1. Helping you patients… focus on not paperwork. Innovian® Anesthesia 5.0
Innovian Anesthesia - What's It All About
Innovian Anesthesia 4.0
Innovian Anesthesia | What's It All AboutInnovian Anesthesia 4.0

2. Innovian® Anesthesia – An Overview Agenda
What is Innovian Anesthesia?
Why is it Important? Benefits & Advantages
Who are the Players?
Anesthesia – “Not Everyone Goes Under”
Where is IA Used? - Understanding Workflow & Care Areas
Modules
Architecture & Components
What is Innovian Anesthesia??
Why is it Important? Benefits & Advantages
Who are the Players?
Anesthesia – “Not Everyone Goes Under”
Where is IA Used? - Understanding Workflow & Care Areas
Architecture & Components
Connectivity: “Not an Island
Modules
Innovian Navigation
Innovian Anesthesia - What's It All About | Sept 2012
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3. What is Innovian® Anesthesia ?
Commonly called:
ARKS – Anesthesia Record Keeping System
AIS - Anesthesia Information System
AIMS - Anesthesia Information Management System
“Anesthesia” Clinical Documentation system that provides an integrated electronic record of all the care they provide to the patient undergoing surgical or interventional procedures.
Innovian Anesthesia intended to be used as a data management system for electronically collecting, displaying, and recording perioperative information for anesthesia providers – Anesthesiologist & CRNA.
Commonly called:
ARKS – Anesthesia Record Keeping System
ARMD (DoD)
AIS (Anesthesia Information System)
AIMS (Anesthesia Information Management System)
Innovian Anesthesia intended to be used as a data management system for electronically collecting, displaying, and recording perioperative information.
In the clinical arena documenting the care one provides is a MUST – if you don’t write it down, you did not do it.
Anesthesia Clinical Documentation system that provides an electronic record of all the care they provide to the patient receiving interventional treatments. Anesthesia providers no longer just stay in the operating room, but provide anesthesia in a variety of settings – Radiology, OB, Cath Labs, Dental clinics, Endoscopy, Pain Clinics, ICU, and the list goes on. Innovian Anesthesia can do this from the preoperative evaluation to discharge from PACU.
SQL Database - Structured Query Language programming language designed for managing data in relational database systems
Innovian Anesthesia - What's It All About | Sept 2012
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4. History - Draeger Owned and Developed
History of System Innovation & Reliability
Anesthesia Web PreOp
4.0 Innovian
Reporting Tool
Co-Writer Vital Signs Plotter
Saturn Information System
1.0 Innovian Anesthesia
2.0 Innovian Anesthesia
3.0 Innovian Anesthesia
ORDM DOS-Based AIMS
ORDM Networked AIMS
PACU Module
5.0 Innovian
Anesthesia
Draeger began work in the automated anesthesia information system product line in 1986.
We have come a long way, with over 26 years of Anesthesia Clinical Documentation
Innovian™Anesthesia (Pre-op, Holding, Intra-Op, Post-op automated doucmentation system)
Innovina Forms Engine (web based, customer configurable, patient assessment tool linked to the Innovian™Anesthesia record)
Innovian Reporting Tool – SQL based reporting tool that allows clinicians to create their own reports based on documented care over time – quality
Over 100 years of clinical expertise / over 26 years of IT experience
4th Generation AIMS Solution
Innovian Anesthesia - What's It All About | Sept 2012
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5. Why is it Important? - Goal Innovian Anesthesia
Current Paper Record
Go from hard to read, sometimes illegible anesthesia record to one of a printed format and very easy to read.
Very difficult for clinicians to let go of their paper record, but in the very near future they will not have a choice
Electronic Anesthesia Record
Innovian Anesthesia - What's It All About | Sept 2012
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6. Why is it Important? - Advantages
Benefits
More focused on patient care
Real time access to patient information
Ease of Use
Workflow Automation
↑ Clinical Efficiency
Meet Regulatory & Compliance mandates (JCAHO, CMS)
Integration into EMR
Interoperability
Eliminates
Paper based processes
Redundant data entry
Illegible records
Legwork to track patient information
Benefits
More time for patient care
Real time access to patient information – able to retrieve previous anesthesia records from the same workstation or any computer house wide with the use of Report Viewer
Workflow Automation
↑ Clinical Efficiency
Meet Regulatory & compliance mandates – JCAHO, CMS with the use of required statements, legible, & retrievable)
Eliminates
Paper based processes
Redundant data entry
Illegible records
Legwork to track patient information
Before we discuss the details of IA, lets talk about who uses IA and where its used.
Innovian Anesthesia - What's It All About | Sept 2012
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7. Who are the Players? Anesthesiologist CRNA - Nurse Anesthetist
Community & teaching facilities
Rural Hospitals
Military
AA – Anesthesia Assistant
The “Newcomer”
Master of Science in Anesthesia
Case Western Reserve University
University of Texas Health Science Center
Emory University School of Medicine
University of Missouri 
Anesthesiologist – the MD who works independently providing anesthesia
CRNA or Nurse Anesthetist –
usually works under the guise of the anesthesiologist;
in rural areas under the direction or supervision of the surgeon.
In the military we found that they work independently of the MD, but are required to consult with them under specific guidelines.
AA –
coming into the arena
= to the CRNA in their roles and responsibilities
7 universities offer a Master of Science in Anesthesia
Innovian Anesthesia - What's It All About | Sept 2012
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8. Types of Anesthesia – “Not Everyone Goes Under”
Anesthesia Goals
To block pain, relax a patient or control a patient’s level of consciousness in conjunction with surgery or other procedures.
General - lala land
Unconscious & have no awareness or other sensations.
IV Medications / drugs
Gases or vapors inhaled through a breathing mask, LMA, or ETT
MAC - patient awake
Light & moderate sedation via IV medication to allay fear & anxiety
Local anesthesia injected at the surgical site by surgeon
Conscious - Arousable by sleep and maintain their own airway
Early discharge from facility
Anesthesia is typically used to block pain, relax a patient or control a patient’s level of consciousness in conjunction with surgery or other complex procedures.
General - lala land
unconscious & have no awareness or other sensations.
IV Medications / drugs
Gases or vapors inhaled through a breathing mask, LMA, or ETT
MAC - patient awake
Surgeon provides local anesthetic,
Light & moderate sedation via IV medication to allay fear & anxiety
Local anesthesia injected at the surgical site by surgeon
Conscious - Arousable by sleep and maintain their own airway
Early discharge from facility
Innovian Anesthesia - What's It All About | Sept 2012
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9. Types of Anesthesia – “Not Everyone Goes Under”
Neuraxial
Name used for spinal, epidural, & caudal blocks
Indications
Surgical Procedures
Obstetrics
Pain Control
Regional Peripheral
Injections temporarily numb area
procedures in the upper & lower extremities
Neuraxial
Name used for spinal, epidural, & caudal blocks
Indications
Surgical Procedures
Obstetrics
Pain Control
Regional Peripheral
Injections temporarily numb area
procedures in the upper & lower extremities
Innovian Anesthesia can document all the care provided for of these various types of anesthesia via our methods pages in the various care areas.
Innovian Anesthesia - What's It All About | Sept 2012
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10. Where is Innovian Used? Understanding Care Areas
Intra-Op
Pre-Op
Holding
Post-Op
Pre-Anes.
Evaluation
Data Flow
Patient Flow
Not only does anesthesiologist provide a variety of anesthetic types, they work on a variety of care areas inside and outside of the mainstream operating room. Let look inside the OR proper first, where there are 4 locations where care may be provided.
This should be covered by marketing presentation
Pressure is mounting to be more cost effective and efficient throughout the patient care path. You’re asked to:
Increase patient safety
Contain costs – increase case through-put & revenue
Make better use of resources
Comply with CMS, JCAHO, etc
Measure outcomes for pay for performance, quality reporting, etc.
Develop best practices
Improve physician, staff and patient satisfaction
So, how does Innovian Anesthesia help you achieve these goals across care areas?
Anesthesia care is provided in a variety of surgical locations.
All of them capture the various activities which occur to the patient and are displayed in their specific portion of the EMR
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Innovian Anesthesia 4.0
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11. Care Areas Care Areas - Preop
Intra-Op
Pre-Anes.
Evaluation
Pre-op
Holding
Post-op
Completed by nurses & anesthesia providers prior to morning of surgery
Preoperative testing - Bloodwork, chest X-ray, & EKG
Health assessment
Evaluation with special attention to airway, teeth, head, & neck
Physical exam
Medications & Allergies
Past Anesthesia & Surgical History
Risk Factors
Completed by nurses & anesthesia providers prior to morning of surgery
Preoperative Assessment Video
Perioperative testing - based on medical condition & age
Health assessment
Evaluation
of the patient's airway, involving inspection of the mouth opening and visualization of the soft tissues of the pharynx
condition of teeth and location of dental crowns and caps are checked,
neck flexibility and head extension observed
Physical exam & History
Medications (including herbals) & Allergies
Past anesthesia & Surgeries
Risk Factors – age, obesity, smoking, general health status, COPD, Asthma
Innovian Anesthesia - What's It All About | Sept 2012
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12. Care Areas Care Areas - Holding “The Morning Of” the procedure
Intra-Op
Pre-Anes.
Evaluation
Pre-op
Holding
Post-op
“The Morning Of” the procedure
Start of anesthesia care
Prep for procedure
Chart review
Assessment of current condition
May initiate anesthesia method
"The Morning Of“ the procedure
Start of anesthesia care
Prep for procedure
Chart review – the resource completing the preoperative assessment usually is not the anesthesia provider who administers anesthesia.
Assessment of current condition
May initiate anesthesia method – administration of pre-op medication to relax you, insertion of catheters to start anesthetic for block or epeidural; insertion of invasive lines to reduce OR time.
Innovian Anesthesia - What's It All About | Sept 2012
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13. Care Areas Care Areas - Intraop Intra-Op Pre-Anes. Pre-op Evaluation
Holding
Post-op
Start or induce anesthesia to provide
Analgesia
Amnesia
Immobilty
Hypnosis
Skeletal Muscle Relaxation
Validate level or effectiveness of anesthesia method
Monitoring of physiological parameters
Start or induce anesthesia to provide
Analgesia – loss of pain
Amnesia – loss of memory
Immobilty – loss of motor reflexes
Hypnosis – loss of consciousness
Skeletal Muscle Relaxation
Validate level or effectiveness of anesthesia method (Block or Epidural)
Monitoring of physiological parameters both cardiac and pulmonary – HR, SPO2, etCO2, respiratory rate, invasive pressures, gas flows, etc.
Provide loss of pain, memory, motor reflexes, consciousness, & muscle relaxation
Innovian Anesthesia - What's It All About | Sept 2012
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14. Care Areas Care Areas - Postop Better known as PACU Transfer of care
Intra-Op
Pre-Anes.
Evaluation
Pre-op
Holding
Post-op
Better known as PACU
Transfer of care
Monitoring of VS & Pain Management
Assessment of Outcomes
Length of stay
Phases
Better known as PACU
Transfer of care from anesthesia to nursing / primary physician or home
Monitoring of VS & Pain Management
Assessment of Outcomes
Length of stay – 1 or 2 hrs
Phases based on type of surgery and patient destination. If discharging to home, patient will stay in Phase 2 for additional time to ensure readiness to be discharged to home.
Length of stay
Innovian Anesthesia - What's It All About | Sept 2012
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15. Modules
Innovian Anesthesia
Innovian Anesthesia 4.0

16. Innovian Anesthesia Modules
E-forms / Preoperative Evaluation
Case Recorder – Care Area Clinical Documentation
Stores anesthesia data entered by clinicians or collected automatically from connected medical devices
List Manager – create site list & system setting
Environment Manager – configure templates
Case Manager – archive, delete, restore, purge, print
Report Viewer
Reporting Tool
E-forms / Preoperative Evaluation
Recorder – Care Area Clinical Documentation
Holding Area
Intra-op Documentation
Post-op Documentation
Stores anesthesia data entered by clinicians or collected automatically from connected medical devices
Uses of anesthesia data
Share with HIS
Include in case reports
Report Viewer
Web based application that allows users to access previous anesthesia records from within or outside the Recorder
Reporting Tool
Very easy to use application that allows clinicians to create reports based on facility requirements.
Innovian Anesthesia - What's It All About | Sept 2012
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17. Case Recorder Overview: Admission
Basic layout tabs and pages
Patient
Lookup feature
Automatically collect patient demographics (HL7)
Name & DOB
Case Information
ASA
Date & location of surgery
Dx & Procedure via codes
Ht & Wt
Staff
Adding participants
E-signatures
Admissions
Automatically collect patient demographic data via a link to an OR scheduling or ADT
system
Italics make it easy to identify data that comes into the system automatically
Select a patient via a configurable census list
Easily “lookup” patients that already exist in the database
Displays key parameters, such as patient name, medical record number, admission date, birth date, sex etc.
Intuitive coding tool and “smart” searching capability, facilitates quick documentation of procedure and diagnosis codes
Staff Management
· Easily accessible throughout the peri-operative episode and supports electronic signatures
Innovian Anesthesia - What's It All About | Sept 2012
Innovian Anesthesia | What's It All AboutInnovian Anesthesia 4.0

18. Case Recorder Overview: Preop
All of the areas they may question during assessment. Any data captured in E-forms will display here
Allergies, Medications, History
Records and displays a summary of all patient allergies with accompanying notes to explain the reaction the patient has to a particular allergy
Documents all of the medications that the patient is currently taking and any comments
Anesthesia history identifies previous anesthetics the patient may have had and the results of the anesthetic
Medical history identifies any or all problems the patient has had over his/her life
Family history helps identify any predispositions a patient may have to a specific condition
Allergy alert consistently displayed throughout the peri-operative episode
Systems Review
Provides a comprehensive exam of the bodies major organ systems with the ability to capture free-text comments
The data collected with each system review is placed into a common viewing window which summarizes key data elements into one view
The following are the systems that are provided: respiratory, digestive, circulatory, nervous, reproductive, urinary, endocrine, muscular, skeletal, integumentary
Physical Exam
Enables clinician the ability to document a patient’s physical condition and other relevant information
Document any hearing, vision, dental, and disabilities allow with any free-text comments
Capture important information in regards to patient’s airway and condition of heart
Anesthesia Plan
Defines what has been agreed upon in order to move forward with an anesthetic
Supports documentation in regards to risk, pre-op date and time, and other types of documentation
Electronic signatures and free-text comments keep track of all that have obtained and/or reviewed the patient’s information
Anesthesia Preparation
Configurable process verification checklist defines all of the tasks that need to be completed prior to anesthesia
Numeric grid to capture any drugs given to the patient or lab results acquired in preparing the patient for surgery.
Innovian Anesthesia - What's It All About | Sept 2012
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19. Case Recorder Overview: Intraop
Trending – collection of device data
Layout navigation
Grid –
Display of automatic data collection of numeric values
Configurable screen size
Milestone customized
Assessments can be displayed on the grid - EKG Rhythum, TOF, warming unit temperature
Repeat Reminders & Incomplete Required Chart Elements
Status bar – indicators for connectivity
Anesthesia Methods
Procedures
Full Audit Trail on all data elements
Intra-Op Charting
Provides graphical trending of vital signs and the numeric entry of medications, fluids, and lab results
Synchronized, chronological view of vital patient and clinical data from beginning to end
Within a single view a user can view up to 36 hours of a case at one time or as little as 1 ½ minutes at a 15 second resolution
Data automatically collected within the graph can also be displayed in the grid simply by dragging and dropping the parameter from the graph to the grid
Configurable screen sizing to determine space allocation of numeric grid and graph
Separate grid is offered to display the automatic collection of fluid balances
Milestone event bar gives the user the ability to customize how a milestone will appear on the chart to differentiate it from other events
Provides a full audit trail on all data elements
Numeric Chart
Each parameter has a common, consistent representative color which corresponds to the icon found on the toolbar.
Easily drag and drop the parameters to tailor the display
Entries that have associated comments can be identified at a glance
Graphic Trends
Displays up to ten user definable graphic trends
Allows symbols, color of display and graph scale of each parameter to be defined by the user
The legend of the graph is automatically populated when the parameter is detected from a serial port connection
Touching the graph at any time will display a tool tip that displays the values of the parameters at that time
Anesthesia Method
Dedicated anesthesia method page that provides comprehensive anatomic fields for more accurate reporting and detailed documentation
Innovian Anesthesia - What's It All About | Sept 2012
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20. Case Recorder Overview: Postop
Chart – ability to only display numeric values; no graph
Scores – standard measurement for condition
Detailed Assessments & Checks
Discharge with discharge instructions
Methods & Procedures
Copy Forward option minimize charting time
Fluid Balance – automatically calculates
Same look & feel as Intraop with quick access – ease of use
Post-Op Documentation
Numeric and graphical screen layout that is customizable by the user
Dedicated assessments page to support standardized nursing protocols
Templates enable the ability to predefine assessments to speed documentation
Supports a single scoring system for each patient
Site configurable score can be defined for all patients which promotes a common measure for all patients in recovery
Thorough patient discharge section to ensure patient is provided with care instructions
Innovian Anesthesia - What's It All About | Sept 2012
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21. Case Recorder Overview: Browse
Access to the intranet or internet
Report Viewer
Continue documenting care
Innovian Anesthesia - What's It All About | Sept 2012
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22. Innovian Overview: Reporting Tool
Innovian Anesthesia - What's It All About | Sept 2012
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23. Innovian Overview: Reporting Tool
Innovian Anesthesia - What's It All About | Sept 2012
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24. Innovian Anesthesia Other Modules
List Manager
Environment
Manager
Case Manager
So, to recap: List Manager is the Data Base that includes all items needed to populate the Environments
Environment Manager are the templates used for different types of cases
Case Manager - is where the case management takes place – deleting, archiving, and batch printing
Innovian Anesthesia: What’s it all about!!!!
Innovian Anesthesia - What's It All About | Sept 2012
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25. IT Structure – Hardware & Integration
Innovian Anesthesia 4.0

26. Architecture
Innovian Anesthesia - What's It All About | Sept 2012
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27. Workstations – Clinical vs. Non-clinical
Medical grade workstation
Complies with UL, CE, & CSA standards
Medical Grade RS232 ports for connectivity
Isolated transformers prevent electrical leakage
Fluid resistant for clinical use
Medical grade power supply
Touch screen
Fanless
Medical grade workstation
Complies with UL, CE, & CSA standards
UL requirements dealing with fire, shock, & safety hazards
Medical Grade RS232 ports for connectivity
prevent ground loops & current leaked from other electronic devices from affecting the WS
Isolated transformers prevent electrical leakage
Sealed for fluid protection to withstand rigors of OR environment
Touch screen & Fanless
Always used in clinical settings where one want to connect to physiological devices – monitor & anesthesia machine
Innovian Anesthesia - What's It All About | Sept 2012
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28. Workstations – Clinical vs. Non-clinical
Commercial grade workstation
Innovian Installed along with all other applications
No RS232 ports for connectivity
Non-fault tolerant
Commonly used for Web Pre-evaluation Form & Configurations
Non-Clinical
Regular Hospital grade workstation
Innovian Installed along with all other applications
No RS232 ports for connectivity
Non-fault tolerant
Commonly used for Configurations
Innovian Anesthesia - What's It All About | Sept 2012
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29. Architecture – Fault Tolerance
Transparent Operation During Network Interruptions
Local Database
Configuration Data
Site List Data
Environment Data
Security Data
Local Queue
Case Transactional Data
Innovian Anesthesia - What's It All About | Sept 2012
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30. Architecture – Fault Tolerance
Fault Tolerance Real Life Example
Hospital Network Down
Continue to:
- Capture clinical data
- Capture financial data
- Remain on schedule
Innovian Anesthesia
Continue to:
- Capture clinical data
- Capture financial data
- Remain on schedule OR
Devices
Innovian Anesthesia - What's It All About | Sept 2012
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31. Innovian Points of Integration
Lab System
Pharmacy
Technical
Billing
Surgical Schedule
ADT
Operating Room Devices
EMR
Professional Billing
Innovian Anesthesia
Hospital Network
We’ve talked about the Innovian software and we have also mentioned its share data with other information systems within your hospital. Here is a flow diagram that may help you understand how data flows between Innovian and other systems like Lab, Billing, Registration, your EMR, etc. Innovian Anesthesia is available with a Web application programmer interface (API) toolkit that enables organizations to build applications that run against the Innovian Anesthesia business tier to access data.
Organizations can create custom data collection and analysis programs for any health care facility that uses Innovian Anesthesia.
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32. Integration Points HL7 - Inbound & Outbound
Specifies # of flexible standards, guidelines, and methodologies where various healthcare systems can communicate with each other
Allow information to be shared & processed in consistent & uniform manner.
Leads to ease of sharing clinical information
API – Application Programming Interface
CCOW
Benefits
Seamless Integration into HIS
Real Time Results
Data Integrity
All information correct; no fat fingering mistakes
Efficiency
Pt demographics & case info pre-populated
Minimizes data entry for clinician
Automation of processes
Financial
HIS integration
HL7 - Inbound
ADT
Scheduling
Labs
HL7 – Outbound
HL7
Anesthesia Summary
File Pointer
Other
XML
ASCII
API – Application Programming Interface
CCOW
Benefits
Pt demographics & case info prepopulated
All information correct; no fat fingering mistakes
Hospitals and other healthcare provider organizations typically have many different computer systems used for everything.
All of these systems show interface or communicate with each other when they receive new information, but not all do so.
HL7 specifies a number of flexible standards, guidelines, and methodologies by which various healthcare systems can communicate with each other.
Such guidelines or data standards are a set of rules that allow information to be shared and processed in a uniform and consistent manner.
These data standards are meant to allow healthcare organizations to easily share clinical information.
Theoretically, this ability to exchange information should help to minimize the tendency for medical care to be geographically isolated and highly variable.
Innovian Anesthesia - What's It All About | Sept 2012
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33. Integration: HL7 ADT Messages
ADT- Admit, Discharge, Transfer
Demographics
Name
Address
Phone
IDs
Next of Kin
Allergies
Billing
Insurance
Guarantor
Height and Weight
Patient Status
Increased Efficiency – save so much time
Innovian Anesthesia - What's It All About | Sept 2012
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34. Integration: HL7 Scheduling Messages
Demographics
Name
Address
Phone
IDs
Scheduled date and time
Staff
Resources
Location
Diagnosis in Free Text
Procedure in Free Text
Height and Weight
Benefits:
Innovian Anesthesia - What's It All About | Sept 2012
Innovian Anesthesia | What's It All AboutInnovian Anesthesia 4.0

35. Questions? What is Innovian Anesthesia??
Why is it Important? Benefits & Advantages
Who are the Players?
Anesthesia – “Not Everyone Goes Under”
Where is IA Used? - Understanding Workflow & Care Areas
Architecture & Components
Connectivity: “Not an Island
Modules
Innovian Navigation
Innovian Anesthesia - What's It All About | Sept 2012
Innovian Anesthesia | What's It All AboutInnovian Anesthesia 4.0