The document discusses using intelligent data and connectivity in healthcare. It outlines several use cases for real-time data integration like clinical decision support, remote patient monitoring, and medical device interoperability. The needs of intelligent healthcare systems include reliable and secure communication between devices, location abstraction, and scalability. The RTI Connext DataBus is presented as a solution to distribute data across these complex healthcare systems in real-time. A deep dive on DocBox, a clinical decision support system, shows how it can improve patient safety by integrating data from various sources and devices like PCA pumps. The Internet of Things is transforming healthcare by enabling smart devices and analytics to share data to deliver better care.

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

2. Intelligent Healthcare Use Cases
• Clinical Decision Support Systems
• Monitoring/Telemetry
• Machine Command/Control
• Data Acquisition
• Device Interoperation
• Hospital Operations Management

3. 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

4. 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/

5. Connecting the Data
Need to
construct
the “Data
Graph”

6. RTI Connext: Distribute the Data
Real-Time
Analytics &
Control
Operator HMI
Sensors Actuators
IT and/or
Cloud
Integration

7. 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

8. 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™

9. 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

10. Connext Builds Intelligent Systems

11. Clinical Decision Support Systems
Workstations, Stor
age, Historical
HL7/EMR Gateway, Enterprise, 3rd Party
Room
Devices
Care Area
Administration

12. CDS System of Systems

13. Remote Monitoring
4G/LTE
Connecting devices with hospitals to provide better treatment while en-route

14. 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

15. 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.”

16. 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

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

18. 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

19. Devices, processes, non-integrated system  errors

20. 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

21. “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

22. Hospitals are Distributed Systems
• Medical Devices
• IT Systems
– EMR
– Lab
– Pharmacy
– Radiology
• Clinicians and Support Staff
• Patient

23. 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?

24. ICE Supervisor
Network
Controller
ICE Interface
Data
Logger
External
Interface
Medical Device
ICE Interface
Other Equipment
Integrated Clinical Environment (ICE)
Functional Elements of the Integrated Clinical Environment
ASTM standard F2761-2009
Published January 2010 Clinician
Functional Elements of the Integrated Clinical Environment
Patient

25. Smart PCA System
Patient
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

26. 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

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

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

29. 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.

30. Internet of Things - Planes
Web Services and Business Apps
Server-to-Server (S2S)
Devices and Intelligent Systems
Control
Plane
Device-to-Device
Device
to
Server (D2S)
TimelinessofResponse
10μs–10ms10ms–1s>1s

31. Another Perspective
Control
Management
Analysis
TimelinessofResponse
10μs–10ms10ms–1s>1s
•Process control and workflow
•Presentation of “live” data
•Security policy enforcement
•Human input / output
•Configuration
•Data mining and analysis
•Equipment control and monitoring
•Performance measurement and calibration
•Fault isolation and automated recovery

32. 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

33. 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

34. Global Support and Distribution

35. About Us
Tracy Rausch, CCE
CTO and Founder, Docbox
tracy@docboxinc.com
617.997.8375
Sumeet Shendrikar
Solutions Architect, RTI
sumeet@rti.com
408.990.7424

36. Your systems. Working as one.
Download
Connext
Free Trial
NOW
www.rti.com/downloads