Hospitals and other health-care facilities faced with too many patients and too few beds, nurses and other resources have turned to RFID-based patient-management real-time location systems (RTLSs). By identifying and tracking patients from the time they arrive at a hospital’s admitting department or emergency room, or at a clinic, through their stay and discharge, health-care facilities can improve patient care and safety, decrease patient wait times, and increase operational efficiencies and the bottom line.
Texas Health Harris Methodist Hospital Alliance, in Fort Worth, for example, deployed a patient-management RTLS from CenTrak, in conjunction with an asset-tracking system, to automate the discharge process and locate patients for friends and family. The Joint Implant Surgeons of Florida, in Fort Myers, boosted efficiencies by implementing a standalone patient-management RTLS from Ekahau to track patients and clinic staff members. It improves appointment scheduling and flow, enabling the clinic to serve patients with shorter wait times.
These solutions can also monitor health-care workers to, for instance, see how long a nurse spends with each patient, identify potential exposure to infectious illnesses and enable a caregiver to call for help. Ekahau’s badge tag, for example, has a duress feature that lets a caregiver signal for help if he or she is injured while lifting a patient or a patient becomes violent, says Emily Nardone, director of product marketing. “The alarm not only alerts personnel to a problem but also supplies the location of the incident, which helps reduce response times and, in turn, can save lives,” she says.
Sanitag‘s RTLS platform includes a nurse-call feature that lets patients in need of assistance push a button on their RFID tag. The alert is received at the nurses’ desk, says Özgür Ülkü, director of global operations, and since the system knows patient location in real time, the nurses can send help to that precise location.
Enhanced patient safety and security are also key capabilities of these solutions. They can help staff members monitor patients who are at risk of wandering off or losing their way in a hospital. “It’s especially important to know the whereabouts of dementia and psychiatric patients,” says Ralph Jarmain, managing director SecuriCode, which offers a patient-management RTLS.
Some hospitals use a patient-management RTLS to improve patient-care throughout within the facility—the system may alert nurses or transport staff when a patient is ready to return to his or her room after an X-ray or other test, for instance. It may also alert workers when an operating room or other procedure area is no longer occupied, so they can begin preparing it for the next patient.
In addition, a patient-management RTLS can automate the bed-management process, by identifying when a patient is discharged and alerting admissions that a room has been vacated. In some cases, cleaning personnel carry RFID tags so they can alert the system that a room is ready for the next patient. SecuriCode’s OccuTag can be affixed to a bed and used to signal personnel that a bed is unoccupied, needs to be cleaned or is ready for the next patient.
“For true workflow automation, health-care facilities must have the ability to segment spaces into clinically meaningful zones including patient rooms, beds, bays, chairs, nursing stations, hallway segments and other relevant areas,” says Adam Peck, CenTrak’s senior director of marketing.
Deployment Options
An RFID patient-management RTLS can be deployed as a standalone system or part of a solution that includes asset tracking. CenTrak’s platform is often deployed solely to support use cases that require tracking of people, Peck says, but asset-management RTLS applications have traditionally been able to demonstrate the quickest, most tangible return on investment. “Once a health-care facility begins to realize significant cost savings from the ability to reduce and/or eliminate equipment rentals and shrinkage,” he says, “they explore other ways to leverage their RTLS investment, such as staff locating, patient tracking and hand-hygiene compliance monitoring.”
Sanitag’s RTLS Platform offers four modules: patient management, asset tracking, staff safety and management, and infant security. “The hospital can deploy all four modules together or start deploying module by module,” Ülkü says. They share the same database and can be fully integrated, he explains. “Some hospitals would like to focus on a specific floor or clinic, and others would like to focus on the entire facility,” he adds.
“In some hospitals, deployment is just in obstetrics, neonatal and pediatrics—mainly baby-related,” says SecuriCode’s Jarmain. “Other hospitals include day care, observation, psychiatry, morgue, visitors and other areas.”
Similarly, Ekahau’s patient-safety solution can be deployed as a standalone system, often along with the staff safety solution, or in conjunction with the company’s asset-tracking and/or temperature-monitoring solutions. Ekahau’s RTLS deployments typically cover an entire facility or hospital, Nardone says.
Location Accuracy
All four leading providers offer active RFID tags and readers, often in conjunction with infrared (IR) technology. In general, active RFID is the main technology for long-range and site-wide location identification within health-care facilities. IR tags can provide room-level and bed-level accuracy. Passive solutions are being adopted in hospitals for applications such as automatic replenishment for low-value medical supplies, consignment product management, and tracking medical instruments and laundry.
All four solutions also operate over Wi-Fi networks, because the networking technology is so common in health-care facilities. By using Wi-Fi for RTLS, Nardone says, clients typically cut installation time in half and save thousands of dollars in costs, because it is wire-free and does not require infrastructure changes. The data travels directly over Wi-Fi.
But active Wi-Fi tags on their own do not provide location accuracy to anything much less than 100 meters (328 feet), unless secondary technologies such as RF exciters, IR beacons, location appliances or specialized network operating systems are incorporated, Jarmain says. SecuriCode doesn’t provide Wi-Fi tags but supplies Wi-Fi readers that act as tag “hubs,” communicating with Wi-Fi networks, he explains.
SecuriCode’s solution can be used to divide rooms into zones, but generally only for large, open spaces such as waiting rooms. Tags communicate with nodes, which then communicate with the company’s Atlas application server. “We can do bed-level location, with specific nodes at each bed, but most hospitals do not have the budget for this and it is generally not necessary,” Jarmain says. “Ward and room level is more than adequate for most.”
Ekahau’s Vision software lets users divide their floor maps into zones, Nardone says. Wireless beacons identify the locations of tags within a given zone and can provide sub-room-level accuracy, she says.
CenTrak’s solution uses Gen 2 IR devices to accurately divide rooms and separate beds or bays. The battery-operated devices can be positioned wherever accurate location data is needed, Peck says, such as clipped to a ceiling tile grid. Low-frequency exciters capture tag movement at department threshold doors and other chokepoints. With this level of location granularity, he says, workflows present opportunities to favorably impact clinical efficiency and quality, staff safety, patient satisfaction and cost compression.
Business Intelligence
Most patient-management solutions include software that collects location data and displays it on dashboards, so hospital staff members can monitor patients. The software also features reports, so hospital administrators can analyze the data to track trends and improve processes.
Location data from Ekahau’s RTLS can be saved into the Ekahau database located on client servers. Its Vision software includes more than 30 standard reports and the ability to customize reports. Some of the reports are related specifically to patient flow, Nardone says. A Dwell Time report, for example, is used to signify the amount of time a patient or caregiver spends in an area, such as a waiting room or triage. A hospital could use these reports to identify changes needed in operations or workflows. The Forensic Replay feature can replay the location of various tags after an event occurs, so administrators can understand how long it took to get assistance to patients or caregivers who triggered alarms.
SecuriCode’s Atlas server enables data to be saved both in a relational database and in log files. It supports browser-based reporting or transmission of reports data to third-party systems. The solution includes a browser-based administrator that runs on workstations and in some locations via Wi-Fi on iPads.
“Depending on the administrator login, users can add and monitor floors, define zones and access rights, monitor and acknowledge alerts, search for assets and run reports,” Jarmain says. Most reports related to patient management are customized for particular hospitals and are confidential, he adds.
The Sanitag platform provides several analytics reports and executive dashboards. CenTrak’s solution does not include end-user software, Peck says. “Our partners offer this and sell our tags and infrastructure as a complete solution,” he says. The solution does include a server that feeds location data to its partner end-user applications, he adds.
The Age of Patient Satisfaction
Most health-care facilities are not taking advantage of these features and their potential benefits, according to the providers of RFID-based patient-management RTLS solutions. But that may be beginning to change.
In Europe, SecuriCode sees approximately five new installations each year, with no signs of apparent growth, Jarmain says. In Africa and Asia, there is more interest, while in the United States and Canada the installed base is small. Yet, he says, the business benefits are clear. In the United Kingdom, for example, health-care organizations are penalized financially if they don’t meet response, waiting, treatment and aftercare times, he explains, so these systems could help them avoid fines.
Interest in RTLS to support patient-flow initiatives and other operational enhancements “is certainly on a steady rise,” Ekahau’s Nardone says. Health-care facilities are interested in understanding where bottlenecks in their operations exist, so they can make decisions to help speed up admission processes, reduce wait times and enhance the safety of those onsite, she says.
Sanitag views its patient-management offering “as a comprehensive solution that includes infant safety, patient safety, and staff and medical asset-tracking systems,” Ülkü says. “When you look at it that way, the savings to the hospitals are huge. The patients are served much better; the system improves quality of service at health-care institutions and, therefore, helps in competition.”
CenTrak’s Peck says sales of its solution are “definitely on the rise. We’re seeing a big jump in [volume] as IT departments are looking for ways to get even greater value from their EMR [electronic medical records] investment,” he says.
The platform can integrate with billing by time-stamping associations of medical equipment, staff and patients. “This is a future use case, Peck says, “but definitely possible with the technology available today.”
In addition, Peck says, “improved patient management will likely increase their satisfaction and improve outcomes,” which will elevate Hospital Consumer Assessment of Healthcare Providers and Systems scores. In the United States, results from HCAHPS—a national, standardized survey of patients’ perspectives of hospital care—factor significantly in the amount of government reimbursement a health-care facility receives.
Increasingly, health-care facilities are focusing on patient satisfaction. In fact, some hospitals, such as Cleveland Clinic and Johns Hopkins Medicine, are employing chief patient experience officers. RFID patient-management solutions can improve patient care and enhance the reputation of health-care facilities.
