2004-01-06 Assigned to GREENKY, LYNN, SACCO, LISA M. reassignment GREENKY, LYNN ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: GREENKY, BRETT B., SACCO, JOHN J.
RFID-based system for tracking billable anesthesiology time in a surgical environment employs hand-held RFID reader devices that record and store timed anesthesia events for each surgical patient. Each patient is assigned a reader device, uploaded with patient data. Each anesthesiology professional has an identifying RFID transponder, and room transponders are located on wall or doorway of each room in the surgical suite. A download cradle is used for downloading the patient data collected during surgery to a central computer. The reader devices are synchronized to a high-accuracy clock, eliminating time accounting problems associated with concurrency and discontinuous time.
This invention concerns a system and method for tracking the billable time of anesthesiology professionals and is more particularly concerned with a technique for use by anesthesia departments in hospitals and surgery centers for data management and billing in the peri-operative environment, reducing the time spent compiling patient data in the peri-operative environment, providing for improved billing accuracy, maximizing reimbursement and optimizing insurance payment profiles.
The demands for greater efficiency in health care delivery and maximized reimbursement have never been more crucial to the prosperity of the hospital or the independent health care providers.
Health care providers administering critical care to patients are often required to spend a burdensome amount of time documenting care, whether by hand, on paper, or by inputting data into a computer. There exists a need for real-time, wireless tracking of patients that is less error-prone than existing systems, and which provides for more efficient care and for more accurate billing that complies with increasing government regulation.
The system presently in place in hospital operating rooms and other critical care areas for tracking patient care are cumbersome and prone to error. Hospitals have been routinely criticized for remaining paper-dependent in the midst of a technological revolution. Manual and paper-based systems are no longer viable. The costs and inefficiencies associated with those systems are too high and the risk of error is unacceptable.
In addition to the enormous time wasted by health care professionals required to document by hand or computer every aspect of care and the time and place in which it occurs, the present manual systems continue to drive up the cost of health care. Insurance companies often deny otherwise valid claims because of minor errors in time entry.
Although there is a significant amount of medical-related software on the market, none of it adequately addresses the need to capture time-dependent data in the peri-operative environment for the purposes of data management, billing and improvement of patient care. Consequently, many billable anesthesia events go unrecorded, poorly recorded, or erroneously recorded in the peri-operative environment.
Time spent by hospitals, physicians and staff recording and properly identifying billing data for insurance and government collection is overwhelming. Despite the amount of time spent collecting and disseminating the data to the proper entities, hospitals and anesthesiologists find themselves being denied payment and subject to government inquiry by reason of data-entry errors. As hospitals and anesthesiologists seek to recover payment for legitimate time spent with patients and to comply with all government regulations, they will look to streamline their operations, secure business processing efficiencies and achieve tangible cost savings, all while maximizing positive cash flow.
(1) Anesthesiologists; and (2) The hospitals and surgery centers in which they practice.
A. Errors in recording; B. Errors in timekeeping; C. Increased invoice-to-remittance lag time; D. Requires shift of focus from patient management to data management; and E. Negatively affects medical insurance payment profiles.
iv. Failure to enter data in accordance with newly released government HIPPA confidentiality requirements.
Time keeping errors in the peri-operative environment are extensive.
I. A recent study determined that 86% of hospital wall clocks are out-of-sync. The effects of out-of-sync timekeeping in the peri-operative environment are manifold. Countless bills are compromised and therefore rejected by reason of unit charge inaccuracies and perceived concurrent time inaccuracies.
II. Inability to properly account for time spent with a patient also leads to failure to bill for justifiably billable time (discontinuous time).
III. Critical events in the operating room are frequently not recorded in a consistent, accurate and timely manner.
C. Increased Invoice-to-remittance Lag Time.
As a result of discontinuous and concurrent timing irregularities, initial invoices are rejected by insurance companies requiring reprocessing and resubmittal.
D. Shift of Focus from Patient Management to Data Management.
Health care providers administering critical care to patients are too often required to spend a great deal of time documenting care, whether by hand, on paper, or inputting data into a computer. Such activity takes up precious time in a fluid and ever-changing environment that, by definition, is treating people in need of immediate or emergent care.
The system presently in place in hospitals and surgery centers requires countless manhours collecting data and analyzing efficiency issues. The data itself are collected and entered by hand. This often renders the data subject to dispute and inherently unreliable; consequently the conclusions reached by analysis of the data are similarly questionable.
It is an object of this invention to provide a solution to the foregoing problem for anesthesia departments in hospitals and surgery centers located in the United States.
It is a related object to provide a system that satisfies the demands of Medicare, Medicaid, HMO's, the Federal Government and HIPPA, Health Care Facilities, and the Anesthesia Care Teams by significantly improving the methods of record keeping.
It is a more specific object to provide a technique that introduces RFID technology to the hospital setting for the purposes of recording time-related events. The term RFID (radio frequency identification) describes the use of radio frequency signals to provide automatic identification of items. RFID equipment is a part of the Automatic Identification and Data Collection (AIDC) industry that includes bar code, electronic data interchange (EDI) and magnetic stripe technology.
Another important object is to provide state-of-the art solutions to the needs identified for both anesthesia groups and the hospitals and surgery centers they serve for accurate real-time record keeping regarding patient care in the peri-operative environment, and to employ RFID technology to obtain a secure and virtually contact-less solution for data capture.
A more specific object is to provide an anesthesiologist a time tracking system that will accurately reflect the identity of the patient including all relevant medical data as well as the identities of all health care providers who assisted in the patient's care; that is, it is an object to provide a system that will "track" the time and place the service was performed and the duration of the service; allowing for accurate billing, elimination of discontinuous time and concurrency problems for anesthesia providers, thereby protecting insurance payment profiles, as well as ensuring compliance with government regulations.
Additionally, it is an object to provide the ability to retrieve data and analyze it to determine both efficient and inefficient aspects of care.
In preferred embodiments of this invention, the system applies RFID technology.
RFID is a flexible technology that is convenient, easy to use, and well suited for automatic operation. It combines advantages not available with other identification technologies. RFID can be supplied as read-only or read/write and has a 2K memory.
Unlike bar coding, it does not require contact or line-of-sight to operate. RFID can function under a variety of environmental conditions, and provides a high level of data integrity. In addition, because the technology is difficult to counterfeit, RFID provides a high level of security. RFID technologies provide unique solutions to difficult logistical tracking of inventory or equipment, particularly in applications where optically based systems fail and when read/write capabilities are required. The technology is stable, and evolving, with open architectures becoming increasingly available.
RFID is presently used in applications such as electronic toll collection (New York State E-Z Pass), railway car identification and tracking, intermodal container identification, asset identification and tracking, item management for retail, health care, and logistics applications access control, animal identification, fuel dispensing loyalty programs, and automobile immobilizing (security).
According to an aspect of this invention, an anesthesiology time tracking system assists in tracking and recording of billable time of anesthesiology professionals including anesthesiologists, certified RN anesthetists, and other professionals. The amount of time the professional spends with a surgical patient is tracked and recorded throughout a surgery suite that includes at least one pre-induction room, at least one surgical operating room, and at least one post-anesthesiology care unit room. Typically, the patient is wheeled on bed a between rooms, and a reader, i.e., a portable hand-held data collection device, accompanies the patient in the suite and keeps accurate track of anesthesiology professional that provide services to the patient.
In this system, there are a number of such hand held portable data collection devices, and each includes an RFID reader for communicating with a set of RFID transponders. The portable data collections devices also include means for inputting patient information and the identity of the head surgeon and type of procedure being performed. There are a plurality of personal RFID transponders in a number sufficient to assign a respective one to each of the anesthesiology professionals. These are all coded to identify the professional when the transponder is held within a predetermined short distance from a given one of said data collection devices. There are also room RFID transponders, each being mounted on a wall or doorway of a the pre-induction room; the operating room; and the post-anesthesiology care unit room, respectively. A carrier or holder is provided on the bed of each patient. This permits the assigned data collection reader device to travel with the patient throughout the surgical suite, but allows the device to be removed from the holder so that it can be held or swept past the associated room transponders when the patient is moved through the pre-induction, operating, and post-anesthesiology care unit rooms, both when the patient enters and when the patient leaves the room. The system also includes a download station in which a cradle is provided. The hand-held data collection devices can be placed into the cradle following completion of the anesthesia services, and data stored on the data collection device is downloaded to a server computer to capture times during the procedure that each such anesthesiology professional was present in each said room during the procedure. This ensures that the events for each professional will be tracked for each patient and for each room. The system will account accurately for anesthesia start time, total surgical time, discontinuous time, pre-induction time, and post-anesthesia care time. The various data collection devices each include a clock, and these are all synchronized with a common high-precision clock. The devices can be synchronized during downloading, when uploading patient information, or can be synchronized continuously using a wireless connection. Preferably, there is a station within the pre-induction room where patient identity and other relevant patient information is uploaded onto the data collection device or reader that will accompany the patient during surgery. The data collection device can have a keyboard or another set of buttons adapted to permit the anesthesiology professionals to enter data to identify and record the identity of the head surgeon and the surgical procedure being performed. The data collection devices also may include a screen for displaying the data collected.
A computer station is also preferably associated with the download station, and includes a capability to permit the anesthesiologist to correct or change the data that may have been entered erroneously.
The technique of this invention provides accurate identification of the patient and all relevant data, accurate identification of all health care personnel providing peri-operative care to the patient, and accurate integration of time-related data into existing medical record software.
The technique of this invention reduces errors in timekeeping. All timekeeping data will be synchronized through a central server. Synchronization of all timekeeping data will reduce the number of payment refusals by reason of concurrency problems involved in anesthesia care, eliminate inaccuracies regarding time of procedures during all aspects of operative and critical care, facilitate capture of discontinuous billing times, and optimize MD insurance payment profiles.
The technique of this invention allows health care workers to shift focus from data management to patient management by achieving virtually hands free, unobtrusive documentation of essential information allowing health care providers to focus on the clinical situation and provide cost-effective quality care.
By implementing this technique, the hospital can initiate ongoing quality improvements in operating room efficiency. Data, which are at present not available to the administration, as well as data only available after considerable manual extraction, will now be available in real time and on a going-forward basis. This will allow, among other things, the ability to focus on cost saving measures, patient transit time delays, surgeon specific cost profiles, procedure specific cost profiles, and so forth. For example, laparoscopic cholecystectomy cost could be examined, comparing variables such as surgeon, shift, patient weight, etc. The cost savings alone of manpower reduction to the operating room and recovery room nurse managers in processing reports involving ongoing efficiency monitors would pay for the systems installation and maintenance.
The technique of this invention has several specific advantageous capabilities; namely, to provide the ability to track overall turnaround times as well as personnel who treated the patient in the peri-operative theater, to provide for accurate billing, compliant with government regulations, to provide paperless storage of data, and to satisfy HIPPA confidentiality standards.
A preferred embodiment utilizes RFID readers and transponders that operate at 13.56 MHZ. Although RFID readers require an active power source (battery or wall outlet), the transponders incorporate a passive technology. The reader emits a low-level radio frequency magnetic field that energizes the tag. The tag then sends back identification date stored in its integrated circuit. This data is then decoded by the reader.
The radio frequency used is ISO 15693 compliant. Compliancy offers increased security and authentication, read-write programmability and inter-operability across all suppliers and applications. The invention does not require reliance upon a single supplier of hardware to operate the system and can benefit from market competition for the non-proprietary aspects of the system. Typically, each transponder has 2K of memory and as a result of the ISO standardization, each transponder has a unique identification number that only the manufacturer can assign. Finally, each transponder has a 128-bit encryption so that date on the transponder is capable of being protected at the highest level of security available today for data encryption. These features are particularly important in the health care field in light of the newly promulgated HIPPA standards concerning patient confidentiality.
The radiation power levels and frequency range here are many times below the limits set by even the most conservative health regulatory agencies and study organizations.
As for the hardware and software requirements in the hospital environment, the software can be an MS-Windows based proprietary system. The hardware required may include a combination of commercially available merchandise as well as value-added commercial merchandise. The commercially available hardware required for the system including, readers, holders, data ports, tags and wristbands makes the cost within reach of the consumer and any needed replacement available in a timely fashion.
The technique of this invention provides that the entrance and exit of each room in the peri-operative suite will be outfitted with RFID transponders. Each room or wall transponder is uniquely identified as to location.
Each necessary health care worker will be supplied with a personal RFID transponder that uniquely identifies him or her.
An RFID reader will be assigned to each operative patient that will contain all relevant demographic data as well as accurately reflect the time of day. The reader will be placed within a holder on the patient's bed and follow the patient through the operative experience.
Docking stations will be placed in the recovery room for downloading the data and eventual erasure thus readying the reader for reuse.
The technique can be employed in an anesthesiology/surgery environment explained simply here. Patient ("P") is diagnosed with a problem that requires the use of anesthesia administered by certified medical personnel—a Medical Doctor (an Anesthesiologist) and/or a Certified Registered Nurse Anesthetist.
Prior to surgery, P is required to provide the hospital with various demographic and insurance data as well as any other information relevant to the upcoming surgery.
P thereafter arrives at the hospital for surgery and is properly gowned and assigned a bed or stretcher. P is then transferred to pre-induction and prepared for surgery. At pre-induction, P is assigned a Reader, which is uploaded with all relevant data from a docking station located in pre-induction. The reader is then presented to the one of the peri-operative room transponders thereby noting P's location. The reader will also properly record the time of day at the moment of presentation to the transponder. The reader will then be attached to P's bed.
P is now "in process". The Anesthesiologist assigned to P may begin anesthesia care in the pre-induction area. He will present his unique transponder to P's reader, thereby noting the place and time of his interaction. The patient will then either remain in the pre-induction area until the operating room is ready or he will be taken directly to the operating room. If the patient is caused to wait for a period of time after the anesthetic has been delivered, the anesthesiologist will present his transponder to P's reader thereby noting discontinuous time.
P is taken to the operating room where the reader is presented to the operating room transponder thereby providing accurate, real-time recording of the entry of the patient in the room. The reader previously attached to P's bed is moved to the operating table. As each Anesthesiologist and each CRNA enters or exits the operating room he or she will present his transponder to P's reader thereby providing accurate real-time recording of the identities of each such person and the time of their entry or exit. If the health care worker exits the operating room in which P is being treated and enters a second operating room, the health care worker will similarly present his transponder to the second patient's reader. The identity and location of the health care worker will be properly noted as well as the time, which will eliminate all issues of concurrency.
P's reader will have the capability of recording the surgical procedure being performed and the identity of the head surgeon. At the completion of the operation, P is removed from the operating room at which time his or her reader is presented to the operating room transponder, noting exit from the operating room and the time of exit. Upon entrance to the PACU (Recovery Room), P's reader is presented to the PACU transponder, once again noting place and time of entry. Billable anesthesia time ends when the patient is stable, and discharged from the recovery room. At that time the anesthesiologist will remove the reader from P's bed and place it in a docking station whereupon data is downloaded from the reader to a dedicated server. All the data is encrypted and complies with all governmental requirements for accuracy and privacy. All errors in recording can be corrected with an override feature that is incorporated into the software. Back-up procedures will be available in the event of system failure.
Once in the server, the data is made available for integration into anesthesia billing and hospital use by properly identified individuals.
This technique, employing RFID, has significant advantages over optical, bar code, or magnetic stripe based systems. Bar coding is an inferior technology to RFID for the purposes of data capture. The optical nature of bar code requires labels to be "seen" by lasers. Line-of-sight between label and reader is difficult, impractical, or even impossible to achieve in hospital environments. In order to function properly, a bar code reader must have clean, clear optics, the label must be clean and free of abrasion, and the reader and label must be properly oriented with respect to each other. RFID technology enables tag reading from a greater distance, even in harsh environments.
In addition, the information imprinted on a bar code is fixed and cannot be changed. RFID tags, on the other hand, have electronic memory similar to what is in a computer or digital camera to store information about the inventory or equipment. This information can be dynamically updated. Further, RFID tags are extremely difficult to duplicate, and are therefore more secure. RFID tags offer a completely contact-less solution for data capture, security, access management and inventory management.
The above and many other features and advantages of the invention will become apparent from the ensuing detailed description of a preferred embodiment, which is described in connection with the accompanying Drawing figures.
FIG. 1 is a schematic view of a hospital operating area, with pre-induction room, operating room, and post-anesthesia patient care unit, showing incorporation of an embodiment of the invention.
FIG. 2 shows a portable, hand-held patient reader device according to this embodiment.
FIG. 3 shows a badge as worn by an anesthesiology professional and incorporating an RFID transponder according to this embodiment.
FIG. 4 shows a wall transponder of this embodiment.
FIG. 5 shows a patient rolling bed incorporating a holder for the patient reader device.
FIG. 6 is a schematic view for explaining a download process according to this embodiment.
FIGS. 7 shows data tables produced by the system which can be displayed on a computer screen or may be printed.
FIG. 8 is a diagram for explaining the process of downloading healthcare professional and location ID data to the RFID transponders.
FIG. 9 is a diagram for explaining the process of downloading patient information to the patient reader device.
FIG. 10 is a diagram for explaining the process of reading and uploading transaction data involving the patient and health care provider(s) during a surgical procedure.
With reference to the Drawing, and initially to FIG. 1 thereof, a surgical suite 10 in a hospital or surgical center typically has a number or patient treatment rooms within it, and here are shown a pre-induction room 12, of which there may be only one or several, an operating room or OR 14, and a post-treatment room, i.e., post-anesthesia care unit or PACU 16. Typically, the patient P arrives at the pre-induction room 12 and is placed on a rolling bed 18. This is the location where the anesthesiologist first meets with the patient, and may administer a block or other anesthesia treatment. The patient's bed has a receptacle or holder 20 mounted at one end. When the patient arrives in the pre-induction room, he or she is assigned a reader device 22, i.e., a hand-held data collection and storage unit with an RFID transceiver as discussed above, and the patient's name and vital data are uploaded into it. Then the reader device 22 is placed into the holder 20 on the patient bed 18, so that the device 22 will accompany the patient throughout the surgery. The RFID transceiver of the reader device 22 typically has a low power with a range of a few inches, and interrogates associated RFID transponders that are placed within a few inches of the device. The low power ensures that the readers do not interfere electronically with any of the surgical or life support equipment.
In the pre-induction room 12 and in each of the other rooms throughout the surgical suite 10 there are wall transponders 24, which may be mounted in a doorway of the room or on a wall. When the patient P is moved, i.e., rolled or wheeled on the bed 18 from the pre-induction room 12, a member of the staff will take the reader device 22 out of the holder 20, and sweep it past the transponder 24 in the pre-induction room 12. The reader device 22 then records the time that the patient leaves that room. Then the patient P is wheeled down to the assigned operating room 14, and the staff member again takes the reader device 22 and sweeps it past the wall transponder 24 in the OR 14. This occurs likewise for when the patient is brought from the OR 14 to the PACU 16, and when the patient is released from the PACU. Thus, the time is recorded when the patient P is present in each of the various rooms in the surgical suite, and when the patient leaves that room. At the OR 14, the patient P may be transferred to an operating table 118, and the reader device 22 can be transferred also to the operating table 118.
FIG. 2 illustrates a typical RFID reader device 22 of one embodiment of this invention. Here, the device 22 is a hand-held data storage and display device, e.g., in the nature of a personal digital assistant. The device 22 has a low-power RFID transceiver 30 attached to it or incorporated into it, as well as keyboard or an array of pushbuttons or keys 32. The latter can be used by the anesthesiology professional for keying in patient or procedural information. An LCD screen 33 may provide for confirmation of correct data entry, as well as confirmation of identity of patient, surgical procedure, and health care person(s) present. At the base is a connector port 34, which is used for uploading or downloading data, as described later. This can alternatively be a wireless connection.
FIG. 3 illustrates one example of a personal RFID transponder 36, here in the form of a card or badge that is worn by the anesthesiologist, CRNA, or other anesthesiology professional. The badge has a small RFID chip 38 or integrated circuit embedded in it or attached to it. As the anesthesiologist or CRNA arrives and is present with the patient, he or she places his or her transponder badge 36 near the patient reader device 22, and his or her presence is automatically captured by the device, so that the start time is known. Likewise, when the anesthesiologist or nurse leaves the patient for any reason, he or she sweeps the badge 36 past the reader device 22 so that the departure time is recorded.
An example of the room or wall RFID transponder 24 is shown in FIG. 5. This can be mounted on a wall, or on a doorpost at an entry or exit to the room, at a location as is deemed convenient. The wall RFID transponder device is parasitically powered, i.e., does not contain a battery, but simply responds to the interrogation from the reader unit 22. This is also the case for the personal RFID transponder badge.
An example of the patient bed 18 is shown in FIG. 5, illustrating a preferred position of the holder or carrier 20 for the patient reader device 22. Here, the holder 20 is at a foot of the bed, but it is possible to position it elsewhere.
In the present embodiment, a download station 40, e.g., a cradle for holding the reader device 22 (see FIG. 1) is located in the PACU room 16, and this permits the anesthesiology professional to download the data stored on the patient reader device 22 to the computer server 42. The download station connects with the connector port 34 of the reader device 22.
As shown in FIG. 6, the download station also connects with a physician's computer 44, e.g., a laptop computer, in the PACU. This permits the anesthesiologist to review the anesthesiology times and various procedural information for the particular patient, and make corrections as necessary. In this embodiment a laptop computer is shown, the physician could instead use a different computer device, such as a PDA. The server computer 42 interacts with billing software 46, which may be resident on the computer server or another computer, and may transmit the anesthesiology billing data directly (i.e., electronically) to the patient's insurance provider 48.
Also as is shown in FIG. 6, a high-precision clock 50, e.g., an atomic clock, provides precise local time to the main computer server 42. This is used for re-synchronizing each of the patient RFID reader devices 22 at the time of patient data upload and also at the time of download. If wireless communications are employed, the reader devices 22 can be re-synchronized continually. This feature avoids erroneous time entry as between different rooms in the surgical suite as all times are taken from the single high-precision clock 50.
FIG. 7 shows several of the various screens that would be presented on the physician computer 44 or on another computer screen or printer associated with the billing computer server 42. A time patient location and tracking report 52 provides the time in, time our and total time the patient has spent in the pre-induction, OR and PACU locations. Another report 54 provides the identity of the various anesthesiology professionals that may have been involved in the surgical procedure and records the time in and time out of each of those professionals in pre-induction, OR and PACU. A third report 56 lists the identity of the head surgeon, the surgical procedure performed and the surgical procedure code. It also lists the anesthesia start and anesthesia stop times. Additionally, it lists discontinuous time and total (non-discontinuous time) for each anesthesia professional. Discontinuous time is an important data item. Discontinuous time is defined as interim time between the conclusion of anesthesia care in pre-induction and the start time of the surgical procedure upon entry into the operating room is not a billable event. By law, anesthesia is required to bill only for that time spent in pre-induction delivering care and may not bill for discontinuous time. Discontinuous time is so difficult to monitor by hand that many hospital anesthesia departments simply do not record the time and thereby fail to bill for hundreds of thousands of dollars of legally billable events. The times here are stored on the main computer server 42, and can be used for hospital management studies, to track times and efficiencies involved by the various physicians for different types of surgical procedures, and from one surgeon to another. These data can be important in scheduling the operating rooms to maximize room use and minimize patient and surgeon waiting time.
The types or reports, and the fields of entry for each report can be expanded and adjusted as need be, for example, to accommodate a larger or smaller number of professionals or a larger or smaller number of patients, or to included additional fields or non-anesthesiology fields, if needed.
With the system of this invention, the time for each anesthesiologist, certified registered nurse anesthetist (CRNA), or other person, the identity of the head surgeon and surgical procedure performed for each surgical patient are accurately tracked and recorded, eliminating time overlap or other discrepancies that might result in refusal of the insurance provider to honor the hospital bill. The system can be implemented at a reasonable cost and without requiring significant additional training. The system of this invention is actually much simpler to implement, and produces a much lower error rate, than any manual system now in place.
The process of uploading health care professional identification and room location identification and then downloading these data to the transponders 24, 36, can be described with reference to FIG. 8. In step 101, all necessary identifying data for each anesthesia healthcare worker is entered into a computer. Likewise, all the necessary identifying data for each room in the surgical suite regarding the location of the room transponders 24 (e.g., "Pre-Induction-North; Pre-Induction-South, etc.) are entered into the computer. Then (step 102) the data entered in step 101 are sent to a server that contains the tracking software. The data are integrated with the software, and stored on the server. The integrated data are then retrieved by a secure link to another computer (step 103), and the retrieved integrated data are transmitted to a stationary reader/writer that transcribes the data onto respective RFID transponders, which then become the room transponders 24 and the personal transponders 36 (step 104). Then the transponders 24, 36 are placed at the appropriate location or provided to the health care professional (step 105), and they are used thereafter to identify the person or place.
The process of uploading patient information to the associated reader device 22 is described here with reference to FIG. 9. At intake prior to surgery, the patient P provides hospital intake staff or his or her healthcare worker in the Pre-Induction Unit with personal and demographic data and insurance data, and these data are entered into a computer that is loaded with the tracking software (step 201). Then the patient-identifying data entered in step 201 is sent to a server (e.g., 42) that contains the tracking software (step 202). The patient data are integrated with the tracking software, and stored in the server. Then, the integrated patient data are retrieved by a secure link to a personal computer (step 203), that is associated with a docking station (e.g., 40). The docking station serves as a means for transfer of data between the computer and an associated portable reader device 22 that contains the necessary tracking software, and the data are transferred to the docking station (step 204. One of these portable reader devices is placed into the docking station, and the patient data are downloaded into it (step 205). The portable reader device is then placed into the cradle 20 on the patient's rolling bed or gurney, and this device 22 then accompanies the patient P through the entire surgical procedure.
The process of actually tracking the anesthesiologist time throughout the surgical procedure can be explained with reference to FIG. 10. First, each relevant healthcare worker and each relevant location is provided with a suitably and properly encoded RFID transducer 36 or 24 (step 301) as discussed above in reference to FIG. 8, and the patient's portable reader device 22 is properly uploaded with tracking software and with the required patient data (step 302), as discussed above in reference to FIG. 9. The device 22 is attached to the patient's rolling bed or gurney 18, and accompanies the patient P throughout the surgical procedure.
The patient is brought to pre-induction 12 (step 303) where the patient is assigned the portable reader device 22 that has been properly uploaded as discussed in step 302. The reader is presented to one of the peri-operative room RFID transponders 24, thereby noting the patient's location. The reader device 22 will also properly record the time of day at the moment of presentation of the transponder to the reader device. The patient is now "in process." The anesthesiologist assigned to the patient may then commence anesthesia in the pre-induction area. The anesthesiologist will present his or her personal transponder 36 to the reader device 22, thereby noting the place and time of his or her interaction with the patient. Other information about this interaction may be entered by pushing keys or buttons on the device 36. The patient P may remain in the pre-induction area until the operating room (OR) 14 is ready, or the patient may be taken directly to the OR. If the patient P is caused to wait for a period of time after the anaesthetic has been delivered, the anesthesiologist will present his or her transponder 36 to the patient's reader device 22, thereby noting discontinuous time.
The patient is taken to the operating room 14 (step 304), and the patient reader device 22 continues to track time and place of the various anesthesiology transactions, and the identity of the healthcare professionals, including the anesthesiologist, CRNA, head surgeon, and the type of operative procedure.
The patient P is taken to the OR 14, where the reader 22 is presented to the wall transponder 24, thereby providing accurate, real-time recording of the entry of the patient into the room. As each anesthesiologist, each CRNA, or other identified healthcare worker enters or exits the operating room, he or she will present his or her transponder 36 to the patient's reader device 22, thereby providing accurate real-time recording of the identities of each such person and the time of their entry or exit. If the healthcare worker exits the operating room in which the patient is being treated and enters a second operating room, the healthcare provider will similarly present his or her personal RFID transponder 36 to the second patient's reader device. The identity and location of the healthcare worker will be properly noted, as well as the times of arrival and departure.
The patient's reader device 22 has a search functionality that will allow the anesthesiologist or CRNA to record the identity of the surgeon performing the operative procedure, and the name and billing code of the procedure.
At the completion of the operation, the patient P is removed from the operating room, at which time his or her reader device 22 is presented to the operating room wall transponder 24, noting exit from the OR as well as time of exit.
The patient is brought to the post-anesthesia care unit (PACU) (step 303) where the patient's reader device 22 continues to track location, time, and identity of health care providers present. Upon entry into the PACU 16 or recovery room, the patient's reader device 22 is presented to the PACU wall transponder 24, noting time of arrival at the PACU. Billable anesthesia time ends when the patient is stable and ready for discharge from the PACU. At that time, the completion of this phase is noted on the reader device 22, and the device is placed into a download station for downloading of the data collected during the procedure.
As indicated in step 306, at the conclusion of billable anesthesia time, when the patient P is stable and ready for discharge from the PACU, the anesthesiologist will remove the reader device and place it into a docking station 40, whereupon the data are downloaded from the reader to a personal computer, e.g., 44. Then (step 307), errors in the recorded data, e.g., erroneous billing codes, etc., can be corrected by the anesthesiologist, using an override feature that is incorporated into the tracking software.
Upon completion of all error correction, the data are downloaded to a dedicated server (step 208). The data are encrypted, and comply with all government requirements for accuracy and privacy. Back-up procedures are available in the event of a system failure.
Once the data have been downloaded to the server, the data are available for integration for anesthesia billing and hospital use by properly identified individuals (step 209). The ability to correct errors at this time is also available to suitably identified authorized personnel.
The hospital and/or anesthesia department billing computer then presents accurate and timely billing (step 210) that are forwarded to the patient's insurance carrier for payment. Because the billing is free from the anesthesiology billing errors mentioned earlier that are characteristic of the conventional time tracking procedures, the bills are much easier for the carrier to process, and can be paid out without delay.
While the invention has been described with reference to a preferred embodiment, it should be understood that the invention is not limited only to that embodiment. Rather, many modifications and variations will present themselves to persons of skill in the art without departing from the scope and spirit of this invention, as defined in the appended Claims.
download station into which each of said and-held data collection devices can be placed following completion of the surgical procedure; and including means for downloading stored data from the data collection device to a billing computer to capture times during the procedure that each such anesthesiology professional was present in each said room during the administration of anesthesia care.
2. The system as set forth in claim 1 further comprising means for uploading, into a respective one of said data collection devices, patient data for the associated patient when the patient is in the pre-induction room.
3. The system as set forth in claim 1 further comprising a high-precision clock, and means automatically synchronizing said data collection devices using said high-precision clock.
4. The system as set forth in claim 1 wherein each said data collection device includes a keyboard device adapted to permit the anesthesiology professionals to record identity of head surgeon and surgical procedure being performed.
5. The system as set forth in claim 1 wherein each said data collection device includes a screen for displaying patient data and time plus data relating to the associated patient.
downloading for such patient, from the associated data collection device to a central computer, the data stored in said data collection device to capture times during the procedure that each anesthesiology professional was present for an anesthesiology event.
7. The process according to claim 6, wherein each patient is placed on a bed to permit the patient to be wheeled between rooms of the surgical suite, and further comprising removably placing the patient data collection device into a receptacle therefor on the patient's bed.


Louis van Gaal has been blasted for his treatment of starlet Adnan Januzaj, with the Manchester United youngster's agent accusing the Dutch coach of blanking the player and playing him when he wasn't fit.
Januzaj was once of the bright spots of a dismal season under David Moyes last term. The Old Trafford club could only finish seventh in the Premier League, but there was huge optimism about the 19-year-old's future after he broke onto the scene.
However, this has not carried on into the reign of Van Gaal, who was appointed as the new boss after Moyes was sacked and legend Ryan Giggs was put in charge for the final handful of games.
Januzaj has made only six substitute appearances so far this season and has seen the likes of new arrival Angel di Maria, Juan Mata and Wayne Rooney placed ahead of him in the pecking order and he has only just played the equivalent of two full matches.
The embarrassing 4-0 Capital One Cup defeat to MK Dons early in the season was pointed out by the Belgian's agent as a crucial point in Van Gaal's judgement, though he claimed Janusaj was not even ready for the match.
"That Adnan had to prove himself for Louis van Gaal in that match is nonsense," Dirk de Vries is quoted as saying by the Daily Star.
"After an elbow in training Adnan's mouth was ripped open and he was under antibiotics and really should not have played.
Despite the disappointing start to his season, there are still high hopes for Januzaj and the talent he showed last season is not going to disappear because he has been left out of the team for a few games.
Every person who has watched him is aware of the potential and he has been linked with moves to several of Europe's top clubs if Van Gaal decides to dispense with him.


His recent release "Okay" effortlessly became a contender for our 2014 summer soundtrack, and it's currently making some serious rounds on the club circuit, shooting straight to the top on Beatport's House chart and coming in at numero 3 on the overall rankings provides – a clear indicator of the power behind this low slung rumbler. As if hearing the track yourself wouldn't confirm that!
It's fair to say that Shiba San is primed and ready to blow. You can't escape the feeling that this could be the start of something big.


Technology is changing industries across the globe. From the use of basic-level robotics to virtual reality (VR) headsets, the amount of technology that humans experience is constantly increasing—even on a daily basis. And the human resources (HR) industry is no different. With obvious benefits such as automated workflows and streamlined processes, it may come as a surprise that 28% of HR executives claim to see no need for such advanced technology. However, the benefits far outweigh the negatives, and it's critical that executives realize and adopt the new HR technologies available to them. Here are some of the new technologies available and how they can help your workforce.
Cloud computing has become a widely used practice across the field of HR. In fact, organizations using cloud computing rose from 68% in 2016 to 73% in 2017. Numerous cloud tools are available to HR executives that help improve their day-to-day operations. Some examples include LinkedIn® recruiting, Google forms, and Lucidchart. These solutions provide HR departments with the ability to implement flexibility across their business. For your remote workers, replacing your on-premise system with cloud integration allows for seamless connectivity throughout the company. Considering more than 43% of Americans worked remotely in 2016, this feature can keep your employees connected no matter where they are.
Moving from an on-premise system also has the ability to safely store data in a more cost-effective manner. While 53% of executives worry about storing sensitive HR data in the cloud, choosing the proper system can mitigate the concern. The key is to identify any threats and create a plan to protect against them. By ensuring that a secure solution is in place, you can reap the cost-saving benefits of automatic system updates and reduce maintenance.
Fifty-four percent of HR executives believe that cognitive computing will affect key roles in the HR organization. Many executives worry that the implementation of artificial intelligence (AI) systems will replace the need for their human workforce. In reality, it's quite the opposite. AI has the ability to work alongside humans and help them be more efficient and productive in the workplace. For example, AI-powered chatbots allow for the automation of repetitive tasks, like answering common questions from employees or clients. These chatbots also eliminate the need for antiquated performance reviews. Currently, Millennials are dominating the workforce, and this unique generation craves feedback 50% more than their predecessors. By utilizing chatbots to provide performance feedback, managers don't need to set aside time to meet with their employees, and employees can receive feedback more often.
AI can also streamline recruiting processes and help provide more comprehensive analytics for employees. The hiring process is often time-consuming, complicated, and frustrating. AI allows HR executives to streamline this process through automated scheduling, ongoing feedback to candidates, and real-time answers. AI also removes unconscious bias from the recruiting process by presenting managers with candidates who may have been initially screened out of the process due to the human tendency to favor similar characteristics.
Continued learning and development is important to most employees. In a recent survey, 44% of respondents revealed that they need to continue to update their skills to do their jobs effectively, while 90% recognize the need to update their skills at least annually. Learning management systems (LMSs) are a great place to start. LMSs allow for continued learning using comprehensive online modules. Other systems have begun to implement more high-tech options as well.
For example, many have started utilizing VR as part of their employee training programs. Employees can use VR to practice challenging tasks in a safe space or even gain experience working with particular equipment in a virtual manner. Gamification has also become a widely used tool in the workplace. This is most likely because gamification elements allow for friendly competition among employees, giving them an incentive that often leads to higher engagement.
It's no secret that HR is experiencing shifts in technology capabilities. From VR and gamification to advanced levels of cloud computing to automate mundane tasks, the benefits far outweigh the risks. Not only does HR technology provide the ability to cut costs and streamline processes, but it also helps produce more skilled and productive employees.
Matt Thomas is the President of Indianapolis-based WorkSmart Systems, Inc., which he founded in 1998. He is active with the National Association of Professional Employer Organizations (NAPEO), and has dedicated more than 20 years to the PEO industry dating back to his early career with industry leaders ADP and NovaCare Employee Services.
Matt's depth of experience proffers a unique vision for the future of WorkSmart Systems and the PEO industry. An unwavering belief in judicious client selection and superior client service is the foundation of Matt's business philosophy. He is committed to continuing the growth and development of the solid client base upon which WorkSmart's success is built.


Two weeks ago an opportunity came my way to do some camera trapping at the Cape Flats Nature Reserve at the UWC (University of the Western Cape). It is a (very) small reserve about 6 km from my house, in the opposite direction as Tygerberg.
 All of my cameras are currently occupied at Tygerberg so I decided to bring my Moultrie out of retirement. I bought some fresh batteries and set it up. Unfortunately nothing was photographed the first week. I moved the camera to a new spot, but the batteries where already starting to run low. On day two at the new location I got a Cape Francolin passing by.
 I was fortunate enough to see this Cape Dwarf Chameleon two weeks ago when I went to set up the camera. These little guys are incredibly charming and very pretty. It was my first time seeing one in the wild.
As a person that loves the herps, that chameleon is epic!
My first cam, a 3 year old Moultrie, is still hanging on, but you put yours through much harder work.
More mongooses would be good.
Hi Henry, thanks for posting the first remote photo taken in the Cape Flats Nature Reserve. Not a bad shot all things considered. I will enquire about getting a remote camera for the reserve and will use this as the evidence needed that it is potantially useful. Best to continue your success at Tygerberg.


Maplewood is a quaint town just minutes from your Third & Valley apartment. Along with restaurants and shops you'll find fun activities such as an art studio where you can sip wine and make your own pottery and paintings on canvas.
Every Thursday from 7:00pm – 9:00pm, Express Yourself Studios located at 1877 Springfield Avenue in Maplewood will host Cocktails & Canvas. Cocktails & Canvas is great for group workshops, private parties, a girl's night out gathering, bachelorette parties and date nights.
The cost is $40 per person and you'll receive materials and supplies. Just bring a bottle of wine (or favorite beverage) and explore your creative side with your favorite people! If you are going with a group of 4 or more you can get a group rate of $35 per person.
Express Yourself Studios is an art studio and art gallery dedicated to being an outlet for children and adults to express themselves creatively via classes in the arts. The Studio offers Pinot & Pottery (Wednesdays 7pm-9pm), Cocktails & Canvas (Thursday – Saturday 7pm-9pm), Coffee & Canvas (Sundays 3pm-5pm), and Wine Glass Painting Workshops (Sundays 1pm-3pm) for adults and weekly Art Classes and a Summer Art Workshop for children.


Our first step is to be able to play the Am Pentatonic all over the fret board, with an understanding of where the additional notes are so that we can use them at will.
Even though you can change scales to match the change of chord it is better, if you want to set yourself up to be a good player learn, to sing the notes so that when you change chord you know what you want to play rather than just playing a new position. This will make a big difference.
By singing the melody you play, you will automatically be phasing the solo, rather than running through your positions. You will be making melodic statements that people will hear and notice. Practice by singing the Pentatonic scale and then adding the additional notes. It does not matter if you can sing or pitch the notes it's the intention of pushing the notes into a musical form that is important.


John Terry is a man of contradictions. A true leader on the pitch, he has often been just as divisive off it.
Controversy has followed Terry throughout his career, from allegations of extra-martial affairs, through drunken and boorish behaviour all the way to a highly damaging incident of racial abuse towards his England colleague Rio Ferdinand.
When the discussion reverts to football, however, Terry's record is virtually exemplary.
A one-club man, he has more than 400 league games under his belt for Chelsea, a significant proportion of which have been as captain. A further 78 caps (again, with many as captain) for England is testament to his exceptional ability as a defender.
Often under-rated for his all-round footballing ability, Terry is two-footed, quick witted and a formidable foe who sees putting his body on the line as a natural part of the defender's art. Throw in outstanding aerial prowess and the happy knack of scoring crucial goals and Terry is rightly regarded as one of the best defenders of his generation in both the Premiership and across the world.


Oxford Film Festival Take 5 With...: Take 5 with "Streets of Plenty"
Take 5 with "Streets of Plenty"
Corey Ogilvie's "Streets of Plenty" screens Friday, Feb. 5 at 5:30 p.m. and Saturday, Feb. 6 at 1 p.m.
CO: Ever want to try homelessness? For 30 days, we did.
CO: Biggest Lesson: all people want to share their story, its just how you ask about it. Best Part: finishing.
CO: I, Corey Ogilvie (co-director) directs factual and dramatic film, of all lengths. "Think Peace" (2008) was his first feature documentary, which premiered at the 2008 Queens International FIlm Festival. Alex Kleider (co-director) graduated Vancouver Film School's animation program, and this film has been his first project. He and his brother Misha Kleider conceptualized the film.
OFF:: What's your dream distribution plan for the film?
CO: We hope to get distribution of any type, so people can see the state of things in Vancouver.
CO: Focusing more on short form projects, both factual and dramatic... currently polishing up a Director's Guild of Canada kickstart short-film editing project. The whole point is to improve with each project.


For your guests to return!
A large part of the assortment is available immediately, while the rest can be provided in a very short time. The quality and design, terms of delivery, professional relationship with our customers as well as a product price range are the main reasons to choose CasaBianca HoReCa to be your partner.


Intui is pleased to present a promotion for webmasters. Great opportunity to earn a commission and an impressive +100$ bonus!
For partners of the Intui affiliate network, a new feature has become available: now you can upload your company logo and it will be on vouchers for transfers from Intui.
Intui now has one more country on the map of transfer routes. Meet the Seychelles!
Intui.travel transfer is in a hurry to please travel agencies, webmasters and publishers with a new, hot special offer!
Great news: Intui will take part as an exhibitor in the 53rd International Tourism Exhibition ITB Berlin 2019.
Dear partners and friends, please accept our sincere wishes for the upcoming holydays.
We are happy to present you the new method for partners working via API wide Intui - GEO - GEO.
Intui is pleased to announce the inclusion of new payment methods for even more convenient booking services.
Knowledge of the client's language is crucial to success in the travel segment.
Intui is customer-oriented and agree that it is required to speak the language of the customers in order to earn their trust and love.
The summer may be over, but that does not mean that your clients missed their chance to explore new directions.
Intui.travel transfer has expanded its inventory: now the partners working on API are available 7 languages.
Intui is going to take part in ITB China in Shanghai 16 - 18 May 2018.
Intui has expanded the service with a new feature: now if the flight is delayed for any reason, the driver expects the customer up to 2 hours from the time of arrival initially provided in the booking, without additional charges.
Intui participated in the 52nd International Tourism Exhibition ITB Berlin 2018, which is considered to be the most important event in the industry, and, according to most experts, it reflects the most significant trends in tourism around the world.
Very soon the spring school holidays, and hence - an excellent occasion for a family holiday! In this regard, the question arises among many who are interested in going to all from small to large. Today we have gathered the most popular amusement parks from around the world and made sure that your tourists can reach easily and quickly them from the nearest transport hub on a special Intui.travel transfer.
In the modern world, tourists are no longer attracted by well-fed Turkish beaches or friendly Italian, now the exotic rules the mood.
Experienced travelers increasingly choose tropical forests with magical butterflies on the island of Mauritius or medieval buildings and small streets of Morocco with colorful bazaars for their new discoveries.
because we have something hot for you - transfers for your tourists in the countries of Asia.
Intui launched a new partner account function "Payment from the balance"
Intui implemented a payment function to the balance with the partner account.
The partner's balance of payments is formed from two sources of income: the accrued commission for reservations and money transfers for its replenishment.
On the advantages of using the new function, read in our article.
New from Intui: FLEXI and STANDARD fares. What is it and what it is eaten with?
Intui.travel transfer strives to improve both for customers and partners.
We have taken into account your numerous wishes and present to you Flexi and Standard fares.
360 km of ski runs or 12 black and 37 red? Known and noisy or cozy and secluded?
With offers of personal transfers from airports to ski resorts, on Intui Travel, you can now choose any place for your client's rest: from the airport to the mountains, to the resort, you can comfortably, even with equipment and children! Booking special transfers for skiers is opened now: personal transfers by car, equipped for skis and snowboards transportation, are ready to be booked.
A year after launching the instrument called White Label Intui® was installed by 300 new partners who have built booking transfers under their own brands in their sales.
White Label is set up as a transfer booking system on partners' websites under their own logo for customers to book a transfer online as an additional service that brings 5%-9% commission to a partner.
Now your clients can start to spend time on vacation interestingly already from the airport threshold.
An entertaining unusual trip on tuk-tuk is not only unforgettable and fascinating, but also comfortable as all transfers on Intui Travel.
Popular summer destinations from Intui.travel transfer - "hot" travel offers for your clients.
It's July already - summer is boiling! We are glad to announce new offers of personal transfers for comfortable trip of your customers, as well as remind you about our cool features and give you some useful tips for transfers booking from Intui.travel transfer.
We always improve our services for you to make it more convenient with lots of useful features.
By popular demand, we added a new "Users" tab - with huge opportunities. You have a lot of managers, accounts and you want to differentiate access, while you want to reserve the financial part and details, and reserve transfers for your agents / managers, see consolidated reservations, + IT specialists give an important technical component.
New destinations added to the transfer map of Intui.travel transfer - best vacation offers of summer with attractive prices for your clients.
Summer is already in full swing and every day Intui.travel adds new routes of personal transfers for a good travel or well-organized business trip for your customers. Many transfer routes are added from the airports of Istanbul, Athenes, Crete Heraklion, Milan Malpensa.
We constantly improve our service for you to make it more convenient with many useful functions.
By numerous requests, Intui.travel transfer system added new options and features.
We are happy to announce a new option on the Search pages for the desired transfer, as well as its further booking at Intui.travel system. Now for a booked trip, there is an opportunity to add additional hours to the main trip for you and your customers.
Month of May is already on its way and every day Intui.travel adds new routes of personal transfers for a good travel or well-organized business trip for your customers. A variety of transfer routes have been added from the airports of Antalya, Hurghada, Milan Malpensa, Paris Charles de Gaulle.
Intui.travel participated as an axhibitor at the international show Travel Technology Europe 2017, which took place in London from 22nd to 23rd of February. At the TTE 2017 exhibition, Intui presented the latest release of our White label Customizable kit + the capabilities of powerful Smart API Wide.
Updated Widget - simple, faster with even more new features.
Widget from Intui.travel - easy way to redirect the user directly on the landing page. The widget can be customized completely to your taste. It is a completely new two-level type + with a new search engine!
New Widget works lightning fast - it just "flying", it shows / tells and it's loading instantly! Working with it is now even more convenient, faster and more efficient.
Welcome to our stand № T84.
Economy Shuttle from Munich Airport. New choice of transfers to ski resorts for your customers.
Choose the most suitable travel option for your customers at the lowest price with Intui.travel transfer.
White Label - customizable kit with settings & many new features in your Personal Account.
Now White Label can be customized with the color of your site and all the color settings can be made in your Personal account. Other features are available as well, you can make testings with the resolution - zoom in, zoom out and immediately see how White Label looks like in different colors.
Pick any favourite color themes that suit your site so the combintation could look more attractive and enjoyable for viewing offers by your customers.
Intui.travel's adaptive white label of booking private transfers is ready for set-up on your site.
Completely new interface of search and booking Transfer is created for all devices. Everything is adaptive - search form and payment form. Desktop, tablets, smartphones - adaptive white label is usable for any devices.
Special conditions: "Install white label and get iframe 6% of remuneration instead 5%"
New features of the Search & Booking page from Intui.travel. Find out right now, what are the new possibilities and features we prepared for you and your clients.
We know how valuable your time is and we are constantly improving our website to make more convenient, fast and up-to-date.
Statistics. Benefits and practical solutions with API Wide of Intui for dynamic packaging.
Dalaman in Turkey, Еkaterinburg in Russia, Aruba and Azores are added to the transfer's map of Intui.travel. Private transfers are available for booking from 9 airports and 5 sea ports of Turkey. Comfortable car, selected while booking, will take you to any resort or coast of Turkey.
New routes are added to the nearest and distant cities of Ural from Koltsovo Airport Ekaterinburg.
Recessed / Embedded white label https://partner.intui.travel/en/news_en/iframe_new_features/ allows to output transfers booking on your subdomain and under your label. It fully allows to use the interface of Intui.travel transfers booking - you do not need to invest in the development of the webpages. Only from 10 minutes to 1 hour - that is all you will need to install an white label on your site.
Deep links from our API light are targeting offers of transfers. Using API light recommendations, you can create deep links in a relevant way to any content.
Solution with white label + deep link https://partner.intui.travel/en/news_en/iframe_new_features/ allows user to stay on your domain! Your customer makes a booking of transfers on your site.
Review, edit, cancel, print out voucher with or without price and make new ones just in one click - all of that created for agencies at Intui.travel.
In Miami, in cities of Croatia, Armenia, Kazakhstan, Cambodia you can book a transfer from airport to hotel, to villa or sea port!
In recent months we have received from you a lot of letters with requests and suggestions for improvement of our affiliate program. We assure you that none of them did not go unnoticed! We present our innovations in API version Light, available to each of our partner after the registration in the Affiliate Program.
33 cities for a day - this is the rate of addition of new routes of transfers.
Intui.travel held a presentation of their services in the largest international tourist exhibition ITB 2016, which was held in Berlin from 9 to 13 March in a large fairgrounds of Messe Berlin.
We wish you achieve new heights in tourism!
We are glad to announce that Intui.travel extend the functionality of API, provided in the affiliate program. Allow your visitors to search, book, edit and cancel transfers directly to your site!
News routes and winter season with Intui.travel!
122 countries are now available for booking transfers on Intui.travel, including Georgia!
122 countries (with the addition of routes in Georgia) now available for booking comfortable transfers on Intui.travel. Your client will be met and transferred from the airport by the chosen car. In Georgia, now available for booking popular destinations - from the airports of Tbilisi, Batumi and Kutaisi.
GDS - Global Distribution System of Intui.travel, unstoppable grows. This month Intui.travel added many new carrier companies. Added thousands of new routes!
We are glad to inform you that we added many new routes of Russia to the Intui.travel transfers. In addition, list of proposals on the existing European destinations also was expanded.
We'll tell you about the benefits of transfers from Intui.travel and how to use them to increase your conversions and revenue.
New landing page for our partners!
We added a new template for the landing page of the airport.
The reservation system Intui.travel now has the ability to edit the details of the transfer. Editing free, available in two languages. Data processing is performed automatically.
API – the interface of the program or service, allows you to perform any of the pre-defined functions in it. It's very convenient to integrate the software with one another, using API.
Affiliate Program to earn money by on-line sales of a transfer service. High Commission. Accounting for orders within 35 days after the last transition.
Added new animated banners for season "Spring-Summer"!


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Q: How to modify anchor's behavior (href/onclick()) after page that uses Vue has been rendered TL;DR
I need to change the URL of an anchor. The anchor has the __vue__ property. Simply modifying the href attribute of the anchor is not changing the behavior when clicking on it. Using vanilla Javascript, how can I change the anchor in Vue so that the anchor points to where I need it to point? (I only have access to the DOM since this is a 3rd party CMS that I can't control).
More details
I'm using a CMS service that allows to load custom Javascript in the <head> section of page.
The rendered website has multiple anchors pointing to different URLs each.
I want to change the URL for one of the elements.
I've tried doing:
els = document.querySelectorAll('a[href*="/here"]');
els.forEach((el) => {
  el.href="/elsewhere";
  el.onClick = (e) => {e.preventDefault()}
})

The problem is that clicking on the anchor element it still goes /here instead of /elsewhere as expected.
Upon further review, the anchor elements have the __vue__ property, suggesting these were created and are managed by Vue.js.
How can I use vanilla Javascript to modify the href of these anchors and update Vue.js on where the link is pointing ?
For what its worth, here's a screenshot of <a/> tag I see in the browser whose href I want to modify:

redpajama_set_name: RedPajamaStackExchange


Editorial: Is Evangelism a Gift or Duty?
Read more about Editorial: Is Evangelism a Gift or Duty?
Members of the Seventh-day Adventist Church in the United States, Canada, Bermuda, Guam and Micronesia are currently participating in Pray One Million. This spiritual initiative is a wake-up call for leaders at all the levels of the church and for every single member of the family of God.
Adventist Education: It's Worth it All!
Read more about Adventist Education: It's Worth it All!
Read more about Give Thanks All Year!


Children's Scholarship Fund Philadelphia (CSFP) is a privately-funded program whose mission is to provide children from low-income Philadelphia families with financial access to quality, safe, K-8th grade, tuition-based schools, thereby increasing their long-term economic and social success. CSFP grants need-based scholarships to children from low-income Philadelphia families, all of which are awarded by random lottery.
CSFP focuses its scholarship support for low-income children in the foundational elementary and middle school years, and is the most broad-based and diverse K-8th grade scholarship program in the state.
All scholarships are need-based. In order to guarantee a fair chance for all Philadelphia children from low-income families living in Philadelphia, CSFP utilizes a blind lottery to select scholarship recipients.
Up to three children in a family may receive CSFP's 4-year scholarships, providing stability for families as they provide quality education for their children.
Families co-contribute a minimum of $500 towards their child(ren)'s tuition annually. With an average household income of just $29,000, this demonstrates the commitment CSFP parents make to their child's education.
Would you recommend Children's Scholarship Fund Philadelphia?


This Universal oil input adapter has 18mm -1.5 thread and a 2-5/8" standard O-Ring. This adapter provides one 1/2" N.P.T. oil input port before filtration. The adapter mounts between the oil filter and block, lowering your filter 1-1/4".


text:
From SxS: Mercury in Aries
Mercury in Aries.
Mercury moves into Aries early this morning. Mercury itself is the metaphor for one's use of intellectual energy, abilities in logic and reasoning, and communications skills. When Mercury is in Aries, ideas are ambitious, assertive, and enthusiastic. Thinking shows a strong capacity for independence, initiative, competitiveness, and pioneering spirit. This energy is known for being adventurous, courageous, direct and dynamic.
There may be a very obvious emphasis on winning and dominating. People feel very strongly about their ideas and viewpoints ... and will vigorously push their opinions, often without caring whether those are welcome or not. They may call this "communicating," which it is, technically, . . . but they're really most concerned with "getting their own points across." Accordingly, styles of speaking and writing may be blunt, self-assured, domineering and contentious.
Basic Stuff About Mercury ---> About Mercury ---> * Mercury occupies the innermost orbit of any other planet in our Solar System. Relative to Earth it is located on the other side of Venus. Mercury is the planet closest to the Sun. * Mercury moves completely through the Zodiac in about a year, but his progression through the signs is very irregular. He goes into retrograde three to four times a year. When he's traveling direct, he stays in a sign about two weeks. But when his retrograde cycle kicks in, he can be in a sign for over two months.
* Mercury in General -- Your Inner Selves of Learning and Work ---> Learning stuff, using your mind and putting it to work ---> Like Venus, your Mercury energy describes two inner selves. One manages your mind and all its talents; the other is in charge of the work you do ... the ways you use your skills and abilities to help others and build the kind of life your want for yourself. Again, as with Venus, these are usually reduced to the basic categories of "mind" and "work," but they also include whole subdivisions of behavior and talents.
* What Does Mercury Represent -- in Your Natal Chart? -- What is it ... and why is it important? ---> In mythology, Mercury was the winged messenger of the Gods. ---> Your mind -- at work and play ---> In Astrology, Mercury represents your conscious, rational mind. It tells a lot about your intellectual self; your ability to study, learn, analyze, communicate and work with information.
Photo courtesy of www.flickr.com/photos/70626035@N00/14201952406/
If You Had Controlling Parents: How to Make Peace with Your Past and Take Your Place in the World
Dan Neuharth

redpajama_set_name: RedPajamaCommonCrawl


text:
SWISS EPRIX MARKS CHALLENGING WEEKEND FOR PAFFETT
Gary Paffett and the FIA Formula E grid headed to Bern, Switzerland last weekend for the penultimate race weekend of the 2018/19 season, where a puncture thwarted Gary's race and challenge for points.
The two-time DTM champion found himself struggling at the 2.7-kilometre Bern city-centre track layout. In qualifying, HWA RACELAB and Gary were already struggling for pace and as a result, Gary had to settle for a 16th place starting position for the afternoon's race.
When the Swiss E-Prix got underway, it wasn't long until the race was red flagged when a multi-car pile up at the first chicane, just seconds into the opening lap, saw the race halted for 35-minutes.
At the restart, it was deemed that the safety car would lead the field, with Gary in 15th place when green flag racing got underway again.
Gary continued to lap in 15th position, until a mistake meant that he made contact with the crash barriers. Now bearing a puncture, Gary was forced to pit to repair the damage. This set-back cost Gary a lot of time, and from there he was in a race of his own, eventually crossing the line in 18th place. Due to a post-race penalty for a competitor, Gary's result was promoted to 17th.
"That was a very tough race," Gary said post-race. "The position was not bad after the re-start, but it is relatively difficult to overtake here. I tried to stay in touch, but picked up a puncture on the wall and had to come into the pits. I am disappointed with my mistake. We wanted to score points today, but unfortunately, that was not to be."
Formula E will head to America for the season's double-header finale in New York on July 13-14, where Gary will be hoping to finish his maiden Formula E campaign on a high note.
DISAPPOINTING END TO THE KYALAMI 9 HOUR FOR GARY PAFFETT
GARY PAFFETT SET FOR SOUTH AFRICA SHOWDOWN
PAFFETT CHOSEN AS SPORTING AND TECHNICAL ADVISOR TO THE MERCEDES-BENZ EQ FORMULA E TEAM


A lot of us know this already, and yet, people are still using resumes – largely because nobody's too clear on what should replace them. Social media? Videos? Contests? All of these have been mentioned as substitutes, but they're all kind of half-baked and only tell a partial story.
Instead, I suggest that companies rely more on third-party feedback – in essence, the candidate's online reputation – and focus on hiring doers, not tellers.
If your company still relies on resumes to screen people, you're almost certainly overlooking some of the best candidates whose resumes, for whatever reason, aren't quite right. Maybe they didn't put the right keyword in. Maybe they didn't go to the right college or take the right major, but they've still got the skills you need.
If you rely on resumes, you're also making yourself vulnerable to exploitation by unscrupulous people who lie on their resumes – or simply stretch the truth a bit.
Resumes say what a candidate can do, but "saying" isn't the same as "showing." Furthermore, saying something self-promotional is definitely not the same as having a validated third party – someone who knows the candidate's work – vouch for the candidate's skills. For these reasons, resumes are increasingly unimportant, and the sooner you move beyond them, the better.
Instead, you should focus on what really matters: What people can actually do and their reputations based on feedback from others who have worked with them, particularly when they are available online and are based on real, paid work.
Here's a simple example of how online reputations are changing hiring approaches today. If you're looking for a plumber, you probably aren't going to request their C.V. You're going to look on a site like Angie's List, where you can read reviews from actual customers.
Similarly, if you're looking to hire a developer, their resume is less important than their work history. You can see a lot of a developer's work history on code repositories like GitHub and Stack Overflow. But sometimes developers do a lot of work for personal projects or open-source projects, filling up their GitHub profiles with large volumes of work that isn't actually vetted (and may not even be used by anyone).
Instead, you want to see what kind of work they've done for paying clients or employers and how well that work was received.
There's another problem with the public repositories like GitHub and StackOverflow: They are incredibly unfair to people who can't afford the luxury of spending a lot of time on unpaid side projects. If you have to work for a living, you may not be able to spend hours contributing to the Linux kernel or an open-source emoji-sharing platform. Your paid work needs to speak for itself.
Just as startups shouldn't spend too much time perfecting business plans or making their websites pretty before they've made minimum viable products and found some people actually willing to pay for them, individuals shouldn't spend too much time gussying up their work histories. Instead, they should identify the talents and skills they have that employers or clients want and then prove that they have those skills in the marketplace by getting someone to pay for it.
For recent college graduates, validated references and portfolios of work can help offset the age-old problem of the resume with nothing on it. In fact, universities could even help their students build portfolios of paid work by offering credit to students who undertake educational but practical projects, get paid for them, and get positive feedback from real clients.
Instead of an internship of dubious quality, what if an aspiring software engineer spent 100 hours doing paid coding work and got real, meaningful feedback on it?
Recommendations matter, particularly if they come from people you know. Some social networks are able to do this: Yelp, for instance, highlights restaurant reviews from people you're connected to, which are way more valuable than reviews from random strangers who, for all you know, never even visited the restaurants they're reviewing.
Similarly, LinkedIn's professional skill endorsements carry little weight. It's not very meaningful when someone sees an automated suggestion and clicks a button to "endorse" a person for a random skill. The fact that a candidate has 57 "endorsements" on LinkedIn for a particular skill from people you don't know is pretty close to worthless. But a written recommendation on LinkedIn from someone you know and trust is incredibly valuable, because it comes from a legitimate human being who took the trouble to write a few words in favor of a candidate.
Once you've gone past the screening phase, there's another part of the hiring process I'd like to phase out: The interview. Like resumes, interviews favor candidates who are good at telling their own stories. If you ask candidates to describe a challenge they faced and how they solved the problem, you'll probably wind up hiring those who tell the best tales. In my experience, that doesn't always correlate with doing good work.
Instead, give the most promising people an actual assignment and see how they do when they're performing real work for an hour, a day, a week, or a month. You can pay them for the test project, especially if it requires any significant amount of time. There's no better way to find out if someone is a good fit for your organization than by putting them to work and asking them to contribute.
In short, it's time to stop hiring people based on what they say they can do. You should be hiring doers, not tellers. Moving beyond the resume is a critical first step in doing so.
As CEO of Upwork, Stephane Kasriel is driving the company's vision of connecting businesses with talent faster than ever. The company is headquartered in Mountain View, Calif., with offices in San Francisco and Oslo, Norway.


text:
Le compte d'affectation spéciale développement agricole et rural (CASDAR) a été créé par la loi  du 30 décembre 2005, loi de finances pour 2006. Le CASDAR a pour objet de financer les actions de développement agricole et rural telles que définies par les articles L.820-1 à 3 et R.822-1 du code rural et de la pêche maritime et selon les priorités fixées par le PNDAR.

Historique
De 1966 jusqu'en 2002, le développement agricole est financé par un Fonds national de développement agricole (FNDA) géré par l'Association nationale pour le développement agricole (ANDA). Ce fonds est alimenté par une dizaine de taxes parafiscales par filière sur les produits agricoles. L'ANDA est une structure de droit privé, cogérée par les pouvoirs publics et la profession agricole.
La loi de finances rectificative de 2002, crée un établissement public, l'Agence du développement agricole et rural (ADAR) qui succède à l'ANDA.

En 2006, l'Etat décide de faire gérer les fonds publics directement par ses services.

Financement
Depuis l'année 2015, le CASDAR reçoit en recettes 100 %, contre 85 % jusqu'en 2014 inclus, du produit de la taxe sur le chiffre d'affaires des exploitants agricoles. Ces produits s'élèvent entre 130 et  d'euros entre 2015 et 2018, avec une variation liée à la variabilité du chiffre d'affaires des exploitations agricoles et financent deux programmes à parts égales : le programme 775 relatif au développement et transfert en agriculture et le programme 776 relatif à la recherche appliquée et l'innovation en agriculture.

Fonctionnement
Deux directions du ministère de l'Agriculture sont chargées de l'orientation et de la gestion du CASDAR : il s'agit de la direction générale de l'enseignement et de la recherche (DGER) et de la direction générale de la performance économique et environnementale des entreprises (DGPE).

La DGER est responsable d'un programme concernant la recherche appliquée et innovation en agriculture (programme 776), relatif aux instituts techniques agricoles (ITA) qualifiés ainsi que les appels à projets.

La DGPE est responsable d'un programme concernant le développement et le transfert en agriculture (programme 775) relatif aux chambres d'agriculture, à Coop de France et aux autres organismes nationaux à vocation agricole et rurale (ONVAR).

Notes et références

Agriculture

redpajama_set_name: RedPajamaWikipedia


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Okay, guys! I'm slightly stressing out this week becauuuuse....we're hosting our first Thanksgiving dinner this week - says the girl that's never cooked a Turkey ever. :) Brian's family is coming into town for a fun & crazy Zurcher Thanksgiving! As I've grocery shopping and putting together our menu, I came across a few of my favorite recipes. Like, the best rolls recipe (seriously!), pumpkin cookies, and the best apple cinnamon swirl cake that's perfect for dessert, or if you're like me, breakfast! :) I've linked to the recipes below. HAPPY THANKSGIVING!
Pumpkin Bread & Free Printable Tag!
Those oreo balls look so cute!! Also, I'm always down for a pumpkin chocolate chip cookie. I may have to try the frosted ones out!


text:
Essays & Memoir
Granta Books
Gilles Peress's 'Compulsory Departures' depicts Muslim refugees fleeing Serbian troops in Banja Luka in Bosnia. The photographs were included in Farewell to Bosnia, published in 1994 by Scalo. They have also been included in an exhibition organized by the Corcoran Gallery of Art in Washington DC and the Fotomuseum Winterhur in Switzerland that is the second part of his ongoing project 'Hate Thy Brother': a cycle of documentary stories describing intolerance and the re-emergence of nationalism in post-war Europe. The project has been supported by the Fondation de France.
Eye For An Eye: A Chronicle of Northern Ireland (Part One)
Nan Richardson & Gilles Peress
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text:
Mixamo Aims to "Democratize" Motion Capture, Keep Dots Off People's Faces
by Eric Johnson
If you've seen "Avatar," Peter Jackson's "Lord of the Rings"/"Hobbit" movies, or "The Polar Express," you've seen motion capture in action. It's the technology that makes it possible, for example, to translate Andy Serkis's real-life motion into the CGI character Caesar in the underrated film "Rise of the Planet of the Apes," pictured at right.
But as that picture shows, motion capture for movies — as well as for videogames like 2011's L.A. Noire — requires some specialized equipment. Most of the time, that means both special cameras and preperformance prep for mo-cap actors like Serkis, who wear tracking dots or other markers to tell computers where and how their faces and bodies are moving.
Animation startup Mixamo is releasing a tool this week that does away with the dots and aims to turn anyone's facial expressions and eye movement into 3-D character animation in real time.
The tool is called Face Plus, and it will be packaged along with the other 3-D character modeling and animation tools in Mixamo's "all access" package, which it licenses to animators and game developers for $1,500 per year. The notion is that those professionals may want to put together animated shorts or cutscenes for games without bringing in actors or otherwise leaving their workstation, so Face Plus is advertised to work with any Webcam on any computer.
"The actor can be the developer," Mixamo CEO Stefano Corazza said in an interview.
Face Plus is designed to work alongside the game engine Unity (the two companies have been partners for years), and Mixamo's announcement was timed to the Unite conference happening this week in Seattle. During the Unite keynote, CTO Joachim Ante played a portion of the following animated short, made by Mixamo inside of Unity:
Face Plus will be accessible through Mixamo's plugins for Unity and will also include access to a video editor for the clips of facial animation users record. I visited Mixamo's office in San Francisco earlier this week, and got a quick demo of Face Plus with Corazza:
As you can see, the demo was not quite L.A. Noire-perfect, but it's impressive how well it worked, given that I started recording just a few seconds after Corazza sat down. I then took his place and had similar results animating the "Battery Boy" character's face. It was especially fun when Corazza tinkered with the sensitivity of the software, making the Battery Boy's "reactions" to our expressions frighteningly over-the-top or adorably subtle.
For users with simpler needs, Corazza said, the animations recorded by Face Plus may be good to go as soon as they're recorded. However, he acknowledged that, as with other forms of animation, the devil's in the details, and pros will want to go in to fix the subtler things. Face Plus, he said, gets those pros "80 or 90 percent of the way there."
Return to: Mixamo Aims to "Democratize" Motion Capture, Keep Dots Off People's Faces
URL: http://allthingsd.com/20130828/mixamo-aims-to-democratize-motion-capture-keep-dots-off-peoples-faces/
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Another offer has been extended to a player that took part in the Pitt prospect camp.
2019 athlete Khadry Jackson from Windermere Prep School in Orlando, Florida is the latest player to receive an offer from Pitt.
Jackson (6-2, 200) plays safety in high school but is being recruited by Pitt to play linebacker. Currently, he holds offers from Iowa State, Maryland, Missouri, Nebraska, NC State, Rutgers, South Florida and Central Florida.
The fact that he received this offer didn't come as a surprise to Jackson.
That all happened yesterday as Jackson received the news from Pat Narduzzi.
Prior to the visit, Jackson was getting educated on Pitt football and the city of Pittsburgh from one of his assistant coaches, former Panther and NFL lineman Mike McGlynn.
Jackson must have enjoyed his visit yesterday because this morning he exclusively told Pittsburgh Sports Now that he will be returning to Pittsburgh this coming weekend to make his official visit.