INSIDE THE CURRENT ISSUE

October 2012

Products & Services

New Technology

Research finds novel airborne germ-killing oral spray effective in fighting colds and flu

University Hospitals Case Medical Center clinical researchers presented findings about a one-two punch to prevent colds and flu in San Francisco at the Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC).

The research team’s data in two poster presentations saws that a new oral antiseptic spray is effective in killing 99.9 percent of infectious airborne germs. Findings from these two presentations led to the development of Halo Oral Antiseptic, a first-of-its kind germ-fighting spray which is currently on store shelves.

"Respiratory tract disease is a major cause of morbidity and mortality throughout the world," says Frank Esper, MD, infectious disease expert at UH Rainbow Babies & Children’s Hospital and lead author of one of the studies. "Yet there has been limited progress in the prevention of respiratory virus infections. Halo is unique in that it offers protection from airborne germs such as influenza and rhinovirus."

Dr. Esper and a team of researchers used glycerine and xanthan gum as a microbial barrier combined with cetylpyridinium chloride (CPC) as a broad-spectrum anti-infective agent to fight respiratory illnesses. To test this, clinical strains of 2009 pandemic H1N1 were used as a prototype virus to demonstrate Halo’s anti-infective activity in cell culture assays.

"The glycerine and xanthan gum prevent the germs from entering a person’s system and the CPC kills the germs once they’re trapped there," explains Dr. Esper, who is also Associate Professor at Case Western Reserve University School of Medicine.

Dr. Esper says that Halo will have clear benefit to aid against infection and reduce disease from epidemic, sporadic or pandemic respiratory viral infections, particularly helping people at risk for severe respiratory illness including immune-compromised individuals with chronic lung disease, and military personnel.

Another study on Halo by Mahmoud Ghannoum, PhD, of UH Case Medical Center, shows Halo’s effectiveness against disease-causing pathogenic germs. The research asserts that respiratory and/or systemic infections through airborne and manually transmitted pathogenic microbes often enter the system through the mouth, making Halo, an oral spray that targets these pathogens, an effective way to prevent infections. Additionally, preliminary data from the researchers found that Halo completely kills all 11 clinical strains of whooping cough (Bordetella pertussis) against which the spray was tested.

The results showed that when a person used three sprays of Halo, it destroyed airborne germs breathed in for up to six hours, even when people were eating and drinking. The concept of coating the back of the oral cavity to prevent germs from entering and then providing sustained antiseptic action to kill airborne germs was developed by a Cleveland company, Oasis Consumer Healthcare.

 


 

Does 2-D, 3-D or RFID bleed red or green?

Experts discuss return on investment for asset tracking tech

The healthcare industry may be immersed in – and obsessed with – standardizing on everything to control costs, but does it make sense to use multidimensional bar coding or radiofrequency identification tags for all people, processes and products?

Healthcare Purchasing News asked key executives at more than a dozen companies that make asset tracking products and technologies how a healthcare organization might cost justify implementing 2-D/3-D bar coding or RFID/Real-Time Location Systems (RTLS) technology for the gamut.


Matt Perkins, Chief Technology Officer and Senior Vice President, Engineering, Awarepoint Corp., San Diego

“Knowing the location of equipment, patients and staff, as well as automatically being able to monitor behaviors and processes brings so much value, especially now that electronic health record adoption is surging. With RTLS, all this accurate data can automatically populate the EHR in real time to improve patient care and staff productivity. Efficient asset management cuts equipment purchase and rental costs and improves workflows to increase patient throughput – a plus for the quality of care as well as the bottom line.    

RTLS offers important benefits and ROI that will amplify as the transition to more patient-centered care accelerates and hospitals seek affordable, easy-to-implement technologies to optimize their clinical, operational and financial performance. Awarepoint has a proven track record of saving our clients between $3 and $7 for each dollar invested. Because we can deploy our solution within 60 days, frequently our clients are cash flow positive before other technologies are even live in the institution.”


Jonathan Karl, Director, Sales, CDW Healthcare Solutions,
Vernon Hills, IL

“Most hospitals will look into an RFID solution for the purpose of tracking assets and basic condition monitoring, but the costs of implementing an RFID solution are usually beyond a customer’s budget when looking at the short term impact and with more recent investments made in barcode.  From a 1-D versus 2-D bar code implementation standpoint, as hospitals continue to implement EMR and PPID solutions, they may change over from 1-D to 2-D bar-code scanners as an industry standard or because it provides greater depth of information.

“There are clear justifications for either investment, including increased patient safety, clinical workflow improvement, and cost savings. Here are a few benefits that result from these deployments:

  • Patient safety, in terms of a reduction of medication errors. According to the U.S. DHHS, adverse drug events (ADE) are one of the largest safety issues facing the industry today. Per the U.S. DHHS, there are more than 770,000 injuries and deaths per year as a result of a medication or ADE

  • Clinical workflow improvement. Coupled with reducing errors, the growth in mobile point-of-care enabling bedside medication and data capture to the HIS application improves not only the accuracy but the speed in which care can be provided to a patient. This further reduces errors while improving the efficiency of the care provider.

  • Cost savings. [This] is achieved through reduction of errors, an improved workflow and the alignment of internal systems. Deployment of these platforms drives synergies between the pharmacies/labs all the way to bedside care delivery, removing the additional logging and checkpoints necessary when working with non-bar coded medications or medical supplies.”


Shlomi Avigdor, Director, Sales & Marketing, LogiTag Systems Ltd., Mamaroneck, NY

“LogiTag envisions a single platform that answers all RFID/RTLS needs of the hospital. To justify its cost, RTLS must be capable of answering any hospital wireless monitoring need – patient tracking, infant protection, asset-tracking, temperature monitoring, wander prevention, staff-attack panic buttons, nurse call, hygiene monitoring, maintenance monitoring – using a single common infrastructure and application-specific tags. With that, a hospital can justify the CAPEX of installing the network, and gain savings in different applications simply by using different tags. In addition, today’s RTLS infrastructure is more mature and easier to install, relaying more and more on wireless mesh networks and less on expensive and labor intensive cables, thus reducing the installation’s cost.” 


Fran Dirksmeier, General Manager, Asset Management, GE Global Services, GE Healthcare, Waukesha, WI

“The real value stems from leveraging real-time operational measurements, which in turn can yield ongoing operational improvements. While the initial deployment of RTLS may bear a significant upfront cost, we’re really just scratching the surface in terms of aggregate value. When evaluating RTLS applications, it’s important to look beyond simple IV pump or other mobile asset tracking, and consider the broader operational environment. This means broadening how healthcare executives define the opportunity to include patient throughput, bed management, and process compliance, to name a few.

“While improved asset tracking alone can generate significant savings and productivity gains, we’ve seen hospitals extend RTLS applications to improve bed turnover time by over 60 minutes, reduce the decision-to-admit a patient to bed placement by over 200 minutes, as well as double compliance rates of staff processes like equipment cleaning. Now suddenly, with these potential operational improvements, in addition to the traditional gains of asset tracking, the justification of implementing RTLS becomes greater.”


Arnold Chazal, CEO, VUEMED Inc., Seattle

“If applied appropriately, both 2-D bar coding and RFID/RTLS technology can be valuable. However, the value of these technologies, as with any technology, is realized based on how it’s implemented and used in each specific context, rather than anything inherent in the technology itself. Often the same objectives can be achieved through process improvement and redesign, for example. Any organization considering an investment in resource-intensive technologies should ensure that they clearly identify how the technology will be used to support the process and achieve the ultimate objectives. You have to look at the whole picture and the entire cost, because such an investment should not only improve the effectiveness of your operations and the accuracy of your documentation and product tracking, but it should also provide a significant return on your investment annually.”


Marcus Ruark, Vice President, Intelligent InSites Inc., Fargo, ND

“A successful enterprise-wide implementation of RTLS will have a positive hard-dollar ROI and a rapid time-to-payback. As part of our RTLS+ process and methodology, we work with our customers to build a rigorous ROI and benchmarking model, then provide ongoing measurement and management, after implementation, to achieve or exceed the predicted hard-dollar cost savings. It’s also worth noting that, as I mentioned above, RFID and RTLS tag prices are getting cheaper each and every year. We’ve designed our solution and our platform’s architecture with the vision that tags will become ubiquitous. The cheaper tags get, the more things will be tagged, the more real-time data we will collect, the more processes we can automate and optimize, and the greater the enterprise ROI.”


Kurt Mensch, Principal Product Manager, RFID, Intermec Inc., Everett, WA

“With some figures showing typical hospital asset losses at $3,500 per patient bed per year, implementing a traceability system that can help eliminate loss, theft, wasteful rentals of redundant equipment due to lack of knowledge of current item locations, and lost time searching for critical items, a compelling ROI can certainly be calculated for an effective and accountable asset tracking system.” 


Richard Philippe, president, Logi-D, New York, and Laval, Quebec, Canada

“Cost justification must be at the forefront of any development project. As we wait for standards to be finalized and rolled out to the industry, the cost of delay should also be taken into consideration. The industry is challenged with cost and resource pressures. It is widely predicted that these pressures will not only continue, they will increase exponentially as time goes on. In addition, back office processes in many instances have been taken for granted, and available financial resources have for the most part been invested in clinical advancements. Given this environment, cost justification is actually fairly easy. The key is to go beyond a unitary price transactional analysis and conduct a thorough value analysis of the outcomes and their payback.

“From a solutions point of view, considering that the deployment of data standards is still in its infancy, most tracking solutions currently implemented are closed loops. Whenever closed- loop solutions are being sourced, their capacity to migrate and read standard codes applied by manufacturers when they become available, whether as bar codes or RFID tags, should be considered.”


John D’Ambrosio, Senior Manager, Core Team Lead — Supply Automation, Omnicell Inc., Mountain View, CA

“The key is to make sure it benefits the organization as a whole and especially the patient. If front line nurses can quickly realize how the change will benefit their patients, they will embrace it. If the caregiver cannot easily understand the patient’s benefit from the changes in their workflow, they will view it as another task inappropriately assigned to them that they will not adopt. The trick is to ensure it simplifies the nurse’s daily routine and improves patient care. Materials managers are programmed to define best practice and then implement it across the board. We need to understand that there may be multiple best practices within a hospital.

“Also, understanding what and where to implement a solution is critical. Bar codes may work great in one location and not so well in another. RFID could easily be justified for interventional radiology but not be a great fit for telemetry. Nursing will embrace the change if it’s the right fit and they believe it will improve care. Delivering patient care is the reason they went to school to receive a nursing degree. Nurses and other caregivers think about patients the most, and very little, if at all, about things like average daily usage, fill rates and replenishment cycles. They were never educated to think like an industrial engineer or a materials manager, and we should not expect them to. They simply want product available to ensure their patients are safe, well cared for and have the opportunity to mend in a comfortable healing environment.”


Adam Peck, Director, Marketing, CenTrak Inc. Newtown, PA

“The justification or Return on Investment for a Real Time Location System is obvious. The traditional value associated with more efficient management of mobile medical equipment has been well documented – less over procurement, lower rental expenses, reduction in equipment shrinkage, higher nurse satisfaction. However, these savings pale in comparison to the financial impact a high-performance RTLS can have in other areas, including:


Tuomo Rutanen, Senior Vice President, Marketing and Business Development, Ekahau Inc., Reston, VA

“Bar codes have industry standards built-in. Some RTLS systems are not built around open architectures and industry standards. True WIFI RTLS systems can work over any 802.11 standard networks and can track any WiFi tags over those networks.”


Dave Stewart, Director, Healthcare, Honeywell Scanning & Mobility, Fort Mill, SC

“When going through the process of rolling out larger, more costly scanning technologies, much of the decision revolves around both ROI and preventing human error. 2-D and 3-D bar coding technology helps doctors and healthcare professionals to avoid simple missteps. Hospitals need to keep in mind that there is no single system that works for all patients, medical devices, technologies and the supply chains within hospitals. Bar coding works well for patient safety, supply chain and specimen collection applications, whereas RTLS/RFID technologies are better suited for other areas in the hospital, not necessarily associated with the individual.”


Joel Cook, Director, Healthcare Solutions, Stanley Healthcare Solutions/AeroScout, Framingham, MA

“As the FDA continues to push for Universal Device Identifiers, hospitals will inevitably face higher accountability. More and more hospitals will turn to bar coding and RFID solutions to effectively track patients, staff and products to meet increasing regulations and compliance demands.”


Jon Poshywak, Managing Director, RTLS Workflow Services, TeleTracking, Pittsburgh

“It is the desire and requirement to standardize efforts that will ultimately justify implementing 2-D/3-D bar coding and RTLS to track everything. These technologies are proven to drive positive outcomes around staff efficiency, asset utilization, reduction and/or elimination of lost assets and supplies, and staff/patient safety and satisfaction.”


Henry Tenarvitz, Chief [Intellectual Property] IP Officer, Versus Technology Inc., Traverse City, MI

“The ROI for RTLS is well-documented, especially when it comes to tracking assets. In just one of many examples from our client base, Sacred Heart Medical Center in Springfield, OR, estimates they saved $600,000 almost immediately by simply being able to utilize their existing fleet of IV pumps. Over the course of 10 years, they expect to save $2.7 million on pumps alone due to decreased leasing and purchasing.

“The ROI for using RTLS for patient flow is somewhat harder to quantify, but is nonetheless striking. A 2011 Emergency Physician Partners financial analysis concluded that if just five patients per day leave an ED without being seen, the hospital’s loss may be as high as $5 million annually. After implementing Versus Advantages, Columbus Regional Hospital reduced their left without being seen rate from 2.75 percent to less than 0.05 percent. Not only does this have direct revenue implications, it also impacts patient satisfaction at a time when HCAHPS scores are increasingly important.

“Complicating matters in the Emergency Department, recent legislation eliminates diversion as an option for most EDs. This means that patient overloads can only be dealt with through improved patient flow management. What other system can provide real-time situational awareness on the pulse of your most chaotic, 24/7 environment? With RTLS, ED managers and staff elevate their communication by simply viewing Versus Glance-and-Go boards to know who is where, what stage a patient is at, or which nurse or doctor is assigned to each patient. Our customers are quoted as saying, ‘we can’t operate without the Versus boards.’ It is communication collected by people simply wearing a small badge, but it produces such huge transformational effects on their workflows.

“In the OR, where costs-per-minute can range from hundreds to thousands of dollars, efficient patient flow and room turnover can significantly impact revenue. One of the top-performing and high volume ambulatory surgery centers in the nation, Northwest Michigan Surgery Center in Traverse City, MI, recently implemented Versus’ RTLS and found they could shave 5-10 minutes off the recovery time for each patient by communicating the patient status via RTLS boards. When you multiply that by the 18,000 patients they see per year, the cost savings are significant.

“Even clinics can benefit from RTLS. Canyon Park Clinic in Bothell, WA, doubled the number of patients they see every month, from 3,000 to 6,000 by using RTLS data to improve efficiency and increase patient flow. At the same time, the clinic improved their customer satisfaction scores, with 91 percent of their patients reporting an excellent overall experience due in part to an efficient visit with little or no ‘alone time.’”


Alicia Torres, Global Practice Leader, Healthcare, Zebra Technologies Corp., Lincolnshire, IL

“At Zebra, we believe every healthcare organization has an opportunity to achieve higher levels of visibility.

“If implementation of new technologies is solely based on cost, one of the most cost effective solutions is 2-D barcodes. On the flip side, RFID or RTLS solutions cannot be the only application standardized – or used – in a medical setting.

“In a fully integrated solution, there should be no priority for standardization of bar coding over RFID or RTLS, or vise versa. These solutions will complement each other in a medical setting, tracking different assets from the supply chain to patient care.”

2-D, 3-D or RFID: That is the question

Does 2-D, 3-D or RFID bleed red or green?

Gazing into the striped crystal ball