An inside look at wireless location services

No longer just for external uses, technology even helps track wheelchairs and patients.

Special focus: A wireless location service at a Harrisburg, Pa., hospital finally solved a problem that you never see addressed on “Gray’s Anatomy” or “ER”: Where to find a wheelchair in a sprawling 546-bed hospital.

Vendors crowding wireless location service markett

A group of wireless vendors, using a mix of proprietary and standards-based radio gear, and a growing array of software application companies, now offer enterprise users the chance to layer on a network of wireless tags and access points to identify, track and locate both things and people. Harrisburg Hospital is doing both.

Tracking operating room patients

The hospital, part of Pinnacle Health System, first deployed in early 2005 a wireless tracking system for surgical patients. The application is PathFinder from PeriOptimum of Pittsburgh. The software works with the 433-MHz radio tags and access points from Lawrence, Mass.-based Radianse.

PathFinder gives Web-based minute-by-minute data on each patient’s location and status in the entire surgical process, drawing positioning coordinates from the Radianse hardware and location algorithm, and mapping these to a floor plan of the operating room complex. The data becomes a critical element in managing staff workflow and moving patients more efficiently through each stage, according to Dr. Craig Wisman, the hospital’s vice president of medical affairs.

In May, the hospital decided to expand the Radianse infrastructure and adopt that vendor’s asset tracking application for locating equipment.

An end to wheelchair hunting

“When I started working in Pinnacle 22 years ago, one of my first meetings was on the availability of wheelchairs,” recalls George Morley, director of Harrisburg’s biomedical engineering group, the people who maintain and repair a vast portfolio of medical equipment. “I had meeting after meeting on this, trying every system possible.”

It’s not just wheelchairs that have to be found, but a wide range of portable medical equipment, from heart monitors to IV stands, thermometer, even walkers. “We have lots of assets, scattered all over the hospital,” Morley says. The one system that worked: hoarding.

Today there are about 3,000 active radio tags glued or tied with a special cable to all kinds of equipment, or attached to a patient’s gown in the operating room. The hospital expects to have 8,000 to 10,000 tags in use by the end of 2008.

During the product evaluation nearly two years ago, the hospital considered, and rejected, 802.11-based location systems, despite the fact the hospital has an internal wireless LAN. “We were never convinced that the Wi-Fi solutions at that time had adequate precision to pinpoint locations to a specific room or bay,” Wisman says. “And the battery life of the [802.11] transmitters was quite short compared to the device we’re using now.”

Another issue was possible interference problems caused by having to add scores or even hundreds of new 802.11 access points to support location tracking.

It wasn’t entirely smooth sailing. Both men had to wait for the hospital’s IT group to install or upgrade LAN switches to which the Radianse access points are connected. And they found that the access points for patient tracking needed to be more finely tuned than for equipment tracking. Using the same access points for both applications could sometimes make tracking patients less precise.

The hospital hasn’t made a detailed cost-benefit analysis yet, but Morley cites a wealth of anecdotes as evidence that a lot of people are spending a lot less time hunting for equipment. Wisman says various studies support his expectation that the OR patient tracking will let the existing facilities handle more surgeries.

No panacea

Yet such systems are not a panacea. They won’t compensate, for example, for poorly designed clinical workflows, or other purely organization problems that will bog down the patient-care process, especially when multiple medical disciplines are involved, notes Greg Malkary, founder and managing director of Spyglass Consulting Group of Menlo Park, Calif., which specializes in mobile computing in healthcare.

“Trends in RFID,” a 2005 Spyglass report, based on in-depth interviews with 100 clinicians, nurses and healthcare IT professionals, uncovered a range of issues about wireless tracking of assets, patients and even staff.

Not all assets need to be tagged, for example. And several respondents stressed the importance of targeting just those portable assets that are costly and in high demand. Another stressed the need for new analytical tools that can transform simple location data into steps that will increase the use of portable medical assets and cut into the cost of patient care.

Not everyone is convinced of the payoff, especially over the long term. Eighty percent of the Spyglass respondents see active RFID solutions as expensive to deploy, with a total cost of ownership that can be difficult to quantify. Those doubts are based on the relatively high cost of active radio tags, of the wireless infrastructure itself (and in the case of Harrisburg of upgrading the wired net) and potential changes in hospital workflow processes.

More than 90% of respondents in the Spyglass survey said they wanted to leverage the existing net for location systems, wireless data and VoIP. At the same time, respondents expressed concern that creating large-scale asset and patient tracking systems could impact the net’s performance and bandwidth.

The new tools are giving people new opportunities, though, Harrisburg Hospital’s Wisman insists.

“An indoor location system offers all kinds of interesting operational advantages in healthcare,” he says. “I don’t think we’ve discovered all of them yet.”

Learn more about this topic

Radianse details

Perioptimum’s PathFinder

RFID tracking system speeds shipping business

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