Evaluating RTLS Technology: Success Criteria for Hospitals

By Raymond Lowe Providence Health and Services

Director Saint Joseph Medical Center/IS Operations

Today’s Presentation

•  Introduction

•  Key Healthcare Requirements

•  Comparison Criteria & Lessons Learned

•  Case Study 1: RTLS Experience at Kaiser Permanente (KP)

•  Case Study 2: Providence Health and Services (PH&S)

•  Summary and Conclusions

Introduction

• Managing mobile assets in a hospital is an enormous task

• RTLS is increasingly important strategic capability for hospitals

Key Healthcare Requirements

•  Mobility –  Health care is inherently mobile – few things maintain a

static location •  Change

–  Hospitals constantly fine-tune their physical plant - RTLS must be able to accommodate this change

•  Physical Environment –  Clinical requirements can make accessing drop ceilings and

drilling in walls, along with more extensive renovations expensive and time consuming

–  Patient care disruption is a major consideration

RTLS Comparison Criteria

– Accuracy

– Reliability

– Planning, Deployment and Operational

Concerns

– Cost and Ongoing Maintenance

Accuracy

•  Knowing location, status and movement of things is what RTLS is all about

•  Lessons Learned: – Must provide enterprise-wide coverage – Must offer persistent location accuracy

throughout an organization

Reliability

• What ongoing maintenance/upkeep is required to maintain reliable positioning?

•  Lessons Learned: – To eliminate ongoing fine tuning by our IT

group, select a technology that is both self-calibrating and self-healing

Planning Scope: Have a thorough understanding of exact steps

required to scope, plan and design RTLS

Lessons Learned: •  Some vendors “guesstimate” certain portions of the planning

process •  Get clear agreement on who’s responsible in the event of

unanticipated costs

Plant: As the hospital physical plant changes what physical and software reconfiguration is required?

Lessons Learned: •  Be sure the entire planning and deployment cycle does not need to

be repeated

Deployment

•  Understand actual installation, configuration and testing of the system

•  Lessons Learned: – How and where are receivers actually installed?

How many are required? – Get clear understanding and documentation of

deployment time – Confirm location accuracy against requirements

Costs •  There are 3 main components:

–  Actual labor, hardware, and software costs –  How the system is packaged and sold to the hospital –  Ongoing maintenance and support

•  Lessons Learned: –  Significant cost variable in receiver installation –  Receivers require power and network connection – how

connections are made greatly impacts costs –  Confirm receiver density required to achieve desired

positioning accuracy

Costs

•  Lessons Learned: – Purchase of RTLS can be packaged as a

capital purchase, lease or rental – How RTLS is packaged can greatly

impact future costs and the degree of risk you may assume over the life of the system

Infrastructure

Infrastructure - Sensor Network RTLS

•  802.11 – Aeroscout – Radiance (433 Mhz)

•  ZigBee Sensor Network RTLS – – Awarepoint

Case Studies

•  Case Study 1 – Asset tracking in new hospital – Kaiser Permanente Los Angeles Medical Center opened 3/31/2009

•  Case Study 2 – Patient tracking system in Providence Health and Services – Roy and Patricia Family Cancer Center 4th Qtr 2009

Case Study 1 - RTLS at KP LAMC

•  New hospital to opened March 31, 2009

–  800,000 Square Feet –  2,000 Assets; Asset Expansion

Underway •  Concurrent install of new hospital

–  Install completed in 12 days (Dec 2008)

•  Federated searching of assets between facilities to manage inventory between sites

•  Commenced RTLS in 2006 –  400,000 Square Feet –  2,000 Assets Tagged

•  Primary asset categories include: –  Ventilators, Pumps, Transport

Monitors

Case Study 1: RTLS Initial Goals

•  Administrative –  Reduce lost, stolen, misplaced equipment –  Increase equipment utilization to reduce capital budget –  Enhance staff productivity, efficiency and satisfaction

•  Clinical –  Reduce time searching –  Increase patient care time

•  Materials Management –  Increase efficiency of PM process –  Improve equipment request response time

Case Study 1 : KP LAMC: Primary Use Case

• Clinical users search by asset type – Of particular value are clinical asset types

not managed through Materials Management, Central or Biomed (Lifts, Scales, etc.)

• Materials Management users search by specific Asset ID number for preventive maintenance

Case Study 1 : How it Works

Case Study 1: LAMC RTLS Comparison

Accuracy •  Consistent 1-3 meter

location accuracy throughout the enterprise

•  Solution allow applications where tags are to be tracked in boxes, cabinets, closed carts, and other enclosed areas

Reliability •  As soon as sensors

plugged in, they begin forming wireless network

•  Sensor network organizes automatically and continuously – self-calibrating and self-healing

Case Study 1: LAMC RTLS Comparison

Planning •  Did not require any pre-

installation RF surveys or detailed system design

•  Sensors plugged into standard electrical outlets

•  As soon as they’re plugged in, they begin forming the wireless network

Ongoing Maintenance •  RTLS in operation for over 2

years •  Zero IT maintenance

involvement during this time •  System maintains positioning

accuracy and high reliability – self-healing, self-calibrating

Case Study 1: Outcomes Estimated Reduction in Staff Time Searching (Per Employee Per Shift) Before RTLS After RTLS Time Savings/EE/Shift

~2.5 Hours < .5 Hour >2 Hours

Time that can now be spent on patient care and equipment PM tasks

Case Study 1: Outcomes

• Capital Equipment Savings – Reduced shrinkage (lost, stolen,

misplaced) – Increased utilization (no idle or hidden

equipment, missing asset alerting, improved PM cycles)

•  Savings already in $100’s of thousands annually

Case Study 1: Next Steps

•  Establish multidisciplinary team to review pent-up demand for tags (OR, ICU)

•  Integration to Materials Management preventive maintenance software

• Missing asset integration to alert Security Dashboard

Case Study 2: PH&S - Disney Family Cancer Center (DFCC)

•  Roy and Patricia Disney Family Cancer Center

•  Provides Radiation and Medical Oncology Services

•  Opens 4th Qtr 2009 •  IT Installation planned for

summer 2009. •  RFID Asset tracking:

Patient tracking

Use Case 2: DFCC

Case Study 2: PH&S – Disney Family Cancer Center

•  Passive RFID card issued to patient •  RFID Environmental Controlled Rooms for Music,

Lighting, Temperature •  RFID location information – allows staff to view

patient location information in bldg. Integrated with Avaya Phone Systems.

•  Desktop Messaging •  Nurse Call notification

Summary & Conclusions •  Accuracy:

–  Must provide enterprise-wide coverage –  Must offer persistent location accuracy throughout an organization

•  Reliability –  Must work reliably in dynamic environments where people and equipment are

constantly on the move and where radio frequency (RF) challenges can be considerable.

•  Planning, Deployment and Operational Concerns –  Have a thorough understanding of exact steps required to scope, plan and design

RTLS •  Cost

–  Purchase of RTLS can be packaged as a capital purchase, lease or rental –  How RTLS is packaged can greatly impact future costs and the degree of risk you

may assume over the life of the system •  Ongoing Maintenance

–  Solutions must be easy configure, maintain, update, and reconfigure when required –  Selecting a fully managed solution relieves my IT department of critical, but costly

responsibilities

Summary & Conclusions •  For maximum clinical and financial impact, solutions must offer:

–  Rapid Impact Installation: –  Rapid, clean (dust free), minimally invasive (no wiring, minimal patient

room interruption) –  Easy retro fit into existing environments and easily accommodate

change

•  Pick a vendor vested in your success

•  Technology allows us to rethink how we can provide care.

•  RTLS allows the enterprise to do more with less

•  RTLS allows us to personalize healthcare for our patients

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