2010
Compiled by: Liz Veazey
From ideas and visions submitted by members of AHVAP, Allen Caudle, Jim Gleich, Laurie Jonsson, Mariam Lowen, Christine Miller, Marcy Parsons, and Liz Veazey

Zoom! I’m off to work in my ‘smart car’ that not only knows the way, but ‘listens’ to signals from other ‘smart cars’ and route markers to chose the best route. Once there, I do not have to check in because the RFID chip on the lapel pin I wear signals the main computer that I am on duty. It opens the files I need, loads my daily to-do list and reminds me of meetings for the day.

I work in Strategic Resource Planning (Formerly Materials Management) where we have streamlined our business model to include just in time deliveries in every department. We no longer keep inventories. Our Vendor-distributor outsourcing partners have specialists who manage daily levels of all supplies direct to the patient level.

One of my first tasks is to provide real-time data and an e-contract for a Patient-Physician-Vendor meeting where the patient is negotiating the level of care he desires based on documented outcomes and his budgetary constraints. I believe this patient, who is accompanied by his private insurance representative, has already contracted for his nursing care, and pre-selected his rehab and home based clinical staff.

The ‘Vendor’ is what was previously called a distribution representative. As distribution is more automated and data driven, and the manufacturers’ product details are more available to every consumer and physician. The ‘Vendor’ of today is an independent agent with access to the best fit products for any given situation.

As for my department, Strategic Resource Planning, we now do all our analysis on line. With the regulations controlling Web security, we no longer use the cumbersome paper and easily forged signatures. It is not legal until we receive your authorized e-code. Indeed, ‘beam me’ has replaced ‘lets shake on it’ as slang for ‘we have a deal’.

After the meeting, I walk through one of the nursing units where the night shift is just synchronizing their patient data with the main records computer and preparing the PDA/VSM units for the relief staff. These units automatically up load patient vitals and notify staff for any reading outside the staff selected parameters. Their drop down lists and full body charts allow the nursing staff to quickly identify the precise location of pain, rales and wheezes, or wounds and drainage. Staffs spend much of their time in teaching and counseling sessions with patients and families since the charting, research and planning functions are not only automated, but portable and communicated in real time to other clinicians, patients and their families.

As the physicians are preparing for rounds, they check their own PDA/VSM unit to review the overnight trends for their patient’s labs. This is a painless procedure consisting of a query of the patients’ bedside unit which is constantly monitoring blood values through the tip of their IV site. Any value out of normal would have alerted the nurse and physician, but staff still likes to review the specifics. These same PDA/VSM units will send and receive med updates (What used to be called e-mails) to families and other clinicians to set up consultation and counseling sessions.

Nursing staff includes a Clinical Information Technologist who manages the multiple monitoring devices and the network of sensing equipment that allows them to interact. As with all emerging technologies, she must ensure calibration and inter-connectivity of all equipment. We recently worked with a vendor to add an O2 Sat monitor that, when a patient’s oxygen saturation drops or his CO2 level increases, will detect and place on hold any IV or PCA device delivering substances with respiratory suppression capabilities and notify the nursing and medical staff of impending danger.

The Auto Trans gurneys are lined up and humming in the hallway awaiting today’s list of patient transports. With the remote monitor unit attached to the patient and the Auto Trans receiving signals from nursing units and destination departments, the stable patients are safely transported to their destinations. For those less stable patients, the MRI and CT mobile scanners (Boxy little robotic units roaming the halls) will be summoned to the bedside. Of course, collision avoidance and perimeter detection sensors are standard equipment on all these items as well as route mapping and congestion detection software.

Excuse me, but my ID pin just notified me of a request from the CEO to stop by his office. Even in 2010, when the boss calls, I feel obliged to go. At 99 years old, he carries a lot of authority and wisdom and has been one of my mentors. At 63, I am just a child in today’s world. With monitoring, early diagnosis and treatment, and the recent advances in DNA and life style research, my mentor and I should be playing golf together when he retires in ten years.

Well, this walk through my day must end. My CEO wants me to chair the community based service group dealing with a vendor problem. It seems the ‘wear sensing hip implants’ used by our Orthopedic group 3 years ago have been sending eminent failure signals 7 years ahead of schedule. The community group wants me to chair a task force with the manufacturers and physicians to explore solutions or recall options. Again, we are working with our vendor partners to handle the situation. Since the national moratorium on medical legal liability suits and the strengthening of the "Four Corners of Medicine" initiative (Patient-Physician-Care Delivery-
Manufacturers), our collaborative efforts have sent most medical lawyers to retrain as used Auto-Nav and Hum Vee dealers. HPN