Improving Acute Care – Monitoring /IT

Connected Technologies
Frieska Irdamarsya & Andi Jaya
Product Manager & Service Manager
Draeger Medical Indonesia
 in 1998 in 2019

Mobile phone Smart phone

 in 1998 in 2019
Patient Monitor Patient Monitor ?
1961
1961 1967 1976 1980 1994 2008 2016

First prototype Central Station IC 106 Modular Patient First digital, software Introduction of the Introduction of the First to Receive
of a central patient for 6 patients with the Monitoring System controlled and modular smallest, lightest, Infinity Acute Care DIACAP Certification
monitoring unit components of the with extensive range patient monitor with color portable System for Information
measuring station B of modules infrared modules patient monitor Assurance (IA) from
(1964) the U.S. Government
Lessons learned from Nokia’s failure:

Amalia Sterescu, Leadership Consultant

Improving Acute Care
Connected Technologies
What can we offer today ?
Danny VK (Van Kersschaver) – Marketing Manager Mon/IT Region AAA
 Value creation
Protective
Improving in the hospital
How means
our balancing Care-centred
Reducing
outcome improvements and
clinical outcomes
Therapies actual offering
patient experience with
costs
Workplaces
of care
supports
the costs of care, but this
improving
can only be achieved by also

acute
improving the care
work life of
clinicians & staff.

Enhancing
Connected Improving
patient experience Comprehensive
staff satisfaction
Technologies Services
Connected Technologies

How users perceive a connected system

from: Mendelez, Medical Device Connectivity Conference 2011, Boston

Connected Technologies
The reality:
How the infrastructure really looks like

So let’s have a look on it,

step by step

from: Mendelez, Medical Device Connectivity Conference 2011, Boston

 Connected Technologies

What is a connected system ?

An integrated system for acute care that combines patient monitoring, therapy and information
enabling a new dimension in safety, efficiency and quality of patient care

10 | 42 FOR INTERNAL USE ONLY

Connected Technologies

Across the Critical Care area’s

INTENSIVE CARE OPERATING ROOM NEONATAL CARE

Connected Technologies

First we need to learn about and listen to Customer Challenges and Expectations

Patient Safety
Top Quality and High Reliability Fast Service Response and Fix Times
Investment Protection
Designed for the realities of the OR
Easy and Intuitive Technology
Scalable to support different patients
Flexible equipment mounting
Manage complexity of medical devices
Optimize workflow
Easy and quick access to information

High quality of care vs cost savings Automatic documentation

Tools that support therapeutic

Integration with hospital IT applications decisions
Time saving device preparation
Convenient handling, moving
and cleaning

FOR INTERNAL USE ONLY

 Connected Technologies

Improving Acute Care

We share your goals …

Improving Clinical Managing Cost Ensuring Staff Enhancing Patient

Outcomes of Care Satisfaction Experience

13 | 42 FOR INTERNAL USE ONLY

 Connected Technologies
…offers us the ability to design Dräger Workstations
…supporting more efficient clinical workflows

Consider
the number of duties Anaesthetists /
Anaesthesiologists need to keep track of during each
case – Patient Care, Procedures, Quality, Regulatory,
Documentation etc…
A true system
approach
Connecting essential
technologies to share
information and work in sync
with one another, and with
healthcare providers, for
achieving best possible
clinical outcomes.
Device integration Connectivity Clinical data management
Improving Clinical Managing Cost Ensuring Staff
Workstations combining vital Connect patient data to the Add vital signs data and Outcomes of Care Satisfaction
signs monitoring with therapy Hospital Information System therapeutic data from integrated
devices in the OR integrate and Clinical Information devices to produce detailed
data to facilitate clinical System with standard patient records for analysis and
decision-making. communication protocols. reporting.
…enabling clinicians and patients to be more mobile

Consider Remaining
the distance your typical patients connected to
cover over the course of their stay
and the number of intra-department
transfers
your patients
from admission, during transfers
and all the way through to discharge so
that every clinical issue can be detected

Remote data access Pick and Go transport Telemetry

Bring data together from monitoring
and connected therapy devices,
revealing valuable information for
making the most beneficial treatment
choices.
Transport needn’t limit data capture.
Continue monitoring all parameters
while en route, adding to patient
records once reestablishing network
connection.
Real-time surveillance of heart rate
and oxygen saturation for ambulatory
patients is possible anywhere in the
hospital that has wireless network
coverage.
…keeping patients and care providers safe

Consider Implementing
the impact of a more tranquil care trusted systems
environment on patient recovery, if
exposure to audible clinical alarms
could be minimized
and strategies
that complement how you work and
protect what matters most, your most
vulnerable patients

Clinical alarm management Infection-control Data security

Streamline alarm response and Hygiene specialists will assist you in Maintain data integrity and patient
minimize alarm fatigue with an alert implementing strategies that help confidentiality with systems certified to
distribution system customized to reduce the potential and spread of demanding network security and data
your clinical protocols. nosocomial infection. encryption standards.
 …containing the cost-of-care and cost-of-ownership

Consider Saving time,

the value of a partner you can rely as well as
upon for workspace design,
technical advice, training, and
service should problems arise
financial assets
with technologies and services designed
to reduce many of the complexities of
caring for the most fragile patients

Device scalability Professional & technical services Straight-forward networking

Adapt any monitor to a new patient Call upon our teams before, during Avoid the cost of data conversion
setting or acuity level, adding or and long after installation, offering hardware and software, connecting
reducing measured parameters to expert clinical guidance and therapy devices to the hospital
the patient’s immediate needs. technical support. network through Medical solutions.

17 | 15
Example of Connected Technologies
Infinity Cockpit used for Device Integration, connectivity and Clinical Data
Management
Bed Label, Care Unit, Battery Status Patient Info, Profile Name Date / Time Alarm & Message Notifications
(links to Biomed) (links to Profiles) (links to Biomed) (links to Current Alarms)

Alarm Bar
Patient Category Alarm Volume
(links to Demographics) (links to Alarm Settings)

Tabs for
Vitals and IT
Applications
Menu with
configurable buttons
Connected Technologies
Device Integration: Infinity® Acute Care System™ (IACS)
IT tabs: Web browser
Connected Technologies
Device Integration: Infinity® Acute Care System™ (IACS)

Philips PACS integration

Connected Technologies
Device Integration: Infinity® Acute Care System™ (IACS)

Sony camera integration on the Cockpit

Split screen

Full screen
Device Integration: Infinity® Acute Care System™ (IACS)

Integration of PACS images using TSPlus

Shown on Arab Health 2019!

Using Radiant DICOM viewer

Device Integration: Infinity® Acute Care System™ (IACS)

Arab Health 2019:

IT integration (PACS and Ascom Digistat) in Full or Split screen on the
Cockpit!
Device Integration: Infinity® Acute Care System™ (IACS)

Project in Japan:
IT integration of FujiFilm Synapse in Full or Split screen on the Cockpit!
 Connected Technologies

From the very beginning…

Mechanical Integration Software Integration

Designed to
Bio compatibility testing
work together Safety testing

25 | 42 FOR INTERNAL USE ONLY

Connected Technologies

Connecting Medical Devices Today – step by step

Hospital IT

Monitoring
Gateway
EMR LAB PACS
Monitoring Network

proprietary data
output
Connected Technologies

Did you know ? Promotion: Infinity Connect the dots promo for IACS

ANESTHESIA

Perseus A500
Primus/Primus IE/Apollo
Zeus IE

VENTILATION

Evita V500
Babylog VN500
Evita 2D
Evita 4
CCO Evita XL
BIS NMT Savina 300
Edwards Vigileo
Carina
Edwards Vigilance II
Covidien BIS Vista Tof Watch SX Oxylog 3000 Plus
Edwards EV1000
TofScan NMT Evita V300
Maquet Servo-i (v7)
Connected Technologies

Improving acute care

requires an offering
that goes beyond
world-class products.
Connected Technologies

Value
Howcreation
our
Protective
Improving in the hospital means balancing
offering todayand Care-centred
Reducing
clinical outcomes
Therapies outcome improvements costs
Workplaces
of care
patientalready
experience with
the costssupports
of care, but this
improving
can only be achieved by also
improving the work life of
acute care
clinicians & staff.

Enhancing
Connected Improving
patient experience Comprehensive
staff satisfaction
Technologies Services
Connected Technologies

How to use Protective Therapies safely using Connected Technologies ?

Lung Recruitment monitoring using the Analysis Tool in the IACS

IACS Technical Training | Martin Wattke | 08.08.2016

 Connected Technologies
Clinical Objectives of Lung Recruitment by using the Analysis tool

- optimize gas exchange and oxygenation with a careful monitoring of airway pressure and its effect
on blood circulation

31 | 415 IACS Technical Training | Martin Wattke | 08.08.2016

Connected Technologies
Analysis Tool used for Lung Recruitment Monitoring

32 | 415 IACS Technical Training | Martin Wattke | 08.08.2016

 Connected Technologies
… used for Fluid Management with the support of the Analysis Tool
SCENARIO: FLUID MANAGEMENT

Decision Support Patient starts bleeding during surgery Clinician administers colloid Results are analyzed
A powerful clinical decision support tool
with a comprehensive and customizable
trend page for visualizing information

Precision level of 1 second

and configurable duration
from 1 minute to 4 hours

HR, PVI, MAP react to the occult volume loss. HR, MAP and PVI drop due to volume substitution. Using the calliper tool, clinicians can analyse the patient’s
response to fluid and use the data to determine treatment
Hb stays stable Hb drops due to dilution effects

FOR INTERNAL USE ONLY

Connected Technologies

…using 3rd Parties for Fluid Management

ANESTHESIA

Perseus A500
Primus/Primus IE/Apollo
Zeus IE

VENTILATION

Evita V500
Babylog VN500
Evita 2D
Evita 4
CCO Evita XL
BIS NMT Savina 300
Edwards Vigileo
Carina
Edwards Vigilance II
Covidien BIS Vista Tof Watch SX Oxylog 3000 Plus
Edwards EV1000
TofScan NMT Evita V300
Maquet Servo-i (v7)
Connected Technologies
Integration
Connectivity with Edwards EV1000, Vigilance and Vigileo

Fluid Mgt .
 Connected Technologies
… importing the EtCO2 waveform from the connected therapy device into the PPV and SPV tool
Decision support
Consolidating vital signs and therapy data provides clinicians with a
comprehensive cardiopulmonary profile supports early identification
of correctable physiologic alterations before they become life
threatening

Ability to configure waveforms from therapy

devices as respiratory references Process data from more than 50 parameters,
providing automatic computations of hemodynamic,
oxygenation, and ventilator parameters

FOR INTERNAL USE ONLY

 Connected Technologies

… offer Consolidated Display of Information

Clinical Vision
Simultaneous display of Vital Signs and therapy
information on one screen.

Vent Parameters Gas Measurement Agent Consumption Gas Consumption

Pressure, flow waveforms Loops Trends Analysis Tool
37 | 99
Connected Technologies

Connecting Medical Devices Today- the next step: Infinity Gateway

Hospital IT

Monitoring
Gateway
EMR LAB PACS
Monitoring Network

proprietary data
output
Connected Technologies

Infinity Gateway
What is it?
A set of applications, interfaces and data access tools
enabling the exchange of data between the
Infinity and Hospital Network

PatientWatch HL7 Interfaces Alarm History Database Time Master

WinAccess API FileAccess Paging Interface ASTM Stat Lab

interface
Connected Technologies
Infinity Gateway
How does it work?

Hospital Information Clinical Information

System System

Infinity Network Hospital Network

Infinity Gateway

Lab Information Paging System

System
 Connected Technologies
Infinity Gateway
Alarm History Database
The Alarm History Database records alarms for all
Draeger devices connected to the Infinity Network,
allowing collection and analysis of clinical alarms.
This can be used to define mitigation measures to
manage alarms and reduce alarm fatigue.

The raw alarm data can be

exported to a text file

Raw data includes:

• Time of the alarm
The data can be imported into standard
• Bed label, Mon Unit, Care Unit reporting tools for analysis
• Patient ID
• Alarm Grade, State and Message
• Parameter Label, Value, Upper and Lower Limits
• Alarm Duration
• How the alarm was cleared (acknowledged, timed out, shutdown)

41 | 22 FOR INTERNAL USE ONLY

 Connected Technologies
Infinity Gateway
WinAccess API in action

DocPrint Ascom Unite Connect Mobile Patient Watch

A Web application intended to be used on

An application to generate custom reports using
the data from the Infinity Network and export the
PDF to the Hospital Information System
Infinity Alarms are sent to network connected Ascom devices as a
Mobile devices and desktop Pc to view
secondary notification. Alarm filtering and prioritization determines
patient data from the monitoring and
distribution and escalation pathways to help reduce alarm fatigue
connected systems

42 | 22
Connected Technologies

What is Mobile Patient Watch?

Insert
photo
Insert photo MPW is a
web-application
showing
patient data
Insert on
photo
smart phones
and on
desktops
received by
MPW Infinity Gateway

Infinity Gateway
Optimized Mobility Devices, Seamless Workflows
Strategies,
Trusted systems Services Best-in-class Support
and strategies
Connected Technologies

Thank you!

Danny Van Kersschaver

Marketing Manager Monitoring/IT AAA region – Africa, Asia, Australia

danny.vankersschaver@draeger.com
Evita Infinity® Vseries
System overview

Infinity® Medical Cockpit™ (C500)

USB port to transfer configurations and
System cable connection service information
Rotary knob (replaceable)

Flow sensor
Inspiratory and expiratory ports
Water trap (with RFID-based Infinity® ID accessories)
Rail for additional
accessories
Rail for active
humidification system

Trolley

✓ Modular system to allow flexibility and interchangeability

Basic Ventilation
Basic Ventilation
Vseries Internal Diagram
SDC
Service-oriented Device Connectivity
Remote Service
 Remote Service

Process Description – Networked and Non-networked devices

Fix the problem

USB/ USB
RS232 Remote Service
Link / USB
Non-networked device Biomed Laptop

Web
Web
Network Email Web
ServiceConnect
Gateway ServiceConnect
System DrägerService®

Networked device

53 | 386 Infinity Acute Care | 25.11.2013

Service Maintenance
Concept
Why ……..?

To ensure equipment in “operational” condition

What …….?

Inspection Fix it before it break

Preventive Replace it before it fails
Corrective Repair it to make its function back to normal

How……?

Plan
Comprehensive test procedures
Test Equipment
 Overview of contract portfolio
Options

Options Options can be add in a contract to cover

Hospital individual customer specific requirements.
(Examples)

Support Digital Services Training Software Update Documentation Consulting

Customer gets Connected Execution of Device will be Customer gets Regular reviews
access to an Maintenance regular updated on latest access to online with the customer
extended help (e.g. Help Ticket), Application or SW. documentation and hand out of
desk (24/7) or Data Analytics, Technical (e.g. IFU and management
loaner devices Asset Information Trainings (e.g. First Line) reports
First Line
Service)

55 | 28 Contract portfolio | Global Academy | April 2019

Service Contract (service models)
Connected Technologies

Thank you!
Thank you for
your attention.