Hide and seek

At University Health System (San Antonio, Texas), a study was conducted at the 604-bed University Hospital to determine how much time nurses spend looking for medical equipment. Not surprisingly, it was found that not only do clinicians waste a great deal of time searching for devices, but once they locate the items, the clinicians tend to hide them on their unit for future use. The problem with this, says vice president and CIO Bill Phillips, is that it forces organizations “to spend a lot of money for extra smart pumps and extra devices, because there's really no good control or management of those items.”

Similar results were unearthed at Pinnacle Health, a four-campus organization based in Harrisburg, Pa., after IT leaders spoke with the biomedical team. “It was evident that there was a lot of equipment redundancy,” says CIO Steve Roth. “When staffers are unable to find the original, they buy more. So even though we only need five thermometers, there might be 10 of them on the unit.”

To address what was becoming a serious cost management issue and improve equipment utilization, Pinnacle implemented a real-time location system from Andover, Mass.-based Radianse in its 546-bed Harrisburg campus in 2005. To date, Pinnacle has tagged more than 6,000 devices, including biomedical equipment.

“We tagged items to maximize location, and essentially, to make it easier for people on the clinical units to find what they were looking for,” Roth says. The goal was to tag items that were in highest demand to the staff, which included thermometers, pumps and, interestingly, patients.

To that end, Radianse is also being utilized at Pinnacle as the tracking solution behind Pathfinder, the patient tracking software from Pittsburgh-based PeriOptimum that is deployed throughout the hospital. With this application, staff members can locate patients who are due for surgery. “From the time the patient goes into the surgical suite, they are tagged with a disposable arm band,” Roth says. “They are tracked through the entire process from pre-op, intra-op, post-op, all the way through all of the services that occur in the surgical suite.”

RFID a Priority within Two Years (for Hospitals)

The patient tracking component, he says, was one of the primary drivers for tracking at Pinnacle.

According to Liard, a small number of other organizations have implemented patient tracking in emergency rooms “to mitigate lines and help ease that admissions process,” as well as for applications like tracking infants and mothers to prevent abductions. “RFID technology is getting better and better, and it really does have a whole host of functionalities,” he says.

Making it count

However, while many CIOs are certainly familiar with the capabilities offered by real-time tracking technologies, there is still some hesitancy to make the leap. Some are monitoring the trends to make sure tracking isn't just a flash in the pan, but instead, an investment that will yield long-term results.

This was precisely the tactic employed by Phillips, who kept RFID on his radar for two years before deploying it. “I actually started monitoring the technology before it made a penetration into the healthcare environment,” he says. “We kept watching it, and when it looked like it got to a maturity level that I was comfortable with, we took out on an RFP.”

Phillips' team purchased a system from Hatboro, Pa.-based InfoLogix Inc., for its regional Level I trauma center, University Hospital. The overarching vision, he ways, was to improve workflow and patient care by enabling clinicians to more quickly locate assets. Included under this umbrella were high mobility clinical assets such as defibrillators and fusion pumps, as well as IT assets like computers on wheels and tablets.

“The dollars aren't there to track every item. You need to identify your high value, high mobility assets, and that's what we did,” he says. Based on a questionnaire given to nurses, Phillips' staff concluded that the majority of nurses' time was devoted to searching for infusion pumps and defibrillators.

But instead of adopting a tracking system that would merely solve one problem, University set its sights higher, opting for a solution with built-in potential for cutting-edge applications. According to Phillips, University is leveraging the InfoLogix system to implement refrigerator and temperature monitoring throughout the hospital and ambulatory clinics. With this system, once devices are tagged, temperature changes are measured and alerts are issued when temperature-sensitive equipment, such as insulin pumps, malfunction.

Instead of relying on clinicians to record temperatures manually, University plans to store data from refrigerators in a central location. “When a refrigerator is out of range, it will automatically page the responsible person to notify them that it is failing,” says Phillips. This will enable clinicians to save medications and prevent waste, while ensuring compliance with Joint Commission standards.

University also plans to leverage the technology to track sponges and other devices in the operating room and prevent “foreign bodies” from being left inside patients following surgery. “Our plan is to take tracking from the refrigerators, to the asset monitoring, to the patient tracking, and to the clinical setting and the surgery sides,” Phillips says. “It's a technology that CIOs need to take a serious look at.”

Liard notes that some organizations are even tagging prescriptions and storing them in RFID-enabled medicine cabinets. “The value propositions become multiple,” he says. “Therefore, the cost justification and the adoption scenario around RFID become easier.”

The dollar factor

But while many CIOs say tracking is a high priority, there are questions as to whether the current economic situation will prevent more from jumping in.

“I think any project could be pushed back,” says Phillips. “But I think there's enough soft return around asset tracking that it probably wouldn't be one of the first places I look to postpone a project. It's not inexpensive, but it's not one of my top 10 expenses either.”

At Pinnacle, Roth and his team are delaying projects like digital signage, but pushing ahead with bigger tasks that carry more potential for long-term value, such as the acquisition of a health information exchange. During times like these, Roth says, “Everything and anything is on the table for deferral. But one of the things tracking does is it reduces our duplication of inventory, in particular some of the smaller, handheld kind of biomed equipment like diagnostic equipment.”

While Pinnacle hasn't conducted a formal ROI model to determine how tracking has reduced its inventory needs, Roth says he has noticed a need for less duplication; particularly with some of the smaller pieces of biomedical testing equipment. “We were losing hundreds of thermometers a year,” he says. “But we're now able to not just track where they are, but also hold the management on those teams accountable for their loss.”

Phillips agrees, adding it's more important than ever for organizational leaders to defend the clinical investments that have already been made, especially as capital money becomes scarce. “I think the name of the game now is efficiency and protecting your capital investments,” he says. “It's pretty easy to get your ROI back on a true RFID system. If you run it over your existing wireless infrastructure, you're protecting that capital investment and not having to run a lot of cables throughout your organization.”

Liard urges CIOs to look beyond the initial costs of the technology — which, he says, are fairly insignificant compared with other roll-outs — and focus on the long-term benefits. “While it might be an upfront cost, think about the savings you might have in finding equipment. That's an operational improvement that's going to improve the bottom line.”