By Jim Fedele, CBET
As part of our new patient tower expansion, the building planners convinced the decision makers here that RFID and wireless temperature monitoring should be included in our state-of-the-art facility. The benefit of nurses not having to look for equipment or manually document temperatures is very enticing. RFID provides a solution that relieves people of the responsibility of keeping track of their equipment and documenting temperature. Since I am responsible for the medical equipment and “we would benefit the most” from the system, (according to the sales guy) I was volunteered as the project manager and system administrator. I have learned a lot about RFID systems, what it takes to implement a system and keep it running. I would like to share some of my experience with you so if you are planning on taking the leap to RFID you know what you are in for.
There are many different types of RFID systems in the market; passive tag, active tag, dedicated network, some even use the internal AC wiring. Our system uses an active tag that transmits on 802.11b and ultrasonically. The system uses the existing hospital network to get the tag information into the positional server and user software. The setup of all the components was very involved and required both IT and Facilities Resources. Facility maps need to be acquired, converted to the correct format and then loaded into the system. It took us a few times to get maps in the system that had good enough resolution to be useful. Our system also included wireless temperature tags; these tags were placed in medication refrigerators throughout the hospital to monitor, in real time, the temperatures within these devices.
To get the RFID system implemented, the company assigned a project planner to assist us in set up and workflow. He was probably one of the better project managers I have had to work with. He was very thorough and he really understood the system and helped us with making it work for us. He also showed me tips and tricks for getting the information into the system. However, before the project was completed, he took another position in the company and we finished the implementation on our own. It was at this point that I realized the amount of time this was going to require of me and my team. The company did send us another project manager, he was new to the company. Given that we were in the middle of the project he struggled to be effective.
When considering RFID there are a few things you should be aware of before purchasing a system. On the surface, the ability to log into a program, enter an asset ID and pull up its location instantly is a time saver. However, for the management of the system we purchased, the assignment of the tags and resolving issues seems to be eroding any promised time savings. Please do not misunderstand. When the system works, it is great. However, as we all know, nothing works as promised 100 percent of the time.
Tag management has proven to be a rather arduous task for me and my team. Our first problem occurred after we finished tagging 450 new IV pumps just to be told that the tags all needed their software updated and we would need to replace all the tags. I thought my head was going to explode. This took weeks to accomplish because units where now deployed and on patients. Another problem we have is that occasionally batteries fail without warning. The system can inform us of a low battery, but defective batteries typically just crash. When the tag loses power the system sends a notification that includes the last place it was located. I do not think the engineers realize how fast equipment moves around in a hospital. I have been on many “wild goose chases” trying to quickly capture these offline devices. We have over 900 devices tagged and this seems like a weekly occurrence.
A few other things we ran into are finding suitable locations for tags on equipment, tags being torn off equipment, the cost of each tag, the associated “licensing fee” and software maintenance fees make the system rather expensive to use.
When a salesperson is selling RFID to you and your facility, they tend to minimize the amount of work required to manage the system. For our system, we added the temperature monitoring component, which is great for meeting compliance requirements. However, the tags need their calibration checked every one or two years. We have over 300 of these tags so it is always a huge coordination effort to get the tags replaced or checked. During system downtime, managers need to be notified to go back to manually monitoring temperature. In my opinion, I doubt much time is actually saved when it is all said and done. We simply have shifted where the time is spent. Instead of nursing going out looking for equipment, my team is repairing tags and managing the system. Essentially, we have added another big, complex, piece of equipment that doesn’t always work right and needs to be fixed and managed. The system is not simply a reliable plug and play device. My advice regarding the purchase of a RFID system for tracking or temperature monitoring is to consider:
- Who will be the system administrator?
- How will tag requests be made and paid for?
- Who will be responsible for the maintenance and licensing fees?
- How will the users maintain their competency of the system?
- Who will troubleshoot tag and system issues?
- Who will manage the alerts from the system?
- Who will be responsible for developing and maintaining the system policies for the organization?
In my opinion, if nursing and maintenance (for temperature monitoring) aren’t fully committed to utilizing and owning the system then the use and benefit will never be maintained.
Jim Fedele, CBET, is the senior director of clinical engineering for UPMC. He manages six Susquehanna Health hospitals. He has 30 years of HTM experience and has worked for multiple service organizations.