1. Homogeneity... ...to identify entities
The completion of domain specific message and document definitions by process control mechanisms:
Project Idef-IS: Identification as Key for Quality Management
Spital Thun-Simmental AG
Dr.med. Marc Oertle
Head Clinic IT
Medinorma LLC
Christian Hay
Partner

2. Agenda Identifications as a Challenge: Background of Project
IdefIS
Identifications as a Challenge: Background of Project
Path to a Solution
Standardisation with GS1
Deployment

3. Background (3) Transfusion (when declared...) Switzerland and U.K. :
IdefIS
Transfusion (when declared...) Switzerland and U.K. :
near miss every 340 transfusion
Full incompatibel transfusion with morbidity: 1:100‘000
Hospital Thun 5‘100 transfusions yearly, but : every ~ 18 Month a transfusion error
Thun: März 2005-März 2006 declared events:
Laboratory: 26 (wrong blood tested....)
Number of non-declared errors estimated as very important
CIRS (Critical Incident Reporting System) additionnally: 13 Declaration in 3 Months (13/46) concerning wrong Patient, medication given to wrong Patient (Hypnotika, Morphium, …), near wrong site surgery, wrong Patient to Xray examination. It is said that weekly laboratories have to eliminate samples badly identified

4. Objective: the 7 R Right patient Right time
IdefIS
Right patient
Right time
Right plan (to act): prescription e.g.
Right action
Right resource
Right person
Right place

5. Landscape impacting Idef-IS
CIS, PIS, LIS are in place
WLAN access across all the Hospital, medical and nursing documentation electronically accessible; mobility with Laptops
Requirement for efficient, user friendly and safe System
Hospital Group with 4 Sites
No Budget

6. Pre-requisits for Idef-IS
Existing Systems to be used
Existing identifications to be used
Standardisation of existing and new identifications to achieve uniqueness
Role based identifications; management of attributes
Generic Architecture, has to be used for all cross-matching
All Resources to be handled similarly (Staff, Patient, Material, Locations)

7. Example of blood transfusion
IdefIS
Accounting / re-ordering
Electronic order entry
Feed-Back
Blood sample with reference to Patient
eID-Check
Transfusion
Blood analysis
Clearance
Cross Match with Patient
Blood product dispensed

8. Uniqueness: GS1
IdefIS
Standard System with set of components (GSRN, GLN, GTIN...)
Individual : Global Company Prefix
Integration of existing (non-unique) Identifications
Example: Global Service Relationship Number
18 digits Code (numeric)
Global Company Prefix + 10 digits + check digit
GCP+ (Attribut+existing identification)+C

9. Concept IdefIS
IdefIS
GS1: uniqueness; attributes for roles

10. Identity Management GCP PAT FID p 7601005 200 2258316 6
IdefIS
GS1
unique
Role Management
Standardisation
GCP PAT FID p
Identification: Who/What is it
Mapping: belongs to ?
Validiation: expiry date?
reading the 3 entities in free sequences
Idef-IS Tabels

11. AIDC (Automatic Identification Data Capture)
IdefIS
GS1 GTIN
Medication
Proprietary Barcode (migration to GS1 planed)
Blood sample
RFID ISO 15693
Patient wristband
GS1 GTIN
Materials
RFID ISO 15693
Badge Staff
ISBT 128
Blood product

12. Last but not least Dr. Lucian Leape, Harvard School of Public Health
IdefIS
Incompetent people are, at most, 1% of the problem.
The other 99% are good people trying to do a good job who make very simple mistakes and it's the processes that set them up to make these mistakes.
Dr. Lucian Leape, Harvard School of Public Health

13. Contact Dr.med. Marc Oertle marc.oertle@spitalstsag.ch
IdefIS
Dr.med. Marc Oertle
Christian Hay