Real Time Locating Systems on Track in Hospitals

July 27, 2011
This report originally appeared in the July 2011 issue of DOTmed Business News

By Trevor Bromley

Real Time Locating Systems have evolved dramatically since their inception as merely equipment tracking systems. Today, more forward-thinking hospitals are using RTLS to track staff and patients, opening opportunities to improve workflow, enhance throughput and increase revenue. RTLS have become sophisticated enough for automated nurse call logging and cancellation, schedule management, patient flow control and even “smart rooms,” which have the potential to revolutionize patient-caregiver interaction.

RTLS in brief
Presently, two categories of RTLS hardware are in use in hospitals: low accuracy or low-resolution tracking, and a new generation that provide room-level and, in some cases, sub-room-level accuracy. Traditional tracking is carried out by Wi-Fi tags that use the hospital’s existing Wi-Fi access system. Though inexpensive, they only give an approximate location for an object. These systems can seldom tell apart tagged equipment or people in different rooms and facility levels as Wi-FI transmits through building walls and floors. The utility of these systems is therefore limited.

But newer RTLS systems, particularly those based on advanced ultrasound technology, can find tagged entities within a 3-D space within one inch. This level of accuracy helps facilities move beyond coarse equipment tracking and into more sophisticated applications.

The emergency department and operating suite are two areas that greatly benefit from RTLS. According to Dick Tabbutt, executive chairman of Sonitor Technologies, RTLS can provide rapid financial return. “Managing and optimizing patient workflow can enable departments to see more patients in less time,” he said.

For Dr. Michael Gonzalez, vice chair and director of operations of the emergency medicine department at VCU Medical Center, increased revenues come from an increased level of operational preparedness.

The former Navy doctor has deployed USID-based RTLS to help pre-stage IV pumps and other equipment, in order to become more efficient. “When a patient comes in, we’re fully prepared and don’t need to hunt for anything and don’t have to guess about whether or not it is functioning properly,” he said.

Gonzalez also derives a better understanding of staff utilization by analyzing a variety of staff-dependent patient care tasks. He can, example, figure out the time it takes to carryout physician orders. “We can now have real data to help us to properly adjust staffing levels and deployment.”

Getting smart: RTLS-enabled smart rooms
One of the more advanced applications of RTLS is being seen in “smart rooms” —technology enabled work areas, usually in inpatient nursing units, which are designed to organize and prioritize work for nurses and other providers. The University of Pittsburg Medical Center and IBM partnered to create the first smart rooms. The work areas, which rely upon ultrasound-based RTLS, use small ultrasound tags. The tags then make it possible for the smart room system to identify health care workers entering a patient room. Upon identifying the staff member, a series of programmed events occurs. Patient information is then displayed on wall mounted monitors based on the need-to-know requirements of the identified staff member. The display provides information such as recent and current vital signs, care plan data, allergies, drugs prescribed and scheduled times to administer them. All this information is provided in real time and all the staff member simply needs to enter the room to get all this information immediately, without needing to dig through charts.

Ultrasound tags on any other health care worker entering the patient’s room would initiate a different set of smart room actions, depending upon their clearance level. For instance, a case worker would automatically receive information about a patient’s expected discharge from the hospital and contact information for family members, whereas tagged food service personnel would receive information specific to dietary orders, food allergies and patient preferences upon entering a room. All of this RTLS-enabled functionality has the potential to improve the way hospitals work and how patients are cared for, bringing greater efficiencies to the health care system and ultimately, paying for itself through the savings increased efficiency delivers.