Evaluating RTLS Technology: Success Criteria for Hospitals By Raymond Lowe Email: Raymond.lowe@providence.org Providence Health and Services IS Director Saint Joseph Medical Center CA Regional Director IS Operations
Today s Presentation About Providence Health and Services Introduction; Problem and Solution RTLS Technology Options Key Healthcare Requirements for RTLS Healthcare IT Infrastructure RTLS Experience at Kaiser Permanente Case Study 1: RTLS for Enterprise Asset Tracking Now Planning at Providence Health & Services RFID Environmental Controlled Rooms and Patient Tracking Summary and Conclusions
Introduction Real-time Location Systems (RTLS) are an increasingly important strategic capability for hospitals Managing assets and patients in a hospital is an enormous task Enterprise-wide asset management Patient tracking
The Problem How to gain visibility for resource tracking? Mapping Resources (Assets, People) Monitoring the Status of Resources Measuring Resource Utilization Evidence Based Business Improvement
The Solution Real-time Location Solution (RTLS) Location, status and utilization of resources Departmental functionality Improvement Enterprise efficiency improvement Improve quality, reduce cost and risk of care
Technology Options Have Multiplied COST / COMPLEXITY High Medium Low Wi-Fi USD UHF+IR UHF WSN/ZIGBEE UWB In-Building Zone In-Room Precision (100m -30m) (30m -10m) (3m -1m) (1m -0m) LOCATION RESOLUTION
Hospital IT Infrastructure
Key Healthcare Requirements Accuracy Reliability Planning, Deployment and Operational Concerns Ongoing Maintenance Cost
RTLS Cross Functional Considerations Clinical & Financial Needs Knowing location, status and movement of things is what RTLS is all about Must provide enterprisewide coverage Must offer room-level location accuracy throughout an organization IT Needs What ongoing upkeep is required? Will are interference concerns? Select a low maintenance solution Must co-exist with LAN s, WLAN s (Wi-Fi), networkenabled and wireless equipment
Deployment Lessons Learned Understand actual installation, configuration and testing of the system How and where are receivers actually installed? How will this integrate or interfere with existing systems? What is deployment time? Will it provide location accuracy that meets the requirements of all your constituents (clinical, biomed, materials management)?
Cost Lessons Learned 3 main components: 1. Actual labor + hardware and software Significant variable in receiver installation Power and network connections how connections are made greatly impacts costs Receiver density required to achieve positioning accuracy 2. Ongoing maintenance and support costs 3. Purchase can be packaged as a capital purchase, lease or rental How RTLS is packaged can greatly impact future costs and the degree of risk you may assume over the life of the system
VALUE Business Improvement Revenue Cycle Mgmt Clinical Workflow Beyond the Care Facility RTLS A Phased Rollout PHASE FOUR Enterprise Workflow (Six Sigma) Patient Flow Throughput Staff Efficiency Departmental Apps Biomed / Clinical Engineering OR / ED Central Services / MM Security Asset Management Shrinkage Rental Utilization PHASE THREE PHASE TWO PHASE ONE TIME Validate Adopt Integrate Institutionalize Optimize
Accounts from the Real-World Kaiser and Providence Case Study: 802.15.4 Zigbee network Enterprise asset tracking at Kaiser Permanente Los Angeles Medical Center (opened 3/31/2009) Use Case Planning: 802.11 Wi-Fi Network Environmental room controls and patient tracking system in Providence Health and Services Roy and Patricia Disney Family Cancer Center (1 st Qtr 2010)
Kaiser Los Angeles Medical Center
RTLS at Kaiser LAMC Zigbee 802.15.4 Sensor Network Commenced RTLS in 2006 400,000 Square Feet 2,000 Assets Tagged Primary asset categories include: Ventilators, Pumps, Transport Monitors 2 nd Hospital Installed (12/2008) 800,000 Square Feet 2,000 Assets Federated searching of assets between facilities to manage inventory between sites
RTLS Goals for Kaiser LAMC Reduce lost, stolen, misplaced equipment Increase equipment utilization to reduce capital budget Enhance staff productivity, efficiency and satisfaction Reduce time searching Increase patient care time Increase efficiency of PM process Improve equipment request response time
How it Works 802.15.4 Zigbee Network
Kaiser RTLS How Did We Do? Clinical and Financial Needs Room level accuracy throughout the enterprise Reduction in staff time searching ( saved ~1.5 hours per employee per shift) Reduced shrinkage (lost, stolen, misplaced) Increased utilization (no idle or hidden equipment, missing asset alerting, improved PM cycles) Deployment As soon as sensors plugged in, they form wireless network (no planning, no disruption) Install completed in 12 days
Kaiser LAMC RTLS How Did We Do? Planning Did not require any preinstallation RF surveys or detailed system design Sensors plugged into standard electrical outlets As soon as they re plugged in, they begin forming the wireless network Ongoing Maintenance RTLS in operation for over 2 years Zero IT maintenance involvement during this time System maintains positioning accuracy and high reliability self-healing, self-calibrating
Providence Health & Services Disney Family Cancer Center
PH&S DFCC 802.11 Wi-Fi Network Roy and Patricia Disney Family Cancer Center (DFCC) Provides Radiation and Medical Oncology Services Opens 1 st Qtr 2010 IT Installation planned for Fall 2009 RFID integration with system integrator application for room environmental, setting, automated check in and patient tracking within facility
Use Case 2: DFCC
PH&S DFCC Goals for Patient Tracking Active RFID card issued to patient Use 802.11 Wi-Fi network RFID environmental controlled rooms for music, lighting, temperature RFID location information allow staff to view patient location information in bldg. Integrate with Avaya Phone Systems Desktop Messaging Nurse Call notification
Concerns When Using Wi-Fi Designing a Wi-Fi network to support RTLS (802.11a vs 802.11g vs. Zigbee) can require expensive Wi-Fi redesign and deployment Ongoing support will require dedicated monitoring, system administration and possibly specialized support agreements
Open Questions with Wi-Fi Will additional RTLS hardware and Wi-Fi APs be needed to accomplish our patient tracking goals? What will it actually cost (in time and expertise) for ongoing maintenance? Who provides the trained individuals to keep it calibrated? How will added RTLS traffic affect our Wi-Fi network? Will increased noise Wi-Fi RTLS tags generate degrade communications performance?
Conclusions RTLS must be inexpensive to deploy and must retrofit easily into existing buildings IT must get cross-functional evaluation team to outline use cases clear clinical and financial ROI Underlying technology has an impact that can affect price and cost of ownership Technology also influences positioning accuracy and reliability
Summary At Kaiser, Zigbee network provided rapidly installed enterprise coverage, returned clinical and financial value, and did not require IT support (no interference, no maintenance concerns) At Providence, Wi-Fi network will be used for departmental patient tracking solution. Still to be proven, as deployment is not complete.
Bottom Line RTLS technology allows us to rethink how we provide care RTLS allows the enterprise to do more with less RTLS allows us to personalize care for our patients