ConCensis: Tracking to Infinity and Beyond with an Instrument Tracking System

Hello, everyone, and welcome to another episode of Consensus, a podcast from Sensis Technologies. I'm your host, Tyler Kern. Thanks so much for joining us for this episode of the program. Today, we're gonna be taking you into instrument tracking and beyond. And so this is that's our title for this episode. It's gonna be a fun episode where we're gonna start with the basics and get deeper and deeper as we go into instrument tracking. And so joining me today, we have two experts from Census Technologies. First, have Jacob Long. He's a sales engineer at Census. Jacob, welcome to the podcast. Thanks for joining us. Yeah. Thanks, Tyler. Happy to be here. Absolutely. Happy to have you on. And we're also joined today by Seamus Johnson. He is the director he's a senior director of application development at Census. Seamus, welcome to the podcast. Sorry, I forgot senior. That's alright. Thanks. Thanks for having me. Well, we are pleased to have both of you here on the podcast today. And so, like I said in the introduction, let's start off here at the beginning just with the basic level of instrument level tracking. So we're gonna call this instrument tracking one hundred one. So guys, what is an instrument mark and how and why do we use them? Give us some idea into what these things are and then how they're used and why that's so beneficial. Yeah, the basic problem is this. If you talk to any circulating nurse at any hospital in the United States and ask them how often do you open a tray and there's instruments missing? They'll tell you it happens every day. It's been a struggle for as long as sterile processing departments have been putting instruments in trays, right? And so the kind of the idea that Census was founded on was that if you put a barcode on an instrument and people scan those instruments into the trays, the computer can ensure that every tray is accurately assembled every time. It's really the only way to eliminate that persistent problem. And to understand why that's important, if the know the nurse opens a tray or something missing, then they don't have the instruments that they need in order to perform the surgery. They got to go and pull extras. Which means as a result, most hospitals carry excess instrumentation just to compensate for a quality problem. That's a great point. Jacob, anything you want to add to what Seamus said there just about the importance of instrument level tracking and why this is such a big thing? Yeah. Yeah. Of course. Seamus' example is is is right on. I'm pretty sure we see the same consistent issues, the same struggles, whether it's a circulating nurse or a scrub tech doing their counts or an SPD technician, you know, putting their sets together. We see a lot of the same issues constantly that all professionals have to deal with. And being able to have each almost like a fingerprint for each one of these instruments and then like Seamus mentioned using like that in conjunction with like a computer and a scanner, it really helps all these technicians and nurses regardless of what stage they're in have that level of visibility. So regardless if I'm the nurse in the room or if I'm the person putting the set together, being able to have that instrument to instrument traceability, it gives them, it lets them know exactly what they're handling and then it lets everyone know downstream what they handle. So as long as the instrument marks are used from start to finish, it creates a really seamless cycle of what instruments exist in what sets, who's been using them, how often they've been used and things like that. So it's really great not only just for the end user experience because it helps them know what they're handling or what they should expect to be handling, but then everything that's done with also a platform like Sensitrack, it also gives them just that traceability record as well. So it's not only just the benefit from the end user, but everything that ever gets done gets logged as well and it's all reportable. So from the end user experience, it's really important and then also just from any sort of data or any record retention, it's also really valuable for healthcare professionals, anyone in a sterile processing environment really. Yeah, that's a great point, you know, beyond just getting trays assembled correctly every time, marking to instrument level allows you to do some other things as well. For example, you can track your instrumentation, instruments go lost all the time. You can track quality issues to the instrument, you can track repair issues. So if you have high dollar instrumentation, you can mark that and understand how often it's going out for repair, why it's going out for repair, where it's getting damaged. Is it is it happening in transport, is it happening in the OR room, is it happening in you know in decon when it's being processed. So there are all these other problems that you can solve as a result of tracking instrumentation to the instrument level rather than just to the track. You can trace instruments to a patient. So if you have a CJD scare, you can now get information about all the patients that may have been exposed because you know exactly which instrument was used on every patient. And these are pieces of data that without a system in MARRC's it's nearly impossible to have. If consider this on paper there's no way to know exactly what instruments are being used. We know what type of instrument, but it's impossible to know exactly what instrument. So these are pieces of data that until just within the last couple decades was almost impossible to even get. So it's a whole new world of being able to have that type of management and oversight of these instruments. And for SPD managers it also helps them with customers outside of just the OR too. So a lot of SPD departments service clinics and it's very important to be able to show to the clinic, okay here are exactly all the things that you sent me to reprocess and here is everything that I'm sending back to you. And by the way, I'm not losing your stuff. Sometimes that happens but the problem that they have a lot of times if they're not tracking to the instrument level is that a clinic will say, you know, I'm missing this that or the other, I'm pretty sure you guys lost it. And then the clinic won't do anything to try and find that instrumentation until, you know, an exhausted two week search has gone on in the SPD department, right? And if you can show them right away, no I didn't lose it, then they'll look for it right away and they're much more likely to find it. So even though both the clinic and SPD are part of the hospital and it's the hospital's budget overall that's impacted by, you know, losing these instruments. It's really important to understand how things are getting lost, where they're getting lost, because otherwise you just can't fix the problem. Yeah, that's a really good point. This feels like technology being utilized and used to provide transparency kind of all throughout all of these operations, right? So it provides that visibility, that transparency that's necessary to make sure that, yeah, things don't get lost, that things are there where you expect them to be and all those sorts of things, right? Right. Excellent stuff. So we we talked a little bit about instrument marking but what are some of the methods used for instrument marking? Can you talk us through some of the methods and some of the technologies there? Yeah. So so at Census, we actually offer two different strategies. We have one strategy which is referred to as electrochemical marking or ECM for short. And that uses essentially like a electronic potential to put almost like a tattoo. That's all I can think of it. It's like a stencil that gets applied to the instruments. So it can be applied to stainless steel instruments and it's like a little QR code almost like you would scan for like a restaurant or a menu at a restaurant or something. So we can use electrochemical marking to adhere those marks to instruments. And then there's also laser technologies that exist today as well. And we also offer a laser that can do the same type of mark, just of course a different method using laser marking to the material as opposed to a micro chemical mark. They both create marks on the instruments that can be scanned with our systems and then they both can attach those as well. And then what's also kind of changing in the industry is manufacturers of surgical instruments themselves are starting to be expected to put these individual UDI marks on their instruments. And while there's no official mandate it's projected to occur anytime in the near future. I think within the next year or two, instrument manufacturers will actually be required by the FDA to have unique device identifying marks on their instruments. So there's quite a few different ways to get those in the market today. Seamus, any follow-up? Yeah, that's a really good point about manufacturers putting marks on instruments, you know, for a lot of our customers, they have a large inventory of instruments. And I think what's important to understand is that you don't have to mark all of your instruments in order to see a return on your investment here. Some of those instruments are already going to come with marks, so you can take advantage of that today with Synthetriq. And then you can put together a roadmap for which instruments to mark first so that you see maximum benefit right up front. So you might, for example, target your high dollar scopes first so that you can track, repair, and damage the scopes, or drills so that you can, you know, track when drills go missing or something like that. And then move on to peel packs and clinic items so that you can get value out of that set. And then eventually you get to a point where everything's marked and you can put things in trays through assembly and guarantee that no nurse ever has to open a tray and missing instruments ever again. That's a great point. Excellent, excellent point. And so talk to me then, you were talking about the two primary methods that that SensiTrack uses. Tell me about using SensiTrack in tandem with these marks. What are some of the benefits that are that are provided there? Kind of talk me through what that looks like from a benefit standpoint. Yeah. No problem. What's great is Seamus already hit on a lot of these is once those instruments are marked, we can actually tell our solutions what that instrument is. So there's kind of two stages to the marking process. There's the actual application of the mark onto the instrument if it's needed. And then the second stage is what we like to refer to as commissioning. So a fingerprint is kind of useless unless we tell SenseiTrack what that fingerprint is. So then the SenseiTrack knows in that commissioning process exactly what that instrument is because we tell it that. And so now it knows exactly what that instrument is and because it knows exactly what that instrument is, we then get a lot of benefits there. So like I said, Seamus mentioned quite a few of these, but we get traceability. We know exactly where these instruments go. We know who assembled them, know when they got assembled, we know when they got sterilized, where they got sterilized, where they got put away, where they got used, when they got used. So every time a scan event happens with a marked instrument that gets logged. So you get full traceability is like you said, I'm trying to transparency as well. We know everything, the whens, the wheres, the clues for these instruments. And once again, it's a level of data that hasn't really been possible too much in the past or without a platform like this. And then Seamus also mentioned like maintenance and usage. It lets us know exactly how many times we're using instruments. I think a lot of the times SPDs and ORs, they kind of have a rough approach or an estimated approach to when they should refurbish or repair a lot of their instruments. It's usually set like on time intervals, like every ninety days or on usage intervals, every sixty uses or something. But it's usually like what I refer to like a shotgun approach. They'll just sharpen and repair a whole tray or something. Well, if we know exactly what we need to refurbish based on instrument usage, we can then make really cost effective decisions for maintenance that way. Why refurbish an entire tray if only at least half of the instruments in that tray need maintenance or refurbishment? So there's that type of data as well. And then that just corresponds to purchasing. Seamus also hit on missing instruments. I'm pretty sure every STD and OR like he mentioned deals with missing instruments at one point or another. And being able to know exactly what you're missing, being able to know what you need to purchase also really helps with those decisions as well. I'm not purchasing instruments I don't need to purchase. And also I can locate instruments that might mitigate me from having to make purchases. And then also for the users benefit, we can also attach like instrument specific messages and instructions for use to them, also known as IFUs, so they can be proper reprocessing because as the industry evolves, these instruments are evolving as well. Instrumentation is a lot more complex than it used to be a few decades ago. So there's a lot of instruments these days with moving parts, with integrity test requirements, things like that. And it's really difficult for technician or a professional there to memorize and remember all those things. So being able to scan an instrument and then have a message show up on screen that says, hey, this instrument needs particular care, please do X, Y, and Z. Those are all really valuable things to make sure these instruments get properly handled and maintained and reprocessed. So that way when they get used, they're perfect for use. They've been assembled and reprocessed according to how they should be. Right, yep. Yeah, I think along with that, you know, you were talking earlier about the different methods to marking instruments. I think what one thing is important for customers to understand is that, you know, there's a lot of different ways to mark instruments out there, but it's not actually super easy to mark an instrument, mark it well, and to read the instrument. In the early days of census, we went through a lot of trial and error trying to find the right combination of technologies to make this easy. So if you think about, like when you go to a supermarket, and you go through the checkout, and you scan a UPC code at the self checkout for example on something that's really easy to do, right? You just swipe the thing over the scanner, it does it. And that's the kind of experience you want when you're scanning an instrument as well. But with instrumentation, you're looking at a stainless steel surface. It's usually curved and it's usually very shiny. And the way most scanners work, if you remember from the supermarket examples, they illuminate their target with laser lights, right? So if you shine laser lights at a shiny curved surface, you just get laser light back in your face, and it blinds the camera. So we put a lot of work into coming up with the right combination of technologies to make that fast, effective and affordable. You know, I think everyone is pretty good at using the self checkout line except for whoever the person directly in front of me is. I don't know if that's been y'all's experience, but that's certainly been my experience. So as we talk about the technology that enables this to happen, tell me a little bit about the Cognex scanners and the different, maybe the latest model details and the things along those lines there that kind of enable this level of tracking and technology to take place. Yeah, so Cognex has been a great partner, Roars, for many years now. It took us a long time, several years to find the right scanner. In the very, very early days we were experimenting with a number of different methods. Like I said, you know, you illuminate the target directly with laser light, it just blinds the camera because you're basically shining laser light onto a mirror almost. And so the first innovation that we came up with was to illuminate the target with diffuse light instead. So instead of shining laser beams directly onto the mark, you shine the laser beams onto a flat white surface and then let that yeah exactly and then let that illuminate the target, right? So we developed what looked like hoods that went over the front of scanners. And yeah, we'd have like a cone on the front of it and that worked pretty well. And then the folks at Cognex came along and said, well you know there's actually a better way to do that. And they had a plexiglass attachment on the front of the scanners that would diffuse the light. So the light actually went through the plexiglass and came out across the target and it was diffused. And that made the target a lot easier to read. You didn't have a lot of light coming directly back into the camera anymore. And then they did some really cool things with the way that light gets created, the angles at which it gets created, specifically for reading marks on surgical instruments. And so today we've got a solution that makes it super easy, just like that supermarket experience, to scan marks on instruments. That's pretty fascinating. Remember even I've even seen evolutions of the Cognexes just since I've been with the Census. The new models we have read the marks really quickly. You don't have to get as close. There's also a setting that's really nice for text where for my example here, have to push the button, have to kind of push the trigger to make it work for my model, but they can also be configured to just be always on. So that's really handy when I'm assembling or when I'm reprocessing because I can have my scanner just on a stand that holds it and I can just run my instruments under it without having to free up my hands. I don't have to worry about using my free hand to pull the trigger or hold the scanner. With it being always on, putting it on a stand, with all the technology to diffuse the laser that Seamus referred to, it makes it to where you can scan those instruments really easily. So if you can imagine this would just be on all the time when I'm assembling and I can just scan my instruments under it. So the combination of the technology as well as how it's deployed with those Cognex scanners really helps us get the most out of those marks and really improves the user experience as well. Yeah, so in concept it's really easy just to put a barcode on an instrument and start tracking but in practice it's really quite difficult. And the advantage that we have is we've been doing it for twenty years. Absolutely. That's a great point. There's that track record there. There's that. Yeah, I suppose it's not a better way to say it than then there's a track record there. There's a history of success. And there's a knowledge that comes with that track record. And with the amount of time that you spent doing this sort of thing, you you kind of learn the ins and outs, the different challenges that exist. And because of that, you you come away, you know, knowing what some of the difficulties are and how to navigate them. So that makes a lot of sense. So talk to me about the Census software as a service kind of instrument level tracking relationship that you're able to develop with clients and how you're able to then work with other people to make sure that they're able to find success using these tools and instruments and making sure that these SPD departments are able to really do the things that they need to do and create these new efficiencies. Talk to me a little bit more about the software service aspect of this. Yeah twenty years ago we launched the ScentiTrack as software as a service which wasn't a thing twenty years ago in the late 90s nobody was talking about software as a service. Primarily at that time, if you walked into a sterile processing department, they would be using Microsoft Excel or Microsoft Word to keep track of the what they call count sheets, what's in every tray. Sometimes they had physical paper count sheets. And so, you know, we were going to hospitals and we were saying, hey, you know, we have this great tracking system and by the way, it's a website And it'll keep tracking your account sheets and all this stuff. And they kind of looked at us like, why do you want me to sign up for a website? I've got Excel over here, right? But the advantage, and the world knows it now, right? The advantage to cloud deployed software is really in the return on investment for the hospital. So if you have traditional software and you deploy that software to servers in the hospital and the desktops in the hospital, the IT department has to care and feed for that, right? When servers go down, the IT group has to know how to stand them back up again. The IT has to learn all those different pitfalls that come with a new technology. IT has to, review security and scalability and reliability for all these different services. And, know, there's a cost to that. It's not free. And the advantage that cloud deployed software brings is that we do all that for you. We have a team of professionals that do nothing but care for and feed ScentsyTrack. So they already know all the ins and outs of, you know, the pitfalls and how to configure it properly and deploy it in a highly available configuration. You know, so it saves you all of that trouble. I think for the first ten years that we were in business, that was an uphill battle. And somewhere around two thousand and eight, two thousand and nine, small hospitals started to really look for that value. And at small hospitals, was because they didn't have a vast IT infrastructure, you know, to dedicate to a new software product. And then around twenty fourteen, twenty fifteen, large hospitals started to look for that value as well. I think prior to that, there was always a concern about, you know, in the 90s, patient health safety, patient privacy, security. And so there were a lot of hospitals that really just wanted to bring everything in house because the only way they could guarantee that that information was secure is if they held it. What we've learned over the last twenty years in terms of cybersecurity is that nobody's safe. Hospitals get hacked every day. And so what you really need is you need a team of dedicated professionals that knows the best way to secure a particular software product. And like I said, that's what we do all day every day. And so you don't have to, you know, train new staff to do it and send them to classes and buy servers and and, right? Instead, you can simply hem out the census. We don't charge anything extra for it, and you get a much bigger return on your investment as a result. That's really well put. Jacob, what kind of follow-up do you have to that? Yeah. No. That's that's perfect. I I always like to see it from also from, like, the end user experience as well. When this when facilities, whether there's a large hospital, smaller hospital, like she was looking for that that safety and that return is is always at the forefront there. But we never wanna forget the end users too. And when it comes to how we deploy the cloud based software, we offer free patches and upgrades and developments primarily based off either where the industry is going or customer feedback that we find value for the industry. So by deploying a cloud based solution like this, update and upgrade our customers databases with little to no downtime, we don't interrupt their work. We offer those without additional charges to subscription and things like that. So using that cloud based offer also helps from a support and development point of view as well. So anytime we come out with a new feature or new bells and whistles, all of our customers get access to it as soon as they're released. And also our licensing, the way that we allow facilities to deploy SensiTrack wherever it works, wherever they need it, they can get that cloud based solution at any workstation. So whether that's a charge nurse's desk or a manager's office or a decontent reprocessing area, we can go ahead and install SensiTrack wherever it makes the most sense for those customers. And then using the cloud based deployment, once again we can update them, we can have a lot of oversight and just that really takes a lot of the stress off the customers as well from the IT group down to the end user. There's a lot of things that I don't even think they realize when we deploy this way. There's a lot of things that they don't have to worry about because of the way that we manage a lot of this in house. That's yeah. That's that's really great. Now I I think I like how you put that. Just kind of removing some of the headaches, making sure that you've reduced downtime for them and and that sort of thing, I think, yeah, really provides that peace of mind that's that's necessary to focus on the job at hand, the tasks at hand. Right? And that's, I think, an important thing about what you're talking about and what you're doing. So let's talk a little bit more about Sensei SensiMark and some of the data offerings that you have as well. Can you kind of talk us through the advantages that those provide and the benefits that they can provide to SPD departments? Yeah. So so SensiMark is a team dedicated at Census where, you know, they eat, sleep, breathe instrument marketing and data. So we have really dedicated teams at Census. That way, you know, from from any sort of support characteristic, have a team dedicated to it. So for example, we have a client management team, client services, which is dedicated to client manager to customer one on one support. We have clinical services, is a team of healthcare and industry professionals, which make sure that what we're doing at census is on par with the industry. Know, we have really specific teams to help us move forward in advance. And with that, we have our SensiMark team and program. And the SensiMark program is designed specifically to help our customers that are interested in instrument level tracking get there successfully. So SensiMark helps customers lay out their strategies. Like Sheamus mentioned earlier, something really important to consider is we don't expect someone to to mark all quarter million of their instruments in a week or something like that. It makes it really difficult. So SensiMark's designed to gauge a customer's desire first of all, when we wanna get that instrument level tracking. Do you wanna track your high value instruments? Do you wanna track scopes? Do you wanna track DaVinci or robotic instruments? So, and then next, it's how do you want to do that? Do we want to go electrochemical? Do we want to go laser? What makes the most sense for your facility, for your budget, etc. Once we get to the next stage, we then help facilitate the marking either with some of our professional partners or we help the customers learn. We teach them and train them how to do the marking themselves. There's different hybrid strategies to get the instruments actually marked and commissioned. And then there's the training associated with going to instrument level tracking. So SensiMark's designed specifically to get a customer to instrument level tracking with all the considerations that are involved from when you first get the idea to when you're deploying it live and we have stages and steps and process there to make sure it's done correctly. I always tell our customers too, I always like to think of it as like a crawl, walk, run type of thing. You never wanna just hit the ground running with instrument level marketing. You wanna you wanna get exposed to it, you wanna understand it and SensiMark's designed to help our customers do just that. Seamus, any follow-up to Jacob's comments talking about SensiMark? Yeah, so one thing I would say here is that this is a really, really important part of what we do. Maybe close to the most important part of what we do. We don't, for a long time, you know, you could look at Census and you could say, there's a software company. But we don't think of ourselves as a software company. We think of ourselves as a service company. We are in the business of making our customers better. And, you know, service is the tip of the spear in that regard. So, you know, when we have, you know, engage with a customer, we're looking for a way to help them improve. Take waste out of the system, do things more efficiently, do things better, ultimately knowing that they are going to make patients better, right? That's the number one goal. Yeah, I think that's really important. Doesn't that kind of keep the central goal, the main thing, That in the end, this is all about creating better outcomes for patients, but that can take a lot of different forms and what you're doing helps allow for that, right? Yeah, absolutely. Absolutely. Hundred percent. That's a great point and I think a great way of looking at it and keeping the main thing the main thing, right? And so I think that's really, really well said. Really well said. Well guys, this has been just an awesome conversation. I've really enjoyed getting to chat with you guys more about this and to learn a little bit more about instrument tracking and really kind of starting at the most basic level and going deeper and deeper as we've gone along. But do you have any final thoughts? Anything you wanna leave our listeners and viewers with here today? If there's something we haven't covered yet or just a conclusion kinda statement to wrap things up for people. Jacob, let me kick it to you first just for any final thoughts. Yeah. So I guess put me on the spot there. You give out a time. I don't know. We we covered a lot of valuable information. I think because also just some background, I I used to implement for census. I used to go and train and stuff, so I've been elbow to elbow with technicians and nurses, seeing how they respond to this, seeing how they like it. And I think something that's really important to close on is it's not easy to get there, but when we get there, we'll help you get there And when we do get to the instrument level tracking stage, it just makes an immeasurable amount of difference for these end users. Like I said, there's a lot of data and a of offerings that years ago no one even knew or knew existed could be possible. Like having the instrument level capabilities that are available now to us through SenseiTrack and instrument level tracking. For SPD technicians and professionals, it's a whole, I don't even know how to describe It's just an amazing tool that helps them make sure that everything's done properly, everything's done efficiently, everyone always has eyes on what they need to have eyes on. And communication and communicative paths in SPDs and ORs is also a struggle. And being able to know what I'm handling, being able to know that I'm handling it properly, being able to know that when I use an instrument in the OR room that it was reprocessed properly. There's a lot of considerations and worries that can just really just disappear. So for the end users and being there elbow to elbow and seeing them see the benefit was always really cool because especially if I'd go somewhere to a hospital that was coming from paper, like Seamus mentioned, they were printing out Excel spreadsheets through their accounts with a pen. And then you show them this computer software, the solution that all of a sudden is just an all in one future proof way to make sure that they're handling their instruments properly and they know where they're at and all those things. So it's hard to describe what the end user experience looks like, but it was always just a lot of fun to see it happen because it's one thing to just talk about these things but it's another thing to see it in action. And I always really liked training and showing technicians, this is you scan an instrument and then just, woah, that's it. Then, yeah, look, here's some pictures, here's some IFUs, things like that. So it's just the doors it opens for the end users are also something that's always at the forefront of my mind with Internet level tracking as well. Excellent stuff. Really well put. Seamus, go for it. Yeah. So big picture. Before I worked at Census, I didn't know what the sterile processing department of a hospital was. Yeah right, if you ask people most people don't know but having worked with people from SPD for a long time now, sterile processing is really the engine behind the OR. If sterile processing stops, the OR stops, right? And it's super important, super critical. If they don't do their job well, people get sick. It's really, really important. And so for me, I see a lot of purpose in what we're able to do here at Census by making that department better. It's super important. It's just awesome to be part of it. It is. Yeah, I've really enjoyed getting to hear and to learn more about this. I like the way that you both explain these topics and and the way that you talk about the opportunity to be a part of making these departments, operate more efficiently and better and things along those lines, I think, been, really enlightening and really great. And so, Jacob and Seamus, thank you guys so much for joining us here on this episode of Consensus, sharing a little bit more just about instrument tracking and and all the things that goes into it and the ways that this can make SPDs more more efficient and productive. So thanks again guys for joining the podcast. Well, you. It's been pleasure having us. Absolutely. Everyone out there, thank you for tuning in to another episode of Consensus and for joining us for this conversation. For more, make sure to head to Consensus' website where you can ask questions. You can reach out and learn more information there. And stay tuned. We'll be back soon with more episodes of the podcast. But for this one, for Jacob Long and Seamus Johnson, I've been your host, Tyler Kern. Thanks for joining us.