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Confidential // Do Not Reproduce without prior written permission from Neoris
Pre
senta
tion
Apr
10
, 2
02
3
practical Visionaries
RFID for asset tracking
Technology or Processes
Lionel Carrasco, Neoris CTO
Confidential // Neoris
2
CtO
“Will your company make new investments next year in any of the following application categories?”
Innovators and Early Adopters to Capture More Differential Value
RFID in healthcare
0% 5% 10% 15% 20% 25% 30% 35% 40% 45%
Enterprise portals
Business intelligence
Procurement software
RFID
Content mgmt software
CRM software
ERP software
HospitalsOthers
It is a consistent trend in the industry although is a new technology …
Majority Followers Late Followers
LaggardsEarly Followers
Value
Risk
Innovators
Early Adopters
Immature – High Risk Tested – Low Risk Mature & Stable – Very Low Risk
Marginal Value Residual ValueHigh ValueTime
Adoption CycleDifferential Captured Value
Diff
ere
nti
al V
alu
e /
Ad
op
tion• HCA | Ascension | JMH
• Bon Secours Health System• Barnes-Jewish Hospital• White Memorial Medical C.• VHA | MedAssets | Etc…
• Wal-Mart• DOD
• More than 20% of hospitals are going to be doing new investments in RFID.
• Vs only 8% in other industries.
• The majority of providers plans for RFID are related to asset utilization
Confidential // Neoris
3
CtO
Specialized solutions are in place or being currently tested at several institutions to perform:
RFID related technologies at work
Technology is already proven and supported by several success cases
Counterfeit product tracking
Patient medication control
Inventory management
Caregivers tracking (assistance)
Patient tracking (elders/ infants)
Point of use tracking
Confidential // Neoris
4
CtO
Patient & Financial Health
Context and Players
CaregiversLocating Assets
Highly MovableElusive
Expensive
Assets
Patients
Using
Operational Excellence and patient care is derived from people, processes, management controls and technology
A coordinated effort is critical to the health of the patient and financial health of the hospital.
Clinical Staff
Inventory
Finance
Maintenance
Procurement
Purchase Rental Forecast
SLA Negotiations
CorrectivePreventiveMaintenance
Central SupplyInventoryDelivery
Monitor and ControlEnsure Profitability Risk Management
DeliverOrganizeControl
Operations
Confidential // Neoris
5
CtO
There is severe financial and operative derived risks by not assuring compliance
Why now?
• SOX presents a high risk on asset reconciliation deriving on write-offs and high cost on inventory checks.
• Regulations have been issued by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).
• In order to remain accredited as healthcare facility, organizations are required to demonstrate that life support equipment receives a high priority in their equipment maintenance programs. Enforced by July 1, 2005.
Bringing more patients may increase revenue but not necessarily profits
efficiency efficiency efficiency
PatientsCapitalProfit
+
_
• In an industry where patient service comes first, the lack of profitability in many healthcare providers has been reluctantly tolerated. Not Anymore.
• Profitability is not achieved solely by more patient acquisitions but trough efficiency as the key for operational excellence.
Lack of profitability and risk management drives adoption …
Opportunity
Threat
SOX JHACO
Deadline
Risk
Confidential // Neoris
6
CtO
Location Services applies to specific industry processes
Typical problems in a hospital scenario
High concentrationof assets not being utilized
Leased asset thatwas ready for returnbut not visible
Available asset,but not visible, often resulting inreplacement by procurement
Lost asset during atransfer
Employee spendingvaluable time locating assets
Confidential // Neoris
7
CtOTypical problems on core processes
Location Services applies to specific industry processes
Shortage of staff
Out of flow during supervision rounds
Maintenance due for a defibrillator
Unauthorized exit on mental health
Soiled area entrance & status change
IV Pump on idle for too long
Unauthorized asset removal
IV Pump on idle for too long
Confidential // Neoris
8
CtOAsset Utilization and Life Cycle Control
Asset hoarded in a storage room
Paying late rental feesShrinkage by theft or during transferClinicians wasting
time looking for available asset
Unnecessary purchases
Asset requires maintenance
Unsatisfied patient
Visualizing the day-to-day problems
Knowing where the assets are to increase utilization, ROI, control and compliance.
Asset’s ROI
Usage
(+)
(+)
(+)
(-)
Usage
(-)
Usage
(-)
Utilization Impacts Financial Results
Purchase
Receive
Use
Store
Maintain
PlanDispose
Refurbish
Inventory
Asset Control Life Cycle
Confidential // Neoris
9
CtOThe Roots of the Problem
Proper Compliance
Tight Financial Control
Efficient Operations
Accurate Planning & Forecast
High Quality Clinical Services
Timely Maintenance
Solving the causes of poor Asset Utilization and Control positively impacts other core processes
Our understanding of your operations enables us to identify the causes at its source.
Asset Visibility Asset Status
Asset location
Unknown last location
Asset availability
Unknown actual status
etc… etc…
Asset AccountabilityProcess Enforcement
No event recording
Paper based & no time
No responsibility
No event recording
etc… etc…
Asset Utilization & Control
Confidential // Neoris
10
CtO
Integration of open standard technologies to cover all available methods without relying solely on process enforcement
Let your current operation and infrastructure maximize the return of your assets.
Suggested approach
Accurate location and tracking by triangulation Presence location
by zone
Mobile scan to report last known location and status Browser based update
of information
Exit and entrance control
Leveraging existing WiFi infrastructure
Wireless data access
Automatic status changes, no human intervention
Messaging through the same Voice Over IP network
Outdoor control
Notifications via VOIP Phone (WiFi)
Tagging is determined by the cost, elusiveness and portability of your assets
Active RFID for highly movable expensive or elusive assets.
I.e. Defibrillators, SCD (sequential compression device), Feeding pumps, IV pumps, Suction machines…
Barcode support for low cost and/or fixed assets
Passive RFID tags for mid-cost portable assets
I.e. Oxygen cylinders, Stretchers, Hypothermia pads, C-PAP
I.e. Waiting room TV’s, Computers
Printers, Furnishing – tables, side chairs, Slide tables
Confidential // Neoris
11
CtOAsset Visibility and Status Control is the Key
Controlling assets lifecycle to increase utilization, control, compliance, etc.
Asset Lifecycle Downtimes in Utilization
Allocate
The Acid Test for ROI on Utilization
In U
se
Discharge
Idle
Un
know
n
Soil
Idle
Availa
ble
Locate
Idle Unavailable
Maintenance
Un
availa
ble
Release
Available
Vis
ibili
tyS
tatu
s
SLAs
SLA
s
Demand
Setting Theoretical Capacity
By Encounters Number of Physicians 400
Productivity Measure Physicians 4,200Number of Mid-level Providers 200
Productivity Measure Mid-level Providers 2,100Total Theoretical Capacity of Encounters 1,722,000
Real Number of Encounters 1,200,000Capacity Rate 70%
By Occupancy Set Up & Staffed Beds 400
Days the hospital was opened 365Theoretical Capacity of Occupancy 146,000
Real Inpatient Days 123,458Occupancy Rate 85%
Maximum Expected Utilization Rate for Assets 77%Number of Discharges 150,000
• More capital expenses (new purchases)
• More demand from the nurses and operations staff
• More rental expenses
• More maintenance down time
• More capital expenses (consumable purchases)
Select & Tag
Record Retool Evaluate
Based on cost and demand
Business as usual
Introduce visibility and control
Evaluate results on operations
Confidential // Neoris
12
CtODerived Benefits from Maximizing Asset Utilization & Control
By resolving the root of the problem, tangible and traceable benefits can be derived
Direct impact on profitability and better service to patients
Timely Maintenance (Operative Expenses)
Maintenance Costs Ratio
Reduction on maintenance fees 10-15%
Reduction on biomedical expenses n/a
* Typically annual maintenance cost is 7%
Proper Compliance (Risk Management)
Regulatory Compliance Impact
SOX cost on asset reconciliation Depreciation
JHACO compliance License
Efficient Operations (Labor and Productivity)
Labor Savings Ratio
Operation staff less time on searching 25%
Clinical staff less time on searching* 5%
* Typically employees spend 30 minutes a day
Increased Patient Services Ratio
More medical procedures (efficiency) 2%
High Quality Clinical Services
Satisfaction Factor
Increased staff responsiveness n/a
Increase the Safety and Quality of Patient Care
n/a
Tight Financial Control (Operative Expenses)
Short Term Rentals Ratio
Reduction in rentals 10-15%
Decrease of rental periods 20-25%
Asset Visibility Asset Status
Asset AccountabilityProcess Enforcement
Asset Utilization & Control
Accurate Planning & Forecast (Capital Expenses)
New Assets Purchase Ratio
Reduction in equipment purchase 10-15%
Asset Shrinkage Ratio
Shrinkage reduction* 40-50%
* Typically annual shrinkage is 10%
Confidential // Neoris
13
CtO
Collecting all the relevant information of the assets’ life cycle
Information is stored, processed and integrated with core processes and legacy systems ...
Reporting Demos
CorrectiveMaintenance
SLA
PreventiveMaintenance
SLA
AssetInventory
Reconciliation
Others …
When?Visibility AccountabilityWho?
Why?Control TraceabilityWhat?
How?Details TrackingWhere?
Reports
Day 1 Day 5
In Use
Available
Cleaning
Repair
Inventory Out
Inventory in 8:00 AM
4:00 PM
UtilizationReport
LeaseInvoice
Verification
Maintenance
Compliance
Demand Forecasting
Day 2 Day 3 Day 4
7:00 AM
1:00 PM
10:00 AM
4:00 PM
7:00 PM
6:00 PM
Legacy Info DB
Events Log DB
Med
itech
SC
M
ER
P
Etc
.
Etc
.
CR
M
Main
t.
Invento
ry
Data IN Data OUT
Confidential // Neoris
14
CtO
Confidential // Neoris
15
CtOPositioning Requirements & Available Technologies
Heterogeneous environments demand several positioning techniques …
Entrance & Exit Zones (Present Location)
Near Real Time Location Outdoors Location
• Detect and report last passage through a choke point
• Detect and report presence in a zone identifying last known location
• Detect and report triangulation coordinates as well as presence in zone
• Detect and report triangulation coordinates within a few meters accuracy based on density
Available technologies
RFID gateways
WiFi Exciters
Available technologies
RFID readers
WiFi location readers
Barcode readers
Available technologies
WiFi location readers
Available technologies
WiFi location readers
GPS
Cellular
A C B
1
Maintenance
2 3
Confidential // Neoris
16
CtOLocation Modes
Triangulation
Virtual Zones
Presence Location
Item Z is located some where on area E
Item X in located on area A on X-Y position
A, B and C virtual zones within a physical area
Triangulation is provided with 2-10 meters accuracy depending on the environment and the technique used to determine positioning such as TDOA or RSSI.
Presence location is reported when only one access point can detect signal from one tag. This method is useful for large items on very well defined zones.
When several access points share the same area is possible to define virtual zones within a map, using walls as reference or simply virtual spaces.
Confidential // Neoris
17
CtOLocation Modes
Physical Entrance & Exit
Telemetry
Exteriors Support
Container G45H is the present at X-Y on north yard
Wheelchair 48 crosses exit B9 at 7:04:30 PM
Temperature on Food container FF45T is 34°c
An Exciter triggers Tags to transmit at specific points, adding the Exciter ID to the standard Tag message. Provides instant knowledge that a Tag passed through a gate or doorway or some other tightly defined area.
The Exterior location receivers are designed to operate outdoors. Supports extreme weather operation conditions and provide wide range coverage.
A serial port is available on each tag to support Telemetry data reports. Can store up to 10 messages of 10 bytes each. A call button can also be provided.
Confidential // Neoris
18
CtORFID Evolution - Supplementary Technologies
Bar Code – Designed to provide check points during processes manually
Active RFID – Designed to provide real time location and data collection automatically
Passive RFID - Designed to provide check points during processes automatically
Load Manifest Cross Docking DeliveryManufacturing
Load Manifest Cross Docking DeliveryManufacturing
Load Manifest Cross Docking DeliveryManufacturing
Bar Code is been used for decades and is widely adopted. The cost of tags and infrastructure is very low. Is labor intensive and the reliability of the date depends on processes and human performance.
Passive RFID has reach maturity and is been adopted primarily on retail and CPG. The cost of tags is prohibited for item level and the infrastructure is expensive. Accuracy is still an issue but provide greater visibility and labor savings
Active RFID will abandon RF and adopt WiFi. The cost of tags will continue to be high, but the adoption of standard WiFi infrastructure will lower the investments. Provides greater visibility and data collection and process control.
Confidential // Neoris
19
CtOHow to Choose the Right Technology?
Barcode
WiFi Active RFID
Proprietary Active RFID
Cellular Phones
Passive RFID
GPS / dGPS
Labor Intensiveness
Interactivity / telemetry
Range
Environment sensitive
Lifetime
Cost
Labor Intensiveness
Interactivity / telemetry
Range
Environment sensitive
Lifetime
Cost
Labor Intensiveness
Interactivity / telemetry
Range
Environment sensitive
Lifetime
Cost
Labor Intensiveness
Interactivity / telemetry
Range
Environment sensitive
Lifetime
Cost
Labor Intensiveness
Interactivity / telemetry
Range
Environment sensitive
Lifetime
Cost
Labor Intensiveness
Interactivity / telemetry
Range
Environment sensitive
Lifetime
Cost
Confidential // Neoris
20
CtOThe Wireless Integrated Services
One Single Infrastructure
RFID LocationWireless VOIPWireless Data Access
Asset TrackingCrisis ManagementWireless Order Entry
LocationVoiceData
Integrated 802.11 WLAN Infrastructure
Wireless Dispatch Stations
Patient Record Management
Mobile Telephony
Staff Tracking
Yard Management
Discrete Process Insurance
Confidential // Neoris
21
CtO
Business Scenario in a Hospital (Example)
Neoris’ Approach Provides a Unique Integrated Solution
Accurate assets location and tracking by triangulation
Presence location by zone and status control
Mobile scan to report last known location and status
Web based based update of information
Exit and entrance control of shrinkage
Outdoor control of assets during transfers
Notifications and escalations via VOIP Phone (WiFi)
Applications Scenarios
RFID LocationWireless VOIPWireless Data Access
Asset Tracking & ControlMedical Staff SchedulingWireless Patient Record
Crisis ManagementWireless Asset Management
Patient NotificationsWireless Medications
Staff & Patient Tracking
Medical Procedures Enforcement
Confidential // Neoris
22
CtO
Confidential // Neoris
23
CtOPositioning Events vs. Logical and Business Events
Business Events
Physical Events
Logical Events
The logical event will be received by an human who would take decisions or by an application that will be able to apply a business rule and or execute a transaction.
An event processor server will receive the location message and process the physical event to monitor specific conditions that could originate an logical event and communicate the information to the application tier.
A Location Engine will determine the exact location of a Tag and provide X,Y,Z positioning along with the map of reference and a unique ID represented by the MAC address of the Tag.Visibility =
ID + (X,Y,Z) + Map
The application will process the event and ask a clerk to very the status and take the asset to the soil room
The Dwell-Absence event monitor will detect the event as a potential asset release and send a notification.
An IV Pump will report its location in the same position for over 36 hrs.
Status Monitoring = ID max idle time
Status Control = ID maintenance due
Scenario Event ProcessBusiness Event
Scenario Event ProcessLogical Event
Scenario Event ProcessPhysical Event
Confidential // Neoris
24
CtOFrom Physical Events to Business Events
Converting coordinates into logical events and deriving business process impute
From earth to business heaven
Visibility = ID + (X,Y,Z) + Map
Status Control = ID exiting soil room
Status Control = ID maintenance due
Physical Event
Logical Event
Business Event
Forms Manager
Asset Utilization Infant Abduction
Active RFID
Active Gateway
OR Cart Tracking.
Staff & Patient Tracking Process Enforcement
Location Engine
Passive RFID
Xxx
LE Port Xxx Port
Security Mg Location Mg.
Entity Mg. Events Mg.
Category Mg Entity Locator
Report Mg. PDA Locator
Alarms & Msg. Etc.
Event Processor Server
Backend and scheduling apps.
Confidential // Neoris
25
CtOSystems and Services Architecture
From earth to business heaven
Active Gateway
LE Port Xxx Port
Event Processor Server (Mobile View)
Security Mg Location Mg.
Entity Mg. Events Mg.
Category Mg Entity Locator
Report Mg. PDA Locator
ActiveSuite™ Shared Platform
Forms Manager
Asset Utilization Infant Abduction
OR Cart Tracking.
Staff & Patient Tracking Process Enforcement
Alarms & Msg. Etc.
1Processes Design
Systems Integration
Application Development
Bu
siness E
ven
tsLo
gica
l Even
tsPh
ysica
l Even
ts
2System Implementation
Systems Integration
Outsourcing
3Systems Design
Systems Implementation
WiFi RFID
Location Engine
WiFi RFID
Cisco LE
Passive RFID Barcode
Confidential // Neoris
26
CtOThe Role of Events on Process Management
Business Process Management Integrate People, Information and Products-Services Based on Events
Accountability
Interactions
Management & Access
Human Roles Physical Assets Roles Systems Roles
Decisions & Actions
Data
Processes
History
Status
Visibility
Control
Location
Tracking
Integration
Intelligence
Processing & Storage
Analytics
Data
Processes
LocationVoiceData
Integrated 802.11 WLAN Infrastructure
Business Process Management
Confidential // Neoris
27
CtO
// Q&A
Appendix
…
…
…
…
Back
up M
ate
rial
Apr
10
, 2
02
3
Confidential // Neoris
28
CtODemonstration
/ Collection of Data from Multiple Sources / Mobile Barcode Scanners/ Mobile & Fixed RFID Readers/ WiFi Locators
Asset Location Reporting Web-based User Interface Pre-defined and Ad-hoc Reporting Capability Reporting by Asset History and Location Reporting by Status and Location
Asset Location Map Web-based Graphical Presentation of Current Asset Location Easy-to-use, User Friendly
Flexible Application Architecture Multiple Tiers can be Distributed for Scaling Supports Integration to External Applications Supports Technical Migration as Desired by Client
CB A D
B
Confidential // Neoris
29
CtOThe Neoris Approach – Driven by Value
B
Assets Type B, Tagged with Passive RFID and traced by zone and room
RFID Enabled PDAPerforming processes(Allocation, Release, etc.)
Assets Type A, WiFi Tagged for real time
track and trace
Assets Type C, Barcodetagged and
manually traced
LeveragesExisting WiFi Infrastructure
Passive RFID ReadingPoint to control asset shrinkage
Confidential // Neoris
30
CtOSystem Integration Features
∕ Based on open standards (J2EE, SOAP)
∕ Designed to support Windows NT and Unix Operative Systems.
∕ Provides secure communications
∕ Integrates with AeroScout and Cisco Positioning Engines
∕ Provides tag and category management features
∕ Provides visualization modules
∕ Provides user and role based security
Mobile View Features
Application Development
∕ Provides a Web Services based programming interfaces for all transactional and information extraction as well as for dynamic instantiation of objects.
∕ Application development are supported for Java and .net programming environments.
Scalability
∕ One single Gateway can handle thousands of messages per minute.
∕ One Server is able to process more than 500 messages per second and thousands of event monitors simultaneously.
∕ The system can scale relying on J2EE services, as well as trough the addition of gateways on different facilities.
Application Integration
∕ Logical event can be defined by item or category and communicated to other systems by calling Web Services, Java Messaging interfaces, posting an HTTP message, sending emails or even sending messages via Voice XML.
Confidential // Neoris
31
CtOMonitors
Detects and reacts to presence of a tracked entity or category of entities on a specified location. Detects entrance to/from a location as well as the passage trough checkpoints with the capability of determining the direction of the movement
Zone Entrance / Exit
Shortage / Overflow
Detects when a specified location contains more/less entities of the specified category during a predefined period of time. It is also triggered when too many entities (of the specified category) have passed through a specific point during a predefined time interval
Allows the tagged entities to transmit telemetry data to the central server trough a serial port in the tags. The system is then capable of parsing the message and perform regular expression comparisons. The tags can also provide a call button feature to transmit predefined messages to the server to signal specific events.
Telemetry / Call button
Out of Flow
Monitors an entity’s location and progress over a specified route. It is capable of detecting missing route points and delays over transit periods.
Detects when an tracked entity or category of entities stays inside or outside the specified location longer than the indicated period of time. The absence monitor is also able to detect when a tracked entity is no longer visible by the system due to a tag failure or tag tampering.
Dwell / Absence
Friend / Foe
Detect when a pair/set of entities get separated apart from each other more than a permitted distance or have been separated to different zones. Detects when entities of specified categories get close to each other more than allowed distance or remain on the same location longer that the specified threshold time.
1234
Confidential // Neoris
32
CtOThe Tag - Details
∕ Supports AeroScout Location Receivers and Cisco Wireless Infrastructure
∕ Includes Wi-Fi transmitter (2.4GHz) and LF Receiver (Low Frequency 125kHz)
∕ Up to 4 years of battery life depending on the bit rate programmed
∕ Non-interference with Wi-Fi. Does not establish a permanent connection
∕ Includes proprietary Wi-Fi compatible clear channel assessment mechanism
∕ Long range - Up to 200m (600 feet) outdoors, 60m (180 feet) indoors
∕ Power Output (@ antenna input) – 19dBm
∕ Flexible mounting options. Tag hanger for car rear view mirror, wrist strap, employee badge, trailer and container mount, safety pin etc.
AeroScout T2 Tags
Network Utilization
∕ A 500bit tag message consumes ½ msec
∕ 3000 tags transmitting every minute = 50 tags per second = 25msec out of a 1 second timeslot are consumed = 2.5% air interface utilization
∕ 3000 tags transmitting every 5 minutes = 10 tags per second = 5msec out of a 1 second timeslot are consumed = 0.5% utilization
WiFi Mobile Units Tracking
∕ AeroScout can locate any standard 802.11b/g* unit
∕ Location Receivers listen to a specific message and position it (CTS)
∕ No special software needs to be installed on the mobile client unit
∕ Location positioning does not interfere with WLAN communication
Security
∕ Tags do not associate with Wi-Fi Access Points.
∕ Tag location message consists of a minimal amount of data in the frame body (several bytes)
∕ Tags can work on a dedicated WLAN VLAN and are indifferent to Access Point WEP settings
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