Jun 15, 2010While many RFID systems require weeks or months of installing hardware around a building, running cable through ceilings or walls to connect a permanent reader infrastructure, Hartford Medical Group is utilizing a system that installs in a matter of hours, and can be uninstalled even more quickly. In fact, the company reports, mobility is the whole point.
Hartford Medical Group, a member of the Hartford Health Care Corp, is using a real-time location system (RTLS) designed by Queralt to be employed on a temporary basis. The system uses RFID readers and infrared (IR) emitters (called signposts), as well as hybrid IR/RFID battery-powered RFID tags, manufactured by RF Code. The readers and signposts are applied with Velcro fasteners, and will be moved from one health-care office to another, to provide Hartford with a baseline of analytic data regarding each center's efficiencies before it installs a new electronic medical record (EMR) system at that location, as well as afterwards.
Buying a small of quantity of readers and other RTLS hardware that can easily be moved to any of its 16 health-care sites was the most efficient option for Hartford, which wanted to collect data on a temporary basis at each location, explains David Stec, president of Vizibility, Hartford Medical's process-improvement consultant. Beginning this week, Queralt is installing the system at the group's facility in West Hartford, to measure efficiency in existing business processes. Each staff member there will wear an active IR/RFID tag that will transmit its location to a back-end system, while patients will carry clipboards with RFID tags attached to them. Information regarding time spent by patients and employees in examination rooms, waiting rooms, offices and the lab will be collected on a software server provided by Queralt. Three weeks later, Queralt will remove the system and install it at another of the group's sites, while the EMR system is being implemented in West Hartford. Once the West Hartford workers have had a chance to become familiar with the EMR system, Queralt will re-install the RTLS tags, signposts and readers there in order to measure the impact that the EMR system is having on the staff. After several weeks, the firm will then move the RTLS to another Hartford Medical facility.
Hartford Medical maintains 16 outpatient medical services offices throughout Connecticut, with a total of 38 physicians on staff. The largest, located in West Hartford, has six doctors and three assistants, and serves up to 120 patients daily. While staff members have, until now, managed medical charts, prescriptions, diagnoses and lab results on paper, the health-care provider intends to install an EMR system for every one of its facilities, in order to increase accuracy and efficiency by reducing the time spent searching for folders or other handwritten or printed information about patients. The company wants to gauge how beneficial the system is, one site at a time, to determine whether physicians are adapting to the new system, and if it is, indeed, saving them time. It also wants to know if some physicians seem to require additional training to use the system properly. In addition, the firm hopes to gain an overall understanding of its operations, determine where bottlenecks may exist and how long patients wait for service, and identify other efficiencies.
"With RFID, we hope to track time and motion," Stec states. "We're trying to become more efficient, but we didn't have an efficient way to track the process." If each center had measured efficiency by manually recording the time each patient or staff member spent in a particular location, he notes, the cost and time expended would be too great. By using RFID, he says, Hartford can automatically collect and measure data regarding bottlenecks and delays in each center's operations. The system will also help the firm compare the pre- and post-EMR processes.
This week, Queralt began installing the system throughout the West Hartford medical center. To identify the rooms, Queralt installed A750 signposts. Each signpost transmits an RF signal encoded with a unique ID number linked in a database with the location in which that emitter was installed (there are a total of 35 IR signposts for the examination rooms, waiting rooms and physicians' offices, as well as two readers). Each RF Code tag has a built-in IR sensor and an RFID chip and antenna. The IR sensor receives signals from the A750 signpost in the room in which the tag is located, and the tag then transmits a 433 MHz signal encoded with its own unique ID number, along with that of the IR emitter, to the two battery-powered RFID readers installed in the hallway. No signposts were installed in the hallway, however, so if the tag is in that area, it will transmit only its RFID number (without a signpost ID number) to the readers. The readers then forward that data to the back-end server using a Wi-Fi broadband card. If the tag is emitting only its own RFID number, the system knows the tag is in the hallway, while if it includes the IR signpost data, that additional information is used by the Queralt software to determine in which room the tag is located.
Hartford 's April pilot tracked several staff members and patients, in up to four exam rooms. That three-week pilot generated data that is already proving to be useful for the center, Stec says. By providing an RFID-enabled clipboard to each patient and instructing that individual to carry the clipboard with him or her throughout the visit, Hartford Medical was able to determine, for instance, how long patients spent in the waiting area, one of four treatment rooms, or a doctor's office. The firm could also measure how long a doctor spent at each location, and how much time was spent with the patient. Initially, Stec notes, the data showed that, on average, 40 percent of a doctor's time is spent in examination rooms. Therefore, the company intends to further study how the remaining 60 percent is occupied, and whether there is a way to improve efficiency by increasing the percentage of time spent with patients. That research, however, will not require the RFID/IR system, Stec says, since while the system can provide data indicating a doctor's location, it does not indicate what he or she is doing, for example, when not in the examination room.
By measuring the time doctors spend with patients, in their office, or elsewhere before and after the EMR system's installation, the center also hopes to gain insight into which physicians may be spending more time adjusting to inputting data into the EMR system, and less time with patients, as well as whether, as a whole, staff and physician efficiency increases with the new electronic data system.
Once the project is complete, in approximately one year, Hartford Medical plans to use the RTLS as needed at individual sites for further efficiency and patient-satisfaction studies.
