Dec 26, 2018Health-care technology company DeRoyal has released a solution for hospitals employing its Continuum UHF RFID-based platform, for use in tracking pumps that are utilized for negative pressure wound therapy (NPWT). The system leverages RFID technology built into cabinets, as well as tags and GPS technology—along with cellular and satellite connections—built into pump units to identify where they are located in real time. The solution enables the pumps to be used at hospitals, and to travel with patients after they are discharged, with insurance companies billed accordingly.
DeRoyal conducted an eight-month case study of the solution involving 529 patients at one Level One trauma center. The firm found that it could save the hospital more than half a million dollars during a one-year period, says Ryan McBee, DeRoyal's technology manager. Since the test was completed in September 2017, the company has released the solution commercially for other hospitals.
NPWT is a therapeutic technique that employs a vacuum dressing aimed at draining a wound to promote the healing of chronic wounds or second- and third-degree burns. A pump, attached to an injury via a special sealed dressing, acts as a vacuum to draw out the fluids and increase blood flow to that area. Typically, the dressing is changed two to three times per week.
Administering NPWT at hospitals involves a complex process of transitioning from one pump, used in-house, to another as the patient leaves the facility. Usually, a single pump, permitted for use at the hospital, is rented to the facility by a vendor for inpatient care, while a durable medical equipment (DME) rental company provides a mobile pump unit to serve the patient's at-home care needs.
The exchange of pumps must be coordinated by staff members as a patient is being discharged, because any pumps used at the hospital must remain on the premises. Employees must remove the hospital pump, remove and apply a new dressing, and then install the new pump. Additionally, they must record the time at which the pump was at the hospital, for the purpose of billing the patient's insurance. Because workers cannot change dressings daily, patients sometimes require additional time at the medical facility.
Occasionally, pumps can end up missing, which creates an expense for a hospital that averages approximately $20,000 to $30,000 per lost device. It's not uncommon, McBee says, for a medical facility to lose three to seven pumps every year.
According to McBee, when one health-care facility (which has asked to remain unnamed) began working with DeRoyal, the technology company went onsite to watch how the pumps were used, how often personnel touched them and where processes could be automated. As a result, DeRoyal built the system, employing its existing Continuum inventory-control platform, then piloted the technology at that facility. The hospital was already using DeRoyal's RFID-based solution for surgical tool tracking, so it was familiar with the system and could use the same cloud-based software platform for pump management.
The NPWT Continuum solution consists of a single pump system, using pump units that can be tracked no matter where they end up. Hospitals can deploy a Continuum Vault—a cabinet that resides at a hospital—loaded with Continuum mobile discharge units. "These are custom cabinets that arrive ready to go," McBee says, requiring a power and network cable to connect data to a server. The mobile pump device has a built-in UHF RFID tag, as well as GPS, cellular and satellite units, enabling it to be tracked anywhere.
The vault comes with an Impinj RFID reader and antennas built in. It continually reads Smartrac MiniWeb passive UHF RFID tags attached to each pump, the forwards the collected data to the Continuum cloud-based software via a cabled connection.
While DeRoyal initially looked at off-the-shelf RFID-based cabinet technology to read RFID tags, it determined that a custom system would be required for the challenging, highly metallic environment. "There is a lot of metal in the cabinet and in the pump itself," McBee says, so it designed the cabinet and antenna system to ensure that all tags would be interrogated despite the cabinet's orientation or the quantity of the units stored within.
When a patient requires an NPWT pump, a staff member proceeds to the Continuum Vault, retrieves a pump and indicates which patient will use it. The system then sends a notification to the DME that owns the pump, so that the company can obtain any pre-authorization required from the patient's insurance company. This allows him or her to take the pump home upon discharge. The vaults can also contain dressing supplies to be used during the administering of a pump, or to be sent home with a patient.
In the case of pumps or dressings, the reader built into the cabinet stops capturing the unique ID number of the asset's RFID tag, and the Continuum cloud-based software identifies that action and links the specific item to that particular patient. Upon release, he or she can take the pump home, along with a transition kit customized for his or her needs, as well as any dressings or other supplies.
The Continuum software knows where each kit is located and which patient is associated with each unit. As a patient leaves the hospital, he or she passes through a GPS-based geofence created in the software as a perimeter around the facility. Crossing that geofence indicates the patient is leaving the hospital and prompts billing to the insurance company, while also updating the pump's status as having been taken home.
When the patient is finished with the pump, the DME dispatches a van to that individual's home to pick up the unit and bring it back to the hospital. The Continuum software identifies the pump's return via GPS data, and the new status is forwarded to the hospital and DME so that the time and date of return can be recorded. In addition, the insurance company is billed accordingly.
During the eight-month pilot, the company found that patient discharge times were reduced by 28 minutes, on average, due to a decrease in the amount of time they waited for paperwork to be completed. For clinicians, the time savings were about 45 minutes per patient, since the system eliminates approximately 90 percent of the discharge dressing changes.
Furthermore, the system saved 89 hospitalization days by enabling discharge on "non-dressing change" days, and the average inpatient NPWT use decreased by 2.9 percent. Overall, the company found that it saved approximately 210 hours of hospital time and $503,320 of expenses. Since the pilot was completed, the hospital has continued using the technology on a permanent basis.
