Bon Secours Richmond has one of the most extensive asset-tracking programs with 20,000 pieces of equipment across four hospitals, according to CIO Jeff Burke. About two years ago, Burke picked Agility Healthcare Solutions for the project. Bon Secours couldn't risk a big investment in infrastructure or time, said Burke, and Agility guaranteed that cost-savings would pay for maintenance and implementation costs, including installing a wireless network in the hospital.

Agility Healthcare Solutions charges through a subscription model that includes hardware, software and training. Sara Shah, an analyst with ABI Research, said that such rental programs are gaining traction with hospitals because they can be put into hospitals' budget with less risk.

Burke said he saw cost-savings within six to nine months, and current savings are about 50 percent more than the cost of the subscription.

The tracking system means that rented medical equipment is used more efficiently, said Burke. If an infusion pump or other piece of equipment isn't at hand, busy nurses are more inclined to order a rental than to prowl hospital corridors for it. Once the asset management system was in place, rates of utilization for rental equipment rose to 70 percent or more; previously it was closer to 40 percent.

Labor costs went down too. Bon Secours outsources preventive maintenance for medical equipment. Before RFID, personnel tasked with scheduled maintenance could not find the appropriate equipment about 20 percent of the time, a rate comparable with other hospitals. With the RFID program in place, said Burke, that figure dropped to zero. In fact, when Bon Secours opened a fourth hospital this September, the maintenance crew had freed up so many hours that the additional hospital could be serviced at no extra cost.

Safety has also improved. For example, if a particular model is recalled for safety reasons, hospital staff can readily locate each potentially dangerous pump or monitor and take it out of commission. Previously, said Burke, the process was much more haphazard.

But there's no guarantee that an asset-tracking program will be successful. Brad Sokol, vice president of American RFID Solutions, said he's seen such programs fail because clinicians don't incorporate new processes, like consulting a computer screen to see where a piece of equipment might be. "If it's not properly communicated or rolled out, it's not going to be successful," he said. He advises starting pilot programs in revenue-generating departments and making sure staff education and input begin well before the pilot program.

"The hospital needs to sit down with its own staff to figure out what really needs to change," agreed Rick Hampton, wireless communications manager with Partners Healthcare. Hampton is implementing a pilot program at Massachusetts General Hospital that monitors about two dozen staff members and 300 devices.

Radianse provides proprietary RFID tags, readers and software. The RFID network then communicates with the hospital's network. Hampton and his team decided how to place the RFID readers and tags to match the hospital's specific needs.

For example, Hampton and his staff decided not to tag defibrillators or patient monitors because they weren't getting lost. But, he said, "we are tracking telemetry transmitters and 12 lead EKG cables. They cost several hundred dollars a piece, they get wadded up and tossed in with the laundry." Rather than placing RFID readers in places where the equipment is unlikely to be, MGH figured out where equipment could get waylaid, like the entrance to the laundry room, and beefed up readers there.

Hampton is skeptical about the resolutions that non-proprietary systems can provide. "If you want to know if the respiratory therapist is with the patient with the ventilator, you need to have better than a 10-meter resolution." He also thinks companies that specialize in health care will be better able to handle next-generation tags that transmit more data than location, motion and battery power. "Something that works fine in a warehouse will not work for us," he said.

Brett Mello, director of information technology at Bronson Health Group, said tags that communicate directly with the wireless network have the advantage of ease and simplicity. "We were able to utilize our existing Wi-Fi infrastructure, so I didn't have to put in a separate infrastructure of readers." The system can also track VOIP phones, laptops and other wireless devices.

His team only needs to decide what equipment should be tagged, rather than how to place RFID readers. It can also use tags produced by more than one vendor if it chooses. (Pango, Aeroscout and Ekahau all make tags that communicate directly with the wireless network.) Occasionally, he said, it's unclear whether a piece of equipment is in a particular room or in an adjacent room. But the program generally shows an item's location within a couple of feet, he said, which is sufficient for his hospital's needs. (Hospitals will vary in level of resolution depending on the density of their wireless coverage.)

Mello has started a pilot program tracking 25 assets and has plans to tag 100 wheelchairs and 600 infusion pumps.

The program began by tagging wheelchairs, since difficulty locating wheelchairs was wasting both patients' and nurses' time. Also, hospital wheelchairs would occasionally leave with the patient. "We found wheelchairs down the street, at the shopping mall," said Mello, "It was a silly thing to lose money on." Tagging just 25 wheelchairs has virtually eliminated the problem.

Gregg Malkary, head of Spyglass Consulting, said there's no question that asset tracking can save money, but he worries vendors are not coordinating their efforts sufficiently. Currently, vendors are experimenting with point solutions, he said, "but to move forward, we'll need tightly integrated end-to-end solutions not just to track equipment but to act on the data." That kind of progress will require vendors to provide open standards so that products can work together, he said.

Hospitals need to make sure they know whether one company's tags are compatible with another company's software. Even if a vendor claims that its software has open architecture, the IT staff should not assume that all vendors' RFID tags will be compatible.

Malkary also warned that most vendors and hospitals will find it difficult to scale up and integrate projects. "The pilots deployed have had a limited number of assets. What happens when you start to measure 5,000 assets?"