a business mindset - balancing clinical and business.  The technology implemented was a Centrak RTLS System tied into a Perioptimum tracking board.


According to Iliken - The Goal of the Implementation is to “Improve Surgical Services throughput and productivity by utilizing a system with Real Time Accuracy.” A secondary goal was to "Increase Transparency."

The Primary Goal is “easily” definable – increase utilization, and ultimately increase revenues. Iliken has seen a 10% increase in Utilization during Prime Time. They are mobilizing staff and moving patients more efficiently and effectively, and they are able to identify bottlenecks readily.

One of the key ways that they accomplished documenting efficiency was to utilize the three flexible buttons on the In-touch badge. The way Iliken designed the processes ,which were enabled by the technology, is each button represented the next step in the process – the wow factor in the design is as the badge physically moved into a different area (Pre-OP, OR, PACU, etc) the buttons would change meaning.  Thus, offering extreme flexibility.  For example button 1 (represented by a *) means “Anes ready” in PreOp, in OR it means “Induction Begins”, and in PACU the same button means “Phase 1 Complete”.  To aide in the ease of use color coding was used on the tracking boards in the staff area recording and identifying the patient’s location and specific steps in the process.  Each staff member is provided with a "cheat sheet" that is card sized and fits into the ID badge holder.  In addition, since the button pushes were not tied to a physical item such as a wall it provides for additional future flexibility.

The ability to dissect a process is a powerful tool. Think of it like an assembly line at Ford. Each person in the process touches the product, and with extreme accuracy they can identify where the issue occured. They can also identify if it was a people or process issue.  Can all of this be achieved with RTLS and process design in a hospital? While I am on board with lean and six sigma design and the ability to reduce errors by using strict process – I believe that healthcare at its core is about people helping people. People who are sick and people who are taking care of them – no matter how we try there will always be a people element. Technology is a tool – it’s not always total the answer.  
Stay Tuned for Part Two - The secondary goal, I found most fascinating, probably because of my groupie like appreciation for Paul Levy’s blog. Transparency means no holds bar real data – the truth that bypasses the finger pointing and assumptions.

Location, Utilization, and Movement

I had an interesting call with Will Lukens, Vice President of CENTRAK, a Real Time Locating System (RTLS) company. There are a number of debates swirling around RTLS such as what’s the best technology to use? (Wi-Fi, RF, Hybrid - Check out JHIM from Fall 2008 for further reading on the technology.) No matter what technology you use in the background, RTLS is a great mechanism to track the effectiveness of workflow for staff and “stuff”.

Step One is always to decide “what” you want to accomplish prior to deciding “how” or with which technology you want to use. The "what" or goal froma workflow perspective can be evaluated in three areas Location, Utilization, and Movement. Using these areas you can evaluate numerous abilities to track implemented technologies and initiatives.

LOCATION: It’s been reported that caregivers currently spend less than 30% of their time at the patient bedside, but that’s an average which is not applicable for every facility. Using RTLS a hospital could track the actual time frames that a caregiver spends with a patient and set a baseline for their specific facility.

Location is the portion of the puzzle that has the most value and the most apprehension. The ability to track caregiver’s locations with detailed reports of who, when is sometimes labeled “Big Brother” and “Micro-Management” and honestly, would you be pleased to wear a tag that tracked your movement the entire time you are at the office? “Bob, you spent way too much time at the coffee pot.” Using this as a coporate means of improvement as opposed to individual tool for punishment is really key.

UTILIZATION: “Work Around Artists” is a term that Karen Cox, Executive Vice President of Children’s Mercy Hospital in Kansas City coined in the last issue of Ingrams. That name captures the innovative spirit of the caregiver. They are the modern day MacGyvers using available resources to find more efficient paths.

Often hospitals will implement initiatives, or provide technologies with the desire to see an improvement in something that is lacking. For example, if there are high infection rates they may implement a hand washing initiative and provide a new sink in every patient room. What if the utilization of the sink could be documented automatically – even more so what if that information could be correlated back to the reduction of infection rate.

MOVEMENT: Frank Lloyd Wright would watch people’s movement habit’s to design walk ways. Once he didn’t put in a single side walk at a University until after the students had worn paths to show where he should be putting those walk-ways. RTLS is the modern day observation and automated documentation of movement habits. A caregiver walks 1 to 4 miles per day (depending on size of facility and quantity of patients) often a technology is provided to reduce that foot traffic. Hospitals can have humans track the movement with clipboards and pens or pedometers, but if they have an RTLS system that information is being collected.

Before you begin your journey - A great resource when planning RTLS purchase and implementation Robert Konishi’s RFID-RTLS Strategy and Planning Guide. Robert is the former CTO of UCLA Medical Center, and Current CEO of T2 Technology Group. According Konishi, there are four main areas that can be assessed to link to value when evaluating the RTLS system for equipment tracking:

• Cost savings associated with rental or duplicate purchases
• Lost Revenue and Opportunity Cost due to utilization
• Lost Time for Staff
• Quality of Patient Care, Throughput, and Regulatory

Konishi provides very helpful insights in the article from RFID News (http://www.rfidproductnews.com/pages/searchview.php?key=konishi&p=issues/2008.03/medical2.php) and a subsequent RFID-RTLS Strategy and Planning Guide.

The power of RTLS is the ability to track specific information. That information can become a metric which can be used to help the hospital better assess their workflow choices. A metric on it’s own is important – every business needs to track it’s ability to improve – however correlating those metrics with other data is the most powerful way to look at the data. That's why Sphere3 has developed our automated web based Sphere3 Scorecard™.

We look forward to sharing it with you.