WO2018195615A1 - System and method of electronic management of a surgical unit by means of the automation, identification, authentication and traceability of items and people based on a real-time localization system with secure technology - Google Patents

Abstract

The present invention relates to systems of automation, identification, authentication and traceability of items and people based on a real-time localization system with secure technology for the hospital environment. To this end, equipment, accessories, RFID labels (TAGs) were developed, such that, when attached to items, people and locations, they monitor routine processes of the institution, and allow real-time registration and monitoring, process automation and visibility, automatic notifications of noncompliance, providing patient safety, electronic management with trustworthy data and a decrease in operating costs and health costs. Consequently, the inventions, ideas, methods, logic, design features, specifications, drawings, uses, application and software logic, and the real-time e-governance method based on the intelligence of the items are constituent rights of the present patent and protected herein.

Description

 SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACEABILITY OF ITEMS AND PEOPLE BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY

FIELD OF USE

01. The present invention relates to a system composed of equipment, accessories, software and applications implementing a surgical unit automation method based on the location of items and persons in a contextual and real time manner (TLS) incorporated herein. for hospital-safe technology, exemplified but not restricted to Wi-Fi, Bluetooth, and RFID (Ultra-Frequency Identification) operating at Ultra High Frequency (UHF) that can be inserted into or attached to wristbands, badges, equipment , assets, accessories, blood and blood derivatives, medicine boxes, surgery kits, instrumentals and their containers, surgical textiles, psychotropic drugs, emergency medicines and the like or other, for the purpose of providing patient safety, automation and governance by monitoring the flow within the unit in a contextual manner.

 02. The method of identifying these items by UHF can be done through portals, antennas, collectors or area trackers (Arrays) designed to operate in the hospital environment.

 03. Alternative use of this technology is foreseen in other closed units, such as Intensive Care, Emergency Room, ambulatory etc., with the same purpose. Also for non-medical use, monitoring flow in critical or complex sectors and automatically setting operation status.

 04. To this end, it creates new features and integrates inventions previously or not submitted to patent application, creating integrated solution.

05. When it comes to updating, this patent will be mentioned, as well as in the body of the detailed description, the significant changes that motivated its updating. 06. For example, the TAG module for surgical instruments. This refers to the patent update filed under BR 10 2016 024329 7 of Ultra High Frequency (UHF) Radio Frequency Label Modules (TAG) that can be attached to metal objects, especially instrumentals permanent surgical procedures for the purpose of identification and traceability and monitoring.

07. The method and equipment are described in the patent "UHF RADIO-SURGICAL SURGICAL INSTRUMENT MONITORING DURING SURGICAL ACT AND IN THE CYCLE CLEANING, STERILIZATION AND MAINTENANCE - RADIO-INFRARED TOOLS AND METAL OBJECT MONITORING IN THE PROCESS number BR 10 2015 032172 4 and the module coupled to the interior of the TAG which aims at its functionality is the reason for this. The composition and new mounting technique allowed longer cycle survival.

08. Alternative use of this technology is foreseen in general tools, especially in the Aerospace industry, for the same purpose. Also as with the metal object component, giving intelligence to items to which it is attached.

09. Still the method as they are tracked are updated from the patent BR 10 2015 032172 4 which deals with ultra high frequency (UHF) radio frequency label that can be coupled to metallic and non-metallic surgical instruments with the purpose of their identification.

10. The method of monitoring these instruments through this technology during their use cycles (surgery, cleaning, maintenance, sterilization and dispensing) and the sensors for this technology are described.

11. Alternative use of this technology is foreseen in critical operation industries such as Aerospace and Military among others. Also the monitoring of cylinders or other metal devices by radio frequency in UHF is provided in this patent.

12. Patent Application No. BR 10 2016 002291 6 is also updated and refers to a frequency operating radio frequency tag (TAG). 00027

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Ultra High Frequency (UHF) that can be coupled to surgical textiles for identification and traceability during surgery.

13. The method of monitoring these textiles through this technology and the sensors for this technology are described in other patents (Applications BR 10 2013 010599 6 and BR 10 2015 011434 6), and are also compatible with the elements presented in this patent application. , which adds technical elements to the construction method in addition to creating the specific TAG for surgical textiles.

14. Alternative use of this technology is foreseen in general textile industries for single use purpose and low longevity (considering wash cycles). Also as a component of wearables, giving intelligence to clothing items.

15. In addition, patent update BR 10 2016 024327 0 describes a personal identification card equipped with three distinct technologies to identify the user in a complex environment, for example the hospital environment, operating with ultra high frequency radio frequency (Ultra High Frequency). Frequency (UHF) and High Frequency (HF) compatible with the Mifare solution and EMV technology, the Brazilian digital identity standard, for the purpose of identification and traceability and monitoring of people in a complex environment.

 16. Its isolated applications are widely known, however the need to reconcile the use of 2 (two) or 3 (three) electronic technologies in the same environment leads to the need to use identification cards with each technology used.

 17. The development of single card containing 2 (two) or 3 (three) distinct electronic technologies and the use of optical technologies can be added, for example QR Code, Datamatrix and magnetic data tape. and written text and image is the original creation advocated in this patent.

18. Alternative use of this technology is foreseen in highly controlled environments, especially in monitoring access and location in critical environments such as servers, the military, jewelry industry and others. 00027

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goal. Also as a component of monitorable objects, giving intelligence to items to which it is coupled.

19. It also updates patent application BR 10 2016 002301 7 for an Ultra High Frequency (UHF) radio frequency tag (TAG) that can be attached to hospital identification bracelets with the identification and traceability of persons.

 20. Alternatively, the wristband may be equipped with a variety of sensors to automate patient vital signs and clinical status, with full system integration through hospital-safe technologies such as Wi-Fi, Bluetooth, and UHF RFID.

21. The method of identifying people by UHF can be done through portals, antennas or "RAIN RFID".

 22. Alternative use of this technology is foreseen outside the hospital setting and in general animals for the same purpose. Also as a component of wearables, giving intelligence to items of clothing or accessories that operate close to the skin.

 23. Also updates patent BR 10 2016 005739 6 and refers to the method of tracking items and dependent individuals.

 24. Initially designed to monitor critical items and dependent people in the hospital setting. Its alternative use is provided for in the protection of high cost small items such as jewelry, watches, microprocessors etc, and people.

 25. To apply this method totems, UHF passive radio frequency identification bracelets and software were created to work together to monitor guardianship.

26. Due to conceptual and technological developments, it also updates patent BR 10 2016 024325 4, which deals with equipment and methods that together provide identification, authentication, monitoring and assistance in dispensing psychotropic drugs, physically similar drugs and high-surveillance drugs. . 27. For this purpose, equipment, radiofrequency tags operating in contact with ampoules, sealed radiofrequency tags, dispensing table and dispensing monitoring unit have been developed which, together with the present method, characterize the present invention.

28. Alternative use of this technology is foreseen in the use of tracking small items such as jewelry or electronic circuits, for example, indoors and for the same purpose. Also for non-medical use, monitoring flow in critical or complex sectors and automatically setting operation status.

29. New processes and methods also update the patent BR 10 2016 002931 7, where there is a record of a set of solutions that aim primarily to automatically monitor the hand hygiene process in a hospital environment, to identify vectors and to monitor cases along the patient trail. Identified vector.

The invention further contemplates the automatic monitoring of hand hygiene in the surgical environment with a view to controlling surgical infection.

31. Alternative use of this technology is intended to monitor people, objects, equipment, medications, blood products and others in hospital circulation to ensure patient safety by preventing adverse events.

32. More than isolated units, the present patent defends the integration of the processes, methods and inventions described herein with the principle of creating a hospital management interface that allows visibility of the processes, as well as e-governance, allowing the planning of preventive and preventive actions. corrective

 33. Hospital management is currently highly dependent on computerization, which has allowed greater control over processes, business visibility, and means of identifying and gauging institutional policy outcomes.

 34. Information, the largest institutional asset, is currently acquired through hospital management systems. Data imputed in the system is highly dependent on human operators, subject to operational failures.

35. Aiming to generate high reliability data and lessen the work of health professionals in collecting and entering this data, this invention was created. Through data are automatically generated during patient care processes (Standard Operational Processes - POPs) that are exported to the management system, ensuring reliability and dedicating the healthcare professional to patient care. , specifications, methods and inventions described herein direct defended by this patent application.

TECHNICAL STATE

36. Today, the surgical unit is highly dependent on the human interface for its operation.

37. An individual admitted to this unit has its status updated through manual control or computer system through an operator with a human interface (data collector). Despite their great effort and dedication, there are variations in the registry that are operator dependent. These records serve as a basis for strategic and administrative decisions and their inaccuracy leads to misconceptions and misleading conclusions.

38. Also, the need for a dedicated or dedicated operator increases the average surgical time and its cost. Associated with this, the verification of the necessary items to the procedure is done by manual verification, which increases the preparation time and the surgery. All of these events are time consuming in a unit that relies on high turnover for profitability. In addition, failure to record events can lead to medical complications, which can hold the institution legally responsible.

39. Health Quality Certification Institutions such as the Joint Commission (https://www.jointcommission.Org/assets/l/18/Summary_2Q_2016.pdf) and the NHS map these adverse events on a list entitled "Never Events", events that should never occur, but which are nevertheless common.

40. Patient replacement, wrong surgery or inadvertent retention of surgical items are the most frequent events, despite the best efforts in the best institutions in the world. Cause analysis of these events points to failures such as counting errors, divergence in counting methods, overconfidence, non-observance of alerts and signals (functional blindness), overload for multiple tasks, among others.

41. Awareness measures and policies aimed at preventing these events have immediate but fleeting effect. When other events take priority, the incorporated practice suffers a decrease in attention and associated with the high turnover of professionals in these sectors leads to the risk of recurrence of these events. Because they are simple events, but with serious repercussions for everyone, solutions to mitigate such risks should be implemented in each institution, preserving the relationships between patients, professionals and institutions dedicated to caring for life.

42. In the United States, the third cause of mortality is health care (www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf). The Joint Commission identifies 82% of hospital events and up to 96.1% has the potential to occur in the operating room.

43. Surgical instruments routinely used in hospitals and clinics are currently monitored using artisanal techniques. Because these assets are used in critical operations, their traceability and monitoring are essential for the safety of patients and institutions.

44. To this end, traceability is achieved by color coding by stickers or painting of the instrument. However, due to the high demand, this coding is lost, being necessary its maintenance.

45. To streamline these processes, Datamatrix technology has been developed, where various information about the instrument is printed on a two-dimensional barcode on the surface of the instrument. The limitations of this method are that coding can be impaired by dirt or damaged by friction between the instruments.

46. In order to solve this problem, the TAG described in the patent registered in IN PI under process number BR 10 2015 032172 4 was conceived and updated in the present patent application. To operate depends on chip inside. This chip is an electronic module containing a standard electronic circuit and a printed circuit base for the purpose of inductive coupling between the instrument and the electronic circuit.

47. TAG reading performance is directly dependent on coupling. This is determined by the design of the module and its tracks. For each situation and type of instrument material and chip model there is a need for a dedicated design, which are features defended in this patent.

48. In order to operate properly in all scenarios, various module designs have been designed to suit the different manufacturers of chips and materials under monitoring.

49. Surgical instruments routinely used in hospitals and clinics are currently monitored using artisanal techniques. Because these assets are used in critical operations, their traceability and monitoring are essential for the safety of patients and institutions.

 50. As stated above, to streamline these processes, Datamatrix technology has been developed, where various information about the instrument is printed in a two-dimensional code on the surface of the instrument. The limitations of this method are that it is dependent on line of sight and time spent locating the marking and coding can be impaired by dirt or damaged by instrument friction. Another impression about the instrumental invalidates the same. It also leads to increased repetitive strain injuries (RSI).

Radio frequency has emerged as an obvious solution to the problem, but limitations arise immediately. Low radio frequency (LF) has the ability to penetrate the metal, but its range is short, leading to the need for direct contact identification. This technology, while superior, has a unique added advantage over Datamatrix, which is the durability of the information stored there. Metal acts as an insulator for higher frequencies like UHF, which was impeding to the technology until this invention. 52. The advantages of UHF are identification at greater distances and at higher speeds, and scalable solutions can be applied to the operating room and central sterile materials.

53. In the aerospace industry, non-localization of tooling may lead to the need to disassemble the aircraft for localization purposes. Such control is done manually. The same limitations have applied to these industries to date.

54. Surgical textiles routinely used in hospitals and clinics are also monitored with artisanal techniques. Considering that textiles are the item most commonly left inside the patient (90.5% according to Dr. Dario Vianna Birolini) and events like these occur in 1 (one) out of 1,000 (7,000) to 7,000 (7,000) surgeries According to Egorova, its importance is very great. So much so that institutions like the Joint Commission have declared maximum alert to events like these. Aiming at patient safety, this committee tabulated the biggest complications in hospitals and gave priority to resolution according to how often they occur. Inadvertent retention of foreign bodies is the second most common problem on their list.

 55. In order to prevent these events, manual counting of textiles with high false negative rates is performed. In review of cases against doctors and institutions, 84.5% of the cases had manual manual counting of textiles.

 56. Due to this condition, electronic radio frequency counting (RFID) systems were created. To operate, radio frequency labels are required. The use scenario includes movement, folding, impregnation with biological fluids (blood, secretions, urine, feces, exudates and transudates) as well as liquids, creams and ointments used for antisepsis and local patient care.

 57. In this update, construction engineering has been updated as a result of early breakages in the previous design.

58. As for people, identification and authentication solutions currently in use in hospitals are based on Mifare and visual technology. THE Brazilian law has standardized the digital identity for electronic document signature authentication based on the digital certificate, identifying the user through EV technology electronic card, USB Token or certificate installation in a personal machine.

59. In a collective environment, card use with EMV technology has been the most commonly used. Due to the physical and economic characteristics of RFID operating in UHF and its safety, this technology has gained space in environments that require intense monitoring with fluidity, such as operating room, central pharmacy, ICU, among others.

60. It is a fact that each of these technologies relies on a distinct user identification medium with its specific characteristics. This fact leads to the need to use several identification devices, namely badges, to be used for each specific function.

61. This condition allows a diversion where an individual is identified on a computer while moving to another sector and is identified by another technology at a different location.

62. In these settings this condition is undesirable, especially in the hospital setting where care staff can be quickly requested.

63. The multiplicity of ID cards also leads to inconvenience for the user, who has to carry several badges. They also increase the risk of disease transmission and may be a reservoir of infectious agents.

64. The people represented here by patients are temporary users who need to be identified during bathing or anesthetic procedures.

65. These individuals are now routinely identified in hospitals and clinics through wristbands imprinted with their name, date of birth, medical records, one- or two-dimensional barcodes and other personally identifiable data. 66. Considering that the most frequent complication in health care, according to the Joint Commission, is treating the wrong patient, wrong site (rong site, wrong procedure), it can be concluded that the safety of this technology It is not effective or efficient in its purpose. Barcode or Datamatrix identification has been implemented, but scanners are unavailable and the need for a manual (handcrafted) operator-dependent reading process. Even with these additives, patient identity change is a reality to be corrected.

67. Radio frequency identification (RFID) technology appears as a reliable alternative. In order to operate in a hospital environment, interference with electromedical equipment should be considered, especially when considering pacemakers and automatic defibrillators.

68. In an in vitro study conducted by the US FDA and led by Seidman (Seidman et al RFID EMI to Pacemakers and (COs - Heart Rhytm, Vol 7, No 1, January 2010 pages 99-107), interference generated by readers of Although RFID was evaluated on fully implantable pacemakers and defibrillators, although there was no evidence of major concerns about RF interference, it was clear from the body of the article that when operating in UHF, the interference was insignificant and no interference in this frequency range. generated events with potential lethal or trigger clinical symptoms.

69. On the other hand, the human body is a great insulator for the UHF frequency. The proximity of TAGs to the body isolates RF signals in UHF, making their performance minimal or unnoticeable. Still other adverse events can be prevented with the addition of sensing. Accelerometers can detect risk behavior for falling and even the event itself. Coupled sensors for Oximetry, Pulse Rate, Blood Pressure, Respiratory Rate, Temperature, and even Sweating can automatically monitor patient status, enabling automation of the care process and patient monitoring in non-complex and complex units. 70. This bracelet enables the automation and reliable recording of patient clinical signs, reducing overwork on the nursing staff. Also, acts as a call button through the interaction of gestures on the TAG. Regardless of wires or batteries, it allows calling from anywhere in the room under cover. When a call occurs, vital signs are automatically checked, giving speed and effectiveness to the call.

71. Assuming that the Newborn (RN) does not move without assistance from third parties, we developed the concept of electronic guardianship, a method defended in this patent.

72. In this the RN has its identity monitored by a group of 3 (three) to 4 (four) tags equipped with passive radio frequency tag (TAG) operating in UHF. Three of these are attached to the printed identification wristbands mentioned above according to patent BR 10 2016 002301 7 and updates, and one of them is attached to the umbilical clip, exemplified in FIGURES 7.1 and 7.2 and feature defended in this patent. They all identify the RN for the system.

 73. The contents of this chip are recorded and encrypted in such a way that it is impossible to duplicate your information. The encryption methods adopted are confidential and are based on the fact that no two (2) chips are the same. One uses the EPC memory number and the Chip serial number (TAG ID) to create a hash function, a bracelet's authenticity certifier.

 74. UHF technology is known to have the longest reading range, but proximity to the body reduces its performance. These factors were considered in the engineering of the umbilical TAG.

 75. These GADs are identified on portals and totems located in all areas of NB circulation including, but not limited to, the birth unit, central and sector nurseries, ICU, diagnostic unit, and mother's room.

76. In this way the NB will always be localized and constantly identified avoiding the dreaded changes at birth. 77. When the newborn is transported from one sector to another, there is a responsible for the infant during its transport. This is a Tutor and its guard is automatically determined by the system, which checks if it is qualified for such a function. If so, it is monitored along its path through Arrays and Portal systems, which create consecutive virtual fences. Any deviation or perimeter violation is notified in real time, making it also a tool to support the security system and ensure compliance with the Institution's Standard Operating Processes (SOPs).

78. This technology should not replace or be the primary tool of the institution's security system. In alternative use of this technology we can monitor, with the same principle of electronic tutelage, the flow of psychotropic, high cost equipment or OP ES, among others.

79. Also, outside the health environment, monitoring of jewelry and other critical or high value assets is envisaged. This concept also extends to medicines.

 80. The law determines the full traceability of psychotropics due to the nature of their effects. The loss of psychotropic drugs incurs criminal liability characterized as drug trafficking. Faced with this responsibility, health services make a great effort to control and monitor these drugs from their arrival at the hospital until their final dispensation. Such control is through signed and stamped forms and forms where each professional is responsible for the medication in their possession. Such control is determined by law and must remain, however, is not effective in the problems observed in daily use.

81. The Joint Commission, an independent entity responsible for health care quality certification, reports in its list of preventable adverse events that drug error is the 8th (eighth) most common complication, followed by anesthesia-related event. in 17 ^s (seventeenth) place and medication overdose in 189 (eighteenth) place. Despite strict control, these events together account for 680 (six hundred and eighty) events reported to this institution since 2004. Adverse events together determine a mortality of 2018/000027

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57%, reflecting the need for greater control in this highly regulated and monitored flow.

82. When we consider medication error, we have to deal with the physical similarity of medications and the context of their use.

83. Great difficulty occurs in the case of injectable ampoules. Due to their established design, they differ very little, basically in size and transparency of glass. Amber glass provides protection for photosensitive medicines, while transparent glass allows the content to be identified by the content aspect as well.

 84. One (1) or two (2) ml (milliliter) amber vials are small in size, making the letters printed on the glass or label small. Many urgency or emergency medications are packaged in these ampoules causing a high risk of medication change. Such scenario favors errors and medication changes.

 85. Although nosocomial infection is a life-threatening factor, and with the emergence of multidrug-resistant strains, the need for increased use of alcohol gel in hospitals has increased. Hand hygiene reduces the spread of infections caused by multidrug-resistant organisms according to published studies on the subject and compiled in a systematic literature review conducted by the World Health Organization.

86. Currently, hospital infection control centers (HICCs) are making a great effort to disclose the systematic use of alcohol gel. To this end, they publish protocols, positive examples from each institution and visually monitor the degree of use of alcohol gel in each unit. In identifying the emergence of cases of nosocomial infection, CCIH observers are directed to this sector and adopt guidance and monitoring measures in the unit until the effective control of the outbreak. When control occurs, they are directed to other sectors, and the degree of hand hygiene compliance with alcohol gel tends to decrease over time, giving rise to recurrent outbreaks of infection. These measures are effective in reducing the number of cases infection, but are inefficient in effectively reducing infection cases. In addition, there are severe limitations to vector traceability of these infections as they are costly and inefficient in daily practice.

87. In addition to lives, nosocomial infection increases the length of stay and the cost of hospitalization, increasing the cost of health for trustees and for the hospital with lower bed turnover.

88. To measure the degree of hygiene compliance, the CCIH sector has trained observers who routinely circulate through the hospital noting the degree of adoption of the recommended protocol. For cross-sectional studies, they depend on a large number of observers, who merely observe a fraction of those who circulate in the institution for logistical reasons.

89. This difficulty in controlling the adoption of protocols is not limited to hand hygiene, but also to medicines, blood products or procedures, especially during emergencies, which may lead to risks to the user.

 90. Such resources give visibility to hospital processes enabling e-governance.

 91. The hospital currently relies on electronic management for its large-scale operation. To this end, it has a computerized management system focused on legal, fiscal compliance and loss reduction during the intrinsic processes of health services. For such a system to operate, it needs data to be entered into the database. Thus, they rely on the human interface to type, scan or authenticate items, patients, people and processes.

 92. Because human-dependent operation is subject to failures and delays due to physiological limitations, to mitigate the risk of errors, the system works with data entry redundancy to confront and qualify the information provided by the user.

93. This action, while technically correct, implies rework, increasing the tasks of the already overloaded health care team. 18 000027

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94. From a management standpoint, data reliability is very important. Based on these, fine management decisions are made to optimize processes and increase profitability. Erroneous or inaccurate data lead to decision difficulty or erroneous decisions.

95. In a reality where errors cannot occur, data needs to be accurate.

96. Even when we attribute to the health professional the data entry activity, it stops acting in the direct care of the patient, assuming the function of adding data to the system. In addition to the cost of paying highly skilled professionals for such demand, it is estimated that it consumes 30% of their working time in this role. Adding up to 20% more of the time looking for assets to provide care, we have an expensive and highly skilled workforce diverted from its role.

97. Moreover, there is no way to manage a large hospital today without these data tools and without the great effort of the healthcare team.

98. The worldwide decline in the number of active health professionals and the numerical deficit of beds is notorious worldwide. In contrast, the number of older people increases, leading to their greater need, a paradox to pressure us in the near future.

TROUBLESHOOTING

99. In order to optimize the performance of the surgical unit, we have created systems and methods advocated here, in which the status of the surgery, staff and the necessary procedural items are continuously and automatically monitored.

 100. Based on the context of each, the procedure schedule grid is automatically updated, informing the status of each monitored item through color coding and visual alerts throughout the management chain.

101. With this technology it was possible to determine the status of each surgery and its deviations automatically without the need for the human interface. 102. Based on the Internet of Things (IOT), Item Intelligence (II), and Cloud Computing (CC) principles, which together shape the Internet of Everything (IOE) , we have created Electronic Governance (E-Governance) tools for High Complexity Units, High Cost Units and for the prevention of adverse events, providing patient safety.

103. Thus, the Intelligence solutions described here are based on Health E-Governance and Automation to provide patient safety and cost reduction in Health.

104. These are possible through continuous electronic monitoring of the institution's Standard Operating Process (SOP), with automatic notification of their deviations before they become adverse events.

105. With this concept were created various products which described, updated and integrated, constitute this invention and are source for other patents of the same creators.

106. The safety of technology in the hospital environment is of paramount importance having as its first rule the old and current concept of "Primum non nocere".

107. Extensive literature review has been conducted that identifies as currently secure Wi-Fi, Bluetooth, and RFID technologies operating in UHF. RFID operating in LF and HF must be of limited power to avoid interference with Pacemakers, Defibrillators, Neuro-modulators and Electroencephalograms.

108. RFID technology operates as follows. The functional element is commercially available UHF operating radio frequency chips inserted into Inlays (TAG Antennas) designed specifically for each application. The identity of each of these is determined by a hex code encoded in each one (EPC - Electronic Product Code). The junction of the chip with the Inlay and its encapsulation conforms to the identification tag or TAG. The activation and reading of each of these are performed by means of an antenna, designed for each specific function, connected to a reader operating in a range regulated by the communication agency. each country. Reader specifications such as mode of operation and power, among others, are set specifically for each application.

109. The information generated is presented to the software that filters and directs it according to the identity of each tag, following a specific flow logic for each item or person. This logic follows a principle but varies according to the institution where it is applied.

110. The flow logic of each application operating this solution is also right here defended.

111. In order to rationalize the presentation of the ideas, concepts, and methods advocated here, this document has been divided into chapters.

Chapter 1

112. In order to optimize the performance of TAGs coupled to different materials of surgical instruments, the present invention was developed whereby TAG has its performance optimized for different types of instruments and radio frequency chips operating in UHF. The interaction with the chip and instrument material "couples" the TAG with the instrument to receive and relay UHF radio signals. In order to do so, it was necessary to develop different modules for FID TAG, through finite field element software, its anechoic chamber test and the physical resistance test to the sterilization cycles for each type of chip, instrumental. and distinct material. TAG's construction engineering and respective dielectrics are also part of this patent and the aforementioned patent, registered with the INPI under process number BR 10 2015 032172 4, added to the improvements described herein.

113. With this technology it was possible to estimate the maximum unhindered reading distance for each module with its chips and materials, coupled with the surgical instruments. For this evaluation, the standard transmitter power was set at 30dBm and a 6dBi gain antenna was used. 114. Tuning adjustments were made considering elements that could potentially be added to the TA6 and instrumental.

115. Since structural elements determine performance under conditions of use, the encapsulation has been developed and tested for reading performance. Tests of reading consistency under different conditions and physical resistance to manipulation allowed us to determine the best settings considering the conditions of use.

116. With the emergence of instruments with plastic coatings, carbon fiber and others, it was created metal coupler to be inserted in them in order to incorporate traceability to them with the same technology.

117. Elements added for increased performance and dielectric constitution are an inherent part of this patent.

Chapter 2

118. In order to remedy these drawbacks, the present invention has been developed whereby the surgical instrument or metal tooling is used as an antenna for receiving and relaying UHF radio signals. In order to do so, there was a need for the development of radiofrequency TAGs to act in this condition. Using the instrument as a large dipole, the electric current induces the current in the module and its chip through electromagnetic coupling, and operates according to the standardized standards of UHF technology. The chip is strategically positioned for proper operation of the radio frequency tag (TAG). The mapping of the instruments was performed with tests in anechoic chamber, identifying the point of highest performance for each instrument. This point has been balanced with the ergonomics of the instrument, allowing to identify ergonomic position with higher radiofrequency performance.

119. With this technology it was possible to estimate the maximum measurement distance up to 150 cm (one hundred and fifty centimeters) without obstacles. 120. Considering that there are delicate materials and others more robust, distinct labels considering the dimensions of the instrumental were developed. With the evolution of materials, we currently have surgical instruments made of composite materials, plastics, ceramics and carbon fiber, to name a few. All of these present distinct interaction with radiofrequency and therefore require fine adjustments. The TAG for coupling to these instruments also provides solution for these instruments so that the full range of instruments can be monitored.

121. Also preserving visual identification, an effective feature used in the routine of the instrument cycle, the TAG is composed of 2 (two) plastic coating components, allowing the constitution of a binary color identity. The use of two (2) or more colors in the plastic coating may further enhance this identification by creating distinct patterns of exponential scale combinations.

122. As instruments must be heat sterilized, the TAGs were kept in the oven for 10 (ten) hours at a temperature of 170 ^S C (one hundred and seventy degrees centigrade) and maintained reading performance thereafter. They were also submitted to contrast cycles of dry heat at 1652C (one hundred and sixty-five degrees centigrade) and wet cold at 18 ^and C (eighteen degrees centigrade) to the equivalent of 1000 (one thousand) cycles of use under normal conditions, without deterioration. Additional cycles are being performed to determine TAG longevity.

123. To monitor these instruments, there was a need to create equipment and software capable of operating these signals in a hospital environment.

124. In the operating room, adapters for and / or special auxiliary tables have been developed so that instruments and other items equipped with UHF TAG are continuously monitored during surgery and at the first conference after the procedure is completed. Table with clothesline was specially designed to operate as an electrical ground, preventing reading of the items positioned on it. Thus, the table engineering allows us to identify the instruments effectively used during surgeries, generating precious information for the management of each box's arsenal, allowing to increase or decrease its content according to demand, avoiding unnecessary processing of materials and also of loose items. 125. For the second conference, held at the purge, table and cabinet were developed for verification, organization, tracking and preparation for dispatch to the contaminated sector of the sterile materials plant.

126. Monitoring and conference stations have also been developed for the contaminated, clean and sterile sectors of the sterile material plant, as well as cycle sensors have been developed to monitor washing and sterilization events.

127. Real Time Location System (RTLS) was developed for the identification and location of surgical boxes stored in the clean, sterile, and operating room sectors.

128. Software for the integration of this information was developed, allowing the automatism and visibility of operations. The software, which operates independently and in the cloud, automatically exchanges information with the hospital management system, with no need to modify the hospital's management tools. This solution decreases human work, increases patient safety and ensures greater information reliability by providing e-governance.

129. In the aerospace industry, continuous tool monitoring by the same technology enables you to identify when the tool has been removed from its base. Integrated with the UHF badge system, it also identifies who removed the tool. By crossing this data with the execution schedule, we know in which area of the aircraft that worker was working when the tool or instrument was lost, making it easier to locate and not having to finish the construction of the aircraft to perform the tool audit.

Chapter 3

130. In order to optimize the performance of TAGs in surgical textiles, the present invention has been developed whereby TAG has its optimal performance (tuning) when exposed to biological liquids. The interaction with liquids Biological tuners "tune" the TA6 antenna to receive and relay UHF radio signals. In order to do so, there was a need for the development of the radiofrequency TAG antenna through finite field element software, its anechoic chamber test (FIGURE 4.3) and the physical resistance test to perform under these conditions.

131. With this technology it was possible to estimate the maximum reading distance between 150 (one hundred and fifty) and 200 (two hundred) cm without obstacles.

132. Tuning adjustments should be made for additional graphics.

133. Because structural elements determine performance under conditions of use, some types of encapsulation have been tested for read performance. Reading consistency tests after usage cycles and physical handling resistance allowed us to determine the best settings considering the conditions of use.

 134. These TAGs are designed to be integrated into textiles by stitching or gluing, according to patent applications BR 10 2013 010599 6 and BR 10 2015 011434 6. They may also be incorporated into the hollow loop stitched inside of the textile. During durability tests, the fragility of the connection between the chip and the antenna was identified. This condition was solved by reengineering the fixation process by adding epoxy polymer on the chip, a feature defended in this patent.

Chapter 4

135. In order to reconcile the use of safe technologies for the hospital environment in a single passive device, the identification card was created that allows the operation with up to 6 (six) technologies being 2 (two) or 3 (three). electronic technologies simultaneously. Thus only one card enables all the specific features of the hospital environment for each system necessary for the proper functioning of the institution. Certainly the three (3) technologies interfere with each other, so that one can lead to lower performance of the other. To avoid this issue, during the In the development of the card, such interference was considered and tested in order to optimize the operation of UHF technology mainly in the presence of EMV chip and LF or HF Inlay for Mifare or other technology. For this purpose the antenna design was tested in Finite Field Element Software, prototypes were developed and tested in anechoic chamber and in tests and the final design was conceived.

Chapter 5

136. In order to maintain the identification system in force in each hospital, we developed an accessory to be incorporated into the identification bracelet by adhesive and that is also fixed to it by tabs (FIGURE 6.6-B)

137. In order to optimize the performance of TAGs in contact with the person's body, the present invention has been developed whereby TAG has its optimal performance (tuning) when close to the skin (FIGURE 6.1). Interaction with the skin "tunes" the TAG antenna to receive and relay UHF radio signals at the correct frequency. In order to do so, it was necessary to develop the TAG radio frequency antenna through finite field element software, its anechoic chamber test and the physical resistance test to perform under these conditions. Yet TAG's construction engineering with its dielectrics is a constituent part of this patent (FIGURES 6.2 and 6.5).

 138. With this technology it was possible to estimate the maximum reading distance above 300 (three hundred) cm without obstacles, with the tag applied to the bracelet and coupled to the human body. The transmitter power was set at 30dBm and a 6dBi gain antenna was used (FIGURE 6.4).

139. Due to the dimensions of the aforementioned model, it is not compatible with newborn (RN) use. This fact led us to reengineering, creating a model specifically for this function. It is a model of reduced dimensions and also with a reduced range of a maximum of 100 (one hundred) cm (FIGURE 6.3). This fact was offset by the Electronic Guardianship system, where the RN is carried by adults. identified by badges with a range of up to eighteen (18) meters. Thus, newborns can be identified before entering the room, avoiding the exchange of infants.

140. This technology is also designed for use in children, adolescents and adults. With a larger area for the construction of TAG, it has its reading distance increased. Also due to its dimensional characteristics, the bracelet is used as a temperature, humidity and gesture sensor.

141. As a temperature sensor, allows you to continuously record patient temperature when under monitoring. Automatic alerts for hyper or hypothermia are generated, allowing you to automatically acquire early signs of infectious events as well as monitor their progress.

142. As a moisture sensor, it allows the identification of the patient's sweating, an important clinical sign in pain control, diagnosis of acute pathologies such as Myocardial Infarction, hypoglycemia, fever and others.

143. The same label, when installed on diapers, allows to identify if the patient needs changing it, without unnecessary manipulation of it.

144. Even the bracelet can be used as an interaction sensor. Linear movements on the wristband generate a wobble pattern, measured by varying the signal strength or RSSI. Each movement type generates a distinct response pattern. This way, the wristband can also be used for the nursing call or other preprogrammed actions. Different movements on the bracelet are predicted to generate distinct response patterns that will be interpreted by algorithm and determine specific action. Additionally, incorporating battery and shielded disposable electronics, we may include oximetry, heart rate, blood pressure and accelerometer sensors (FIGURES 6.7 and 6.8). They can identify and monitor basic vital signs at regular times or immediately when there is a sudden event. In this way we can provide automated monitoring of vital signs throughout the hospitalization period independently, inside and outside the surgical unit, regardless of the connection to larger volume equipment that depends on physical and electrical connections for this function. 145. RFID TAG tuning adjustments were made considering elements that could potentially be added to the TAG, such as additional sensors and batteries.

146. Because structural elements determine performance under conditions of use, the encapsulation has been developed and tested for reading performance. It was also designed to allow bathing and avoid contact of components with the patient's skin and mucosa. Tests of reading consistency under different conditions and physical resistance to manipulation allowed us to determine the best settings considering the conditions of use. Sprinkler bath survival and daily use tests were performed without any drop in performance or disruption of operation. Activation of the wristband electronics occurs automatically when serialization with the medical record number is entered. The frequency with which it reads is configurable according to the unit you are in and the amount of call responses.

147. The concept of separating layers aimed at enhancing near-body performance and dielectric constitution is an inherent part of this patent.

148. TAG's features and construction, including the bracelet fixing tabs, are features of this patent.

149. The concept of adding electronics to the wristband for the automation of vital sign acquisition is an inherent part of this patent.

 150. The concept of integrating efficient identification system with automatic vital sign monitoring system is a creative concept advocated in this patent.

 151. The interaction by gestures on the bracelet as a means of triggering nursing and other calls is a creative concept also defended here.

152. The triggered call can trigger the measurement of the patient's vital signs. Chapter 6

153. Regarding the Newborn (RN), we assume that it does not move without assistance from third parties and developed the concept of electronic guardianship, a method defended in this patent.

154. In this case the RN has its identity monitored by a group of 3 (three) to 4 (four) tags equipped with passive radio frequency tag (TAG) operating in UHF. Three of these are attached to the printed identification wristbands mentioned above according to patent BR 10 2016 002301 7 and updates, and one of them is attached to the umbilical clip, exemplified in FIGURES 7.1 and 7.2 and feature defended in this patent. They all identify the RN for the system. The contents of this chip are recorded and encrypted in such a way that it is impossible to duplicate your information. The encryption methods adopted are confidential and are based on the fact that no two (2) chips are the same. One uses the EPC memory number and the Chip serial number (TAG ID) to create a hash function, a bracelet's authenticity certifier. We know that UHF technology has the longest reading range, but proximity to the body reduces its performance. These factors were considered in the engineering of the umbilical TAG.

155. These GADs are identified on portals and totems located in all areas of NB circulation including, but not limited to, the birth unit, central and sector nurseries, ICU, diagnostic unit, and mother's room.

 156. In this way the newborn will always be localized and constantly identified avoiding the dreaded changes at birth.

157. When the newborn is transported from one sector to another, there is a responsible for the infant during its transportation. This is a Tutor and its guard is automatically determined by the system, which checks if it is qualified for such a function. If so, it is monitored along its path through Arrays and Portal systems, which create consecutive virtual fences. Any deviation or perimeter violation is reported in real time, and is also a tool to support the security system and to ensure compliance with the Standard Operating Processes (SOP). Institution. This technology should not replace or be the primary tool of the institution's security system. In alternative use of this technology we can monitor, with the same principle of electronic tutelage, the flow of psychotropic, high cost equipment or OPMES, among others. Also, outside the healthcare environment, monitoring of jewelry and other critical or high value assets is anticipated.

Chapter 7

158. In order to track, monitor, authenticate and control the dispensing of critical drugs, and the performance of the surgical unit, the method advocated here was created, in which the drug that needs to be monitored arrives at the central pharmacy, where it is identified. with TAG specially designed for this function. Its origin, batch and validity are associated with TAG's EPC number, creating a serialized GTIN (SGTIIM). Properly identified medications go to the dispensing units. There, the medicines are placed in boxes according to their destination. These boxes are sealed with longer range TAGs, which are monitored by tracking units (Arrays).

159. At destination, the seal is opened and medications are validated, ensuring that they have reached the correct patient.

 160. In the case of anesthetics and emergency medications, the box containing them is placed over the dispensing monitoring unit. This identifies the date, time and place each component was taken from the box, generating automatic recording of medication time. Text-to-speech feature identifies each item removed from the box in real time, preventing changes or medication errors.

161. With this technology it was possible to accurately determine the time each drug was used without the need for the human interface. Thus the system described here allows full automatic monitoring of the dispensing of critical medicines. Also, with reliable information determined by the intelligence of items and processes, it becomes a reliable electronic management tool, as well as the automatic science of those responsible for transporting critical drugs and their itinerary. 162. High cost items can also be tracked individually as well as their container. Low cost items can be monitored together through the monitor box and its tamper sensing seal. Orthotics, prosthetics and special materials are costly items and can be individually monitored through this technology.

163. The intelligent video system connection allows you to track the path of this item in real time or by automatically retrieving recorded images.

Chapter 8

164. In order to solve the problems of Hospital Infection, the present invention was developed, whereby the alcohol gel dispensing is automatically monitored, identifying the user who triggered the dispenser and who did not. To do this we created a totem on which the alcohol dispenser is installed. When an individual is identified a record is generated containing the date, time, location of the totem and whether or not the user triggers the alcohol dispenser. This record containing date, time, location, user and trigger status is forwarded to a central server. These data allow us to observe the degree of compliance with the sanitation protocol.

 165. Additionally, we have a flow mapping of all users. By identifying a case of nosocomial infection in 2 (two) or more beds by the same strain of bacteria, we can identify which users have been in these beds, with the potential to track human and non-human vectors of infection in a much smaller population. Still, with the identified vector, we know which beds it went through, allowing surveillance of potential cases. Targeted guidance, identification of health factors that make it a vector, and treatment of underlying disease are subsequent actions with the human vector for infection control and prevention of new cases.

166. The totem still generates feedback on sanitation compliance. With the intention of generating positive reinforcement, human factors strategy engineering was made and elements of the science of cognitive behavior were inserted. Like this By the way, the processification of the process was conceived. In this "electronic game", the intention is to reach the nearest 100% or maximum score. To do so, the ratio of triggers before entering and leaving each room over total events creates a ratio expressed in percentile. This number generates a score that classifies "the players", and the disclosure of the most assertive, a stimulus to others. Incorporating social marketing elements, one can create social media outreach, a valuable positive reinforcement element in creating a hand hygiene culture.

167. Just as the room is a reference, the nursing station, the inpatient unit, the floor, the block, the building and the hospital can also constitute virtual fences, with monitoring before entering and leaving each of them, providing exponential gain according to the number of virtual fences interposed between the hospital entrance and the patient's bed.

168. The compiled data guide the CCIH's strategic actions. With large accumulated data it is possible to detect diffusion patterns of nosocomial infection and create knowledge through the use of data mining tools, a late step to be instituted.

Chapter 9

169. In view of the evident waste of health workforce, the present invention, comprised of computer equipment, logic, methods and software (Software - SW), allows for the automatic acquisition of health event data, notably but not restricted to the surgical unit. Through secure technology, we monitor intrinsic health processes, generating event data, as well as monitoring their deviations, warning of nonconformities.

170. Automatic data acquisition gives us reliable and accurate information because it portrays the intrinsic processes of health as it goes along.

171. However, individualized information is only material to be interpreted by managers. Thus, the need arises to create a platform for monitoring where automatically acquired data integrates to present distinct operational information for each hierarchical level of health promotion and management to automate processes and create electronic health management tools with real-time updates and alerts.

172. Admittedly, there are multiple processes in health management that are integrated so that they continue to converge in patient care. Allowing data to flow between departments so that management has real-time information clarity is imperative.

173. Based on the technologies and methods advocated here, we have real-time visibility of processes without relying on data entry through the human interface.

 174. Based on this reliable data, we created an up-to-date, irvterative Dashboard with the institution's key performance and health indicators.

 175. We have also created tools so that custom charts and indexes can be created according to the characteristics of each service, allowing you to customize the solution for each institution, sector, unit and hierarchical level.

 176. This creates an integrated and hierarchical monitoring platform as an e-governance tool.

 177. Use in segments other than health, for example Industry, production, agribusiness, trade is provided for in this patent.

DETAILED DESCRIPTION OF THE INVENTION

178. The invention described herein relates to a set of continuous complex closed unit monitoring systems and methods exemplified by the operating room but not exclusively directed to this unit.

179. In this invention the operating room is constantly monitored by radial range circular tracking units in relation to its center. positioned across the industry, spread out and integrated with each other to continuously monitor the entire area under its coverage. Coverage for these tracking units is expected within each room or department and can operate on UHF radio frequency, under i-Fi, Bluetooth, infrared, ultrasound or other industry-compatible technology, acting alone or in combination. As an applied example of this invention we describe the methodology in UHF.

180. In this coverage area, monitored items circulate through technologies compatible with those applied to circular tracking units, such that these items are constantly monitored.

181. As each system has its method and its specific technology developed, we will discuss by each system the technical developments and the methods inserted in them in order to represent the rights defended herein.

182. Given the integration and interoperation of systems, this invention in its entirety does not represent only the isolated expression of each of the parts.

 183. For a proper understanding of the methods, we will first discuss the developed equipment and its specifications (inventions), summarized in FIGURE 1.

Chapter 1

184. The invention described herein is a UHF tuned passive radio frequency label module for optimum performance when installed in TAG for surgical instruments, and has physical characteristics that allow it to be subjected to various cycles of use and sterilization during operation. instrument life. Alternatively their use can be incorporated into tools in critical and precision industries.

185. The radio frequency (TAG) tag operating on ultra high frequency (UHF) is composed of 4 (four) elements (FIGURE 2.1). 186. The functional element is a commercially available silicon-based chip module designed to operate in UHF to manufacturer's specifications and track design, which adjusts performance, sensitivity, tuning and consistency for each item to be monitored. The design of these tracks is designed to optimize the performance of different chips and instruments, considering their construction and arrangement in relation to the chip and its location in the instrument, and are original features of this patent defended in this document.

187. This chip receives and transmits information through the module tracks that, by magnetic induction, use the instrument as a tuned antenna to optimize the radio frequency signal. Proper electromagnetic coupling between the tracks and the metal instrument depends on the proper design of the tracks that is printed on soft or rigid printed circuit boards with various geometries, tailored to each type of chip and instrument geometry. The presence of the chip as well as the module, encapsulation and fill were considered in the development of this. This patent provides for tuning tuning by incorporating unique graphics into the track design. Such adjustments are made through finite field element software being tested and confirmed in anechoic chamber.

188. The TAG is designed to be welded to instruments currently in use in hospitals or to be integrated with instruments manufactured with the recess carved in the piece itself. To this end, the module with the chip attached is submerged in non-toxic adhesive (USP class VI - ISO 10993) contained in the base of the package. It is closed with the package lid after being positioned in the hole of the metal base. This locks the plastic lining in the metal recess. The encapsulation is made of medical grade polyphenyl sulfone. Because it is designed for continuous use, its encapsulation makes TAG impervious to water, blood, secretions and microorganisms. This set was considered in RF engineering as well as its dielectric constants.

189. Given the diversity of chips and instruments with different shapes and electrical characteristics, a variety of modules have been designed to fit the characteristics of each item to be monitored, and their performance validated in anechoic chamber measurements (FIGURE 2.5). 190. Also providing for use in instrumentals made of plastics, carbon fiber and other non-metallic materials and compounds, TAG was created to identify these, best described in FIGURE 3.1 on the right. Instrumentals, such as laparoscopic forceps, have their handles made of plastic in some cases. In these the base of the TAG can be injected during its construction or later incorporated as provided in FIGURE 3.2-F.

191. The biocompatible plastic coating filled with polymerized non-toxic adhesive that, after the construction of the TAG, welds the anterior and posterior encapsulation with the metal base, preventing any contact of the internal TAG elements with the patient. It also occludes all recesses preventing the accumulation of microbiological agents, residues or secretions.

19Z. The tuning of the module suffered severe interference from the non-toxic adhesive used in the encapsulation, generating the need to redesign the module based on the observed frequency deviation, compensating for this effect for proper tuning of the module. The instrumental does not represent tuning deviation factor, but its positioning determines the transmitted and received powers.

 193. The chip should be soldered to the module with refractory technique, preventing its disconnection during the cycle of use, as well as the infiltration of residues, liquids or secretions.

 194. The material that makes up the module must have little expansion and contraction to exposure to thermal oscillations, an idea defended in this patent.

Chapter 2

195. The invention described herein is an evolution of the previous version described in patent application BR 10 2015 032172 4 and has several components in its constitution, each described separately, but which together act synergistically for the purpose. audit, monitor, control flows and processes, control maintenance and durability, accompany cleanliness, organize and endorse sterilization of surgical instruments or metal tools and equipment.

196. Initially we characterized the radiofrequency tag operating in ultra high frequency (UHF) and its variation (FIGURE 3.1, right and left), which is composed of 4 (four) elements (FIGURE 3.2).

 197. The functional element is a commercially available, high-temperature, silicon-based chip designed to withstand temperature cycling-resistant modules (FIGURES 2.2, 2.3, and 2.4), with "Inlay" on its surface to which the chip is placed. refractory technique, preventing its release during the cycles of use of the instruments. This was further detailed in the previous chapter entitled "UHF TAG FOR INSTRUMENTARY TAG FOR SURGICAL SURGICAL INSTRUMENT MONITORING LABEL"

198. The metal base (FIGURE 3.2-A), when soldered to the surgical instrument, uses said tooling as an antenna that forms a dipole between its ends. The radio frequency (RF) wave at UHF, upon reaching such a dipole, induces the electric current through the metal base of the TAG. Such current forms a magnetic field that, by induction, generates electric current in the module that electrically conducts it to the chip, which responds in the same way and in the opposite direction. The use of surgical instruments as an antenna is a creative and constructive concept defended in this patent.

 199. The internal design of the module socket in the metal base has been updated (FIGURE 3.2-A right), with the square cutout intended to bring the edges of the module closer to the metal, intensifying the electromagnetic coupling. It is an invention defended in this patent the internal indentation of the base on four (4) sides perpendicular to each other, as well as the design of the module with the trail near the outer edge, intensifying the electromagnetic coupling.

200. In order to keep the module in the proper position for its functionality, a set of lockable plastic covers has been designed (FIGURES 3.2-B and 3.2-C). These covers have wide flaps that cover the entire metal surface on each side. In a constructive option, they may cover part of the side face of the metal base. THE T BR2018 / 000027

 35

Radio frequency chip is glued to the inside recess of the part, created to accommodate glue and drain any excess. The cover design containing the module provides centralized positioning of the module, with the intention of optimizing the electromagnetic coupling performance. The cover also has hooks that engage recesses in the back cover. The countercap has variable height according to the thickness of the metal base required in each case. A flap-like projection serves to position the back cover by filling the slot in the metal base. This solution maintains the positioning of the TAG and prevents recesses that accumulate dirt. The caps and back covers are made of high-strength engineered plastic with a thermal tolerance of over 150 cent centigrade.

201. Plastic parts have different colors, allowing the instrument to be visually identified by binary color coding. The range of colors is fundamental to constitute the identity of each instrument. Injecting plastic with two (2) or more distinct colors can create patterns in addition to colors, making it easy to binary encode instrument identity by patterns and color combinations.

202. Plastic parts lock under pressure, maintaining a large contact area. This area is intended for ultrasonic welding of the two caps. This way the chip will be sealed inside without the possibility of impregnation by water, liquids, fluids or secretions. Covers should be connected with the base positioned inside the metal ring, with the cover or base pressed. When coupled, no decoupling should be possible.

 203. The metal base has the electromagnetic coupling function of the module with the metallic instrument used as antenna. This base is soldered to the instrument to ensure that TAG will not separate from it. In order to optimize the welding process, a surplus of 0.5 (half) mm was added, allowing the initial fixation at 2 (two) opposite points, followed by the watertight welding (FIGURE 3.2-D). patent.

204. In an alternative construction, the surgical instrument may be made with the recess in the same dimensions and technical characteristics as the metal base of this TAG, allowing the module and plastic components to be fitted directly into the original manufacturer part (FIGURE 3.2-E). . 205. This also applies to the updated version of the base (V2.1 - FIGURE 3.2- D center). This new conformation where the cutting of the metal base conforms quadrilateral with precise fit between it and the module, increasing the coupling area between them, allowed greater effectiveness, increasing the reading distance, which is also an element of knowledge defended in this patent (FIGURE 3.2-The right).

206. The positioning of the TAG in the instrumental was also studied and determined for each instrumental according to the best radiofrequency response observed and the ergonomics of each instrument. This positioning has been confirmed in an anechoic chamber study and is also a feature defended in this patent (FIGURES 3.3 and 3.4).

207. In order to transmit and receive radio frequency signals, adapters were created, which are positioned and fixed on auxiliary tables of various sizes and models commonly used in the operating room. Auxiliary table sizes vary slightly in size according to manufacturer standards. Measurement variations are foreseen in this design.

 208. Also designed with and without clothesline auxiliary table and Mayo table with this built-in technology associated with trash (Hamper) and cabinet with built-in electronics (FIGURE 3.5). This set allows monitoring of Operating Processes during surgery, alerting for nonconformities in real time.

 209. The constructive features of tables and adapters are:

 A. Mineral Solid Surface (SSM) Top with a preferred thickness of 6 (six) mm and a maximum of 12 (twelve) mm, supported on the edge by stainless steel structure and in the center by the stainless steel housing containing the antennas and readers.

 B. Use of 3 (3) to 6 (6) circular polarization antennas per set immediately under the SSM.

 C. Stainless steel clothesline determining ground when no reading of the items is desired during the procedure, identifying only the items actually used.

D. Carbon fiber clothesline when you want to identify all open items on the auxiliary table. E. Power to the reader via POE (Power Over Ethernet) using IP67 dust and liquid-tight connector and cable.

 F. Metal-walled or radiant-walled trash can or Hamper with a single circular angled antenna in a specific projection to make it possible to read from any position inside the trash can into a radio frequency "cannon".

 G. Hamper operating connected via radio frequency cable (F) or wirelessly via Wi-Fi or Bluetooth connection with metal detector on its top opening and long battery life equipped with Wireless Charge technology containing Angled circular polarization RF antenna, specifically designed to make it possible to read from any position inside the bin.

 H. Identification of trashed items and real-time notification to the user and the appropriate Hierarchical Level when processed.

 I. Synchronous operation of tables and dumpsters (Hampers) in the same procedure allowing the monitoring in large and high complexity surgeries.

 J. Association of boxes, instruments, textiles and other assets monitored by UHF RFID technology to the procedure automatically, ensuring legal determinations, markedly in Brazil, RDC 15/2012 that determines the unit traceability of instruments in hospitals with more than 500 (five hundred) ) surgeries per month except deliveries.

 K. Medium, large and Mayo tables operating synchronously or independently.

210. The auxiliary table adapter and auxiliary table (FIGURES 3.5 and 3.6) are composed of a set of three (3) to six (6) commercially available circular polarization antennas that connect to the reader directly or in pairs via frequency. Alternatively the reader communicates with the antennas via HUB, the radio frequency signal distribution unit. Signals are sent and received by a radio frequency reader installed below the antennas. This is fed through the network cable (POE), ensuring proper electrical insulation for operation. THE External connection is made through IP67 sealed network connector and cable, preventing contact with liquids and secretions. The signals then go directly or indirectly to a computer that, controlled by software specifically designed for this function, monitors, manages, and directs surgical instruments, textiles, and other items monitorable by UHF RFID technology throughout the procedure and immediately thereafter.

211. In a constructive option, the Application may be embedded in the reader, eliminating the use of a dedicated computer. In this way the cabinet is eliminated and all operation takes place through the cloud with the data presented in real time on the room computer and replicated to the upper hierarchy.

212. There are also 1 (one) or 2 (two) F connectors to attach monitored trash. This is intended to detect discarded instruments during surgery, as well as textiles and other items identifiable by discarded UHF RFID technology. Software questions the reason for disposal, and when identified in the clean room, the item goes to the appropriate sector, guiding their flow through the stations involved in the processes related to instruments and other monitorable items.

213. The adapter or similar table is installed in the purge room, where the instruments used during surgery follow. Software-driven, another logic applies to this feature, which prepares the instruments for cleaning and sterilization cycles while checking the box contents. The function of such a table is to electronically count the instruments of the newly completed surgery. The lack of any item alerts to possible loss or retention in the patient. Alternatively, this electronic check can be done on the auxiliary table itself at the end of surgery, releasing the patient after the countdown is complete. In one construction option, this table has a built-in scale that weighs the instruments and compares with the weight after mounting the box in the clean section of the material center. Any variation for less alert about the loss of instrumental.

214. To assemble the instrument cases, the mounting table was designed (FIGURE 3.7). Composed of 3 (three) antennas and external or internal connection for fourth antenna connected to RF reader that communicates with application-controlled computer specific for this function. It has the function of assisting in the assembly of the box. 18 000027

 39

faster by certifying each item as proper to each previously configured box. In one construction option, the base has an integrated scale that weighs the assembled box with all components and lid before packing. This weight should be equal when compared to the postoperative period, ensuring redundancy in the instrument control processes.

215. For case control, they also receive a TAG that operates in UHF and is resistant to sterilization cycles (FIGURE 3.8). The logical association between the instruments and their cases is performed at this station.

216. The TAGs can still be fully passive (FIGURES 3.8 left and right), allowing for long service life and virtually zero maintenance, or battery assisted allowing pressure sensor, temperature, accelerometer and humidity coupling. It is sealed and term resistant to sterilization cycles. Armed with RGB LEDs, it tells you if the sterilization cycle has been completed as scheduled and expected.

 217. Information is downloaded via UHF, Bluetooth, or Wi-Fi to the system, allowing each cycle analysis and automatic ineffective cycle alerts. Additionally, the RGB LEDs flash in a color pattern, number and frequency that visually identify the cycle result.

 218. Passive GADs were subjected to 1652C (one hundred and sixty-five degrees centigrade) dry heat contrast resistance and eighteen-degree centigrade (189C) wet cold stress tests simulating 1000 (one thousand) usual sterilization cycles, without significant degradation or disruption of operation.

219. Sterile instruments are stored in specific rooms, which in this invention are equipped with Arrays (FIGURE 8.9). This equipment, commercially available and adjusted to operate in the hospital environment, identifies and locates sterile surgical boxes for ease and convenience of surgical planning. The maximum reading distance of the passive TAG ranges from 6 (six) to 18 (eighteen) meters. 2018/000027

 40

220. With extensive sensing, it is possible to monitor the entire cycle of use of surgical instruments directly on the tables, or indirectly through their boxes with TAGs, generating visibility and allowing to verify that the entire operation complies with the Institution's Standard Operating Process. , fact defended in this patent.

221. Any deviation is promptly notified allowing for prompt intervention and preventive action. Software and applications have been developed to capture, process, generate and receive this information with high speed and low network bandwidth.

222. The alternative use of this technology, also provided for in this patent, is the traceability of tools and instruments in industries such as aerospace, automotive and other critical applications.

223. The traceability and organization of instruments in monitored panels and monitored boxes enables continuous and real-time auditing of all tooling involved in critical operations. Continuous monitoring of instrument cases in the arsenal complements these actions, reducing the risk of any instruments remaining inside the equipment.

Chapter 3

224. The invention described herein is a passive radio frequency tag operating in UHF tuned to optimize its performance in close contact with biological liquids and which has physical characteristics that allow it to be integrated into surgical textiles without risk of damage to anatomical structures.

 225. The radio frequency label operating in ultra high frequency (UHF) (FIGURE 4.1) is composed of 5 (five) elements (FIGURE 4.2).

 226. The functional element is a commercially available silicon based chip designed to operate in UHF to manufacturer's specifications.

227. This chip receives and transmits information through a perfectly tuned antenna to optimize the radio frequency signal when near biological liquids. The presence of the chip as well as the encapsulation were considered.

228. This patent provides for tuning to incorporate unique graphics. Such adjustments are made using finite field element software being tested and confirmed in anechoic chamber (FIGURES 4.3 and 4.4).

229. The external dimensions of the enclosure are 32 (thirty two) mm x 4 (four) mm and the antenna dimensions are 30 (thirty) mm x 3 (three) mm.

230. To verify fine adjustments, the TAG was tested in a free anechoic chamber and in contact with biological material in conjunction with other versions (FIGURE 4.3). Results are shown in FIGURES 4.4 upper and lower.

231. The TAG package has two (2) distinct functions. First it must give the malleability and strength necessary for the textile to be flexible, but keep the antenna in its conformation. Second, it must isolate all functional components of GAD from contact with blood, secretions, urine, feces, exudates and transudates, which could potentially contaminate the patient.

 232. For this purpose we use biocompatible plastic coating that, after the construction of the TAG, welds the anterior and posterior encapsulation, preventing any contact of the internal elements of the TAG with the organism.

 233. Initially, GADs did not last in manipulation tests simulating long surgeries.

 234. To address this issue, protection of the medical grade epoxy drop chip applied prior to the fusion of biocompatible plastic blades, a technique called the "Glob top" (FIGURE 4.2), was required. Epoxy USP VI ISO 10993 was used.

 235. TAG's construction, antenna design and components, and integration form are elements defended in this patent.

Chapter 4

236. The invention, described herein, is a user ID card via passive radio frequency tag operating in tuned UHF to optimize its performance when installed simultaneously with passive radio frequency tag operating on HF (Mifare type or otherwise) or LF and with EMV chip for Brazilian standard digital identity. All of these components are combined within a PVC card that is laminated, making the above internal components of the card. External to this card, optical identities such as QR Code, Datamatrix or barcode and magnetic tape can be added. The UHF (ultra high frequency) radio frequency label is composed of antenna and chip (FIGURE 5.1).

237. The chip is a commercially available model, which is coupled with an antenna designed according to the characteristics of the chip and the interaction with other components and the proximity of the human body.

238. The chip may still be common to HF and UHF or distinct according to the required application, in this case exemplarily distinct chips.

239. The HF chip and its antenna form the Inlay HF identified in FIGURE 5.1.

240. Due to the required security, the digital identity chip is unique and has no interface with others except being inside the same card. In this way the encrypted data stored by the certification agency is preserved without the risk of data leakage.

 241. It is a fact that this chip also interferes with the tuning of the UHF antenna, and its presence is considered in the project. When built without the EMV (dual electronic technology) chip, Inlay's metallic design simulates its presence to tune into the UHF antenna.

 242. The PVC encapsulation allows card durability as well as printing on the card, and also serves as a visual identity for the user and the institution, as well as a barcode, QR Code or magnetic tape deployment platform (FIGURE 5.1 - right).

 243. Using both sides of the card allows the addition of photographic printing of the user's face in addition.

244. Unique badge incorporating 2 (two) or 3 (three) electronic technologies being EMV, UHF and HF or LF associated with optical identification technologies such as QR Code, Datamatrix and Bar Code, whether or not associated with magnetic read technology and added Identification by Name and Printed Photo are elements idealized and defended in this patent.

Chapter 5

245. The invention described herein is a passive or battery assisted radio frequency tag operating on UHF, Wi-Fi and Bluetooth alone or in combination, tuned to optimize its performance in close contact with the human skin, with built-in sensors. and has physical characteristics that allow it to be integrated with identification bracelets without risk of harm to the patient.

 246. The ultra high frequency (UHF) radio frequency label (FIGURE 6.1) is composed of 4 (four) elements (FIGURE 6.2).

 247. The functional element is a commercially available silicon based chip designed to operate in UHF to manufacturer's specifications.

248. This chip receives and transmits information through a perfectly tuned antenna to optimize the radio frequency signal when close to the human skin. The presence of the chip, as well as the encapsulation and dielectric spacers were considered in its development.

 249. The incorporation of electronic components has also been considered in the design, allowing monitoring of basic vital signs when in use. Compensating for the presence of drums and electronics were considered in the design and tuning of the TAG bracelet.

 250. This patent provides for tuning to be incorporated with the incorporation of unique graphic elements also considering the presence of electronic elements. Such adjustments are made through finite field element software being tested and confirmed in anechoic chamber.

251. TAG was designed to adhere to bracelets in use in hospitals, taking advantage of the infrastructure already installed in the institutions. For both use sticker non-toxic Considering the built-in battery-operated electronics wristband, it has handles through which the body of the wristbands currently in use, which when sealed, keeps the electronic component attached to the patient. Because it is designed for continuous use, its encapsulation makes the TAG impervious to water, even with electronics, making it the battery pack injected in human plastic and activated by wireless technology. Also for user comfort, the face in contact with the skin is partially or wholly composed of non-allergenic plastic foam. In one construction option, the adhesive layer exceeds the TAG side measures, forming side flaps. These allow, when attached to the bracelet, the TAG wraps around the entire bracelet, giving greater engagement to the coupling. The structure of the fully passive TAG is described in FIGURE 6.2 and that of the electronic and battery operated TAG in FIGURES 6.7 and 6.8. In another form of passive TAG construction, the tabs are thin, alternate or aligned and straight or curved, allowing interdigitation or interlocking.

 252. The external dimensions of the package in the newborn (RN) version are 40 mm to 95 mm x 20 mm at 4.14 mm thickness and the antenna dimensions are 37.6 mm to 92 mm x 15 mm TAG adult dimensions, however, vary according to the sensing built into it. Thus the passive adult TAG provides monitoring of body temperature and humidity. When applied to hospital diapers, the same TAG allows to identify temperature, humidity and presence of eliminations, avoiding unnecessary manipulation of the patient. The presence of liquids and temperature variation within human tolerance limits lead to impedance changes in passive GAD which, when interpreted by specific software, identifies the immediate temperature as well as the degree of humidity.

 253. Thus, when exposed to the radio frequency field, they report the current temperature and humidity status.

254. Sudden changes from previous measures warn of events. Sweating without fever portrays some important medical emergencies such as hypoglycemia, angina, or myocardial infarction. Hyper or hypothermia may be early signs of infection, which have better responses when treated early. 255. Also, when we touch passive TAG, we produce changes in the radio frequency response intensity or RSSI. This change has a pattern according to the location or movement made about it.

256. Thus, it is also part of this invention, the interaction of the wearer, companions and health professionals with the bracelet. Different movements may correspond to different responses. This way, covering the entire label by hand can trigger the nursing call. Sliding in one direction may correspond to one message, to the other side another message and the movement of clamping yet another alert.

257. Thus, passive GAD can, in addition to identifying the user, inform about basic clinical signs and alert the patient's demands through manual interaction with them.

258. To verify fine adjustments, the TAG was tested in a free anechoic chamber and in contact with human skin in conjunction with other versions (FIGURE 6.3). Results are shown in FIGURE 6.4.

259. The TAG package has two (2) distinct functions. First it must give the malleability and strength necessary for the bracelet to be flexible, but the antenna retains its conformation. Second, it must isolate all TAG electronic components from skin contact.

 260. For this purpose we use biocompatible plastic coating that, after the construction of the TAG, welds the anterior and posterior encapsulation, preventing any contact of the internal elements of the TAG with the patient.

 261. The form of construction of the passive TAG is best described in FIGURE 6.5 and is a model advocated in this patent. The technical form of battery-assisted TAG construction is the subject of another patent, but its medical functionality is defended in this patent.

262. The correct form of use and application is exemplified in the images of FIGURE 6.6. The tabs for wrapping the bracelet are exemplified in their construction in FIGURE 6.6 - B and are protected by this patent. Chapter 6

263. The method described here, and the inventions thereof, together form a means of electronic protection of dependents and critical or high value items. For example, the logic adopted for the infant will be presented, but not restricted to it.

264. At birth, the Newborn (RN) is readily identified with three (3) labels on the limbs. Yet your umbilical cord receives an umbilical clip to prevent bleeding. When attaching this seal, the umbilical tag shown in FIGURES 7.1 and 7.2 is inserted into the handle of the seal prior to locking. This TAG has, inside, a filter paper housing, which stores and isolates blood from the umbilical vessels, promoting DNA reserve in case of identity confirmation need. Variations of this such as label without DNA reservoir, otherwise constituted DNA reservoir or different antenna designs are provided in this patent.

265. Following umbilical clamping and initial care, the NB is identified with bracelets on 3 (3) of 4 (4) limbs. These are usually printed before surgery, confirmed by the mother or guardian, and follow the chart. Adhered to these, the best characterized TAGs are placed in FIGURES 6.1, 6.2, 6.3, 6.4, 6.5, 6.6, 6.6 - B, 6.7 and 6.8, which associated with the mother's name at the time they were coupled, allow the identification of the newborn when they are affixed to it.

266. At birth, the responsibility for the NB lies with the Neonatologist, who is taking care of it. After the initial evaluation, the neonatologist sends the newborn to the best indicated sector according to its clinical condition. It usually proceeds to the birth unit's nursery, where it is par 30 (thirty) minutes to 2 (two) hours under observation.

267. The room is transferred to the nursery by the responsible circulator. To do so, it must assume the electronic guardianship of it. Therefore, in front of a totem (FIGURE 7.3) or smart drawing board (FIGURE 7.4), the identity of the RN is confirmed by reading the printed label and reading the RFID. If both coincide, the employee's badge is read within 5 (five) seconds after the identification of the RN to assume the guardian of the same. In case of divergence, the guardianship is not transferred and the nursing manager is called. Care continues normally, but the newborn is placed under institutional surveillance.

268. Upon arrival at the nursery, the door opens identifying the RN and the clerk together. The NB is placed in the crib and identified by the birth unit nursery manager in the same way. In case of congruence of the information, the guardianship is automatically assumed by the responsible of the sector and the circulating can go to another unit of birth. In the nursery of the birth unit, automatisms are predicted as an alarm for the risk of hypoglycemia after 2 (two) hours of birth or 1h30 (one and a half hours) after the birth of a diabetic mother, among others.

269. Upon discharge from the birth unit nursery, the NB should proceed to the central nursery. To this end, the transportation officer will assume the guardianship of the RN after verifying the printed and RF identity, and will pass the guardianship to the destination unit in the same way. Every time a guardianship is passed, a system log is created that can be reviewed and documented. Note that the guardianship automatically migrates to the next responsible when arriving at the correct destination.

270. These logs can be displayed on the mother's room totem screen automatically, so that parents know, in real time, who is responsible for looking after their newborn and where they are. Arriving at the bedroom door, the tutor carrying the RN in a crib, approaches the same as a multifunctional totem located at the mother's bedroom door. If the newborn in question is not from that mother, a warning screen appears, preferably red, warning of the divergence. If this is the mother, a confirmation screen, preferably green, authenticates the parity. The tutor enters the room and verifies the mother's identity through the double-confirmation bracelet. After this routine, the newborn is identified by the totem system inside the room. When the mother is present in the room, the guardianship is automatically transferred to her. In order to acquire the guardianship again, the employee must proceed as in other sectors, identifying the RN and then himself. 271. At discharge, the NB is only released after the mother takes over the NB. They move to the hospital reception where, for free, a totem takes a picture of the parents when they are identified mother and newborn together in front of them. This image should be uploaded to the database along with all RN guardianship records, ensuring long-term record of RN monitoring from birth to discharge.

272. The cord clip is usually removed between the second and third day of birth, very close to discharge. With a view to safety monitoring, the clip will be removed near the time of discharge in uncomplicated NBs who are expected to be discharged by the third day. This withdrawal is made only by the nursing staff due to the inherent risks such as bleeding or infection. The withdrawal is performed on a smart bench, which automatically identifies the RN, best described in FIGURE 7.5. The umbilical TAG (FIGURE 7.1) is attached to the patient's medical record and constitutes an association between the genetic material inside and the newborn, and may be used in the future to resolve differences. The TAG can also be used by the medical scheduling and statistics service (SAME) to identify the medical record automatically, by hand scanner looking for the electronic identity registered in the medical record and expressed on the label.

273. The smart bench consists of a radiofrequency transparent surface, preferably Mineral Solid Surface (SSM), under which the identification antennas are positioned. They also automatically identify the user, letting them know if they are a doctor, nurse or caregiver. Interactive screen allows automated annotations of key markers observed during the immediate postnatal period. Thus, when a doctor stands in front of the bench with a particular NB, his medical record appears and information such as jaundice zone, Ortolano maneuver, among others are recorded by the user and constitute part of the patient's electronic medical record, streamlining the process of medical evolution. Likewise, when a nurse places the NB on the workbench, a specific menu is available that includes, but not exclusively, gives access to the umbilical clip removal menu, nursing notes, among others. An assistant approaching the smart bench has access the specific menu, which allows you to note diaper changes, appearance and amount of meconium and urine, among others.

274. Automatic scale, better characterized in FIGURE 7.6, is also provided for in this solution. When the newborn is positioned over it, it is identified and its weight is automatically recorded in the electronic medical record. The height can be recorded by any touch screen enabled user. Keyboards are avoided to prevent transmission of infectious agents. Interaction with other systems such as hand hygiene compliance monitoring is anticipated, as well as importing and exporting data to the hospital management system.

 275. Variations in presentation form and customizations are provided in this patent. To this end, the interactive Standard Operating Process (POP) flow authoring and editing tool has been designed and built for ease of customization as well as fast, real-time updates. Such a tool is interactive with the connection of logic blocks via mouse, allowing the user simple interaction based on their business experience.

 276. Considering alternative use of this technology such as monitoring jewelery, equipment, orthotics, prosthetics and special materials (OPMEs) and psychotropic cases packed in tamper-resistant RFID-sealed boxes operating in UHF, described in FIGURE 7.7 .

277. It was designed using finite field element software and was tested and validated in an anechoic chamber with the measurements shown in FIGURE 7.8. The tamper violation shown in FIGURE 7.8 on the left keeps the TAG working, but with a changed information bit. This change in information leads to institutional alerts when off-site. Integration with video surveillance system allows to retrieve the image in real time and present the fact automatically to the security service. Additionally the concept of concentric virtual fences is created, idea defended in this patent. With comprehensive monitoring, we can create consecutive logical fences, increasing the effectiveness of identification and authentication. With the newborn in co-accommodation with the mother as an example, a first virtual fence encompasses the mother's room, the local nursery and the runners between them. A second fence involves common areas such as family room and access to lifts and stairs. A third virtual fence surrounds the common areas of other floors and reception and a fourth fence surrounds the institution's access (entry and exit) roads. Still a fifth virtual fence can be created in the common outdoor areas. The effect of consecutive filters is thus applied, exponentially reducing the risks of deviations and losses. Concentric virtual fences applied to electronic guarding with safe technology to the hospital environment is a creative method defended in this patent.

278. The concept of guardianship of these assets applies equally to, but not exclusively to, assets and is intended for different purposes in the transport of critical, high value or highly regulated items ranging from medicines to ammunition and armaments.

Chapter 7

279. The invention described herein is a method of continuous monitoring of high and low cost items in a closed complex unit, exemplified by the operating room, but not directed solely to this unit.

280. In this invention the items of interest are identified with the radiofrequency tag (TAG), preferably in their origin by the pharmaceutical industry, rather than being admitted to the hospital's central pharmacy. This is best characterized in FIGURE 8.1. After that, they are placed in internal distribution boxes (FIGURE 8.4), where they are counted, identified and serialized according to the GS1 standard. The information contained in the chips is, for example, but not restricted to, Medicament, manufacturer, batch, validity and serialization (unitarization). Along with the system, these serials are associated with invoice number, unit cost price, vendor, purchase date, delivery date, and RFID serialization date. These items, now identified by this technology, go to the dispensing point, where they are distributed in dispensing boxes as prescribed or industry standards such as anesthesia box, sedation box, blue code emergency box, surgery, among others. 281. Low-cost items are treated differently. When admitted, they are serialized according to the GS1 standard using two-dimensional QRCode code, which guarantees the unitarization of the batch. This can be printed on the packaging or on a label added to the item. For the surgical environment, standard kits are assembled according to the size of the surgery, whether small, medium or large. These items have their SGTIN identified by QR code scanners and are added to the box equipped with passive UHF RFID tags (FIGURE 8.5) and sealed with tamper-sensing UHF RFID trackable tag (FIGURES 7.7 and 8.3). . In this way the low cost items are monitored together ensuring good value for money, full traceability and real time auditing of even the low cost items.

282. These boxes, which are already standardized for each hospital, are sealed for safety. In our model, the box is sealed with the RFID tag, exemplified in FIGURES 7.7 and 8.3. This seal has several versions according to the desired reading distance, and changing a bit of information indicates the breaking of the seal, alerting the system.

283. It has a longer range than drug labels, allowing you to track the box along its route to its destination. Log records are created by storing information about the path taken by the box. Coupled with a commercially available video surveillance system, we can track the cashier's path in real time or view the archived video over the entire track where video is monitored. If a seal rupture is detected, an institutional alarm occurs automatically, and the video of the path traveled from the last intact seal detection to the broken seal detection moment is automatically made available. This is particularly interesting for tracking high cost equipment, OPMEs and psychotropic medications.

284. All strategic path or points from origin to destination are monitored by Arrays (FIGURE 8.9), portals or totems (FIGURE 9.1), which verify the identity of the box and its seal as well as the integrity of this second. 285. Upon reaching its destination, or alternatively in the case of the psychotropic, when the box (FIGURE 8.8) is placed over the monitoring unit best described in FIGURE 8.2, the security seal may be breached without activating institutional alarms. This unit and Array automatically recognize user enabled and records the time and place the seal was opened and who broke it.

286. At the table medicines when they are taken out of the box are automatically identified. The name and dose appear on the equipment screen, as this data is converted into a voice message, ensuring assistance during emergency care and avoiding medication change due to the small size of ampoules, making it difficult to read the text reliably. The box also contains a reservoir dedicated to the deposit of empty drug shells. TAGs still transmit, but an observed difference in signal may allow us to infer that such an ampoule is empty. At the end of the medication use the box is closed and sealed with a new seal, previously located inside the box. This seal is also monitored along its way back to the pharmacy, where the box is deposited on a reading unit and checked. Any reading divergence is checked manually at any time it has been observed. Upon return from the pharmacy, the seal is reopened and the reservoir containing the empty hulls is read over the monitoring unit and checked manually. The result of reading with the pharmacist's endorsement authenticates the use of the medication and generates charge with the paying source. The box is filled with the missing drugs, resealed and made available for the next procedure.

 287. Alternatively the seal may be reusable, with magnetic or mechanical locks that can be opened only at destinations.

288. In the case of surgical boxes, they are accompanied to their destinations, ensuring arrival at the correct place. If the seal has been breached before reaching the room, institutional alarms occur and the contents of the box must be reconciled. In the room, items inside the box are consumed. At the end of the surgery the box follows with unused items for the pharmacy. In the case of the box with high cost items the reconciliation is done in a specific station, as shown in FIGURE 8.11. It's Faraday's Cage Specially designed to hold the box with items inside. Its technical design dimensions and RF sealing techniques are detailed in another patent. If the reading coincides with the consumption form, the box is received by the pharmacy. In case of divergence, the divergent content is reconciled. Returned items return to the internal distribution boxes and the box becomes available for the next use cycle.

289. The concept of guardianship, defended in patent BR 10 2016 005739 6 and updated in this application, also applies to this scenario, where at all times there is a person responsible for the box and its contents. The guardianship is passed by identification with identification badge of the individual qualified for such function. From the point of view of software logic (SW) every time the box is identified by the tracking system a log is created with local time and tutor date. In combination with camcorder system, you can monitor an item, person or organs and tissues all along its route in real time or by retrieving specific segments of recorded images.

 290. Due to real-time information, we can map the actual times that events happen, thus creating a real-time electronic governance tool that identifies and authenticates medicines, their containers and tutors.

 291. By supporting these items, an adequate and reliable substrate for corrective administrative actions is generated, as well as optimizing the unit's performance.

 292. Alternative use of this technology is foreseen in the monitoring and tracing of high value-added small items such as jewelry, electronic circuits, slide bank, bone and tissue.

 293. TAGs, best illustrated in FIGURE 3.8 on the left, may also be applied to surgical unit equipment (FIGURE 8.10). This allows the location of the item in real time under the monitored area and determines the last detected location, allowing to identify its probable destination.

294. In addition to facilitating localization, it allows automatic association of equipment with the procedure, facilitating billing and identifying non-human vectors of nosocomial infection. 295. From the perspective of clinical engineering, it also allows to make available or block the use for maintenance, concert or others, providing visibility of the resources available to the surgical unit manager.

296. Operating passively, with high thermal and impact resistance, requires virtually no maintenance.

Chapter 8

297. The invention described herein is about equipment, software, logic and method that work together in synergy for the purpose of monitoring hand hygiene compliance, identifying users, identifying vectors and potential cases. It also serves to create virtual fences to monitor hand hygiene compliance at various levels, enhancing the effectiveness of the process.

298. The equipment is the Sanitizing Totem (FIGURE 9.1), the Pre-Surgical Antisepsis Sink (FIGURE 9.3) and the Brush Dispenser (FIGURE 9.5). The first consists of a radio frequency antenna connected to a decoder reader equipment that transmits the information to a screen processing unit (FIGURE 9.2). In a build option this screen can be touch sensitive with conditional interaction to the identified user. It may not have a screen yet, and the visual interaction through the RGB led colors visible on the right side of the alcohol dispenser. The processing unit may also emit audible signals for verbal and nonverbal sound communication. In a construction option, such interaction may occur across the reader board. As a means of interacting with the system, the user is identified by a badge operating in the frequency range of the reader (FIGURE 5.1), as well as the alcohol dispenser, which is equipped with TAGs with the same characteristics. The TAG of the alcohol dispenser is logically associated with a position, such that the user's location can be determined when his badge is identified at a particular terminal (Totem). From a logic point of view the equipment can be inside or outside a certain place, area or sector. Thus, sanitation monitoring occurs when there is an ackohol dispenser logging before entering and before leaving a particular environment, area or location. To do so, logs with date, time, location, user, position (inside or outside) and sanitization compliance are generated and stored on a cloud server. When detected within an environment, this record is consulted, checking for hand hygiene compliance on an ongoing and individual basis. All with badges are monitored. The user without a badge is not identified by the system, but anonymous hygiene registration is performed.

 299. By using one totem pole inside and one outside, we can infer the compliance of Sanitation at times 1, 4 and 5 advocated by the world health organization. This way, electronic compliance can inform the indexes within the standards established today.

300. By checking sanitation compliance before entering and leaving the room we obtain the bed compliance index.

301. It is well known that patients with high complexity or high degree of invasion present a higher infectious risk. By monitoring compliance before entering we can estimate the risk of contamination of this patient.

 302. Similarly, by monitoring the hygiene index on leaving, we can determine the risk of spread of infection identified in the specific bed.

 303. This creates a virtual fence limited by the bedroom door, and the risk scores for contamination and spread of the inpatient unit.

 304. Following the principle of consecutive filters, we know that the implementation of concentric virtual fences increases the effectiveness of the hand hygiene event exponentially.

 305. Thus, this invention also relies on the creation of concentric virtual fences in units, floors, sectors, blocks, buildings and hospitals.

306. Measuring hand hygiene compliance when crossing the various fences allows us to estimate the risks of contamination (hygiene compliance on entry) and dissemination (hygiene compliance on exit) from sectors, units and other monitored areas. The consequent barriers determine an exponential fall in the risk of transmission of infectious agents. 307. In this way, we monitor the entry and exit times of rooms, rooms or boxes, preventing microbial agents from reaching or leaving the monitored unit. High adherence to the process reduces the risk of contagion through the hands.

 308. To increase adherence, elements of cognitive behavior were added in such a way as to encourage the user to interact voluntarily.

 309. To this end, the concept of interactive electronic game was created. When an individual is identified, the animation of an infectious agent appears on the screen and interacts with the user. When the alcohol dispenser is triggered, the figure reacts, running away and a soft beep sounds. When the user does not sanitize their hands a warning beep sounds as the infectious agent changes color to red, indicating that it is getting stronger and more dangerous (in game). This agent is tied to the user, such that sanitizing their hands in other instances will "weaken" the microbiological agent.

 Alternatively, the interaction may be simpler, with only positive reinforcement elements to the sanitation performed. In this model, when doing hand hygiene, a Tefa image gives positive feedback, recording the event, while the absence of the sanitizing act is not reported.

 311. This sanitization event is reported to the cloud server where it will be part of the database validating this event within software logic.

 312. In order to maintain the perception of the game, a score was created that classifies users according to their degree of adherence to the process. Thus, the maximum score to be reached is 100%. Users are ordered according to their score which is determined by the formula: Compliance

 Compliance + Non-Compliance

313. With the strategy of disseminating good examples of hand hygiene compliance, the best scorers social networks. This way everyone is aware of their score and how far they are from the leading scoring leaders, opinion makers. With the unconscious desire to surpass competitors, there is expectation of increased adherence to the hand hygiene process.

314. Converting this daily task into an interactive game is a means to encourage hand hygiene, and allows us to effectively and efficiently evaluate all users and sectors individually or collectively. A large amount of data is generated and stored on server. This information automatically comes to the administrators.

315. For the CCIH manager, the hand hygiene compliance index is updated in real time and can be either general or filtered by industry, business unit or even sorted individually. Individuals who have sanitation rates below a score, here suggested of 55% (fifty-five percent), should undergo recycling by the HICC sector. This value will be updated according to the reality of each service and serves only as the initial parameter.

316. When an outbreak of nosocomial infection occurs, the same strain of bacteria is identified in 2 (two) or more inpatients. When we cross-check the location, date of diagnosis of the infectious event with the log of persons and identified items up to 96h (ninety-six hours) prior to culture collection we can identify potential human and non-human vectors of infection.

 317. These potential vectors can further be classified according to their hand hygiene compliance index and should be investigated for secondary causes that make them vectors such as onychomycosis, rhinitis, omphalitis, chronic dermatitis, among others.

318. Once the vector has been identified, we can follow its trail to the present date, knowing who it was with and thus locating potential cases of contamination that have not yet manifested infection but remain under surveillance by the institution. 319. Such a solution also allows us to create and visualize the thermal map of infectious events in the institution, in order to allow surgical actions and real-time response measurement.

320. With the accumulation of a large amount of information, including infectious events, the possibility arises of "data mining" through third party specific software that, through neural network, identifies patterns of dissemination and contamination, allowing us to adopt specific prevention measures for each service.

321. In a concept option, each room is identified by a set of 2 (two) terminals, one inside and one outside. Knowing who the patient is in that room for a certain period of time, we can use these terminals to identify people, as well as check that medications, blood products and equipment are going to the right room with the right patient, avoiding exchanges and promoting patient safety. People may be visitors, doctors, nurses, technicians, third parties and even newborns (RN), identified by a bracelet fitted with a radio frequency tag. In the particularity of the RN, who does not travel without the help of third parties, it is possible to identify who carries it, the tutor, and whether or not it is an authorized tutor, generating institutional alarms. Still with the concept of guardian, the exchange of newborns between mothers is avoided, since the identity is verified before entering the room.

 322. There may still be the automatic time stamp that each of the inputs and / or people entered the room, reducing the work of nursing, which may be more dedicated to the care side. These records are also management tools, serving to measure the time elapsed for each action to be taken. This way you can adjust each process individually for fine tuning and performance optimization of each unit.

323. Due to the specific characteristics of surgical units, hand hygiene monitoring is complemented by hand brushing time monitoring. For this purpose the monitoring equipment described in FIGURES 9.3, 9.4 and 9.5 have been designed. In the same way as the described invention above, the equipment is comprised of a brush removal sensor surgical brush dispenser (FIGURE 9.5), radio frequency antenna array, radio frequency reader / decoder circuit, and computer screen. Here, the user is also identified by a badge that operates on UHF radio frequency.

324. Upon arrival at the hospital, virtual fences determine hand hygiene points until, upon reaching the operating room, alcohol sanitation has occurred 1 (one) to 2 (two) times. When starting surgery, hand brushing is required or alternatively the application of specific antiseptics during a certain period.

 325. For this scenario the pre-surgical degeneration monitoring solution was created (FIGURE 9.3). When removing the brush from the tank, a time counter is activated within 5 (ten) to 10 (ten) seconds. User identification is automatic and individual identification of multiple users is also provided.

326. All interaction is contextual and independent of triggers. Just be with the technology-compatible ID badge, exemplified in FIGURE 5.1. The identified surgeon has a stopwatch visible on the computer screen along with information about the surgery to perform. Information about your surgical schedule, relationship program and topics of interest declared by the user. When time is up, visual alarm arises. From a management standpoint, brushing time is continuously monitored and logged on the server, creating a hand hygiene compliance score based on brushing time (5 minutes for the first brushing of the day and 3 minutes for brushing). subsequent).

327. Individuals with low sanitation compliance scores may be directed towards continuing education, allowing CCIH agents accurate surgical actions and risk management.

328. The principles of science of human behavior and the elements of social marketing were also allied in reinforcing the adoption of hand hygiene measures. 329. From a managerial point of view, in case of a surgical infection case, the retrospective analysis of the data may suggest potential vectors, allowing measures directed to each vector.

330. Integrated with the alcohol gel hand hygiene system, it also allows checking the adherence of anesthetists, nurses, assistants, circulators, technicians and third parties working in the surgical unit.

331. Combines operate as real-time locating equipment and can locate people, equipment, medicines, psychotropic boxes, OPMEs, blood products, instrumental boxes and monitor and authenticate.

332. As a result of this identification, the automation of operating room processes can be promoted. Very elementally, one can determine the start of surgery when the patient is identified within the correct room and the time the surgery ends automatically when the patient is identified outside the operating room after the procedure without the need for manual annotation or typing to feed the system. This automation enables you to streamline the operating room's internal processes, reduce the workload of nurses and technicians, and even provide managers and administrators with real-time and reliable information as they do not rely on the human interface to feed the system with data. Additionally it checks to see if the right patient has gone to the right room and that the right equipment and staff are attending to it, avoiding one of the most frequent adverse events, "Wrong Patient, Wrong Surgery and Wrong Location". With information about teams and cases of surgical wound infection, we can determine the common items and people that will be evaluated as potential vectors and will be subject to scrutiny by the Hospital Infection Control Commission (CCIH).

333. From a management point of view, there are interfaces to the CCIH, Central Sterile Materials (CME), Surgical Center (CC), Surgical Pharmacy (FC), Cleaning and Hospital Superintendents and Presidents. This contextual and dynamic interface informs individuals with poor hand hygiene compliance for re-education purposes. Integrated with the hospital management system, it allows you to receive information about positive cultures and the number of medical records associated with them. 334. In this way an infectious map of the institution is created automatically, including allowing analysis of pathogen dissemination patterns.

335. The CCIH also has access to the information displayed on the bedroom display, enabling those entering the room to be informed of the type of insulation, pathogen name and specific hygiene compliance index of that bed upon entering and leaving (risks of contamination). and dissemination respectively). Additional data such as Clinical Scores (APACHE and Fragility, for example) allow quick understanding of the case during emergencies and emergencies.

Chapter 9

336. Based on the technologies, methods, designs, and logic described herein, we may acquire process and flow data automatically. The data mean little if we can't use or interpret them properly and in real time.

337. Based on automatically acquired data, we create tools for direct user interaction, sector management, business unit and institutional management.

 338. This is not about legal or tax management, nor is it about the performance of processes intrinsic to the end activity of the institution.

 339. Below is a description of the features of the system and its operating logic, illustrated exemplarily in FIGURE 11.1.

 340. For greater assertiveness, redundancies are instituted. A heat map is displayed and updated in real time, visually identifying critical points and occurrence patterns. From the operating point of view of the Surgical Unit, the visibility and predictability resulting from the information allows quick adjustments ensuring fluency and optimization of room turn-over coupled with reduced surgical risk.

341. The flow configuration and information display is best characterized in FIGURE 10.6. 342. The principles governing this E-governance tool are:

(FIGURE 10.6):

A) The user in direct interaction with the patient has access to the data related to their procedure in real time without the need to enter data or make verification barriers, or just to carry out the standard operating process and be alert to signs of inconsistencies or divergences. The focus of this is patient care directly or indirectly.

B) The hierarchical level above is represented by the managers. They have the function of supervising the operation of several units simultaneously. In your dashboard you can see the progress of all procedures, updated automatically and independently of human interventions. When room alerts occur (wrong patient, wrong destination of medications, materials, equipment, and people) an alert signals the room and the occurrence. In case of operator not responding to the patient within a period of time, this alert is signaled at this hierarchical level.

C) The next hierarchical level is represented by the management of the surgical unit. This is presented real-time operation dashboard with room occupancy rates, average surgery time, delayed start of surgery to name a few. Alongside current figures is the average reference for the last quarter and the same month of the previous year. From this level upwards we have the interactive dashboard where the user can perform manual data mining and determine visualization options according to what he wants to rehearse. This is the industry's strategic SWOT analysis tool to plan strategic actions. As for patient care, is aware of cases on institutional alert.

D) At the oversight level, the dashboard presents historical series of indicators and their comparisons with current status, as well as performance indicators by user, operator, patient, specialty, etc. This way you have visibility of the operational history and can define strategic solutions. Yet it is also notified of cases of institutional surveillance ^'and the high being dependent on its seal (legal liability). E) At the presidency level you have access to the evolutionary history of the indicators, moments of strategic actions and response metrics.

F) The entire hierarchy has access to information below its chain to the patient care center, allowing for broad access and monitoring throughout the chain.

343. The dashboard is user editable and customizable, allowing you to look at your industry dynamically and according to the needs of each service and user.

344. In this way, the institution's internal processes gain automation and visibility while providing patient safety, ensuring legal technical compliance and lowering operating costs.

Claims

01. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACKING OF ITEMS AND PERSONS BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY which is characterized by software and safe methods characterized by the hospital environment, exemplified here by Wi-Fi, Bluetooth, and UHF RFID, which, together or in isolation, lend themselves to providing surgical unit automation, e-governance, and patient safety by monitoring institutional standard operating processes with alerts automatic deviations in real time.  02. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACEABILITY BASED ON REAL TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY TRACKING AND MODULES FOR PASSAGE DESIGNING UHF, for use in surgical instruments and tools, whose performance is optimized by the design of the tracks in the modules and described here, using it for inductive coupling with the instrument, allowing its use as an antenna.  03. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY TRACKING AND MODULES FOR OPERATING TAG TRACKING UHF, for use in non-metallic surgical instruments, for example Plastic and Carbon Fiber, characterized by a metal extension coupled to the TAG base for instruments and which has its performance optimized by the design of the tracks in the modules and described here, using it to inductive coupling with the instrumental, allowing its use as an antenna. 04. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACEABILITY OF ITEMS AND PEOPLE BASED ON TIME LOCATION SYSTEM REAL WITH SAFE TECHNOLOGY characterized by passive TAG module for surgical instruments and their track design when the track and chip are on the same face as the module.  05. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACKING BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY TRACKING MODULE AND TRACKING INSTRUMENT when the track and chip are on opposite sides of the module.  06. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACKING BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY DESIGNED TRACKING MODULE AND TRACKING INSTRUMENT when the track and chip are connected via "Air Bonding" to one, two or more Pads.  07. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACEABILITY BASED ON REAL TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY TRACKING MODULE FOR TRACKING AND TAGGING INSTRUMENTS when the module is square and the drawn tracks respect this geometry.  08. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY TRACKING MODULE FOR INSTRUMENTS AND TAGS its geometry is circular with or without a rope and the tracks follow the outer lines of the geometry. 09. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACEABILITY BASED ON REAL TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY characterized by TAG module Surgical instruments and their track design when tuned to operate in the presence of non-toxic adhesive, compensating for its effects on tuning.  10. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY based on the instrumental metal positioning of the instrumental instrument with the passive positioning of the instrument balance between radiofrequency performance and ergonomics (usability).  11. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY TRACKING MODULE AND TRACKING INSTRUMENT The module substrate is made of material with low dimensional variation when exposed to thermal oscillations. 12. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY TRACKING MODULE AND TRACKING INSTRUMENT The chip is soldered to the module with refractory technique, resistant to thermal oscillations between 0 ^and C (zero degree centigrade) and 180 ⁹ C (one hundred and eighty degrees centigrade).  13. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACKING OF ITEMS AND PERSONS BASED ON REAL TIME TECHNOLOGY WITH SAFE OPERATING TECHNOLOGY OPERATING INSTRUCTIONS the metal of the instrument as an antenna, and with visual identification by binary or greater combination of colors, with alternative use intended for tools and metallic items outside the hospital environment. 14. ELECTRONIC GOVERNANCE SYSTEM AND METHOD OF SURGICAL UNIT THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACEABILITY OF ITEMS AND PERSONS BASED ON TIME LOCATION SYSTEM REAL WITH SAFE TECHNOLOGY characterized by passive TAG module for non-metallic Surgical Instruments operating at UHF frequency that uses a TAG-based trailer-mounted metal implant and incorporated into the instrumentation acting as an antenna, and with visual identification by binary or larger color combination with intended alternative use for tools and metal items outside the hospital environment.  15. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACKING BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY OPERATING TECHNOLOGY MODULE FOR SAFETY OPERATING TECHNOLOGY It uses a TAG-based trailer-mounted metal implant incorporated into the instrumentation acting as an antenna, and with visual identification by binary or greater combination of colors, with alternative use intended for tools and metallic items outside the hospital environment.  16. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACKING BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY Instrumented by passive assisted instrument box or instrumented module or tooling, operating in UHF resistant to impact and sterilization cycles and with large read distance, with alternative use intended for surgical kit boxes, movable or mobilizable assets.  17. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACKING BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY and auxiliary and non-surgical adapters for May and May for intraoperative monitoring of instruments and items identified by RFID UHF technology. 18. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACKING BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY CONFERENCE CALLING, CONFERENCE CALLING AND CONFERENCE TECHNOLOGY in the purge and clean area of the materials, as well as for mounting surgical boxes, with option of mounting on scale for double weight check.  19. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION IDENTIFICATION, AUTHENTICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY, temperature, pressure and temperature sensor, pressure and humidity sensor validation of sterilization cycles of the instrument cases and their contents.  20. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACKING OF ITEMS AND PERSONS BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY MONITORING METHODOLOGY management and location of surgical instruments.  21. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY based on software monitoring with automatic alerts of your deviations.  22. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACKING OF ITEMS AND PERSONS BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY AND CHARACTERISTICS 23. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY STORAGE BOXES 24. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY featuring its passive antenna TAG design and frequency; for use in surgical textiles, whose performance is optimized for the presence of liquids and biological secretions, using them to optimize antenna tuning.  25. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACKING BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY characterized by "passive wear intelligence" that allows for "passive wear intelligence" .  26. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY characterized by two-piece design and two TAG design and construction ) outer layers of biocompatible plastic, an Inlay layer, a chip and the application of Glob top, with the fusion of the outer layers to prevent contact of the inner environment with TAG constituents for incorporation into textiles for use. unique and intense handling.  27. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY INTELLIGENT TAG FIXING or without gauze pad. 28. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SECURITY TECHNOLOGY simultaneously operated by UHF ID Card or LF and EMV, whether or not allied with the visual identification printed on it, and / or identity codes 1D (Barcode) or 2D (Datamatrix or QR Code examples) or magnetic strips.  29. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACKING BASED ON REAL-TIME LOCATION SYSTEM WITH SECURE TECHNOLOGY for UHF Antenna Card Design Perfectly Synthesized presence of EMV and Inlay HF chip.  30. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACKING BASED ON REAL-TIME LOCALIZATION SYSTEM WITH SECURITY ID card operating simultaneously with passive ID card technologies and UHF operating on a common chip, whether or not allied with the visual identification printed on it, 1D or 2D optical identity codes or magnetic tape.  31. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SECURITY TECHNOLOGY ACTIVATED BETWEEN HF PASSWORD TECHNOLOGY or LF and EMV, whether or not combined with the visual identification printed on the card, 1D or 2D optical identity codes or magnetic tape.  32. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACKING BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY IDENTIFICATION characterized by its TAG pass antenna design and accessory , operating at UHF frequency, for use in people, which has its performance optimized for proximity to human skin, using it to adjust antenna tuning. 33. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACEABILITY OF ITEMS AND PEOPLE BASED ON TIME LOCATION SYSTEM REAL WITH SAFE TECHNOLOGY characterized by passive TAG as a bracelet accessory and its antenna design, operating at UHF frequency, for use in people, which performs temperature and humidity monitoring alone or simultaneously.  34. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACKING BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY characterized by its accessory passive TAG design and accessory antenna tag , operating at UHF frequency, for use in people, which has interaction with the human user through contact gestures on the inlay, indicating a need or requesting an action.  35. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACKING BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY characterized by its accessory passive TAG design and accessory antenna tag , operating at UHF frequency, for use in people, which has the user identity encoded in an Electronic Product Code (EPC) and has its authenticity confirmed by a HASH algorithm.  36. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACKING BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY characterized by its accessory passive TAG design and accessory antenna tag , operating at UHF frequency, for use in people, which has temperature and humidity sensors and touch sensors allowing user interaction and monitoring and has its performance optimized for proximity to human skin, using it to adjust antenna tuning. 37. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY characterized by active and assisted identification. antenna operating at the UHF frequency for use with in people, who have battery-operated electronic sensors that allow them to capture the patient's clinical signals, such as Pulse Oximetry, Pulse Rate, Blood Pressure, Respiratory Rate, Agitator, Accelerometer, Temperature and Humidity Sensor. automatically and during calls, emergencies or emergencies.  38. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACKING BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY characterized by its active assisted identification and TAG design UHF frequency antenna, for use in people, which has sensors that are activated on a regular basis for the purpose of automatic and regular monitoring of the patient's vital signs during hospitalization.  39. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY characterized by its active assisted identification and TAG design UHF frequency antenna, for use in people, which has sensors that are automatically triggered to check vital signs in case of nursing calls or a declaration of urgency or medical emergency.  40. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACKING BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY characterized by active tagging and accessory assisted design antenna operating at the UHF frequency for use in people, which has identification, authentication, interaction and sensors integrated in a single bracelet. 41. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACEABILITY BASED ON REAL TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY characterized by active assisted tagging ID bracelet and its antenna design, operating at the UHF frequency, for use on people, which is attached to the bracelet through biocompatible adhesive and self-locking tabs of different designs.  42. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY IDENTIFICATION CHARACTERISTICS , operating at UHF frequency, for use in animals, which has its performance optimized for contact with the hair, using it to optimize the tuning of the antenna.  43. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY characterized by "wearable intelligence" .  44. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY characterized by model and pass construction its antenna design, operating at UHF frequency, using biocompatible dielectric for tuning adjustment.  45. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY characterized by Model and pass construction its antenna design, operating at the UHF frequency, using adhesive to incorporate it into current wear bracelets. 46. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACEABILITY BASED ON REAL TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY characterized by model design and method construction passive as a bracelet accessory and its antenna design, operating at the UHF frequency, using flexible adhesive tabs to attach it to current bracelets.  47. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACKING BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY IDENTIFICATION PERSONAL IDENTIFICATION SYSTEM RFID to current identification bracelets.  48. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY featuring its passive antenna TAG design and frequency; for use in newborn umbilical clip, which has its performance optimized for body proximity and presence of diaper with fluids and biological secretions, using them to optimize antenna tuning.  49. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY IDENTIFICATION FOR AUTOMATIC IDENTIFICATION or semi-automatic with the newborn's medical record.  50. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACEABILITY OF ITEMS AND PEOPLE BASED ON REAL TIME TECHNOLOGY SECURED TO THE IDENTIFIER bed and mobile means of verifying the identity of the newborn. 51. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY Interface characterized by scale interface radiofrequency to identify the newborn and record its weight automatically in the chart. Adult version is also provided.  52. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACKING BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY-RELATED MONITORING METHODS real-time identification and location, seal integrity and authenticity, exemplified herein by UHF radiofrequency identification technology.  53. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACEABILITY BASED ON REAL TIME LOCATION SYSTEM WITH SECURITY TECHNOLOGY item characterized by the item of responsibility items or container or persons is transmitted or inherited in a contextual manner without the need for a specific authentication process.  54. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACKING BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY-BASED MONITORING METHODOLOGY real-time identification and location, sealing integrity and authenticity, where the Standard Operating Process (SOP) is monitored in real time and alerts are automatically generated in case of process deviations (Non-compliance). 55. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACKING BASED ON REAL TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY CONTROLLED, METHOD-BASED MONITORING METHODS real-time identification and location, integrity and authenticity of the seal, where the seal breached in unforeseen location generates institutional alert and indicates the need for manual reconciliation of the content or item.  56. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACKING BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY For monitoring-dependent, monitoring-dependent method containers or items based on real-time identification and location, integrity and authenticity of the seal, where the rupture of the seal in an unforeseen location leads to institutional alert with or without integration with video surveillance system.  57. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACEABILITY OF ITEMS AND PERSONS BASED ON REAL-TIME LOCATION SYSTEM WITH SECURE-TECHNOLOGY-RELATED MONITORING METHOD containers or items based on identification, real-time location and sealing integrity and authenticity, where virtual logical fences are created for each individual or monitored item, exponentially increasing their efficiency and automatically alerting this violation at any level.  58. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACKING BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY For monitoring-dependent, monitoring-dependent method containers or items based on real-time identification and location, sealing integrity and authenticity, with concentric virtual fences determining risk and alert levels and security redundancy. 59. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACEABILITY OF ITEMS AND PERSONS BASED ON REAL TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY METHOD monitoring of dependents, containers or items based on the conformation of concentric logical virtual fences with safe technology to the hospital environment, linked to warning levels of adverse events and nonconformities.  60. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY featuring its passive antenna TAG design and frequency; for use with attached containers, which have tamper sensing for the purpose of authenticating, monitoring and alerting off-destination tampering to ensure the contents of the protected container.  61. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SECURE TECHNOLOGY IDENTIFICATION, PERSONALITY TRACKING METHOD AND IDENTIFICATION and physically similar, high-surveillance psychotropic drugs based on a real-time RFID tracking system operating in UHF and Electronic Guardianship.  62. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACEABILITY OF ITEMS AND PERSONS BASED ON REAL TIME TECHNOLOGY OPERATING TECHNOLOGY (SAFETY TUNING) over glass ampoule filled with isotonic fluid in relation to the blood. 63. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACEABILITY OF ITEMS AND PERSONS BASED ON SAFE TECHNOLOGY LOCALIZATION SYSTEM WITH LIFFREF OPERATING TECHNOLOGY Identification of violation of the box contents containing monitored items, by changing the information bit, in the short and long reading versions. 64. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACKING OF ITEMS AND PERSONS BASED ON REAL-TIME TECHNOLOGY LOCATION SYSTEM by TIFF-tagged identification by radio-frequency-tagged operation. intra-hospital transit items container.  65. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACKING BASED ON REAL TIME TECHNOLOGY LOCATION SYSTEM with secure monitor identification unit physically similar, highly vigilant psychotropic medicines.  66. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACKING BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY for process flow monitoring , aggregation and breakdown of boxes during their use in the hospital environment.  67. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY COMPONENT MONITORING AND MONITORING sealed with tamper sensor.  68. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY tamper-based technology tamper-resistant tamper-evident tamping technology in real time under the monitored area. 69. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND ITEM AND PERSON TRACEABILITY BASED ON SAFE TECHNOLOGY REAL TIME LOCATION SYSTEM characterized by concept of electronic tutelage identifying the responsible for items and aggregates (containers) in real time in the monitored area.  70. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACKING BASED ON REAL-TIME LOCATION SYSTEM WITH SECURE TECHNOLOGY RFID characterized by monitor monitor system configuration Electronic kanban with reconciliation and real time monitoring.  71. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACKING BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY for in-room hospital system distribution  72. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY TYPE CHECKED UNIT UHF  73. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACEABILITY OF ITEMS AND PEOPLE BASED ON REAL-TIME LOCATION SYSTEM FOR SECURITY PREVENTION FOR SECURITY FENCE PREVENTION deviations. 74. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACEABILITY BASED ON REAL TIME TECHNOLOGY WITH INSURANCE TIFF passive monitoring equipment featured by TAGF accessories in the hospital environment. 75. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY GLOBAL MONITORING COMPOSITION identifying location, users and trigger compliance of the alcohol or antiseptic dispenser.  76. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY User-based interaction-based behavior-based method and strategy engineering of human factors leading to the gameification of interaction, which leads to the creation of scores where those with higher scores are disseminated (direct mail and social media) to reinforce the positive example.  77. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY IDENTIFICATION TRACKING between the location of infectious events and individuals identified at the same sites.  78. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACKING BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY Identification of potential cases by identification of potential cases by the identified vector. 79. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACEABILITY OF ITEMS AND PEOPLE BASED ON REAL-TIME LOCATION SYSTEM WITH SECURITY TECHNOLOGY, TRACKING METHOD, TRACKING METHOD AND TRACKING , equipment and accessories used in health. 80. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACKING BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY for hand-held monitoring or surgical monitoring equipment user interaction.  81. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY based management and automation center monitoring system real-time location monitoring system based on Wi-Fi, Bluetooth and UHF RFID technologies.  82. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY, RECORDING AND MONITORING PROCESSES automatic alerts for nonconformities, providing patient safety, electronic governance with reliable data, and reduced operating costs and healthcare costs.  83. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, AUTHENTICATION AND TRACEABILITY BASED ON REAL-TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY, features, constructs, ideas, specifications, features, ideas, drawings, applications, application logic, and software described above, and the real-time e-governance method based on item intelligence. 84. SURGICAL UNIT ELECTRONIC GOVERNANCE SYSTEM AND METHOD THROUGH AUTOMATION, IDENTIFICATION, IDENTIFICATION AND TRACEABILITY BASED ON REAL TIME LOCATION SYSTEM WITH SAFE TECHNOLOGY Characterized by editable by the user, allowing you to observe events in your industry automatically and dynamically and according to the needs of each service and user.