RFID and RTLS getting 'dominated' by MU
A visit to the Intelligent Hospital Pavilion at the HIMSS Annual Conference & Exhibition can sometimes seem like a visit to Disney's Tomorrowland.
For someone from, say, a small and rural hospital, all the stuff being tracked and measured via radio-frequency identification chips, real-time locating systems and assorted other wireless technology must look like a vision of the future.
But RFID and RTLS exist in the here-and-now. Still, despite the benefits these tools hold for asset and patient tracking, the impacts they can have on cost-savings and hospital safety, the future is where they're going to stay, for the most part – at least for the time being.
The numbers are clear. Hospitals just aren't making use of this stuff yet. According to HIMSS Analytics, 79.94 percent of hospitals aren't automated with asset tracking technology and have no plans to do so; just 0.82 percent of facilities have plans to install it in the near future. As for RTLS, the numbers are even more dramatic: 92.84 percent of hospitals don't have it and don't plan to; just 0.56 percent are thinking of trying it out.
Those that have tried it have liked what it's enabled them to do. As KLAS analyst Steve Van Wagenen said about a 2011 report on the subject, "Providers using RTLS solutions reported finding success when automating the monitoring of refrigerator temperatures; tracking assets, patients or staff members; assessing hand-hygiene compliance; and engaging in a variety of other uses."
Still, he said, "Not all RTLS deployments are created equal. Much of a facility's success with RTLS depends on the breadth of the deployment, the variety of ways RTLS is being used and the level of integration between RTLS and other solutions."
For now, though, that point is academic, since so few hospitals are embracing wireless tracking, as more pressing projects compete for their time and resources.
"It's getting dominated by meaningful use," says John Hoyt, executive vice president of HIMSS Analytics. "There's just no activity."
Sure, there are lots of case studies where real-time tracking is shown to "reduce the number of hardware products that hospitals have to have, such as IV pumps, because they're not stuffed in nursing closets," he says. "I believe the case studies. But I just think the message is loud and clear: People are not buying it right now because they've got money to earn on other things" – meaningful use incentives – "and they're just not paying attention to this one."
When might they start? "I think we're beyond 2015 for that."
Interestingly, says Hoyt, "I'm seeing it in Asia more than I am in the United States – but then again, a 1,000-bed hospital in Asia is commonplace. One such facility is Seoul National University Bundang Hospital, which was the first hospital outside of North America to reach the top Stage 7 on HIMSS Analytics' EMR Adoption Model.
"It's a 1,300-bed hospital, and they use real-time tracking, RFID, on patient wrist bands and of course all their equipment, too," says Hoyt. "When you have these big physical plants, it makes sense. These hospitals are gigantic. So they do that for patient tracking. So do a couple hospitals in Singapore that I've been to. It is a reasonable thing for big hospitals, not just for assets but for people."
But here stateside, enterprise-wide wireless tracking is still exceedingly rare – even in those much-touted "hospitals of the future" being constructed in select cities nationwide, outfitted tip to toe with leading edge IT systems.
"The wireless infrastructure is there," in such newly minted facilities, says Hoyt. "Whether they are committing to the operating cost of a dollar per wrist band is still undetermined."
And that's perhaps one of the prime reasons for such slow uptake: This stuff is expensive. The Department of Veterans Affairs, for example, announced earlier this year that it would enlist HP and Intelligent InSites to deploy RTLS in 152 medical centers nationwide – to the tune of $543 million.
For those looking to embrace the technology, it's important to be smart about it. Have a strategy. "If you're going to spend that kind of money for that kind of infrastructure, all those antennas all over the hospital, you're spending a lot of money for infrastructure. Then use it, for gosh sakes, don't just put it on $5,000 IV pumps. Put it on all kinds of stuff."
From the ED to the OR to the ICU, tracking technology has myriad beneficial applications in hospitals. "I'm hearing about more and more use in the OR, down to the sponge level," says Hoyt. "If you left a sponge in somebody we'll know it.
"We are seeing a broadening use of this technology, not just for assets but for patient safety and patient tracking," he adds. Psychiatric hospitals might be a good use case, for instance. With patient prone to wander, and many of them staying for extensive lengths of time, a dollar wristband would seem to be well worth the investment. Neonatal departments, too, can use the wireless tags to help prevent baby theft.
Hoyt has seen the technology put to use tracking nurses' location in the hospital, in an effort to reduce overhead paging. Instead of "Mary Smith, please call this number because Dr. X is on the phone to tell you what to do next with this patient," the system means, "I call Mary Smith is in room 203 because I know she's in there." In the hospital that tried it, he says, "overhead paging went down 90 percent."
Still, despite its many safety and cost-saving benefits, asset and patient tracking technology seems destined to see extremely slow adoption, at least until most hospitals have cleared some other more pressing projects off their balance sheets.
It's coming, though, soon enough, says Hoyt. "Ten years from now it might be the standard of care in the operating room."
[See also: RFID & RTLS can save lives]