2 CMAX Work Flow A disaster generates mass casualties Digital pens capture patient triage data Patient Tracking Tag is assigned Transfer patients to different hospitals Digital pen transmits triage data to system Triage data is available through BHEPP network Total Patients Triaged: 186 Burn ….. 17 ICU……36 Pediatric…13 Surgical…..24 Data reports are available for emergency personnel Separate Systems but all are linked together

3 Digital Pen Overview The pen – Writes normally but captures pen strokes via a tiny camera and pressure sensors. The paper – Each form has unique pattern of dots telling the pen where it is on the page. The transmission & communications – Transmits through mobile devices or docked with PCs to networks. The software – Provides character recognition, data conversion, data validation, data correction, & others. Integration – Integrates data in to back end applications.

4 Digital Pen Multiple vendors (Nokia, Logitech, Hitachi, Maxell..) Camera takes 50+ pictures per second Store up to 50 Letter size pages of handwritten data Battery life limited to: – Around 5 hours of continuous use – More than 24 hours if capped – Weeks if capped and stored Pen strokes are not recorded if: – Using in an extremely dark environment – Using paper that is significantly wet – Using paper that has been ripped, smudged, or crinkled excessively

5 Digital Form - Dot Pattern 2D dot pattern Pattern of 6x6 dots provide coordinates for pen ~ 465K dots per sheet Patented by Anoto of Sweden

6 Digital Form – Triage Form

7 Form Design & Generation Sample Forms/Ideas Form Designer Digital Form Templates

8 Form Processing Data Capture Data Transmission Form Processing Analysis & mapping Handwriting recognition Interpretation Verification & correction Patient DB Information Integration Application integration Display/reporting Storage

9 How Digital Pen Is Used

10 Digital Pen Summary Report

Patient Tracking System 11 Challenge – How to track the location of patients after their initial assessment at the triage site. Patients may be moved to different locations within an emergency care facility as they are queued, treated, and monitored. Patients may also be moved between facilities/hospitals, in order to obtain needed specialized medical resources, or to balance loads. Purpose – It will track patients locations as patients are moved around one of the facility/hospital, or between facilities/hospitals. It helps determining room/bed availability, knowing if a patient has recently been registered, treated, or why he/she is waiting, and monitoring a patient’s total time in care. It helps improvement of decision-making regarding patients care, transportation/equipments, resource allocation, and incident management.

Patient Tracking System - Flow 12 Patient registration at hospital Master of Tracking System Database Patient Tracking System Patient Info (Last Name, First Name, Category, Patient ID) Data stores in database Patient Tracking System pulls data (location) every 5 seconds

Patient Tracking System - Dashboard 13 System links to Data Exchange and Digital Pen

Patient Tracking System - Category 14

Patient Tracking System – Dropped Off Tags 15

Patient Tracking System – Historical Data 16