May 10, 2010

It’s All About Location — RTLS Establishes Line of Sight for Hospital Assets
By Annie Macios
For The Record
Vol. 22 No. 9 P. 6

Being able to find what you want the moment you want it is usually a luxury. In a healthcare facility, however, having this luxury is vital for providing care in critical situations. Appropriate line of sight on a facility’s assets also enables hospitals to maximize both their physical and employee resources in delivering healthcare in a timely, cost-effective manner. Real-time location system (RTLS) technology is one tool that can help facilities achieve this goal. But what is the best way to deploy this technology to maximize benefits while achieving a hard-dollar return on investment (ROI)?

“From our perspective, our technology is an enabler that supports the critical success factors to RTLS in a healthcare environment,” says Valerie Fritz, senior vice president of marketing at Awarepoint, whose technology is distributed by Skytron.

Fritz offers several recommendations that hospitals can follow to ensure the best RTLS implementation. “First, look at an RTLS solution that provides enterprisewide coverage,” she says, adding that facilities often make the mistake of looking only at a specific department or floor to cover with RTLS. Because assets and people move throughout an entire facility, the network must provide complete coverage for maximum long-term success.

Fritz also recommends that the system minimally provide room-level accuracy, emphasizing “room level” to mean supplying persistent location accuracy across the enterprise—even in areas that are not spatially confined by four walls. Further, she notes that sometimes when IT departments take the lead when adding RTLS, they consider leveraging their Wi-Fi network and often concede to zone-level accuracy, figuring it’s “better than nothing.” “But hospitals don’t have to sacrifice location accuracy. There are cost-effective solutions that coexist nicely with Wi-Fi without the added cost, complexity, and potential interference issues inherent in a Wi-Fi solution,” she says. “Make sure to find out what the facility’s pain points are and who the right constituents are to establish use cases and the right location accuracy.”

Fritz says it’s important to gain an understanding of what type of infrastructure is necessary to meet RTLS goals. Does the solution require cabling, wiring, or other installation disruptions? Ideally, the installation process should go unnoticed by patients and staff.

Providers “also need to understand the ongoing maintenance and calibration requirements as well. What does it mean to IT, and how can it affect the already cumbersome burden of maintaining the IT structure?” Fritz adds.

Staying Up-to-Date
Steve Miller, vice president of sales at Radiant Networks, has helped many facilities discover the benefits of RTLS and the significance of an appropriate infrastructure design. He’s learned that staying on top of technological advances can be vital.

“If you look at the baseline of most customers, typically we find they built their wireless network several years ago. The challenge is that most have designed their networks for applications that existed two or more years ago,” he says. As such, a mistake facilities will make is adding new applications on the existing infrastructure and expecting it to work without the architecture to support them.

“It’s important to take a look at the type of applications that are running. RTLS has a different design; the network needs to be designed to be ‘location ready’ and have the architecture to support it,” Miller explains.

“We see in many cases applications have grown and developed over the last few years but the networks and infrastructures were built when wireless was a secondary priority,” adds Dan Cooper, president and chief architect at Radiant Networks. By tailoring designs to support RTLS migration, it also provides facilities with the support needed for many new applications, so the capacity of the network itself is improved.

Miller says Radiant Networks has designed its system to be “vendor agnostic” to allow it to support other leading players in the wireless market. One mistake he says hospitals can make is being influenced by their vendor to add an application to a network without the certainty of knowing whether it will run as anticipated.

Performing an on-site survey or a predictive model are two ways to understand what will best suit a facility’s needs. “Healthcare is a very complex environment, with floor-to-floor issues and life-critical applications running on a facility’s network. I believe that in a complex application environment, it’s best to do an on-site survey,” says Miller.

Examining and understanding the system’s interoperability is also paramount. “Ask if the system can be used with other systems over time, as there are hundreds of applications in healthcare that can benefit from adding location awareness to enhance the value drivers,” Fritz says. “Educate yourself and understand the benefits and limitations of the technology you are looking at and what it means to your enterprise. Tracking assets is just the start; interoperability is key in maximizing long-term clinical and financial success.”

Cooper points out that RTLS applications have the potential to improve processes, workflow, and the bottom line. “One facility we worked with has more than 4,000 tags to track all of their equipment, from all their phones to COWs [computers on wheels] to laptops, among other things. And that is just one component of RTLS. So having the proper architecture in place to support various applications is paramount,” says Cooper.

Fritz says to keep in mind the business model (ie, how much the system costs up front), how scalable it is if the facility wants to add to it over time, and what ongoing training, maintenance, and client success support the vendor offers.

“If hospitals really analyze these ... things, they will have the benefit of hard-dollar ROI and an infrastructure to take them through a phased approach,” Fritz says. “Enterprise asset management is the best place for a hospital to start, but it’s just the beginning of a long list of benefits RTLS can provide.”

Financial Considerations
The biggest misconception about RTLS is the cost of deployment, according to Cooper. Previously, wireless RTLS was expensive to implement, with a system’s failure or success linked to proper design. “If you don’t get it right up front, you will continually struggle and be in remediation rather than come out of the gate ready to go,” Cooper says.

Miller notes there is a strong ROI associated with aspects such as the cost to replace missing equipment and the amount of time staff have to be pulled from their primary responsibilities to locate items. In addition, the technology can save money simply by keeping rental costs and thefts to a minimum. “At one facility, the RTLS is tracking pretty much everything, from IV pumps, wheelchairs, food carts, even medications kept in a refrigerator. We are always trying to learn about the back-end process to learn how all the tag information is being disseminated,” he says.

With most of today’s hospital IT budgets feeling the strain of a dragging economy, it is often prudent to collaborate with other areas of the facility to share the costs—and benefits—of implementing RTLS technology. Many vendors offer solutions to address budgets of all sizes with the intent of allowing the facility, over time, to migrate to full deployment. “So if a facility is on a budget, we have affordable solutions to help them enter into Wi-Fi where they can deploy A today, B next, and roll each phase into the design of the network,” says Cooper.

— Annie Macios is a freelance writer based in Doylestown, Pa.