Group Health Reinvents Patient Care With RTLS

Aug 22, 2012The Seattle-based Group Health Cooperative has created what the health-care company calls the medical center of the future, with an RFID solution supplied by real-time location system (RTLS) software provider Intelligent Insites. The solution—which employs hybrid infrared (IR) and active RFID technology from CenTrak—is being installed at the newly constructed medical center in Puyallup, Wash., and is designed to reduce patient waiting times during clinic visits, by bringing services to a patient's care room, as well as providing clinic staff members with real-time visibility into the locations and status of patients, care providers and equipment.

Group Health serves more than 625,000 members and operates 25 medical facilities in Washington State. The Puyallup Medical Center, slated to open in December 2012, is built to serve approximately 30,000 patients. The RTLS technology is part of Group Health's Integrated Care and Facility Design (ICFD), designed to serve patients more efficiently, says Donnell Coomes, the senior project director of Group Health's Enterprise Project Management Office.

According to Group Health, the technology is being utilized to transform the patient experience. For example, the waiting room has been nearly eliminated, since patients will proceed directly to a care room instead of waiting within a public area. Rather than a patient having to visit a laboratory to have blood drawn, or to receive a shot, a mobile lab can serve the patient within the care room when needed. In the future, the company notes, the clinic intends to enable a patient to receive visits in the same care room from a pharmacist (for medication consultations), as well as from the business office (to make a copayment), prior to completing his or her appointment.

All of these features are enabled with CenTrak's Gen2IR hybrid IR and active RFID badges worn by patients and employees, IR monitors installed within the rooms, and RFID readers that receive transmissions from the badges. The collected data is then managed by Intelligent Insites' software.

The clinic care area consists of "pods," or care rooms, each with two entrances: one for patients and another for the staff. Upon first arriving, a patient can proceed to the front desk, where a worker will check in that individual on his or her electronic medical record (maintained in EPIC software). The employee will also use the Intelligent Insights software, residing on the clinic's back-end system, to assess room availability for that patient's physician. The patient is then assigned an available care room. The worker can use a bar-code scanner to scan a bar code on the back of the badge with an RTLS transponder, thereby linking the patient with that particular badge. That same staff member also informs the patient of his or her room number, after which the patient may proceed directly to that care room.

Within each care room, a battery-operated CenTrak IR monitor transmits infrared light. Gen2IR will not pass through walls, and does not suffer from traditional infrared line-of-sight limitations. Therefore, when a tag reads a room number, there are no errors. When a patient wearing a badge enters the room, the badge detects the monitor's IR signal and transmits that signal's unique identifier, along with its own unique ID number, via a 900 MHz RFID transmission. An RFID interrogator within the vicinity then receives that transmission and forwards it to the Intelligent InSites software, via a wired connection.

According to Coomes, the center's staff is currently in the process of configuring the system to provide the type of automatic messaging and alerting that will be required once the center opens. The software enables an alert to be e-mailed or texted to staff members; alternatively, a notification can be displayed on a PC, depending on the user's needs. When workers see a notification indicating that a patient either has checked in or has entered the care room, they can respond by providing the appropriate service. The system can not only notify a nurse—for example, at the beginning of the appointment—but also a physician, after the nurse has left the room, since the software also knows where particular employees are located, and thus when they have entered and exited a patient's room.

If the patient requires laboratory testing, the health-care provider can press a button on his or her badge, thereby triggering a notification for the laboratory staff. The combined information culled from the Intelligent InSites and Epic software informs the lab technician of which specific test is necessary. The technician can then bring a Portable Lab on Wheels (PLOW), consisting of a rolling cart carrying a PC and laboratory equipment, into the room.

Some patients, such as those receiving allergy treatments, could be assigned a CenTrak tag with a push button that would enable them to send an alert in the event that they require immediate help. This, Coomes explains, is important in situations in which a patient who has received shots suffers an allergic reaction while awaiting further services.

All data related to the read events is stored in the Intelligent InSites software, enabling management to review the details and conduct business analytics, such as determining how long particular procedures last, how long patients typically wait, and where processes could be made more efficient.

During a second phase of the project, Coomes says, the clinic intends to expand the system to include bringing pharmacists and office personnel to the care room. Each staff member could be summoned to provide private consultation regarding medications prior to filling a prescription, and also to complete the payment process in the care room before the patient leaves.

In that way, Coomes says, the clinic hopes to reduce the number of steps that patients must typically complete down to just one or two. For example, a patient would not need to visit the lab, stand in line at the pharmacy to speak with a pharmacist, or stop at a payment window.

The clinic is providing all 150 employees with CenTrak IT-744 badges containing unique IDs, and several hundred IT-723 badges will be available for patients' use. In addition, the clinic is attaching IT-713 asset-management tags to some assets, such as the PLOWs and other mobile medical devices, in order to track their locations, thereby aiding workers in locating items required for patient care. Upon signing in to the system, a worker could query an item being sought, and the Intelligent InSites software would produce a list of the available items, along with their corresponding locations. Staff members also have the option of viewing a map of the facility, with each available item's location indicated as an icon on that map.

Benefits provided by the system will include improved efficiency of visits, Coomes says, as well as greater patient comfort. What's more, the solution will offer another benefit as well: It will serve as a template for all new clinics. Before such a template was available, Group Health reqiured approximately five years to develop and construct each individual clinic. The new ICFD design and replicable model make it possible to build a new clinic in about a year.

The Group Health deployment is one of the first examples of RTLS technology being used to fundamentally change the way in which health-care services are delivered, says Wil Lukens, CenTrak's senior VP of sales and business development. "We believe that these types of projects will continue to proliferate in both the acute and non-acute settings," he states, "as other forward-thinking organizations adopt the vision of using high-performance, certainty-based RTLS to streamline workflow in pursuit of strong ROI."


For Group Health, Coomes says, it's all about the patients. "Our patients are always at the core of what we do at Group Health," he adds, noting that while the company constantly considers new technological solutions to improve its processes, "this technology takes innovation to the next level."