VA CART and Real-Time Locator System (RTLS) Technology · VA CART and Real-Time Locator System...
Transcript of VA CART and Real-Time Locator System (RTLS) Technology · VA CART and Real-Time Locator System...
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VA CART and Real-Time Locator System (RTLS) Technology:
Automated Capture and Integration of structured device data
Paul D. Varosy, MD, FACC, FAHA, FHRSDirector of Cardiac Electrophysiology
VA Eastern Colorado Health Care SystemAssociate Professor of MedicineUniversity of Colorado Denver
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Overview
• Beyond Meaningful Use• The CART Concept• CART Device Surveillance• VA Real-Time Locator System (RTLS) Technology
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VA and Device Data:Beyond “Meaningful Use”
VA: Multiple IT applications capture device data– GIP/IFCAP – VA Logistics/Supply IT system– Cath/EP recording system– CART Program– Prosthetics system (funding for implantables)– CPRS (VA EHR)– National Cardiac Device Surveillance Program
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Challenges of Device Identifier Capture in a “Pre-UDI” World
• Device-Specific Identifiers:– Manufacturer– Model Name/Number– Serial/Lot Number– Date of Manufacture– Date of Expiration– Size(s)
• Difficult to capture manually
• Non-intuitive• Non-standardized• Prone to data entry
error
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VHA Cardiovascular Assessment, Reporting and Tracking (CART) Program
Integration of structured data collection into the process of care
documentation
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CART SITESAll VA Cath Labs (N=76)
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Current Non-VA Post-Market FDA Device Surveillance
• Underreporting• Voluntary = Passive• Numerators, not denominators
http://www.fda.gov/cdrh/postsurv/medsunappendixa.htmlwww.fda.gov/cdrh/postsurv/medsun.pdf
J Gen Intern Med. 2006;21(9):942-948. Arch Intern Med. 2008;168(1):40-46.
BURDENSOMETIME-CONSUMING
NOT AT POINT OF CAREDIFFICULT PROCESS
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CART-FDA Post-Market Device Surveillance
• Challenges pre-RTLS:– Lack of granular information on device identifiers makes
FDA reporting difficult– Difficult to capture identifiers even with CART in place
• New model:– Seamless capture of device identifiers by RTLS– Closer collaboration with FDA via MedSun program
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Real-Time Locator Systems (RTLS)
• Technology to locate and track assets in real time• Many possible technologies
– Radiofrequency ID (RFID) – active vs. passive tags– Infrared– Ultrasound– Many others
• Examples:
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VHA RTLS
• $543M National Contract – Total cost ~$1.6B (remainder funded by individual
VISNs/sites)
• Part of VA’s “Transformational Initiatives”• T-15: Health Care Efficiency Initiative
– Facility Automation• RTLS – 4 use cases
– Asset Tracking– Cath/EP Supply Chain– Critical Temperature Monitoring– Sterile Processing Workflow
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RTLS in VHA Cath/EP Labs
• Implementation VHA wide for inventory management in Cath/EP labs
• Rationale– Expensive tools (catheters, stents, pacemakers,
defibrillators)– Recall management/device surveillance– CART presents a unique integrative data solution
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RTLS Implementation:
Smart cabinet technology with data integration solution
Single point of data entry integrated into the process of care
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VA RTLS Implementation: Ann Arbor VAMC
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VA RTLS Implementation: Ann Arbor VAMC
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VA RTLS Implementation: Ann Arbor VAMC
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VA RTLS Implementation: Ann Arbor VAMC
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RTLS for Cath/EP Lab Inventory Management
RTLS for InventoryManagement
CART
GIP
PIP NCDSP
CPRS/VistA
Hemo/EP Recording System
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RTLS Implementation
• Planning – (began 2010)• National RTLS Contract (2012)• Nationwide implementation (2012 – 2016)
– VISNs 10, 11 (2012)– VISN 23 (early 2014)– VISN 19 (including Denver), 20, 21, 22 (late 2014)– Remainder of VA (2015-2016)
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Vision
• Collect data ONCE and multiply leverage the data for multiple purposes.
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Vision
Data Collection
Nursing Documentation Billing
and Coding
Supply Chain Management
Registries Device Surveillance Research
QI/QMPhysician Documentation
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Vision
Moving beyond Meaningful Use of HIT
to
Meaningful Integration of HIT
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Vision
Requires Meaningful Resources
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