4 In the initial phase a nurse coordinator will filter SMART’s alerts and recommendations, but the ultimate goal is to have SMART send alerts directly to the most appropriate provider. Appropriateness will be determined by a combination of location, availability, and importance of the alert. For potential cardiac arrest as in the scenario, location would have a high weight, while in a less severe situation availability might have a high weight. SMART will be designed to avoid alerting unnecessarily large numbers of providers for a given case. If a provider does not respond (or the location system determines that he or she is not moving toward the patient) within a defined amount of time, the next most appropriate provider will be called, and if this one responds and reaches the scene, the first one is notified and his alert is canceled. In case the second most appropriate provider does not respond, the third most appropriate will be alerted, and so on. The system may make calls such that the code team is alerted via the hospital overhead paging system in case there are no ED providers nearby.
5 See subcontract Technical Proposal for more details on location devices and tags.