MERS Infection Puts RTLS Technology in the Spotlight

By Claire Swedberg

Real-time location system vendor Versus has seen interest in its products grow following media coverage of Community Hospital's use of the technology to identify all personnel who were in contact with a MERS-infected patient.

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Two weeks ago, Community Hospital, located in Munster, Ind., used data supplied by its real-time location system (RTLS) to search out those at risk of infection when the first case of Middle East respiratory syndrome (MERS) was reported at its facility. A week later, Versus Technology, the supplier of that RTLS solution, began fielding calls from its customers, asking whether their own deployments could offer the same protection, or needed an upgrade to enable that kind of swift response to a contagious infection. Potential new customers have been calling in as well, the company reports.

Community Hospital, like most users of Versus’ RTLS solution, was primarily employing the technology for tasks more mundane than disease control. The technology was installed in 2009 by Versus’ partner Communication Company of South Bend, to automate the hospital’s nurse-call system by enabling the canceling or routing of patient calls to nurses, based on their location within the building. The facility currently has 400 badges on hand that it issues to its nurses. However, says HT Snowday, Versus Technology’s president, when the hospital found itself facing a safety concern like MERS, its staff was relieved that the technology could provide potentially life-saving information as well.

Versus Technology’s HT Snowday

When the patient—a male health-care worker who had been stationed in Saudi Arabia just prior to returning to the United States to visit family in Indiana—checked into the 427-bed hospital on Apr. 28, doctors diagnosed that he had MERS, a potentially deadly virus first identified in Saudi Arabia in 2012. For the hospital, the next step was to identify everyone who had been in contact with him.

To accomplish this goal, Community Hospital used the RTLS data in conjunction with a video surveillance system and its existing Epic electronic health record (EHR) software, the hospital’s chief medical information officer, Alan Kumar MD, told the media this week during multiple interviews (the hospital declined to speak with RFID Journal at this time). In an article posted at EHRIntelligence.com, Kumar reported that the Centers for Disease Control and Prevention (CDC) “was particularly impressed and thrilled that they had data on the exact amount of contact per provider, which is data they never had before in any investigation of this type because they never had a GPS or RFID-style system that tracks time in room.”

Each Versus Clearview battery-powered RTLS badge transmits an infrared (IR) signal to IR sensors installed at Community Hospital, while also sending a 433 MHz RFID signal to RFID readers via a proprietary air-interface protocol. Versus’ RTLS-Nurse Call Integration software determines the tag’s whereabouts, based on the locations of the specific IR sensors and RFID interrogators that receive the tag’s transmissions. The software then forwards that information to the hospital’s Rauland-Borg nurse-call system.

The hospital not only used the RTLS solution to trace which nurses had entered the patient’s room, but was also able to view video footage and review electronic health records, in order to identify anyone else without a badge who may have been within proximity of the infected individual. Thanks to the RTLS, video and EHR data, more than 50 hospital workers were tested for the virus due to their coming into contact with the patient.

The technology is primarily designed to provide location and workflow data for personnel or assets, Snowday says, but it can also serve as a safety tool for those at the facility, when used in the manner that Community Hospital did in April. Although the MERS infection raised considerable media and public interest, he notes, Versus’ customers have often utilized its RTLS technology to identify potential infection transmission. He recalls a case in which a patient who had ingested a large amount of a toxic substance was off-gassing, which necessitated the identification of all hospital workers who had been in the room with that person. In the same way as Community Hospital, the health-care company was able to locate those individuals using the Versus technology. In fact, Snowday says, Versus’ software comes with an Exposure Reports component enabling users to identify not only employees who have been in contact with a particular patient, but also any other individuals who have been in contact with those potentially infected workers. However, he notes, in the case of Community Hospital, the staff was simply able to use the Versus data fed to the nurse-call system to locate personnel who had been near the patient.

Versus learned of the infection and determined that the hospital in question was one of its customers, shortly before press coverage began describing how the technology was used. “My only reaction,” Snowday states, “was, ‘That’s great, I’m glad they’ve got our stuff. That should help them out.'”

The high-profile nature of this incident has piqued the interest of several health-care companies, Snowday reports, adding that Versus has begun receiving calls from its customers asking about their own systems, to ensure that they could be as proactive as Community Hospital in the event of a similar situation. Non-customers have also been calling, he says.

However, Snowday mostly attributes Community Hospital’s ability to response rapidly to a potential contagion to the hospital’s own planning and organization, as it not only acquired technology that could help in such a scenario, but also made sure it could use that technology properly when needed. He cited a statement made by William VanNess, Indiana’s Health Commissioner, during a press conference held on May 12, when the patient was released from the hospital and no other infections were found: “At this point, it appears that MERS picked the wrong hospital, the wrong state and the wrong country to try to get a foothold.”

However, on May 11, a second U.S.-imported case of MERS was confirmed in a traveler who also arrived in the United States from Saudi Arabia. This patient is currently hospitalized in Orlando, Fla., and is doing well, according to the CDC’s website, which indicates that the two U.S. cases are not linked.