Press Release
The First European Pilot Project for a Smart Hospital begins at the San Raffaele Hospital
DRIVE is the result of the today’s most innovative technology applied to healthcare organizations. Through the collaboration of Research Institutions, Universities, Industries, and funding from the European Commission, the DRIVE Project improves the safety and privacy of the patients, the work environment of the health operators, and the efficiency of hospitals and suppliers.
The Pilot demonstrates the effectiveness and the exportability of an experimented innovative solution with high acceptability of the patients and healthcare professionals while introducing the informative wristband and smart cart.
DRIVE is a prototype of the hospital of the future, where informative and sensory devices are distributed throughout, forming an infrastructure that connects all the critical points of the clinical care process of the hospital. The infrastructure recognizes the patients, the operators, and the products (pharmaceuticals, blood tubes, etc.) and interacts with them for guaranteeing doctors, nurses, and pharmacists a thorough and continuous support in the prevention of errors where in many times, is a commonplace for risks to patient safety.
Moreover, the infrastructure automatically returns consumption amounts, of the available pharmaceuticals in cabinets of the ward or shelves of the pharmacy, and apply rules that the doctors, nurses, and pharmacists taught the system their knowledge to avoid stock-outs, over stock, and expiration of products. Finally, each single point of access to the DRIVE system, it’s functions and all sensible data within, protects and guarantees the privacy of the patient.
The system requests the healthcare operator for access authentication through the use of their smart card, providing only the relevant data needed for authorized activities of which however is maintained in the memory.
Through the Internet, the hospital securely connects with other healthcare structures and related suppliers: extending the advantages of an improvement of efficiency to all the actors involved in the supply chain.
DRIVE (Drug in Virtual Enterprise) was developed to focus on the demand for a safer hospitalization of the patient and more effective care with the necessity of limiting waste of products in the warehouses and the precious time of doctors, nurses, and pharmacists. The Informatics infrastructure of DRIVE permits the healthcare operators to concentrate more on the primary necessities of the patient than on the necessities of the same organization to carry out checks of cabinets and warehouses, calculate and order products, control the delivery, and the expirations, etc.
The technological and organizational challenges proposed by the San Raffaele Hospital has also been recognized by the European Commission that, in the area of the Fifth Framework Programme of the Information Society Technology Research (IST), has supported the realization of the DRIVE Pilot, running for 4 months: this is the first experiment of its kind to be developed in Europe. The most significant innovations introduced from DRIVE are:
- The informative wristband[1] for the patients, that reports in bi-dimensional digital form (2D code) the necessary data to guarantee a secure and complete identification (comprised of critical data such as, for example: particular pathology, allergies to drugs, or nutritional data) that allows an active and systemic protection of the patient;
- The informative label on the packaging of the drug, that reports in digital form(2D code) the necessary data for a safe and complete identification of the product(for example: identification of the product and of the lot, the number of series within the lot, the date of expiration) that allows the drug to actively participate both to the protection of the patient and the determination of the consumption;
- The smart cart, adapted with automatic and informative devices (such as: laptop computer and dedicated software, label printer, optical reader to recognize the 2D code, smart card reader, electronic medical instruments for the automatic survey of the vital parameters, automatic drawers for the dispensing of drugs). Thanks to its mobility, the smart cart allows the medical and nursing staff an active support and allows a guarantee of patient safety in every phase of care: from the prescription of drugs to the laboratory testing, to the preparation of the pharmaceutical therapy and vials, to the effective administration of the drug and blood withdrawal at the patient’s bedside. For each of these phases, the cart automatically recognizes the patient and his necessities, the product and its characteristics, the healthcare operator and his activities. Therefore, it systematically and timely finds the inconsistencies and risks to the patient (drug-drug interaction, dosage error, preparation, allergies, etc.), according to the regular taught by the same healthcare operator. Each alarm, suggestion and memorandum must be validated by professional individual, which is responsible for the final decision. For the last task, the smart cart memorizes the quantity and method that each single product has been consumed, and sends this precious information in the management system of the hospital logistics;
- The hospital logistics system (from ward and pharmacy) and collaborative (with other hospital structures and suppliers), that recognize effectively quantitative availability, are able to inform the operators in terms of forecasting consumption and make available e-commerce functions for efficient management of ward supplying by means of the pharmacy and of the pharmacy toward the suppliers;
- The trust infrastructure (that is, the component that guarantees the reciprocal trust between all users of the DRIVE system, including the patients that must have the guarantee of privacy), utilizes the most recent technology in terms of digital security: smart card for the authentication and the digital signature and a system of access control to the particular gradual sophisticated data. Access to such data depends on the roles of the different actors whether internal or external, and the different characteristics of critical data.
The primary interesting results produced by the running pilot at the San Raffaele hospital, in its experimentation phase, demonstrate:
-The significant reduction[2] of the level of risk of errors obtained with the introduction of the smart cart. For example, one of the most critical activities for the patient safety is the preparation of the drugs for administering by means of intravenous, intramuscular, intradermal or subcutaneous. In this case, preliminary studies carried out indicate that the smart cart reduced the level of risk by 71%; instead, in the case of the risk of incorrect patient identification, the risk level was practically reduced by 100%.
-The improvement of the efficiency of the pharmaceutical logistics chain and the reduction of the operative costs (direct or indirect). For example, the preliminary assessments (carried out with the support of a technical simulation) on the operating savings obtainable in the hospital logistics, are higher than 30%, within the real environment that is already strongly organized and computerized!
-The acceptability of the innovations introduced by the smart cart and the informative wristband on behalf of the operators and patients. For example, 91.3% of patients positively accept the use of the wristband because it respects the dignity of the person, does not damage the privacy of the individual, and is not an obstacle in the normal daily activities.
In conclusion, engineer Alberto Sanna of the San Raffaele Hospital, responsible for the DRIVE Project, summarizes the experience: “DRIVE has demonstrated that it is possible to carry out a technologically advanced system that distributes the maximum quality of patient safety and protection of the personal data that responds to logical efficiency. The vision must, however, be global: from the pharmaceutical industry to the patient’s bedside.”
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[1] See sample attached
[2] For details, see Chapter 3