Healthcare technology management departments often reply on a real-time location system (RTLS) to help them complete their many tasks and responsibilities. RTLS has evolved over the years matching the rapid advances in technology in the consumer and healthcare markets. TechNation recently spent some time finding out more about RTLS and how HTM professionals rely on it as well as some of the latest trends and newest features.
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Participants in this roundtable article on RTLS are:
• Duke Health Senior Director of Clinical Engineering Benjamin Scoggin, MBA, MMCi;
• ECRI Associate Consultant, Device Safety Consulting Dustin K. Telford, AAMIF, CHTM, CBET, CRES, CLES;
• HID Healthcare RTLS Vice President of Sales Kerry Brock; and
• Midmark RTLS Senior Director HT Snowday.
Q: HOW IS RTLS CHANGING THE WAY HTM DEPARTMENTS FORECAST EQUIPMENT DEMAND OR PLAN CAPITAL REPLACEMENT?
SCOGGIN: RTLS has shifted forecasting from anecdotal, and utilization-survey driven to data-validated, defensible planning. Instead of relying on staff perceptions such as “we’re always short on pumps,” we can now evaluate actual utilization rates, dwell times, idle percentages and cross-campus movement patterns. From an HTM standpoint, this directly influences capital replacement decisions by identifying true over- or under-capacity, highlighting assets that appear old but are lightly used, and surfacing newer devices that are over-utilized and approaching functional end of life faster than expected. It also supports fleet right-sizing and redistribution across hospitals and clinics, often delaying capital spend while improving availability and clinician satisfaction.
TELFORD: RTLS doesn’t replace capital equipment replacement planning – it finally gives us the missing data to do it properly. Location states like “in-use,” “standby,” “in-transit,” and “stored” reveal the truth about utilization that questionnaires and anecdotal reports never could, but the real power comes from weaving this data together with complementary sources like bed management systems, device-generated utilization logs, and CMMS maintenance patterns. When you discover that 40% of your infusion pumps spend most of their time in “storage” mode while nursing units are calling for rentals, you’ve found money sitting in closets rather than a justification for capital purchases. The magic happens when HTM teams stop viewing RTLS as a standalone solution and start treating it as one instrument in an orchestra – where location data harmonizes with clinical workflows, preventive maintenance schedules, and actual patient census to create a symphony of evidence-based asset management that finally separates real equipment shortages from poor distribution strategies.
BROCK: RTLS provides real-time utilization data, enabling HTM teams to identify underused or overused assets and make data-driven decisions. This visibility helps optimize fleet size, reduce unnecessary purchases, and prioritize replacements based on actual usage rather than estimates. Ultimately, it shifts planning from a reactive to a proactive approach, improving both efficiency and cost control
SNOWDAY: RTLS is enabling HTM departments to shift from assumption-based capital planning to decisions driven by real utilization data. By showing how often equipment is used, where it spends time idle and how demand varies over time, RTLS helps distinguish true shortages from redistribution opportunities. This allows HTM teams to better forecast future needs, right-size equipment fleets and prioritize capital replacement based on actual wear, risk and clinical impact. The result is more defensible capital requests and smarter, data-backed investment decisions.
Q: HOW DO YOU EVALUATE WHETHER A PIECE OF EQUIPMENT TRULY NEEDS AN RTLS TAG, AND HOW DO YOU AVOID “OVER-TAGGING?”
SCOGGIN: We start by asking what decision the data will enable. If RTLS data will not meaningfully influence clinical workflow, capital planning, patient throughput, or HTM operations, then the asset likely does not need a tag. From an HTM perspective, the strongest candidates are mobile, shared assets with high search time, high loss risk, high rental substitution cost or frequent preventive maintenance dependencies. We avoid over-tagging by piloting on a limited asset class, validating the value of the data and then scaling intentionally. Tagging everything increases cost, noise and maintenance burden without increasing insight.
TELFORD: Start with two fundamental questions: “Can this equipment move?” followed immediately by “Does this equipment actually move in our facility?” – because tagging wall-mounted devices or equipment that’s been sitting in the same storage room since 2023 is just burning budget on battery replacements. Before investing in any tagging infrastructure, ask the penetrating questions: Does this device already report its location through the vendor’s proprietary software or our existing hospital wireless network? If this equipment travels to areas with coverage gaps like outpatient pavilions, arboretums, or parking structures, will our RTLS infrastructure even work there? The emerging sweet spot is leveraging RTLS solutions that tap into devices’ own internal wireless capabilities plus your existing IT infrastructure – avoiding vendor-specific tags entirely – and intelligently mixing passive RFID tags (which are remarkably affordable, let you print your own biomed asset numbers, and have no batteries to maintain) with active tags reserved only for high-value assets where clinical practitioners need “find it right now” capabilities. Remember: if you’re tagging IV poles while your $80,000 ultrasound systems wander freely through the enterprise, you’ve missed the point entirely and probably need to revisit what “strategic asset management” actually means.
BROCK: We start by assessing the asset’s mobility, criticality and impact on clinical workflows. High-value, frequently moved or patient-facing equipment typically qualifies for tagging, while stationary or low-impact items do not. This criteria-based approach prevents over-tagging and ensures ROI by focusing on assets that deliver measurable operational benefits
SNOWDAY: HTM departments should evaluate the need for RTLS tagging by considering device value, utilization frequency, mobility and the clinical impact if the equipment is not immediately available. High-value, frequently moved assets or devices that directly affect patient care and throughput when unavailable are strong candidates for tagging. RTLS data helps avoid over-tagging by identifying equipment with low utilization, limited movement or minimal operational impact. This targeted approach ensures tagging investments are focused where visibility delivers the greatest clinical and financial return.
Q: HOW DO EMERGING TECHNOLOGIES SUCH AS AI-POWERED ANALYTICS, UWB, BLE, OR WI-FI 6 IMPACT EXPECTATIONS FOR NEXT-GENERATION RTLS SOLUTIONS?
SCOGGIN: Expectations are evolving beyond simple location awareness to predictive and prescriptive intelligence. AI-driven analytics should help anticipate shortages, predict failure risk based on movement and usage patterns and automate alerts tied directly into CMMS and clinical workflows. Technologies such as UWB improve room-level precision, while BLE and Wi-Fi 6 expand scalability and reduce infrastructure barriers. From an HTM standpoint, the most important expectation is interoperability. RTLS must integrate cleanly with CMMS, asset life cycle systems and cybersecurity frameworks without becoming another siloed platform that requires manual reconciliation.
TELFORD: AI-powered analytics are shifting RTLS from a “where is it now” tracking system to a “what should we do about it” predictive intelligence platform that can forecast equipment shortages before they impact patient care, identify abnormal movement patterns suggesting theft or misuse, and automatically optimize asset distribution across an enterprise. Ultra-wideband technology delivers the room-level accuracy that healthcare finally demands – knowing a ventilator is “somewhere on 4-West” isn’t acceptable when minutes matter in patient deterioration scenarios. The convergence of these technologies with existing IT infrastructure like Wi-Fi 6 and BLE reduces deployment costs and creates opportunities for HTM departments to integrate RTLS data with CMMS platforms, EHR systems, and supply chain management tools, but organizations must resist vendor promises of “AI magic” and demand transparent algorithms with validated accuracy metrics before making million-dollar infrastructure investments.
BROCK: Emerging technologies enhance accuracy, scalability and actionable insights. AI-driven analytics transform raw location data into predictive models for workflow optimization, while UWB and BLE improve precision and flexibility. Wi-Fi 6 supports higher device density and faster connectivity, setting the stage for RTLS systems that are smarter, faster and more integrated.
SNOWDAY: Emerging technologies are raising expectations for RTLS to move beyond basic location visibility into predictive and prescriptive intelligence. AI-powered analytics are now enabling health systems to anticipate a variety of operational needs – such as forecasting PAR levels for high-demand assets like IV pumps, helping ensure the right equipment is available at the right time while reducing excess inventory. Advances in UWB have the potential to deliver room-level precision that supports clinical workflows requiring high accuracy, while BLE offers a cost-effective way to achieve facility-wide coverage. When BLE is paired with infrared (IR) technology that delivers proven, room-level precision, RTLS platforms can meet both operational and nursing needs, driving broader adoption and measurable ROI.
Q: WHAT LESSONS LEARNED FROM PREVIOUS RTLS DEPLOYMENTS WOULD YOU SHARE TO HELP OTHERS AVOID COMMON PITFALLS?
SCOGGIN: The most important lesson is that RTLS is not an IT project or a technology install. It is an operational transformation initiative. Deployments struggle when governance, ownership and workflows are not clearly defined upfront. Additional lessons include involving HTM, nursing, supply chain, IT and security early; validating infrastructure assumptions before large-scale tagging; piloting and measuring outcomes before expanding; and budgeting for ongoing tag maintenance, battery replacement and data stewardship. RTLS success depends far more on process design and adoption than on hardware.
TELFORD: Before you buy a single tag, answer two critical questions: “Who owns this system?” and “Who’s actually supporting it three years from now when the implementation team has moved on?” – because I’ve watched organizations mothball expensive RTLS deployments within a few years when nobody’s looking at the whole picture or evolving the system to solve real problems for end users. The biggest failure point isn’t technology – it’s treating RTLS as a magic solution rather than recognizing it’s merely a tool, and the actual solution requires a skilled team that continuously refines workflows, educates users and integrates new capabilities as they become available. Start with brutally honest success metrics beyond “we can find equipment faster” – quantify reduction in rental costs, decreased time clinical staff spend searching for devices, or improved equipment availability during rapid response events – then pilot with a small scope where you can demonstrate quick wins and learn from failures cheaply. Here’s the uncomfortable truth: if your RTLS implementation doesn’t include a dedicated champion who treats innovation, education, and integration as ongoing responsibilities rather than one-time checkboxes, you’re not deploying a solution – you’re installing a very expensive equipment museum that documents dysfunction rather than fixing it.
BROCK: Start with clear objectives and stakeholder alignment – unclear goals often lead to scope creep and poor adoption. Validate infrastructure readiness early, as network limitations can derail timelines. Finally, invest in staff training and change management to ensure the technology delivers its intended value
SNOWDAY: One important lesson learned is that siloed RTLS deployments – where different departments implement separate systems – often increase costs, complexity and long-term maintenance challenges. Taking an enterprise approach allows health systems to share infrastructure, data and insights across asset management, clinical workflows and safety use cases. It’s also critical to plan for operational realities such as ongoing battery replacement for sensors and tags, whether managed internally or through a third-party service. Partnering with a vendor that offers strong local support helps ensure the system remains reliable, adopted and sustainable over time.
Q: HOW DO YOU MEASURE AND VALIDATE THE ACCURACY OF YOUR RTLS SYSTEM, AND WHAT STEPS DO YOU TAKE WHEN ACCURACY ISSUES ARISE?
SCOGGIN: Accuracy is validated through real-world testing rather than vendor specifications. We perform physical audits, timed movement studies and room-level verification against known locations. We also monitor exception reports, such as assets showing impossible movement patterns or extended lost states. When accuracy issues arise, we follow a structured approach that includes validating infrastructure coverage, reviewing tag placement and orientation, assessing environmental interference and confirming system calibration. We also reassess whether the use case truly requires room-level precision or whether zone-level accuracy is sufficient for the operational goal.
TELFORD: Establish baseline accuracy expectations in your RFP and vendor contract with specific metrics – like “95% room-level accuracy within 30 seconds of asset movement” – then conduct quarterly validation audits by physically locating a random sample of tagged equipment and comparing actual locations to system reports. When accuracy issues emerge, the root cause is usually environmental interference (new construction creating RF dead zones), infrastructure changes (relocated access points or receivers), or tag failures (depleted batteries or physical damage), so systematic troubleshooting should follow a documented protocol rather than ad-hoc responses. The most sophisticated organizations integrate RTLS accuracy monitoring into their daily workflows by having clinical engineering techs verify and document equipment locations during preventive maintenance visits, creating a continuous validation loop that identifies degradation before it impacts clinical operations. Remember that accuracy isn’t just about technology – it’s also about user behaviors like improper tag placement, removal of tags, or failure to update home locations when equipment is permanently redeployed between units.
BROCK: Accuracy is validated through controlled testing against known locations and ongoing performance audits. We monitor key metrics, such as location error rates and response times, and promptly investigate any anomalies. When issues arise, we recalibrate hardware, optimize software algorithms and adjust environmental factors to restore performance.
SNOWDAY: RTLS accuracy is measured by validating system performance against defined location requirements for each use case, such as room-level or zone-level visibility. IR technology delivers the power of inherent room certainty. A one-to-one relationship between the sensor and the location allows accuracy to be focused down to approximately 2 feet in open areas. For broader, facility-wide coverage, BLE typically delivers 3- to 5-meter accuracy, which can be improved through calibration or by adding additional BLE sensors or gateways. When accuracy issues arise, teams reassess use-case requirements, fine-tune calibration and adjust sensor placement to ensure reliable, clinically relevant performance.
Q: WHAT ELSE SHOULD TECHNATION READERS KNOW ABOUT RTLS SYSTEMS?
SCOGGIN: RTLS delivers the most value when treated as a strategic operational platform rather than a tracking tool. The strongest returns come from improved clinician efficiency, reduced rentals, smarter capital planning, stronger regulatory readiness and tighter asset life cycle management. For HTM leaders, RTLS has become a data credibility tool. It allows us to engage capital, finance and executive stakeholders with objective evidence rather than estimates. When deployed thoughtfully and governed well, RTLS becomes a force multiplier for both clinical operations and HTM performance.
TELFORD: Here’s what vendors won’t tell you in their glossy presentations: RTLS success depends on organizational change management as much as technical implementation – without clear policies on equipment ownership, accountability for missing assets, and consequences for hoarding behaviors, you’ve just installed an expensive system that documents which nursing units are best at hiding equipment. The future of RTLS lies in creative integrations that most organizations haven’t imagined yet – predictive maintenance alerts triggered by abnormal movement patterns, automatic charge capture when devices enter patient rooms, or AI-driven redistribution recommendations based on predictive patient census and acuity forecasting. Don’t let perfect be the enemy of good; start with achievable goals that demonstrate value quickly, then expand strategically rather than pursuing the mythical “comprehensive enterprise solution” that becomes a multi-year implementation nightmare. And here’s my favorite reality check: if your RTLS deployment doesn’t make nurses’ lives easier – if it adds clicks, creates workflow friction, or feels like Big Brother surveillance rather than helpful technology – they’ll find creative ways to sabotage it, and you’ll discover that even the most sophisticated tracking system is useless when staff members “accidentally” leave tags in drawers or mysteriously forget to attach them to newly purchased equipment.
BROCK: RTLS systems have matured significantly in the past 5 years, but the industry is still not that close to plug-and-play solutions. A successful RTLS solution is a collaborative effort and is an ongoing, evolving relationship. To do this, it’s important to have knowledgeable, available and a geographically proximate partner.
SNOWDAY: TechNation readers should know that the most successful RTLS strategies move beyond siloed point solutions to an enterprise, hybrid approach. By combining BLE for cost-effective, facility-wide visibility with IR for room-certain precision, health systems can support multiple use cases – assets, staff, patients and safety – on a single scalable platform. That same system can integrate with Epic EMR to deliver real-time location data directly into clinical workflows, automating tasks, improving patient flow and reducing manual documentation. The result is a scalable RTLS foundation that maximizes existing investments while driving meaningful clinical and operational impact.Â
