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Crisis and Post-crisis Management in HPSJ by means of ORVital 4.0

1. Global presentation of the solution

 
The ORVital4.0 solution is a digital platform which makes it possible to manage and supervise in real time the different hospital flows (patients, equipment, materials, rooms, messages and tasks) and to ensure their traceability. To achieve this objective, it relies, among other technologies, on the wireless and contactless Bluetooth Low Energy (BLE) geolocation tool. It is used as an Hospital Process Manager (HPM). This is possible by means of the reliable and automatic collection, in real time, of precise geolocation data (<2 m).   As illustrated in the figure above, the patient, or the equipment, is provided with a tag which communicates periodically via the Bluetooth protocol (every 1 - 2s) with terminals arranged throughout the routes pre-defined. The geolocation information is transmitted, analyzed, processed, then stored at the level of dedicated servers and databases, and the appropriate actions are automatically generated. This makes it possible to carry out a precise and real-time monitoring of the different routes which are completed or in progress and, to have a reliable and unbiased view of the location and status of the tag bearer.  
Schematic view of the ORVital 4.0 solution
 

Furthermore, the platform interfaces easily with the vast majority of hospital softwares (from Dedalus, from GE, EMR, etc.). Thus, it can be used, at the same time, as a dashboard gathering essential information (personal, medical, surgical, operational) but also, as a source of information which allows the automatic triggering of actions (sending of messages, generation of tasks, validation of an operational action, ..). This makes it a powerful Hospital Process Manager.
 
By its design and the services offered (Intuitive and Interactive platform, Virtual Waiting Room, Supervision screen, BI report,..), the platform has proven in HPSJ to be a very useful support to allow a quick and easy resumption of activity and, ensure an adequate quality of care and services to patients, in an uncertain and difficult period, always marked by COVID and its consequences.
 


 

2. Medical professionals – Point of view

 
Our first testimonies describe the feelings and experiences of medical professionals (nurses, administrative assistants, medical assistants, Health manager) in HPSJ when, after the crisis, the activity restarted in the Ambulatory surgery Unit (UCA).
 
• Quick and Easy handling and re-starting:
The UCA Unit is facing a significant turnover. This forces the service to regularly call on temporary staff or people from other establishments or services. This requires planning training sessions (handling of software, definition of processes, etc.) and mobilizing time not dedicated to the expected medical service. Therefore, the ease of handling software is essential operationally and economically. When activity resumed in May, the situation was even more problematic, as the usual staff, mobilized to care for COVID patients, was only very partially available. In addition, the difficulty in finding replacement staff forced them to work with a very small number of medical professionals.
 
The ORVital 4.0 platform by its design favors tactile interactivity and is very intuitive. User interfaces are designed around widgets, rapidly identified icons, colors, drag and drop actions and drop-down menus for the most popular, as shown in the screenshots below. This makes handling quick and relatively easy (1-2h), even for people who are not familiar with this type of environment.
 

 
In addition, as was explained in our previous post, the solution makes it possible to automate many actions (generation and monitoring of tasks, generation of alerts in case of an abnormal situation, sending of information messages to the family,…), relieving teams of the repetitive and time-consuming actions that are not at the heart of their medical activity.
 
• Contactless and Reliable Follow-up of patients and room status:
As explained in our previous post, the solution makes it possible to follow, in real time, automatically and without contact, the geolocation and the status of each patient with reliability. This allows to ensure the complete traceability of the latter and to provide it with personalized quality of care and services, despite a difficult and unusual context. This monitoring can be done using several screens. In particular:
 

✱ The supervision screen which gives, at a given time and on a single screen, the status and location of each patient.
 

Supervision screen

  
✱ The user interface which displays the list of patients for the day with all the information (personal, medical, surgical, operational), necessary to guarantee a secure and quality patient journeys.
 

List of the patients of the day

 

✱ The user interface which shows the list of patients in the next 2 working days and, which allows professionals to optimize and organize resources in a proactive way.

 

✱ The screen which allows you to see and manage the status of the rooms (OR, box, bedrooms, etc.) through colors and buttons. It is thus possible to identify the rooms occupied (red color), free (green color) or “to be cleaned” (yellow color). On the basis of this information, tasks (cleaning, allocation of the room, etc.) can be generated using the platform. Monitoring of these can be done remotely via ORVital.
 

 

Management and Supervision of rooms status

 

• Optimisation and Securisation of patient paths:
By means of the screens and user interfaces presented above, it is very easy to follow in real time, without additional action and external intervention (verbal or written exchange), the path and status of patients as well as the location and status of rooms and equipment (used, to be cleaned, free, etc.). It is also possible to have access to their traceability and their history (evolution of the status and locations over a given period of time).
 
On the basis of this information, the tasks and actions required (cleaning, assistance to disoriented or disabled people, repatriation of equipment, reallocation of a patient to another room, communication on the necessary waiting time or status request) can be triggered automatically or manually by medical professionals.
 
In the case of infectious people, it is also possible to follow their route and, thus, quickly identify the rooms and equipment to be disinfected and, possibly, to carry out prevention and screening actions towards people who have been in contact with them. These functionalities can be reinforced by the ATLAS application developed by MySphera in March 2020 (this is not available in our client HPSJ).
 
Patient journeys can thus be made secure, personalized and operationally optimized without any additional action or workload for medical staff.
 
Finally, the real-time updating of the patient lists (via the geolocation tool and, the interfacing with other hospital software) and of the actions, carried out or in progress, increases the responsiveness, flexibility and agility of the service. Indeed, using reliable and updated information and a global overview of the ongoing processes, resources (people, rooms, equipment,..) can be quickly organized and mobilized to deal with any change or hazard. This has proven to be very useful in managing the effects of the pandemic.

 
• Real-Time management of OR and patient paths – Dashboards:
A criticism often expressed by medical professionals is the multiplicity of screens and tools to open and consult to access all the information they need.
 
With the ORVital solution, nursing staff use only one tool, with which they can consult customized screens and user interfaces dedicated to their activity, with a simple click or finger action. Access can be achieved on PCs, tablets, TV screens or smartphones, which ensures complete mobility.
 
In addition, by means of these screens, tasks and actions can be generated manually and, information can be added to the patient files in order to complete them (contact details of the accompanying person, luggage information, etc.). Interactivity and the sharing of knowledge and information are thus facilitated between distant people and services, without direct contact (email, phone, note,..). Furthermore, this ensures the traceability of the information.
 
• Enhanced Reactivity, Agility and Flexibility of the service
This is a direct consequence of the design of the tool.
 
The interactivity in the tool, the reliability and the real-time updating of information in ORVital allow to have a global view of future needs and to estimate the time available to respond to them. This is a real asset to be proactive and, to acquire a certain resilience facing hazards and last-minute events (emergency events, cancellation,..).
 
• Efficient Collaboration
The sharing of information, through intuitive and interactive screens and user interfaces, accessible by all people concerned, makes possible to communicate efficiently and quickly between the remote services and the various stakeholders (cleaning staff, porters, etc.) involved.
 
The ability to generate tasks and monitor their progress in real time using the platform further enhances the quality of collaboration.
 
• Efficient Communication and Information Sharing
The sharing of information, through supervision screens and, intuitive and interactive user interfaces (patient list, room management) which are updated in real time by unbiased data collected along the paths and, which are accessible through secured access by all people concerned, makes possible to exchange, remotely and without contact (written or oral), efficiently and quickly. Each service and stakeholder (nurses, doctors, surgeons, Health manager, cleaning staff, porters, etc.) involved can so, regardless of their objective or availability, be informed in a reliable manner and in real time.
 
The generation of tasks, in real time, and the associated traceability further strengthens the quality of this sharing.
 
In addition, because the design of ORVital aims to limit time-consuming and manual interventions which are sources of error, the solution provides, in order to fill in the additional elements, pre-established forms to be completed via drop-down menus, boxes to check or manual entries if no entry via multiple choice can be considered (name of the person to contact for example).
 
Finally, ORVital provides various tools to communicate effectively and efficiently with families, by sending SMS, or through an access to a screen in the hospitals waiting rooms or by means of the MySphera Smartphone application “Virtual Waiting Room”.
 
• Automatisation of tasks
Another aspect of ORVital that is particularly appreciated by healthcare professionals, especially in the most tense moments, is the automation of many tasks. The latter can take different forms:
▶ The generation of alerts in case of an abnormal situation (duration exceeded in a status, patient located outside the authorized or pre-allocated area, patient being late considering the convocation hour, etc.).
▶ The generation of messages in direction of the family.
▶ Or the generation of tasks towards dedicated people (cleaning, porters, etc.) when necessary.
 
The automatic sharing of information on the status of patients and rooms is another aspect of this automation which relieves hospital professionals of repetitive and time-consuming workloads which are quite far from the heart of their functions. Furthermore, the latter ensures an unbiased traceability.
 
• Efficient Supervision of strategic issues
In UCA, three major challenges have to be managed daily : emergencies and patient integration, management of disoriented patients and management of cleaning/disinfection.
 
The criticality of the latter increased during the crisis because of the understaffing and the enhanced risks generated by the pandemic.
The informational tools and the functionalities provided by ORVital and presented previously allow to manage these challenges effectively, without additional workload for UCA professionals.
 

3. Executive Management – Point of view:

 
The second part of the testimonies is focus on the executive managers and their interest for the solution ORVital.
 
• Reliable and unbiased data and KPIs – BI and Reporting
 
By means of the automatic and periodic collection of reliable data of geolocation and, with the digital traceability of the actions carried out, it is possible to set up unbiased KPIs and to create reporting of activity. Two examples are given below:
 

 
This information can be a substantial aid in the decision-making process because it gives a global and in-depth view of the activity in the desired services and units. It can provide information, among other things, on patient journeys, on the rate and hours of operating rooms occupation, on the actions carried out and the average times to accomplish them over a given period.
 
All these elements are at the customer’s choice according to its needs. This information and documents can be easily shared.
 
• Quick and thorough look into the activity to achieve the excellence of operational processes
Using this information, it is easy to identify bottlenecks, friction points or sources of downtime. In addition, the consequences of a lack of resources or a failing organization can be quickly highlighted. Thus, it is possible to define the points to improve and the action plans to be carried out.
 

4. IT professionals – point of view

 
The last source of feedback is the HPSJ IT department. We have worked closely with them, not only for the deployment of the solution but also, on security issues, legal compliance (GDPR in particular) and to define business continuity and recovery plans.
 
• Quick re-starting
The activity in UCA stopped for 1.5 months in order to be able to redeploy the nursing staff in the Covid units of HPSJ. The recovery took place on 4th, May and all the softwares had to be operational and take into account the changes and constraints that emerged with the crisis. The ORVital solution, which is very modular and based on a click and start model, was able to be used immediately in an efficient manner to support the disrupted activity in UCA. The few adjustments desired later to further improve the user experience and processes could be made in parallel, without disturbing daily activity and without significant involvement of the IT team.
 
• Flexibility and Agility – To manage the last-minute IT and medical changes and constraints
The solution ORVital is built on a set of modules that it is possible to develop and customize individually, which allows us to get as close as possible to customer expectations.
 
Furthermore, from the start of the specifications, MySphera team pays a lot of attention to involve all the project stakeholders, in particular all the operational staff involved and the IT teams who are essential technical partners. A particular care is then given in identifying and defining the operational needs and the expectations of its customers, by working closely with them.
 
Finally, MySphera, whose activity is entirely dedicated to the health sector for 10 years, has acquired an international experience in this sector, which has enabled it to develop a certain expertise in this demanding field. The teams can bring its knowledge and feedbacks to help the customers express their needs and define their specifications.
 
• Privacy and Security of data and information – GDPR conformity
The criticality of the health sector led MySphera to be, very early, sensitive and involved on these subjects. The solution, from its conception, integrated the issues of security and GDPR compliance. When specifying customer needs, these subjects are addressed and treated with the DPO and IT department in order to guarantee that they are taken into account by the customer from the beginning. The solution is deployed on-premise at HPSJ. However, the MySphera teams took care to provide the necessary information and support to the customer to guarantee compliance.
 
Finally, by its design, the solution ensures the confidentiality, integrity and reliability of the data. This is reinforced by the implementation of a secure user access to their personal and individual account, which is based on the hospital’s LDAP.
 
• Support and Maintenance
In order to guarantee constant and quality assistance to its customers, MySphera has set up a qualified technical team “Support and maintenance” who has been trained to GDPR and other current legal issues about data. The team is accessible and present over an extended time slot in order to respond quickly to customer requests at any time.
 
We hope that this brief presentation of our ORVital solution has answered some of your questions. If you would like to know more or determine if this tool can meet your needs, do not hesitate to contact us, we will be happy to discuss with you and to study with you your use case.

By: Mireya Lázaro

08/07/2020

OR4.0