WO2008123992A1 - Tag based knowledge system and methods for healthcare enterprises - Google Patents

Tag based knowledge system and methods for healthcare enterprises Download PDF

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Publication number
WO2008123992A1
WO2008123992A1 PCT/US2008/004272 US2008004272W WO2008123992A1 WO 2008123992 A1 WO2008123992 A1 WO 2008123992A1 US 2008004272 W US2008004272 W US 2008004272W WO 2008123992 A1 WO2008123992 A1 WO 2008123992A1
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Prior art keywords
information
rfid
patient
systems
correlations
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PCT/US2008/004272
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French (fr)
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WO2008123992B1 (en
Inventor
Neeraj Bhavani
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Tagnos, Inc.
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Publication date
Priority claimed from US11/733,056 external-priority patent/US9928343B2/en
Application filed by Tagnos, Inc. filed Critical Tagnos, Inc.
Publication of WO2008123992A1 publication Critical patent/WO2008123992A1/en
Publication of WO2008123992B1 publication Critical patent/WO2008123992B1/en

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    • GPHYSICS
    • G06COMPUTING; CALCULATING OR COUNTING
    • G06QINFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q10/00Administration; Management
    • G06Q10/06Resources, workflows, human or project management; Enterprise or organisation planning; Enterprise or organisation modelling
    • GPHYSICS
    • G06COMPUTING; CALCULATING OR COUNTING
    • G06QINFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q10/00Administration; Management
    • G06Q10/10Office automation; Time management
    • GPHYSICS
    • G16INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16HHEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H70/00ICT specially adapted for the handling or processing of medical references
    • G16H70/60ICT specially adapted for the handling or processing of medical references relating to pathologies

Definitions

  • the field of the invention is data processing operations utilized in the practice, administration, or management of a healthcare enterprise (U.S. Class 705/28)
  • RFID tags Radio Frequency Identification Tags
  • RFID tag systems that are suitable for keeping track of locations of assets.
  • the CiscoTM article, and all other referenced citations are incorporated herein as though fully set forth in this application.
  • a definition or use of a term in a reference which is incorporated by reference herein is inconsistent or contrary to the definition of that term provided herein, the definition of that term provided herein applies and the definition of that term in the reference does not apply.
  • RFID tags can be used to obtain and transmit physical parameters data (e.g., time, temp, and moisture, etc), and operational data (e.g., on/off, ready/not ready, damaged, being cleaned, etc).
  • physical parameters data e.g., time, temp, and moisture, etc
  • operational data e.g., on/off, ready/not ready, damaged, being cleaned, etc.
  • the present invention provides apparatus, systems, and methods in which RFID information is provided for multiple different purposes in a scalable, flexible manner, preferably using rules and correlations that can be altered by healthcare staff having little or no specialized information technology (IT) expertise. Such information may be further combined with patient telemetry to provide positional information of the patient and/or associated healthcare personnel.
  • IT information technology
  • the RFID information will typically include one or more of location information, physical parameters data, and operational data, and it is further contemplated that different types of items can be tagged, including equipment, people, and supplies. Any suitable type of tag, or combinations of different types of tags, can be utilized, with readers (also known as interrogators or transceivers) placed around the enterprise as appropriate. Contemplated systems can have anywhere from a single tag to 5,000 or even more tags in a large enterprise. The readers can advantageously be positioned such that at least 80% of the RFID information is refreshed at least every 10 minutes, and but more preferably the system would be implemented such that at least 80% of the RFID information is refreshed at least every minute.
  • the core of the system is contemplated to be embodied in a general purpose computer.
  • Data entry and display devices communicatively coupled to the computer can be positioned throughout the enterprise, and can include electronic tablets, cell phones and pagers, as well as full sized data entry screens and displays such as might be found in accounting departments and nurses stations. In most or even all cases the data entry and display devices need not be dedicated to handling information derived from the RFID data.
  • Preferred systems and methods include a Java or other cache that stores current RFID information, a rules based engine that derives events from the RFID information, a correlation engine that derives steps from the events, and an execution engine that delivers information relating to the steps.
  • staff members of the enterprise can define at least one of the rules and correlations entirely using menus and/or point and click techniques.
  • Events can fall within any appropriate range of generality to specialization.
  • an event might comprise "a doctor reported to the emergency room for duty” or "Dr. Jones reported to the emergency room for duty.”
  • steps One step might be to "discharge the patient” and another might be to "send an SMS message to Dr. Jones advising of delay in surgery.” All realistic steps are contemplated, including one or more of sending a text message, a page or a voice message, and providing information to disparate systems, including a billing system, a bed management system, a staff timekeeping system, and a medical information system.
  • the inventive subject matter further provides systems, methods and devices in which are RFID circuitry is combined with a telemetry unit.
  • the RFID circuitry can be combined with the telemetry unit in any suitable manner, including for example including the circuitry in a tag, and attaching the tag to the telemetry unit, or to a patient wearing the telemetry unit.
  • the RFID circuitry preferably uses Ultra- Wide band frequency capability, or other high resolution technology. In especially preferred embodiments the RFID circuitry can provide resolution to below five feet in at least some area of a medical care facility that uses the telemetry unit.
  • the RFID circuitry can be used to provide information used in billing use of the telemetry unit, or for some other aspect of billing. Additionally or alternatively, the RFID circuitry can provide information that is used to predict an event related to a patient carrying the telemetry unit and/or as input to an information technology software package in a medical care facility. The RFID information can be used in conjunction with existing applications inside the hospital. The existing application can be any suitable information technology software package in a medical care facility,
  • Figure 1 is a conceptual diagram of an "Intelligent Clearing House" for RFID information.
  • Figure 2 is a conceptual diagram of an alternative view of the "Intelligent Clearing House" of figure 1.
  • Figure 3 is a high level flow chart of data flow within a preferred embodiment.
  • Figure 4 is a chart showing sample records in a RFID table.
  • Figure 5 is a chart showing sample records in a rules table.
  • Figure 6 is a chart showing sample records in a correlations table.
  • Figures 7 A and 7B are screen shots of portions of a floor map demonstrating zoom functionality on mobile assets.
  • Figure 8 is a use case showing how patient care could be improved using a preferred embodiment.
  • Figure 9 is a use case showing how operational efficiency could be improved using a preferred embodiment.
  • FIG 10 is a perspective view of a person wearing a vital signs monitor box and a wristband, each tagged with an Ultra- Wide Band (UWB) Radio Frequency Identification (RFID) tag.
  • UWB Ultra- Wide Band
  • RFID Radio Frequency Identification
  • FIG. 1 depicts an intelligent clearing house system 10 generally including RFID tagged items 20, computer processing hardware and software 30, and third party applications 40. Arrows 21C, 22C, 23C, 41C, 42C, 43C, and 44C depict communications to and from the computer processing hardware and software 30.
  • Tagged items 20 are shown in figure 1 as including Staff 21, Patients 22, and Equipment 23, but virtually anything can be tagged.
  • an enterprise could use a tag carried by a staff member or patient that is already included in his/her cell phone, pager, PDA or other device.
  • Equipment is readily tagged directly on the unit, and in some cases the equipment might already by tagged.
  • UWB Ultra- wide
  • Tags come in a variety of configurations, with the currently preferred tag being about 1 inch x 1 inch (2.5 cm x 2.5 cm) for equipment, a regular badge for staff, and a wristband for patients and visitors.
  • tags Some installations prefer, or are already outfitted with, other types of tags such as passive, semi-passive, and/or semi-active tags.
  • Some tags might deliver only identify information used for determining location, while other tags might provide other types of information such as physical parameters data (time, temperature, and moisture, etc) and operational data (e.g. on/off, status, etc).
  • a major strategic advantage in systems and methods described herein is that they can be completely hardware agnostic to the underlying RFID system that a particular prospective customer employs. Among other things this lowers the barrier to accepting the new service and facilitates choosing the best possible RPID hardware for a particular situation. As illustrated below, further benefits derive from employing a "command-center" approach that interfaces with different RF systems, and can become the central information processing unit of "who, what, where, and when" of medical equipment, staff and patients.
  • any suitable type of tag, or combinations of different types of tags can be utilized, provided appropriate readers are installed, and provided sufficient readers are placed around the enterprise.
  • Contemplated systems can have anywhere from a single tag to 5,000 or even more tags in a large enterprise.
  • the readers can advantageously be positioned such that at least 80% of the RPID information is refreshed at least every 10 minutes, and but more preferably the system would be implemented such that at least 80% of the RFID information is refreshed at least every minute.
  • Current active tag readers can often triangulate locations of tags from up to 200 meters away, through walls and other structures, with a resolution of only a meter or less.
  • Arrows 21C, 22C, and 23C represent potentially two-way communication between the tags and tagged items on the one hand, and the computer processing hardware and software 30 on the other hand.
  • the tags need to wirelessly communicate with the tag readers (upward arrows), and the readers then typically communicate with the computer processing hardware and software 30 using cable or another wireless communication.
  • the downward arrows typically depict communications to the tagged items rather than to the tag itself.
  • the computer processing hardware and software 30 might send an email, voice mail, or page to an appropriate device carried by a staff member or even a patient. It is contemplated that future tags will have displays associated with them, so that a lost patient, for example, could be located and directed back to his/her room.
  • Computer processing hardware and software 30 preferably contains at least the three layers shown.
  • the lowest layer on the diagram is middleware 32, which receives tag data, such as location, duration, temperature, or moisture or other environmental parameters from the readers.
  • middleware 32 can be implemented in a generalized fashion to accommodate any needed inputs, thereby preventing the system from being tied to any particular manufacturer or model of tags or tag readers, or any particular telephone or other communications system.
  • middleware 32 Having received the data, middleware 32 then preferably passes the data into the core engine, described here as an Intelligent Associations And Analytics Engine 34, which preferably has a hot cache or other memory structure 34A, 34B, and 34C and is preferably structured/operated under Java.
  • the core engine 34 applies a set of rules to the RPID information to determine events, and applies correlations to the events to determine steps, and then executes or initiates execution of the steps. Some of those steps provide passing information along to the third party applications 40 via additional middleware 36, described here as the Uniform Enterprise Visibility Applications and Semantic Data.
  • middleware 36 is likely to be implemented as separate processors, such as the blades in a blade server, to handle communications with the various proprietary interfaces of the third party applications 40.
  • Arrows 41C, 42C, 43 C and 44C represent communication between middle layer 36 and the third party applications 40. That communication will mostly involve one-way communication, with the middleware 36 supplying information to the third party applications 40 (upward arrows). But it is contemplated that one or more of the third party applications 40 could send inquiries or other data to the middleware 36 (downward arrows). Communication characterized by arrows 41C, 42C, 43 C and 44D will likely, but not necessarily, be formatted according to a standard messaging protocol, such as Health Level 7 (see www.hl7.org).
  • Hospitals can easily have dozens of third party applications, handling many different types of information.
  • third party applications are an asset management application 41, a staff timekeeping application 42, a hospital information application (HIS) 43, and an electronic medical records application 44.
  • Another of the contemplated applications 40 is a web portal where hospital administrators can pull-up operational reports of not only their hospitals but, when appropriate, see similar reports on medical assets being used at other hospitals for the purpose of comparing notes and sharing and learning best practices.
  • This kind of information can only be obtained by one- to-one (versus many-to-many) conversations; poring through a vast array of industry publications; or by attending expensive, often distant, educational meetings.
  • the web portal application highlights the healthcare IT industry's migration from providing pure information technology to providing information itself.
  • the "Intelligent Clearing House software” can have a mapper-software that integrates processed intelligent data to support Information Technology systems such as IDX, Cerner etc. inside the hospital through GUI screens and "point-and-click" software. Still further, an “Intelligent Clearing House software” engine can move beyond automatic detection of events to automated prediction of events.
  • the predicted events could well comprise HL7 standard events, including for example patient admission, patient discharge, and so forth. Exemplary events include the following:
  • Patient X-ray procedure complete The system can detect that an X-ray procedure was completed, or that a surgical procedure is about to start, by determining that the patient was transported out of the X-ray room, waited in the radiology hallway for a bit, re-entered the X-ray room, and is just coming back to the surgical unit.
  • Figure 2 shows how implementations described herein can coordinate numerous aspects of information flow within a hospital or other health care enterprise, even though the subject matter is not directed to providing a completely unified system.
  • Physician part of Staff 21
  • Patient 22 Patient 22, and Equipment 23, all in accordance with Figure 1, and also additional icons for another type of tagged item (Surgery 24), and additional types of third party applications (Enterprise (HIS) 43, Lab 45, Pharmacy 46, and Suppliers 47).
  • HIS Enterprise
  • RID System corresponds to the computer processing hardware and software 30.
  • Arrows 21C, 22C, 23C, and 43C correspond to the same numbered arrows in Figure 1
  • arrows 24C represent communication between tagged items in the operating room 24 (patient, staffs, or equipment) and middleware 32.
  • arrows 45C, 46C, and 47C represent communication between the third party applications in the lab 45, in pharmacy 46, and suppliers 47, respectively, and middleware 36.
  • the core engine 100 (34 of Figure 1) applies a set of rules 112 to the RFID information 110 to determine events 120, applies correlations 122 to the events 120 to determine steps 130, and then executes 132 the steps 130. As described above, some of those steps 132 provide passing information along to the third party applications 40 via additional middleware 36.
  • Figure 4 depicts an exemplary portion of an RFID tag table, showing field designators (Tag ID, Tag Type, Tag Name, Coordinates, and Time Stamp) in the first column and four sample records in columns 2-5.
  • field designators Tag ID, Tag Type, Tag Name, Coordinates, and Time Stamp
  • Figure 5 depicts an exemplary portion of an Event Rule table, showing field designators in the first column and four sample records in columns 2-5.
  • the data can be generalized.
  • the "who" field (row 4) could reference a type of asset and not necessarily an instance of the type.
  • the corresponding cell of record 1 might use the designation "Doctor” instead of including the literal "Dr. Jones", the corresponding cell.
  • the "where" could be "examining room” as opposed to a particular zone.
  • the data can also be used to interact with third party systems 40.
  • the message field (row 16) could be an HL7 communication to a third party application such as a bed management system, rather than a text message to the corresponding "who" field.
  • the message could be a keystroke recording or other logon script, that accesses context relevant information (from one or more of the third party systems) with respect to the "who" or other information in record 1.
  • Figure 6 depicts a portion of a Correlation Engine table, showing field designators in the first column and four sample records in columns 2-5.
  • Figure 8 is a use case showing how patient care could be improved using a preferred embodiment
  • Figure 9 is a use case showing how operational efficiency could be improved using a preferred embodiment.
  • a person 200 is wearing a vital signs monitor device 210 tagged with a first Radio Frequency Identification (RFID) tag 212, and a patient identification wrist band 220 tagged with a second RFID tag 222.
  • RFID Radio Frequency Identification
  • the person 210 shown is emblematic of all possible persons, regardless of gender, race, age, ambulatory status, and so forth.
  • the specific vital signs monitor device 210 shown here is a MicropaqTM device available from Welch AllynTM, for which additional information can be found on the Internet at http://www.monitoring.welchallyn.com/products/wireless/micropaq.asp.
  • Device 210 should be viewed as emblematic of all possible devices, including for example patient telemetry devices that might be larger or smaller, of different configurations, and regardless of how they are worn about the body. Descriptions of several of the myriad other devices represented by device 210 can be found by following links at another Welch Allyn website, http://www.monitoring.welchallyn.com/products/wireless/resourcelib.asp.
  • Figure 10 should be interpreted broadly to include teachings and suggestions that the same, or an alternative, device could be worn about the chest, leg, coupled to a gurney carrying the person as a patient, and so forth.
  • the critical limitations are that the device 210 can be carried on the person, has a portable power supply, has wireless communication capability, and monitors and provides data for at least one vital sign.
  • tags 212, 222 should also be viewed from the broadest possible perspective, and are emblematic of all sizes and shapes of RFID tags, and all types of such tags including, for example, active or passive tags, standard or Ultra- Wide Band (UWB) frequency tags, and so on.
  • tags can provide two dimensional spatial resolution in at least some portions of a typical hospital setting down to at least about 10 feet (3 meters), more preferably to at least two feet, and most preferably down to at least one foot resolution.
  • Adding a high-resolution RFID tag of whatever type to ISM and WMTS Wireless Telemetry band equipment is contemplated to be valuable in that it enables locating patients in substantially real-time with high resolution. This can be extremely useful, for example, in locating a patient when there is a "code-blue" situation, and also in locating nearby personnel and equipment when such tags are there as well. It is still further contemplated that use of high resolution RFID tags on patients (and/or on or in telemetry devices), in conjunction with appropriate software, can even identify when a patient falls to the floor, or for some other reason stops moving. In such case, an intelligent software system can dispatch nearest staff member. Yet another aspect of using UWB or other RFID tags on telemetry devices is that such use can facilitate efficient and accurate capture of billing information. Among other things the use of the device can be detected and charged on a per-day or other time basis.
  • inappropriate use of tagged patients can be reduced or at least documented.
  • nurses are expected to read a bar-code by scanning a patient wristband, and then to scan the bar-code on drug or medical supply being administered.
  • the patient wristband can be easily duplicated and scanned together with the drug or medical at the nurse's station, thus defeating an otherwise helpful safety system.
  • contemplated systems using RFID technology are expected to improve patient identification accuracy.
  • Active tags are being adopted to track patients, medical staff, and medical equipment.
  • the drugs, medical supplies and lab specimens will continue to have bar-coding or passive tags which will need some type of handheld reader and manual intervention to read. Consequently, it is contemplated that the handheld reader to read bar-code or passive tag on drug, medical supply or lab specimen also includes an active tag embedded or slapped-on, which will help to close the loop on complete matching of "five rights" before the patient is delivered some type of clinical service (The physical location of this hand-held reader that is scanning the drug, medical supply, lab specimen will ensure physical proximity check to the patient automatically).
  • the clinician comes closer to the patient, and both are wearing active tags, the identification of the patient is automatically done through proximity.
  • the next step is for the clinician to actually administer a drug, use some medical supply, verify a specimen or perform some procedure.
  • RFID tags cannot be easily duplicated or printed like barcodes.
  • the physical location of the patient is known as well as the location of medical staff and the hand-held reader that is reading the drug, medical supply or lab specimen, which helps enforcing the "five rights" check with automation using new type hand-held reader and a new method.
  • intelligent RFID technology provides healthcare providers a dynamic and visual model on patient flow at the facility, giving insight on efficiency and quantity of asset usage. Users can instantly locate assets like medical staff, medical equipment, medical supplies, and patients, offering total asset visibility to the healthcare organization.
  • the Return-on-Investment (ROI) is supported by more accurate patient billing, better asset utilization, and better asset preventive maintenance, reduced asset shrinkage, better security, increased productivity, reduced medical errors, thus reducing costs and increasing quality of care and safety.
  • Intelligent asset utilization increases tend to reduce asset purchases and rental bills, an increase in equipment billing accuracies (and in future versions even tagged drugs and medical supplies), cuts asset shrinkage, and potentially increased facility throughput due to increased productivity.
  • contemplated systems and methods may be viewed as adding a horizontal "layer” that cuts across multiple (often disparate) IT systems; each handling a specific vertical operation like asset management, staff time keeping, EMR (Electronic Medical Record), HIS (Hospital Information System), and PhIS (Pharmacy Information System).
  • EMR Electronic Medical Record
  • HIS Hospital Information System
  • PhIS PhIS
  • the RFID information can be used with a new system that is created especially for this added information, or in conjunction with existing applications inside the hospital.
  • the existing applications can be any suitable information technology software package in a medical care facility, for example Bed-Management, EMR, HIS, ADT, CPOE, Scheduling software, and Asset Management applications can all benefit with this added intelligence.
  • an engine provides an open API capability and is positioned as a Tag-based or a Location-based operating system or program.

Abstract

Contemplated systems and methods provide an integration platform to facilitate the exchange of information between RFID tagged objects and non-RFID systems. In especially preferred aspects, RFID tagged objects include patients, personnel, and assets of a healthcare facility, while preferred non-RFID systems include asset management systems, timekeeping systems, electronic medical records systems, and hospital and pharmacy information systems. Contemplated systems and methods will apply rules to associate RFID information with events, which will then be correlated with appropriate steps that can be effected in a varied and automated manner. In further preferred aspects, RFID technology is employed to upgrade patient telemetry to provide positional information the hospital system.

Description

TAG BASED KNOWLEDGE SYSTEM AND METHODS FOR HEALTHCARE
ENTERPRISES
This application claims priority to our copending utility application 11/733056, filed April 9, 2007, incorporated by reference herein.
Field of the Invention
The field of the invention is data processing operations utilized in the practice, administration, or management of a healthcare enterprise (U.S. Class 705/28)
Background
Healthcare enterprises, whether hospitals, nursing homes, surgical centers, physician's offices and so forth, all have challenges tracking their various assets. One problem is that such facilities typically contain a large number of different types of assets, including for example, rooms, gurneys, diagnostic equipment, treatment equipment, bandages and other supplies, drugs, and so forth. Another problem is that such assets are often mobile, and during the course of even a single day can be present at different times in a dozen or more different locations. Similar problems exist for personnel assets, including for example, physicians, nurses, technicians, and other personal.
In addition to difficulties in tracking assets, healthcare enterprises encounter significant difficulties in efficient utilization of assets. That situation occurs for numerous reasons, including for example the fact that many assets are only usable upon cleaning or other preparation, and many are suitable only in combination with other assets. Thus, an x-ray machine might only usable when there is a qualified x-ray technician available to operate it, and a physician might only be able to perform a surgical procedure when accompanied by a nurse having an appropriate skill set.
Healthcare enterprises have made considerable strides over the years in implementing computer systems that address materials management, bed management, staff timekeeping, pharmacy and lab procedures and reporting, and billing. Many enterprises have also implemented applications for specific departments, including for example the emergency rooms (ER), operating rooms (OR), intensive care unit (ICU), and cardiac care units (CCU). Unfortunately, many of these systems have trouble communicating with each other, and some do not communicate with other systems at all. Such lack of communication can significantly reduce efficiency and increase costs.
One might image that manufacturers of the existing systems would develop enterprise wide solution, and indeed in some instances that process is going forward. But enterprise- wide solutions run into enormous problems, not least because manufacturers commonly try to implement proprietary systems and methods that exclude their competitors, and that approach triggers enormous resistance from physicians and staff that might be force to adopt technologies with which they are unfamiliar or comfortable.
It is known that Radio Frequency Identification Tags (RFID tags) can be used to keep tabs on the locations of equipment, supplies, and so forth, and there are already systems on the market that utilize such information for specific applications. For example, there are RFID tag systems that are suitable for keeping track of locations of assets. In 2005 Cisco™ announced its Wireless Location Appliance™ 2700, which uses WiFi access points to gather signal strength indicators from 802.11 devices and tag, and triangulates the information to roughly determine the locations of the devices, (see, e.g. http://informationweek.com/story/ showArticle.jhtml?articleID=162101504). The Cisco™ article, and all other referenced citations are incorporated herein as though fully set forth in this application. Furthermore, where a definition or use of a term in a reference, which is incorporated by reference herein is inconsistent or contrary to the definition of that term provided herein, the definition of that term provided herein applies and the definition of that term in the reference does not apply.
It is also known that RFID tags can be used to obtain and transmit physical parameters data (e.g., time, temp, and moisture, etc), and operational data (e.g., on/off, ready/not ready, damaged, being cleaned, etc). Several manufacturers have already announced plans to include such tags in their equipment, but there do not appear to be any such systems in common use. However, what does not seem to have been appreciated is that all three types of information described above as being derivable from RFID tags (location, physical parameters data, and operational data), can or should be combined and then distributed to multiple different computer systems in a healthcare environment.
It turns out that such a clearinghouse approach to RFID data can bring tremendous value in a highly cost-effective manner. Summary of The Invention
The present invention provides apparatus, systems, and methods in which RFID information is provided for multiple different purposes in a scalable, flexible manner, preferably using rules and correlations that can be altered by healthcare staff having little or no specialized information technology (IT) expertise. Such information may be further combined with patient telemetry to provide positional information of the patient and/or associated healthcare personnel.
The RFID information will typically include one or more of location information, physical parameters data, and operational data, and it is further contemplated that different types of items can be tagged, including equipment, people, and supplies. Any suitable type of tag, or combinations of different types of tags, can be utilized, with readers (also known as interrogators or transceivers) placed around the enterprise as appropriate. Contemplated systems can have anywhere from a single tag to 5,000 or even more tags in a large enterprise. The readers can advantageously be positioned such that at least 80% of the RFID information is refreshed at least every 10 minutes, and but more preferably the system would be implemented such that at least 80% of the RFID information is refreshed at least every minute.
The core of the system is contemplated to be embodied in a general purpose computer. Data entry and display devices communicatively coupled to the computer can be positioned throughout the enterprise, and can include electronic tablets, cell phones and pagers, as well as full sized data entry screens and displays such as might be found in accounting departments and nurses stations. In most or even all cases the data entry and display devices need not be dedicated to handling information derived from the RFID data. Preferred systems and methods include a Java or other cache that stores current RFID information, a rules based engine that derives events from the RFID information, a correlation engine that derives steps from the events, and an execution engine that delivers information relating to the steps. Ideally, staff members of the enterprise can define at least one of the rules and correlations entirely using menus and/or point and click techniques.
Events can fall within any appropriate range of generality to specialization. For example, an event might comprise "a doctor reported to the emergency room for duty" or "Dr. Jones reported to the emergency room for duty." The same is true of steps. One step might be to "discharge the patient" and another might be to "send an SMS message to Dr. Jones advising of delay in surgery." All realistic steps are contemplated, including one or more of sending a text message, a page or a voice message, and providing information to disparate systems, including a billing system, a bed management system, a staff timekeeping system, and a medical information system.
The inventive subject matter further provides systems, methods and devices in which are RFID circuitry is combined with a telemetry unit. The RFID circuitry can be combined with the telemetry unit in any suitable manner, including for example including the circuitry in a tag, and attaching the tag to the telemetry unit, or to a patient wearing the telemetry unit. The RFID circuitry preferably uses Ultra- Wide band frequency capability, or other high resolution technology. In especially preferred embodiments the RFID circuitry can provide resolution to below five feet in at least some area of a medical care facility that uses the telemetry unit.
In other contemplated uses, the RFID circuitry can be used to provide information used in billing use of the telemetry unit, or for some other aspect of billing. Additionally or alternatively, the RFID circuitry can provide information that is used to predict an event related to a patient carrying the telemetry unit and/or as input to an information technology software package in a medical care facility. The RFID information can be used in conjunction with existing applications inside the hospital. The existing application can be any suitable information technology software package in a medical care facility,
Various objects, features, aspects and advantages of the present invention will become more apparent from the following detailed description of preferred embodiments of the invention, along with the accompanying drawings in which like numerals represent like components.
Brief Description of The Drawing
Figure 1 is a conceptual diagram of an "Intelligent Clearing House" for RFID information.
Figure 2 is a conceptual diagram of an alternative view of the "Intelligent Clearing House" of figure 1. Figure 3 is a high level flow chart of data flow within a preferred embodiment.
Figure 4 is a chart showing sample records in a RFID table.
Figure 5 is a chart showing sample records in a rules table.
Figure 6 is a chart showing sample records in a correlations table.
Figures 7 A and 7B are screen shots of portions of a floor map demonstrating zoom functionality on mobile assets.
Figure 8 is a use case showing how patient care could be improved using a preferred embodiment.
Figure 9 is a use case showing how operational efficiency could be improved using a preferred embodiment.
Figure 10 is a perspective view of a person wearing a vital signs monitor box and a wristband, each tagged with an Ultra- Wide Band (UWB) Radio Frequency Identification (RFID) tag.
Detailed Description Figure 1 depicts an intelligent clearing house system 10 generally including RFID tagged items 20, computer processing hardware and software 30, and third party applications 40. Arrows 21C, 22C, 23C, 41C, 42C, 43C, and 44C depict communications to and from the computer processing hardware and software 30.
Tagged items 20 are shown in figure 1 as including Staff 21, Patients 22, and Equipment 23, but virtually anything can be tagged. One could, for example, tag consumables, and especially expensive or controlled substances such as certain drugs and stents. One could also tag documentation such as patient records, computer programs, computer printouts, journals and other library materials and periodicals.
In a real world implementation one would typically work backwards from a business problem being addressed. For example, if an enterprise is increasing capacity of an emergency room, it might be advisable to tag all the medical staff, the patients, and the medical equipment related to the ER. With staff one would typically include an RFID tag on the badges already used for identification, to access certain floors, or possibly on a radiation badge. One might also include a fingerprint or other biometric sensor. For patients it is most advantageous to tag the wrist or ankle bands, so that the tag remains with the patient throughout the stay. Alternatively or additionally, an enterprise could use a tag carried by a staff member or patient that is already included in his/her cell phone, pager, PDA or other device. One could put a patient tag on the patient's chart, but it is much better to put a patient tag on the patient and a document tag on the chart. Equipment is readily tagged directly on the unit, and in some cases the equipment might already by tagged.
It is contemplated that a single entity, whether staff, patient, equipment, or otherwise, could have any type of tag that is functional, and possibly multiple tags. The current preference appears to be for active tags, such as those available from Parco/Multispectral Solutions,™ Pango,™ Ekahau,™ Exavera,™ and Aeroscout™. Some active tags are disposable and some have replaceable batteries. Many modern active tags can operate on an ultra- wide band, and thereby have sufficiently low energy consumption to last four or more years on a single battery. Ultra- wide (UWB) frequency approved in June 2002 by the FCC for commercial use. UWB operates at a very high spectrum band (6.3 GHz) and therefore there are no interference and security issues. The nature of this frequency allows assets to be located within 1-foot granularity. The readers can see 600 feet and employ triangulation algorithms that eliminate the need to have readers in every room. These readers have low power needs and the batteries in the tags have a life of approximately 4 years. Currently preferred readers are those marketed by Parco and Multispectral.™
In general, the exact feature set of the tags is a matter of customer preference and need. Tags come in a variety of configurations, with the currently preferred tag being about 1 inch x 1 inch (2.5 cm x 2.5 cm) for equipment, a regular badge for staff, and a wristband for patients and visitors. Some installations prefer, or are already outfitted with, other types of tags such as passive, semi-passive, and/or semi-active tags. Some tags might deliver only identify information used for determining location, while other tags might provide other types of information such as physical parameters data (time, temperature, and moisture, etc) and operational data (e.g. on/off, status, etc).
A major strategic advantage in systems and methods described herein is that they can be completely hardware agnostic to the underlying RFID system that a particular prospective customer employs. Among other things this lowers the barrier to accepting the new service and facilitates choosing the best possible RPID hardware for a particular situation. As illustrated below, further benefits derive from employing a "command-center" approach that interfaces with different RF systems, and can become the central information processing unit of "who, what, where, and when" of medical equipment, staff and patients.
Any suitable type of tag, or combinations of different types of tags, can be utilized, provided appropriate readers are installed, and provided sufficient readers are placed around the enterprise. For example, if an enterprise uses ultra-wide band tags, then it needs to utilize at least some ultra-wide band readers. Contemplated systems can have anywhere from a single tag to 5,000 or even more tags in a large enterprise. The readers can advantageously be positioned such that at least 80% of the RPID information is refreshed at least every 10 minutes, and but more preferably the system would be implemented such that at least 80% of the RFID information is refreshed at least every minute. Typically one would place readers at doors to detect passive tags, and active tag readers on ceilings and hallways. Current active tag readers can often triangulate locations of tags from up to 200 meters away, through walls and other structures, with a resolution of only a meter or less.
Arrows 21C, 22C, and 23C represent potentially two-way communication between the tags and tagged items on the one hand, and the computer processing hardware and software 30 on the other hand. At the very least the tags need to wirelessly communicate with the tag readers (upward arrows), and the readers then typically communicate with the computer processing hardware and software 30 using cable or another wireless communication. The downward arrows typically depict communications to the tagged items rather than to the tag itself. For example, the computer processing hardware and software 30 might send an email, voice mail, or page to an appropriate device carried by a staff member or even a patient. It is contemplated that future tags will have displays associated with them, so that a lost patient, for example, could be located and directed back to his/her room.
Computer processing hardware and software 30 preferably contains at least the three layers shown. The lowest layer on the diagram is middleware 32, which receives tag data, such as location, duration, temperature, or moisture or other environmental parameters from the readers. Ideally, middleware 32 can be implemented in a generalized fashion to accommodate any needed inputs, thereby preventing the system from being tied to any particular manufacturer or model of tags or tag readers, or any particular telephone or other communications system. Having received the data, middleware 32 then preferably passes the data into the core engine, described here as an Intelligent Associations And Analytics Engine 34, which preferably has a hot cache or other memory structure 34A, 34B, and 34C and is preferably structured/operated under Java. The core engine 34 applies a set of rules to the RPID information to determine events, and applies correlations to the events to determine steps, and then executes or initiates execution of the steps. Some of those steps provide passing information along to the third party applications 40 via additional middleware 36, described here as the Uniform Enterprise Visibility Applications and Semantic Data. In real- world embodiments, middleware 36 is likely to be implemented as separate processors, such as the blades in a blade server, to handle communications with the various proprietary interfaces of the third party applications 40.
Arrows 41C, 42C, 43 C and 44C represent communication between middle layer 36 and the third party applications 40. That communication will mostly involve one-way communication, with the middleware 36 supplying information to the third party applications 40 (upward arrows). But it is contemplated that one or more of the third party applications 40 could send inquiries or other data to the middleware 36 (downward arrows). Communication characterized by arrows 41C, 42C, 43 C and 44D will likely, but not necessarily, be formatted according to a standard messaging protocol, such as Health Level 7 (see www.hl7.org).
Hospitals can easily have dozens of third party applications, handling many different types of information. Among the contemplated third party applications are an asset management application 41, a staff timekeeping application 42, a hospital information application (HIS) 43, and an electronic medical records application 44. Another of the contemplated applications 40 is a web portal where hospital administrators can pull-up operational reports of not only their hospitals but, when appropriate, see similar reports on medical assets being used at other hospitals for the purpose of comparing notes and sharing and learning best practices. Currently this kind of information can only be obtained by one- to-one (versus many-to-many) conversations; poring through a vast array of industry publications; or by attending expensive, often distant, educational meetings. The web portal application highlights the healthcare IT industry's migration from providing pure information technology to providing information itself. Transcending conventional incremental benefits associated with the IT business, the addition of a rich and varied database of the latest information on products, services and methods employed by hospitals, is expected to empower hospital or other healthcare enterprise managers to perceive and react rapidly and in a manner adding significant value and cost savings to their organization. In essence, they will have this knowledge database to help them be proactive and either preclude or quickly "put out operational fires."
In yet another contemplated aspect, the "Intelligent Clearing House software" can have a mapper-software that integrates processed intelligent data to support Information Technology systems such as IDX, Cerner etc. inside the hospital through GUI screens and "point-and-click" software. Still further, an "Intelligent Clearing House software" engine can move beyond automatic detection of events to automated prediction of events. The predicted events could well comprise HL7 standard events, including for example patient admission, patient discharge, and so forth. Exemplary events include the following:
1) "Patient X-ray procedure complete": The system can detect that an X-ray procedure was completed, or that a surgical procedure is about to start, by determining that the patient was transported out of the X-ray room, waited in the radiology hallway for a bit, re-entered the X-ray room, and is just coming back to the surgical unit.
2) "Patient Transfer Complete": By detecting that a patient is transported from OR (after being in OR for 2 hours), and is the entering surgical unit, the system can determine that the patient left one unit of the hospital and is about to enter other.
3) "Equipment Sterilization Complete": By detecting that a equipment was moved to a sterilization unit, was in the sterilization room for a required number of minutes, the system can determine that the equipment is done with sterilization and is being moved back to a patient's room.
Figure 2 shows how implementations described herein can coordinate numerous aspects of information flow within a hospital or other health care enterprise, even though the subject matter is not directed to providing a completely unified system. In this instance there are icons for Physician (part of Staff 21), Patient 22, and Equipment 23, all in accordance with Figure 1, and also additional icons for another type of tagged item (Surgery 24), and additional types of third party applications (Enterprise (HIS) 43, Lab 45, Pharmacy 46, and Suppliers 47). The central circle labeled "RFID System" corresponds to the computer processing hardware and software 30. Arrows 21C, 22C, 23C, and 43C correspond to the same numbered arrows in Figure 1 , while arrows 24C represent communication between tagged items in the operating room 24 (patient, staffs, or equipment) and middleware 32. Similarly, arrows 45C, 46C, and 47C represent communication between the third party applications in the lab 45, in pharmacy 46, and suppliers 47, respectively, and middleware 36.
In Figure 3, the core engine 100 (34 of Figure 1) applies a set of rules 112 to the RFID information 110 to determine events 120, applies correlations 122 to the events 120 to determine steps 130, and then executes 132 the steps 130. As described above, some of those steps 132 provide passing information along to the third party applications 40 via additional middleware 36. Figure 4 depicts an exemplary portion of an RFID tag table, showing field designators (Tag ID, Tag Type, Tag Name, Coordinates, and Time Stamp) in the first column and four sample records in columns 2-5. The reader will note that Figures 4-6 are each oriented sideways to the normal viewing perspective; such that the columns represent individual records and the rows represent fields. Figure 5 depicts an exemplary portion of an Event Rule table, showing field designators in the first column and four sample records in columns 2-5. Of course, it should be noted that the data can be generalized. Thus, the "who" field (row 4) could reference a type of asset and not necessarily an instance of the type. For example, the corresponding cell of record 1 might use the designation "Doctor" instead of including the literal "Dr. Jones", the corresponding cell. Similarly, the "where" could be "examining room" as opposed to a particular zone.
The data can also be used to interact with third party systems 40. For example, the message field (row 16) could be an HL7 communication to a third party application such as a bed management system, rather than a text message to the corresponding "who" field. Still further, the message could be a keystroke recording or other logon script, that accesses context relevant information (from one or more of the third party systems) with respect to the "who" or other information in record 1. Figure 6 depicts a portion of a Correlation Engine table, showing field designators in the first column and four sample records in columns 2-5.
In terms of interfaces, several highly advantageous software functionalities are contemplated, including: (a) reporting the location of the responder as being within one of a plurality of business locations; (b) using scalar vector graphics to display the locations with varying degrees of detail (see Figures 7A and 7B); (c) displaying replay of movements of the assets; (d) displaying utilization profiles of the assets; and (e) coordinating the locations of the at least some of the assets data from a global satellite positioning system (GPS). It is still further contemplated that different ones of the readers (referenced earlier as responders) can operate with first and second different middleware, different frequencies, different types of interrogators, etc, and that the system according to the inventive subject matter can nevertheless consolidate output from the different types of equipment. This could be viewed as an "air-traffic controller" type of system, in that it can operate with and coordinate with a large number of different systems, some of which may be incompatible with each other. Figure 8 is a use case showing how patient care could be improved using a preferred embodiment, and Figure 9 is a use case showing how operational efficiency could be improved using a preferred embodiment.
In yet another preferred aspect of the inventive subject matter as exemplarily depicted in Figure 10, a person 200 is wearing a vital signs monitor device 210 tagged with a first Radio Frequency Identification (RFID) tag 212, and a patient identification wrist band 220 tagged with a second RFID tag 222. Of course, the person 210 shown is emblematic of all possible persons, regardless of gender, race, age, ambulatory status, and so forth.
The specific vital signs monitor device 210 shown here is a Micropaq™ device available from Welch Allyn™, for which additional information can be found on the Internet at http://www.monitoring.welchallyn.com/products/wireless/micropaq.asp. Device 210, however, should be viewed as emblematic of all possible devices, including for example patient telemetry devices that might be larger or smaller, of different configurations, and regardless of how they are worn about the body. Descriptions of several of the myriad other devices represented by device 210 can be found by following links at another Welch Allyn website, http://www.monitoring.welchallyn.com/products/wireless/resourcelib.asp. Thus, Figure 10 should be interpreted broadly to include teachings and suggestions that the same, or an alternative, device could be worn about the chest, leg, coupled to a gurney carrying the person as a patient, and so forth. The critical limitations are that the device 210 can be carried on the person, has a portable power supply, has wireless communication capability, and monitors and provides data for at least one vital sign.
Similarly, the various tags 212, 222 should also be viewed from the broadest possible perspective, and are emblematic of all sizes and shapes of RFID tags, and all types of such tags including, for example, active or passive tags, standard or Ultra- Wide Band (UWB) frequency tags, and so on. There is, however, a definite preference for tags that can provide two dimensional spatial resolution in at least some portions of a typical hospital setting down to at least about 10 feet (3 meters), more preferably to at least two feet, and most preferably down to at least one foot resolution.
Adding a high-resolution RFID tag of whatever type to ISM and WMTS Wireless Telemetry band equipment is contemplated to be valuable in that it enables locating patients in substantially real-time with high resolution. This can be extremely useful, for example, in locating a patient when there is a "code-blue" situation, and also in locating nearby personnel and equipment when such tags are there as well. It is still further contemplated that use of high resolution RFID tags on patients (and/or on or in telemetry devices), in conjunction with appropriate software, can even identify when a patient falls to the floor, or for some other reason stops moving. In such case, an intelligent software system can dispatch nearest staff member. Yet another aspect of using UWB or other RFID tags on telemetry devices is that such use can facilitate efficient and accurate capture of billing information. Among other things the use of the device can be detected and charged on a per-day or other time basis.
In a still further aspect of contemplated systems and methods, inappropriate use of tagged patients can be reduced or at least documented. For example, nurses are expected to read a bar-code by scanning a patient wristband, and then to scan the bar-code on drug or medical supply being administered. Unfortunately, for convenience or other reasons, the patient wristband can be easily duplicated and scanned together with the drug or medical at the nurse's station, thus defeating an otherwise helpful safety system.
In contrast, contemplated systems using RFID technology are expected to improve patient identification accuracy. Active tags are being adopted to track patients, medical staff, and medical equipment. But due to economical reasons, the drugs, medical supplies and lab specimens will continue to have bar-coding or passive tags which will need some type of handheld reader and manual intervention to read. Consequently, it is contemplated that the handheld reader to read bar-code or passive tag on drug, medical supply or lab specimen also includes an active tag embedded or slapped-on, which will help to close the loop on complete matching of "five rights" before the patient is delivered some type of clinical service (The physical location of this hand-held reader that is scanning the drug, medical supply, lab specimen will ensure physical proximity check to the patient automatically). In such case, when the clinician comes closer to the patient, and both are wearing active tags, the identification of the patient is automatically done through proximity. The next step is for the clinician to actually administer a drug, use some medical supply, verify a specimen or perform some procedure. It should be appreciated that RFID tags cannot be easily duplicated or printed like barcodes. There is also no ability to verify where the patient bar-code wristband is being read. In the above method, the physical location of the patient is known as well as the location of medical staff and the hand-held reader that is reading the drug, medical supply or lab specimen, which helps enforcing the "five rights" check with automation using new type hand-held reader and a new method.
Consequently, it is particularly contemplated that conventional handheld readers are used to scan a barcode or passive tag (e.g., on a drug, medical supply, lab specimen etc.) and that such devices are coupled to an active, semi-active or even passive RPID tag with any radio frequency (HF, UHF, 2.4GHz, 6.3GHz and so on) or any wireless standard (Wi-fi, Zigbee, UWB and so on). Most preferably, such tagged readers are then used in the context of Figures 1 and/or 2.
It should be noted that implementations according to the inventive subject matter presented herein offer many benefits. Among other advantages, intelligent RFID technology provides healthcare providers a dynamic and visual model on patient flow at the facility, giving insight on efficiency and quantity of asset usage. Users can instantly locate assets like medical staff, medical equipment, medical supplies, and patients, offering total asset visibility to the healthcare organization. The Return-on-Investment (ROI) is supported by more accurate patient billing, better asset utilization, and better asset preventive maintenance, reduced asset shrinkage, better security, increased productivity, reduced medical errors, thus reducing costs and increasing quality of care and safety. Intelligent asset utilization increases tend to reduce asset purchases and rental bills, an increase in equipment billing accuracies (and in future versions even tagged drugs and medical supplies), cuts asset shrinkage, and potentially increased facility throughput due to increased productivity.
Currently, hospitals are focusing their RFID adoption activities on medical equipment tagging for the purpose of gaining operational insights about equipment utilization, maintenance and billing. But the benefits become even greater as RFID tags become more intelligent and go beyond simple locating functions, e.g., to sense temperature, moisture etc. Among other things the systems and methods described herein provide powerful processing software to harvest all of a client's incremental data as it flows in and through the organization, leading to improved staff productivity (e.g., by finding equipment, staff, and patients easily), which results in reductions in wasted manpower time and effort. Systems and methods according to the inventive subject matter will also reduce patient stays inside hospitals while increasing quality-of-care (e.g., by being able to track and treat patients and monitor their care and medications more efficiently).
Viewed from a difference perspective, contemplated systems and methods may be viewed as adding a horizontal "layer" that cuts across multiple (often disparate) IT systems; each handling a specific vertical operation like asset management, staff time keeping, EMR (Electronic Medical Record), HIS (Hospital Information System), and PhIS (Pharmacy Information System). In effect, these systems and methods permit creation of an "Intranet" connecting medical staff, patients and equipment into an automated and coherent universal communication and real-time operational analysis platform.
The RFID information can be used with a new system that is created especially for this added information, or in conjunction with existing applications inside the hospital. The existing applications can be any suitable information technology software package in a medical care facility, for example Bed-Management, EMR, HIS, ADT, CPOE, Scheduling software, and Asset Management applications can all benefit with this added intelligence. Preferably, an engine provides an open API capability and is positioned as a Tag-based or a Location-based operating system or program.
Thus, specific embodiments and applications of systems and methods for tag based knowledge systems for healthcare enterprises have been disclosed. It should be apparent, however, to those skilled in the art that many more modifications besides those already described are possible without departing from the inventive concepts herein. The inventive subject matter, therefore, is not to be restricted except in the spirit of the appended claims. Moreover, in interpreting both the specification and the claims, all terms should be interpreted in the broadest possible manner consistent with the context. In particular, the terms "comprises" and "comprising" should be interpreted as referring to elements, components, or steps in a non-exclusive manner, indicating that the referenced elements, components, or steps may be present, or utilized, or combined with other elements, components, or steps that are not expressly referenced.

Claims

CLAIMSWhat is claimed is:
1. A method for performing data processing operations utilized in the practice, administration, or management of a healthcare enterprise, comprising: receiving RFID information; storing the RFID information in a memory; receiving rules that associate portions of the RFID information with events; receiving correlations that associate the events with steps; applying the rules against the RFID information in the memory to determine events, and applying the events to the correlations to determine steps; and executing the steps.
2. The method of claim 1, wherein the RFID information includes location information obtained from an electric device, a staff member of the enterprise, a mechanical device, and optionally a patient.
3. The method of claim 1, wherein the RFID information includes location information obtained from different types of tags.
4. The method of claim 1 , wherein the RFID information includes physical parameters data selected from the group consisting of an environmental parameter, and time.
5. The method of claim 1, wherein the RFID information includes operational data selected from the group consisting of on/off status, functional status, maintenance status, analytic data of a clinical test, and a replenishment trigger signal.
6. The method of claim 1, wherein at least 80% of the RFID information is refreshed at least every 10 minutes.
7. The method of claim 1 , wherein the RFID information is obtained from at least 1 ,000 tags.
8. The method of claim 1, wherein the memory comprises a Java cache.
9. The method of claim 1, further comprising an interface that is configured to allow definition of at least one of the rules by a staff member of the enterprise using menus.
10. The method of claim 1, further comprising an interface that is configured to allow point and click operation to thereby change the at least one of the rules.
11. The method of claim 1 , further comprising an interface that is configured to allow definition of at least one of the correlations by a staff member of the enterprise using menus.
12. The method of claim 1, further comprising an interface that is configured to allow point and click operation to thereby change the at least one of the correlations.
13. The method of claim 1, wherein at least one of the correlations associates at least two independent ones of events.
14. The method of claim 1, wherein different ones of the correlations associate an event with different numbers of steps.
15. The method of claim 1, wherein at least one of the correlations associates a plurality of the events with at least three of the steps.
16. The method of claim 1, wherein at least one of the steps comprises sending an electronic message to at least one of the staff.
17. The method of claim 16, wherein the electronic message is selected from the list consisting of an email, an SMS message, a page, and a voice mail.
18. The method of claim 1, wherein at least one of the steps comprises providing billing data for a patient with respect to the event.
19. The method of claim 1, wherein at least one of the steps comprises providing patient location information for a bed management system.
20. The method of claim 1, wherein at least one of the steps comprises providing staffing information to a staff timekeeping system.
21. The method of claim 20, wherein the staffing information includes working time and procedure.
22. The method of claim 1, wherein at least one of the correlations includes a first step that provides billing data, and second step provides staffing information.
23. The method of claim 22, wherein the at least one of the correlations includes third first step that providing patient location information for a bed management system.
24. The method of claim 1, wherein at least one of the steps comprises retrieving medical information regarding a patient, and providing the medical information to a staff member.
25. The method of claim 24, wherein the medical information is selected from the list consisting of a medical history, a diagnosis, a drug listing, a radiographic image, and a healthcare plan information.
26. A method of associating positional information with a patient telemetry unit, comprising combining RFID circuitry with the patient telemetry unit.
27. The method of claim 26, further comprising attaching the RFID circuitry to the telemetry unit using a tag.
28. The method of claim 26, further comprising attaching the RFID circuitry to an identification device of a patient carrying the telemetry unit.
29. The method of claim 26, further comprising provisioning the RFID circuitry with an Ultra- Wide band frequency capability.
30. The method of claim 26, further comprising attaching the RFID circuitry with resolution to below five feet in at least some area of a medical care facility that uses the telemetry unit.
31. The method of claim 26, further comprising using the RFID circuitry to provide information used in billing.
32. The method of claim 26, further comprising using the RFID circuitry to provide information used in billing the telemetry unit.
33. The method of claim 26, further comprising using the RFID circuitry to provide information used to predict an event related to a patient carrying the telemetry unit.
34. The method of claim 26, further comprising using the positional information as input to an information technology software package in a medical care facility.
35. A handheld reading device configured to acquire a barcode or an RFID signal and further comprising an RFID tag.
36. The method of claim 1, further comprising: receiving a request for the RFID information from an application; sending the RFID information to the application.
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