Slowly, 'smart hospitals' on the rise
RFID and RTLS finding footholds
LAS VEGAS – One of the most intriguing areas at HIMSS12 this past month was the Intelligent Hospital Pavilion. Presented in partnership with the RFID in Healthcare Consortium, HIMSS' walk-though mock-up offered an up-close look at the myriad ways radio-frequency identification (RFID), real-time location system (RTLS), sensor and wireless technologies – developed by companies such as AeroScout, AwarePoint, Intelligent InSites and RFID Global Solutions – can optimize inventory management, improve patient safety, streamline clinical workflow and more.
Inaugurated in 2011, the pavilion had grown – from one room to five – in the past year, and it attracted more curious tour-takers this time around. It's "an exciting part of the show … if you hear about it," said Marcus Ruark, vice president of marketing at Fargo, N.D.-based Intelligent InSites.
While the hubbub on the show floors was all about meaningful use Stage 2 and the delay of the ICD-10 compliance date, RTLS is still a vastly underused and under-appreciated technology. Its use in hospitals is still pegged at somewhere between just 5 and 15 percent.
But at the pre-conference RFID & RTLS in Healthcare Symposium, a slate of innovative physicians and IT professionals tried to show how the transformative technology could be more widely deployed and put to use.
RFID chips can be tiny – some are just 0.4 millimeters squared, as small as a speck of sand – but their impact on healthcare can be enormous. Put to work as part of an RTLS system, the tags can have a positive effect on medication administration, asset tracking, bed management, hygiene compliance, security and much more.
As Paul Frisch, MD, director of biomedical engineering at Memorial Sloan Kettering Cancer Center in New York, said at the symposium, those envelope-pushing applications aren't some fantastic vision of the "hospital of the future" but rather "a representation of what we can do today."
Indeed, Neil Halpern, MD, chief of critical care medicine at Memorial Sloan-Kettering noted how other industries are making use of these technologies, from "smart sneakers" such as the Adidas Adizero f50 to growing evolution of "intelligent transportation systems" in cars.
Halpern outlined various innovations that can be deployed to create a "SmartICU" – including "e-glass" that can replace germy curtains and offer "privacy at the touch of a switch," intelligent alarm servers meant to prevent alarm fatigue, smart infusion pumps, conference room dashboards linked to EHRs and ventilator management systems – and even self-cleaning rooms.
The technology may still be in its infancy, but Mohammed Maghazil, head of applications and IT affairs at King Faisal Specialist Hospital & Research Center in Riyadh, Saudi Arabia, said it's the way of the future.
With the potential to reduce medical errors, optimize business processes, improve quality and accuracy (and therefore accountability) and enable long-term cost-effectiveness, RFID and RTLS are hardly "a luxury," he said. Before long, they'll be a must-have. Maghazil's advice is to "plan big, but start small." Soon, he said, it will be apparent that "the sky is the limit" for the number of ways they can be deployed.
In the meantime, most deployments are still fairly modest. That 5 to 15 percent, Ruark noted "counts hospitals with a room or two, or even just a couple tags."
That might be a good start, but it's just scratching the surface, he said. Intelligent InSites specializes in enterprise-wide deployment, because "RTLS has the power to change almost every process in the hospital."
Getting there isn't easy. "Expense has something to do with it," said Ruark. Tags, purchased en masse, can be pricey. But "every year they get smaller, cheaper and the battery life gets longer," he added.
Still, while a smart RTLS deployment may "not [be] on the magnitude of an EHR implementation, to do it properly you need to think big-picture – think all these different things RTLS could change."
Speaking of EHRs, it's arguable that they can be thanked for the slow adoption of RTLS thus far. Once meaningful use happened, "IT departments got other priorities really fast," said Ruark. "The cliché is that it took the oxygen out of the room."
Still, he sees signs for optimism on the horizon. "This year is going to be a transformational year for RTLS." The Department of Veterans Affairs has a procurement under way for $540 million for RTLS, he noted. Half a billion dollars being pumped into a still-young industry is no small thing.
"When we talk to commercial hospitals about what the VA is doing, they get very interested, said Ruark. With the VA having proven its leading edge health IT bona fides, many hospitals "view themselves as followers of the VA." If the department makes a big splash, the commercial sector may well follow its lead.
In the meantime, companies like Intelligent InSites are preparing themselves to ride that wave. Tags may be a tad pricey now, but "we view the future as a place where tags are free," said Ruark. "And we want to make sure we have the right platform and the enterprise-wide approach to handle a world where almost everything" is tagged.
Asset tracking is all well and good, after all. But it's "not just enough to know where an infusion pump is," he added. "You want to know what it's doing."