Page 2By M.L. Baker | Posted 10-18-2005
Hospitals Save Costs, Time with Wireless Tags
A typical hospital owns more infusion pumps than licensed beds. Although not every patient needs a pump, leaving many idle, the hospital rents still more of them to be sure that a nurse can find one when it's needed.
At thousands of dollars a pump, such equipment surpluses are expensive. As a result, many hospitals are turning to RFID technology to keep track of pumps, as well as other expensive mobile equipment, including wheelchairs and patient monitors. According to a report by Spyglass Consulting, the number of hospitals using RFID tags to track assets will skyrocket from 10 percent in mid-2005 to 45 percent by the end of 2007. Such programs promise to cut not only costs, but also the time that clinicians and engineers spend searching for equipment, and the time patients spend waiting for it.
This month, Cisco Systems Inc. pledged to accelerate the process, launching its Clinical Connection Suite. Its latest network service prioritizes information from and tracks the locations of wireless devices, including VOIP (voice over IP) phones, laptops and certain RFID tags.
Within three years, RFID tags will be viewed as just another networked device, predicted Kent Grey, global lead for Healthcare Solutions at Cisco Systems. "Because the tags are just another device on the network, the ability to manage the tag comes with the ability to manage the network."
However, most hospitals currently using RFID tracking systems use proprietary RFID tags that communicate with RFID readers. This creates a separate RFID network that communicates with a hospital's network. According to a survey conducted in April by American RFID Solutions, GE Healthcare's Intellimotion and Agility Health Care Solutions are the most popular; each controls just over a quarter of the market and provides its own tags, servers, software and access points.
Cisco is promoting an alternative: bypassing the RFID readers with more general active RFID tags that hook directly into a hospital's network. Unlike passive RFID tags, active RFID tags require their own power source and can transmit signals for several feet.
In interviews with Ziff Davis Internet, hospital IT executives using proprietary systems did not seem inclined to switch, saying that the proprietary systems offered better resolution and additional features or more-convenient service plans.
But Gary Bayston, manager of biomed at Rockford Health System, waited to implement an RFID tracking system until he could leverage his hospital's extant wireless network. A couple years ago, he and his colleagues began looking into asset-tracking software from Four Rivers Software Systems Inc, but they backed off when learning that cable would need to be installed throughout the hospital, even though an 802.11 wireless network was already in place.
The hospital changed its mind when Four Rivers partnered with Pango Networks Inc., a company that makes RFID tags that communicate directly with extant wireless networks.
Rockford Memorial has just finished a three-month pilot program tracking 20 ventilators. But Bayston plans to ramp up the system quickly. He has a purchase order to update software and purchase an additional 600 tags, and the hospital has budgeted to add 1,000 tags a year.
Bayston first saw the need for an asset-tracking system four years ago. His department has to make sure 9,000 pieces of equipment receive preventive maintenance, but engineers had trouble finding the equipment.
He then interviewed all the other department managers to see what they needed. "The results I got back opened your eyes up wide," he said. "We were just a little portion of it." He took the results to his human resources department. Together they calculated that the system was losing $4,000 a day in wages due to time spent looking for equipment.
Not all of it was medical, said Bayston. When planning an asset-tracking program, he advised, "don't just limit to the nurses." His hospital is considering whether items like food service carts should be tagged too.
Bayston thinks Rockford Memorial will see a return on investment within 12 months, and that returns will grow as technology improves. He expects the cost of RFID tags (about $75 each) to drop by half in a year. Battery life is also expected to improve dramatically. In first-generation tags, batteries last only 60 to 90 days, said Bayston. In next-generation tags, batteries should last a year or more.
Next Page: Cost-savings for Bon Secours.
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?"