Agenda

• Intelligent Healthcare Use Cases & Needs• RTI Connext DataBus• Deep Dive: DocBox• Healthcare & the Internet of Things

Intelligent Healthcare Use Cases

• Clinical Decision Support Systems• Monitoring/Telemetry• Machine Command/Control• Data Acquisition• Device Interoperation• Hospital Operations Management

Intelligent Healthcare IT Needs

• Reliable Operation• Real-Time Performance• System Integration• Flexible Transports• 24x7 Operation• Location Abstraction• WIFI, WIMAX, ISM Bands• Secure Communications• Certifiable• Plug N’ Play Design• Open Architecture

• Fast Development• Legacy Integration• Hardware in the Loop• Scalability• High Throughput• Industry Interoperation• Small Device Connection• Small Device Mobility• Large Fan In/Out• Real-Time and IT Integration

It’s All About the Data

“Health care is burdened by a system where doctors and caregivers have to go searching for vital information; it is inefficient at best and life threatening at worst. We need to make the data more intelligent and integrated, more predictive and proactive, so information finds the doctor instead of the other way around.

Intelligent data flows speed up care delivery and can prevent chronic conditions by getting the treatment right the very first time. Similarly, in terms of health management costs, “intelligent” hospitals are deploying systems that behave like air traffic control for medical staff and devices, and provide a full detailed view of hospital resources. Better utilization cuts capital expenses. Better asset location leaves nurses more time to focus on patients. Better management improves patient flow, cuts operating costs, and saves hospitals millions.”

- Jeff Immelt (Nov 2012)

http://gigaom.com/2012/11/28/the-future-of-the-internet-is-intelligent-machines/

Connecting the Data

Need to construct the “Data

Graph”

RTI Connext: Distribute the Data

Real-Time Analytics &

ControlOperator HMI

Sensors Actuators

IT and/or Cloud

Integration

RTI Connext: The Software DataBus™

• Data centric– Structured, accessible data– Like a database for moving data

• Independent modules– Supports SOA

• Plug and play flexibility– Like a hardware bus

• Peer-to-peer performance– Like streaming protocols

• Standards-based interoperability– Like TCP/IP

• Abstracts Location

RTI Connext DataBus™

Scalable, high-performance, reliable infrastructure that eases integration

Why a DataBus Transport?

• Connects quickly, easily, powerfully• Reduces risk– Proven, reusable, certified

• Saves money– Decouples large problem into solvable

pieces• Enables advanced capability– Reliability: redundant, 24x7 operation– Performance: microsecond latency,

megabyte throughput– Integration: Any transport, OS, language

RTI Connext DataBus™

RTI Connext: Building Blocks

RTI DataBus

Peer-to-peer:• Superior for real-time & near real-

time delivery

Integration Services to connect system-of-systems

RTI DataBus

R

RTI DataBus

R

R R

R R

R R

Integration Services can be composed into a hierarchical

topology

Connext Builds Intelligent Systems

Clinical Decision Support Systems

Workstations, Storage, Historical

HL7/EMR Gateway, Enterprise, 3rd Party

Room

Devices

Care Area

Administration

CDS System of Systems

Remote Monitoring

4G/LTE

Connecting devices with hospitals to provide better treatment while en-route

Machine Command/Control

• Mevion’s Proton-Beam Radiation Therapy system zaps tumors with accelerated protons

• The treatment must be continuous for 30-40 days; downtime endangers treatment success

• Mevion’s PBRT delivers dependable treatment at low cost

Data Acquisition

• RTI powers Varian’s NMR and MRI product lines

• Any one of the sixteen MRI receivers can saturate a 1Gbit network.

• RTI controls and optimizes network use to handle megabytes of load without losing data

“RTI delivered great functionality at a low cost. Using RTI middleware saved us a lot of money, time, and effort compared to our previous in-house developed solution.”

Device Interoperation

• The Integrated Clinical Environment (ICE) standard specifies interoperability for medical devices

• All ICU & operating room devices — from blood pressure cuffs to intravenous pumps to ventilators — could be interconnected according to the ICE standard– Complete logging– Automatic error detection– Better care

• The DDS standard and RTI middleware enables plug & play interoperability across manufacturers

Agenda

• Intelligent Healthcare Use Cases & Needs• RTI Connext DataBus• Deep Dive: DocBox• Healthcare & the Internet of Things

The Problem

• 25% of all hospital admissions have a medical error

• 4 Jumbo Jets full of people a week die from medical errors

• Leapfrog Group has stated it could cost up to $7800 per admit for medical errors in the US

Devices, processes, non-integrated system errors

Requirements from Providers• Complete and Accurate Data• Safe Systems• Secure Systems• Increased Efficiency

– Clinical Workflow– Device and Systems Maintenance

• Improved Quality• Flexible (Inpatient to Outpatient)• Able to deal with new and legacy equipment• Scalable• Facilitation of decision support and data visualization

“Achieving higher quality care at lower cost will require fundamental commitments to the

incentives, culture, and leadership that foster continuous "learning”, as the lessons from

research and each care experience are systematically captured, assessed, and

translated into reliable care.” -IOM 2013

Hospitals are Distributed Systems

• Medical Devices• IT Systems– EMR– Lab– Pharmacy– Radiology

• Clinicians and Support Staff• Patient

Example Scenario 1:Patient Controlled Analgesia (PCA)

• 2-3 Patients per day in the US die from opiate overdose.

• Very little understanding of the cause

• Patient presses button to receive intravenous pain medication• Patients can call to request more analgesia, but, cannot call

for help when over-medicated.• Over-medication can cause respiratory and cardiac arrest• Comprehensive monitoring is not typically used due to high

false/nuisance alarm rate• How can we improve safety of this system?

ICE Supervisor

NetworkController

ICE Interface

DataLogger

ExternalInterface

Medical Device

ICE Interface

Other Equipment

Integrated Clinical Environment (ICE)

Functional Elements of the Integrated Clinical EnvironmentASTM standard F2761-2009Published January 2010 Clinician

Functional Elements of the Integrated Clinical Environment

Patient

Smart PCA SystemPatient

Demographics and History

Medication HistoryDiagnosis

Co-morbidities Orders

Monitoring Data

Enterprise

Point of Care

CDS Algorithm(s)

Observations

Lab Results

PCA Pump

Other Infusions

Other Devices

Safety Interlock

Clinician

Patient

Data-centric Approach

Device 1 Device 2 Device n

Medical App 1

Medical App 2

Medical App n

EMR/Other IS Systems

DDS RTPS Bus

Agenda

• Intelligent Healthcare Use Cases & Needs• RTI Connext DataBus• Deep Dive: DocBox• Healthcare & the Internet of Things

Tim O’Reilly @ GE’s Minds + Machines event in Nov 2012http://www.slideshare.net/timoreilly/lessons-for-the-industrial-internet-pdf-with-notes/

The Internet of Things

• Healthcare IT is not just a part of the Internet of Things– It’s also an instantiation of the Internet of Things

• Smart devices sharing data with doctors, nurses, and analytics to deliver better healthcare.

Internet of Things - Planes

Web Services and Business Apps

Server-to-Server (S2S)

Devices and Intelligent Systems

Control Plane

Device-to-Device

Deviceto

Server (D2S)

Tim

elin

ess

of R

espo

nse

10μs

–10m

s10

ms–

1s>

1s

Another Perspective

Control

Management

Analysis

Tim

elin

ess

of R

espo

nse

10μs

–10m

s10

ms–

1s>

1s

•Process control and workflow•Presentation of “live” data•Security policy enforcement

•Human input / output•Configuration management•Data mining and analysis

•Equipment control and monitoring•Performance measurement and calibration•Fault isolation and automated recovery

Want to Learn More?

Watch Stan Schneider’s webinar replay:

“Understanding the Internet of Things protocols: DDS, MQTT, AMQP”

https://www.rti.com/mk/webinars.html

About RTI

• Market Leader– Over 70% DDS mw market share1

– Largest embedded middleware vendor2

• Standards Leader– Active in 15 standards efforts– OMG Board of Directors– DDS authors

• Real-Time Pedigree– Founded by Stanford researchers– High-performance control, tools history

• Maturity Leader– 600+ designs– TRL 9 1Embedded Market Forecasters

2VDC Analyst Report

Global Support and Distribution

About Us

Tracy Rausch, CCECTO and Founder, Docbox

tracy@docboxinc.com617.997.8375

Sumeet ShendrikarSolutions Architect, RTI

sumeet@rti.com408.990.7424

Your systems. Working as one.DownloadConnextFree TrialNOW

www.rti.com/downloads