An epidemic of misplaced, stolen and stashed medical equipment is costing hospitals millions of dollars a year. Fortunately, technologies to help keep track of valuable assets are pervading the industry, leaving one main question on every CIOs lips: which IT solution is right for my health system?
According to Stan Schatt, vice president and practice director of networking at ABI, a New York-based technology market research firm, the two major wireless technologies vying for position to provide hospitals with real-time locating systems (RTLS) are WiFi (wireless fidelity) and active RFID (radio frequency identification) running off a proprietary network.
“Less than 5 percent of North American healthcare facilities are equipped with RTLS to manage their equipment and inventory, so the market is truly up for grabs,” says Schatt.
The greatest benefit of utilizing a WiFi-based asset tracking system is that hospitals can leverage their existing WiFi infrastructure, explains Schatt. The value proposition is that a facility doesn't need to install a proprietary network, which can be both costly and cumbersome, he says.
An easy choice for CHS
For Carolinas HealthCare System (CHS) — the third largest healthcare system in the United States with 4,900 beds across it 20 hospitals, nursing homes, ambulatory surgery centers and radiology centers in North and South Carolina — being able to leverage its existing wireless network was a major factor in its decision to deploy Ekahau's (Saratoga, Calif.) RTLS, says Clay Fisher, director at CHS.
The facility is currently using Ekahau's system to track medical assets such as infusion pumps and ventilators, and Fisher expects the installation to be complete by early 2008, he says.
CHS invited several vendors to give real-time demonstrations, in which they were each given an hour to map out a certain square footage, says Fisher. He claims, “Ekahau won hands down,” and its accuracy levels were significantly better than anyone else in the marketplace, “aside from a separate proprietary network.”
The decision not to install a proprietary RFID network was not only based on financial considerations, but also on the logistical challenges it presented. “We didn't want to have to punch into the ceilings and pull cables through the millions of square feet that we own. Anytime you don't have to go above the ceiling, the better off you are,” he says.
Although the accuracy levels achieved by an active RFID proprietary network are said to be superior, Fisher claims Ekahau's RTLS can provide what the hospital needs, which is predominantly an asset management solution. He claims 90 percent of items are found within an average of 10 feet, which is more than sufficient when looking for bigger equipment such as wheelchairs or ventilators. However, he is hesitant as to whether WiFi technology is capable of providing “true room-level accuracy.”
Fisher says that although he feels a WiFi-based RTLS will allow CHS to track patients, there are some limits. “I've heard some folks out there are claiming that if a patient is standing side-by-side to a physician, then at that point a billing action kicks off,” Fisher explains. “I don't think that WiFi technology is capable of something like that yet,” he adds.
The resolution of many types of WiFi tracking systems can be pretty poor says Chris Lavanchy, engineering director of the health services group at ECRI Institute, a Plymouth Meeting, Pa.-based non-profit organization that provides consulting services for healthcare IT evaluation. “By resolution, I am referring to the granularity or degree to which the system can identify the exact location of a tagged item,” Lavanchy explains. The best systems can locate an object to within six inches or so, where some of the poorer locating systems can only provide location accuracy to 10 to 30 or more feet, he says. “WiFi technology generally has a reputation of having poorer locating accuracy unless the system is installed with a very high density of access points,” Lavanchy says. “You can't simply take the network and throw the WiFi tags into the mix and expect good performance,” he says.
Organizations that require a very high level of accuracy must go through a lengthy process of mapping the signal strengths of tags in various rooms, explains Lavanchy. “You are likely going to have to add access points (APs), which can be costly and disruptive,” he says.
However, because CHS had originally designed its network for VoIP (voice over Internet protocol), which already requires a high level of APs, Fisher says the organization didn't need to add additional access points. But tweaking the APs presented a minor challenge.
“Some of the access points were directional, and we needed for them to be omni-directional to get adequate coverage,” Fisher says. In other words, instead of the access points pointing straight down the hallway in one direction, they needed to present in more of a circular configuration, he explains.
Ekahau's system uses software-based algorithms to compute the location of tracked objects, Fisher explains. He says that the RTLS is server-based and can be installed in a network operations center so that a multi-campus facility can easily scale to support thousands of tags on a single server. Such scalability was critical, says Fisher.