AAMI 2008, San Jose, Day Three
I was too beat to catch the breakfast symposium. My day started with the session titled…
Designing for the unforeseen: preparing your facility for evolving technologies
Presenters: Barrett Franklin and Sudhakar Nagavalli of KJWW Engineering; Valmik Thakare, Christner; and Dennis Minsent, OHSU.
Major trends that they see:
- Diagnostic imaging – portability
- Clinical information systems
- Video capture
- Transparency (RTLS)
Diagnostic imaging is moving out of conventional settings into surgery, procedure rooms and intensive care. This impacts workflow and consequently, workflow automation. Imaging is becoming an enterprise application, going beyond distributing images on an enterprise basis to include image acquisition anywhere and any time.
Patient monitoring is transitioning from disparate stand alone systems to an enterprise system. This creates specific infrastructure requirements, encompassing wired and wireless networks. Raising patient acuity and an increasing trend to spread higher acuity patients out to their medical services has increased the need for pervasive monitoring capabilities.
Integration was grouped into 3 different applications. Integration started in the operating room, and this trend evolving into a unified enterprise system. There is a growing requirement for disparate systems to work in concert, including: patient monitoring, ventilators, infusion pumps, defibrillators and information systems. This gives rise to challenges in defining a coherent network infrastructure.
Transparency is realized through indoor positioning systems (IPS) that track assets, staff and patients. When planning for new construction, designs that take RF interference into account are important.
The design team for new construction includes clinical, mechanical, electrical and structural engineers, along with architects and clinicians.
Planning for change is critical. While the physical plant may last more than 50 years, much of the technology that goes in it will change significantly over a much shorter term. A planning life cycle of 5 to 10 years was suggested. Designing the physical plant to accommodate change, as technologies, care delivery methods and patient requirements evolve.
An interesting chart showing change probability across various care areas was presented. High acuity and “big iron” diagnostic modalities were ranked as having the highest rate of change. Declining change was shown in inpatient units, office space and support areas.
The presentation then delved into specific planning and techniques for new construction planning. They ended with a case study of “building green” at OHSU in Portland, Oregon. The green approach entailed the utilization of passive solar and state of the art energy efficiency. The building discussed is a research and outpatient clinic facility.
In the following discussion it was noted that some vendors design their infrastructure, like mounting plates, different from their competitors. Selecting vendors that do this impacts the resulting flexibility and can greatly increase the cost to change technology in the future.
More sessions to come, be sure to check back.