Tom O’Boyle, Director of RFID, Barcoding Inc., acknowledged that education and experience has inspired more of a multidisciplinary approach to track-and-trace technologies, contributing to tremendous growth in bar coding, RFID and RTLS.

"Users’ understanding of the benefits and limitations of each technology has allowed for system designers to deploy multiple, and sometimes all three, technologies within the same system," O’Boyle said. "RFID and RTLS have a tremendous benefit of allowing a system to read many items — assets or patients — at one time. Bar coding is still the preferred method to [locate] an asset or a patient and verify a manual operation.  So deploying bar codes in certain instances, like medication dispensing, makes very good sense."

O’Boyle further noted that facilities tend to deploy and use active RFID tags to locate the position of an asset or patient with a facility using triangulation, but even that technology is changing. "Using Wi-Fi-based tags is expensive and the infrastructure burden is high," he said. "Newer active tags using Low Energy Bluetooth (BLE) technology will over time become the dominant technology in the space.  BLE tags and readers are lower cost, follow an accepted standard and have tremendously long battery life. On top of that, every smartphone or tablet being manufactured has a built-in reader allowing for more handheld-based applications."

O’Boyle foresees continued evolution with Passive RFID for automatically updating inventories of assets. "As a technology, its low-cost benefits will allow many suppliers to tag and build in readers into supply cabinets," he said. "We are seeing advancements on the surgical kits, drug supply for LOT tracking, and normal patient consumables.  The costs of the label tags have been consistently coming down over the past five years.  We see some costs below 10 cents now for some tags at high volumes.  That cost will continue to fall with the push to have the RFID antennas printed on the labels. This reduced the label manufacturing costs and allows for custom antennas to quickly be designed and deployed."

Looking forward

Ask track-and-trace tech experts on what asset and patient tracking systems really can achieve if properly applied and smoothly operational and you’ll likely notice them all hovering around higher quality care, improved patient outcomes and lower costs long-term. But what does all of that really mean and how do these nebulous terms apply?

"With an enterprise-wide installation of certainty-based RTLS, healthcare facilities are able to implement workflow automation, automated nurse call cancellation, staff duress/assistance, infant protection, wander management, infection control/contact tracing, among many others," CenTrak’s Naim listed. "By automating processes and making them more effective and efficient, the caregiver is able to spend more time at the bedside with their patient and less time being burdened by data entry, searching for equipment and other manual procedures."

Further, Naim attributes innovative technologies spearheading the creation of the "ultimate experience" for patients who will receive higher quality care as "the standard."

"With lower costs, minimal wait times, efficient care, and reduced risk of infection, the stress patients feel when going to the hospital will be greatly reduced," he added.

When it comes to safety and satisfaction, Intelligent InSites’ Waslaski concurs. "In healthcare, all efforts and investments are geared toward improving patient experiences and outcomes, and that certainly holds true for the use of asset and patient tracking technology," he noted.

Operational efficiency is one key area. For example, giving staff real-time visibility to the location and status of mobile medical equipment empowers them, according to Waslaski. Nurses spend less time searching for equipment, which gives them more time at the bedside. Biomedical technicians save steps and avoid waiting by seeing when equipment is available for pickup versus in use with patients. Supply Chain staff save countless hours by simply waving a wand in storage areas to complete inventory counts, or print a report to show the current location of recalled equipment.

Analyzing the actual utilization of tagged equipment allows Purchasing to avoid redundant purchases and paying rental fees for equipment that isn’t being used, he continued. Real-time PAR level dashboards automate equipment replenishment with notifications and tasks being triggered when equipment counts drop below pre-set minimums. "This means the equipment is just there — with no running around searching or making phone calls to Sterile Processing," he noted. "Bar codes can be attached to folders containing patient discharge instructions so that timestamps are collected when they pass through unit exit doors, enabling length-of-stay metrics that don’t require manual data entry."

Waslaski pinpointed the common element in all of these examples as the use of "pervasively available technology that removes steps, guesswork, redundant data entry, and reliance on busy caregivers to interrupt time with patients to write things down or make phone calls."

Patient safety represents another key area.

"Healthcare facilities are busy and sometimes chaotic environments where caregivers rush between patients while working to maintain compliance with dozens of procedural and diagnostic regulations," Waslaski noted. "Advances in research and predictive modeling help caregivers guard against misdiagnoses or harmful drug interactions."

But Waslaski contended that "far too much reliance is placed on individual human intervention to ensure that basic safety standards are consistently met." These include ensuring patients stay within designated care areas or are seen within an hour of receiving pain medication. Using RTLS, staff can receive notifications when patients pass through designated doorways or aren’t within proximity of a caregiver within an hour of ingesting pain medication, he indicated. Immediately after learning of a patient with an infectious disease being in a healthcare facility, a Safety Officer can print a proximity report showing all of the people and equipment that patient came in contact with so that further spread of infection can be contained and affected individuals can receive appropriate preventative care. Knowing which staff was in a patient room and for how long helps Unit Directors and Nurse Managers understand sequences of events leading to patient falls or abrupt changes in heart rate so they can adjust processes accordingly.

An RTLS-enhanced patient experience also may improve HCAHPS scores, which affect reimbursement, as more satisfied patients spend more time with physicians and less time waiting in overcrowded waiting areas or alone in exam rooms, according to Waslaski.

Minding economics

Albert Larose