How to Sustain Smart Connected Hospital Services: An Experience from a Pilot Project on IoT-Based Healthcare Services / 대한의료정보학회지

OBJECTIVES: This paper describes an experience of implementing seamless service trials online and offline by adopting Internet of Things (IoT) technology based on near-field communication (NFC) tags and Bluetooth low-energy (BLE) beacons. The services were provided for both patients and health professionals. METHODS: The pilot services were implemented to enhance healthcare service quality, improve patient safety, and provide an effective business process to health professionals in a tertiary hospital in Seoul, Korea. The services to enhance healthcare service quality include healing tours, cancer information/education, psychological assessments, indoor navigation, and exercise volume checking. The services to improve patient safety are monitoring of high-risk inpatients and delivery of real-time health information in emergency situations. In addition, the services to provide an effective business process to health professionals include surveys and web services for patient management. RESULTS: Considering the sustainability of the pilot services, we decided to pause navigation and patient monitoring services until the interference problem could be completely resolved because beacon signal interference significantly influences the quality of services. On the other hand, we had to continue to provide new wearable beacons to high-risk patients because of hygiene issues, so the cost increased over time and was much higher than expected. CONCLUSIONS: To make the smart connected hospital services sustainable, technical feasibility (e.g., beacon signal interference), economic feasibility (e.g., continuous provision of new necklace beacons), and organizational commitment and support (e.g., renewal of new alternative medical devices and infrastructure) are required.

Evaluation of radiofrequency electronic system in intraoperative monitoring of surgical textiles / Avaliação de sistema eletrônico por radiofrequência para monitoramento intraoperatório de têxteis cirúrgicos

ABSTRACT Objective To test performance of SurgiSafe®, a radiofrequency electronic device to detect surgical textiles during operations as compared to manual counting. Methods Surgical sponges with radiofrequency TAGs were placed in the abdominal cavity of a pig submitted to laparotomy, in randomly distributed sites. The TAGs were counted manually and also using SurgiSafe®. Positive and negative predictive values, sensitivity, specificity and time required for counting were analyzed for both methods. Results Through the analysis of 35 surgical cycles, SurgiSafe® immediately identified all sponges, with specificity, sensitivity, positive and negative predictive values of 100%. Although not statistically significant, the manual count had sensitivity of 99.72% and specificity of 99.90%. Conclusion SurgiSafe® proved to be an effective device to identify surgical sponges in vivo, in real time; and its use as an adjuvant to manual counting is very helpful to increase patient's safety.

RESUMO Objetivo Testar o desempenho do SurgiSafe®, dispositivo eletrônico de detecção de têxteis cirúrgicos por radiofrequência no intraoperatório, comparado à contagem manual. Métodos Gazes com etiquetas de radiofrequência (TAGs) foram alocadas na cavidade abdominal de um suíno submetido à laparotomia, em locais distribuídos aleatoriamente. As TAGs foram contadas manualmente e com uso do SurgiSafe®. Valores preditivos positivos e negativos, sensibilidade, especificidade e tempo de contagem foram analisados para ambos os métodos. Resultados Por meio da análise de 35 ciclos cirúrgicos, o SurgiSafe® fez a identificação instantânea de todas as gazes, com especificidade, sensibilidade, valores preditivos negativo e positivo de 100%. Apesar de não apresentar significância estatística, a contagem manual apresentou sensibilidade de 99,72% e especificidade de 99,90%. Conclusão O SurgiSafe® mostrou-se eficaz para contabilização de têxteis cirúrgicos em tempo real in vivo, e seu uso como adjuvante na contagem manual é de grande valor para o aumento de segurança do paciente.