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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


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


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


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


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


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


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


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


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


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


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%


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


14

CtO


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


RFID readers

WiFi location readers

Barcode readers





GPS

Cellular

A C B

1

Maintenance

2 3


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.


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.


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



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.


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


Range


Lifetime

Cost

Labor Intensiveness


Range


Lifetime

Cost

Labor Intensiveness


Range


Lifetime

Cost

Labor Intensiveness


Range


Lifetime

Cost

Labor Intensiveness


Range


Lifetime

Cost


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


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


22

CtO


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


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.


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


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


27

CtO

// Q&A

Appendix

…

…

…

…

Back

up M

ate

rial

Apr

10

, 2

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3


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


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


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.


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


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

view powerpoint presentation

Business

asset utilization value

leased asset

asset reconciliation

asset tracking technology

life cycle control asset

visible available asset

control operations

patient care