Asset management remains a hot topic in health care and not just in the biomed shop. TechNation reached out to several insiders to quiz them about asset management strategies, cost savings and more. The answers provide knowledge and solutions for biomeds to consider.
The experts participating in the roundtable article on asset management include:
- Kontkat.io Senior Director of Enterprise IoT Accounts Kapil Asher
- Tech Knowledge Associates (TKA) Vice President of Sales and Business Development Bruce Call
- Renovo Solutions Vice President of Business Development Matt Forrest
- Vizzia Technologies Chief Technology Officer Howard Hatcher
- Midmark RTLS Director of Hardware Research and Innovation HT Snowday
Q: What are some asset management strategies?
Asher: The goal of asset tracking is to contribute data that helps complex operations to function more efficiently. This can mean improving workflows, streamlining processes, reducing the losses associated with downtime or asset search, optimizing asset use and performance, and generally aiding in the pursuit of smart, lean performance. The result? RTLS deployments that are transforming industries and providing unprecedented opportunities for improved performance. For clinical engineers and hospital systems this means never having to go looking for an IV pump ever again: Track the exact location of every asset in real time with clear insights into equipment utilization and AI-powered analytics.
Call: These responses are specific to mobile equipment asset management in a hospital setting. There are lots of definitions of asset management in health care! Our offering is called READI+, which stands for Reliable Equipment, Available, Disinfected, and Inspected.
- Assess your challenges – Lost equipment? Cleaning/processing, or cleanliness of equipment? Hidden or hoarded equipment? Finding equipment for clinical engineering to do PMs? Recent findings on a regulatory survey?
- Involve key stakeholders – Nursing leadership, select staff nurses and caregivers in patient care areas, central distribution employees, supply chain, infection prevention, and others as appropriate.
- Find what is broken in your current practices. Manage to better processes to provide equipment to caregivers in the best condition possible, as quickly as possible.
- Don’t blame … empower! Nurses don’t hide or hoard equipment because they like reading the fine print on the cases, they do it because they want to have access to the devices needed to care for their patients, when they need them. By putting better practices for equipment cleanliness and distribution in place, you will empower nurses to “get out of the equipment management business” and spend more time with their patients.
Forrest: We try to provide flexible options that offer various strategies such as hybrid programs in which we collaborate with an in-house HTM program to assist their team on equipment they do not support. We also provide supplemental technicians or temporary managers for sites that are shorthanded or in need of an interim HTM leader. We also see several health systems willing to take more risk and not have a significant amount of equipment on full-service contract. This provides an opportunity for additional savings but can also be costly when critical parts fail. It is important to understand the risks associated with each device.
Hatcher: Key is the initial discovery of the main pain points in your hospital facility. When implementing an effective asset management solution at your hospital, it takes a village composed of key stakeholders committed to seeing its success and longevity. No matter if you are a biomedical engineer, senior nurse, or the CFO, it’s critical to understand the key pain points of mismanaged assets from these stakeholders’ perspectives. In essence, poor asset management planning can lead to a decrease in patient care, increased operational costs, and time wasted by critical caregiving staff.
Snowday: There have always been debates around the efficiency of centralized versus decentralized asset management approaches, or lease versus own strategies. When thinking about the strategy that works for your facility or health system, we encourage a focus on the people, as much as the process. When starting an asset management project, we bring the front-line teams into the discussion, both biomedical engineering and nursing, to ensure the process and change management fit the need of your people. In terms of RTLS, it’s also important to consider the larger picture of the efficiencies this technology can bring to the health system. We continually see biomedical teams choose one RTLS to manage assets, and then nursing needing another type of RTLS to automate nurse call, impact workplace violence with a staff duress solution, or manage patient flow. Addressing these needs separately, out of separate budgets, is costly to the health system. The best strategy is to address the larger vision: choosing an RTLS that can both be cost-effectively deployed facility-wide for asset tracking but can also provide the location accuracy nursing needs in patient care areas.
Q: What are the advantages and disadvantages of the different asset management approaches?
Asher: When it comes to the technology that powers your asset management solution, an RTLS system powered by Bluetooth Low Energy (BLE) is likely your best approach. Passive RFID is not typically used for asset location purposes since devices using it are not equipped to broadcast their location. Wi-Fi was initially developed for data communication, not asset tracking. NB-IoT and UWB lack constant signals, which makes real-time tracking updates on things that are in constant motion nearly impossible. From a larger perspective, what’s important is that your approach is fast, easy and scalable. This means a deployment that is quick and doesn’t disturb operations with a system that staff can easily learn and leverage day-to-day.
Call: The two primary mobile medical equipment distribution practices involve:
- Delivering to the patient bedside. Most often employed for new admits, and/or in a med/surg patient room setting. The advantages in this setting include that in a less emergent care setting, you can, over time, develop a database and history of demand patterns, and use this data to adjust inventory and processing practices, and the related staffing and work schedules. The disadvantages include that this is often the largest volume of pick-up and delivery work for the staff, and therefore, hiring, orientation, training and retention of staff are critical functions for HR.
- Delivering to a PAR level, usually in a clean utility area. This practice is usually employed in the settings experiencing the most emergent care needs – ER/ED, and ICUs, for instance. The advantages in this setting are that you are delivering “back-up” inventory, which eases nurse/caregiver concerns in settings where needs can ramp up quickly. However, a key disadvantage in this sort of setting can be that in very rapid order, the patients in this setting can “crash” and even more equipment is needed, rapidly.
Forrest: As stated above, most of the advantages or disadvantages are based on the willingness of the health care organization to take on risk. We have historical data on most clinical equipment in use and can help our clients make better decisions when it comes to service coverage options.
Hatcher: Most health care systems are comprised of multiple facilities across a geographic, metropolitan area (i.e., hospitals and clinics). Thus, a comprehensive, enterprise-wide plan will yield the highest levels of success (i.e., cost savings, staff satisfaction and increased patient care). Due to the nature of moveable medical equipment, deploying an asset tracking service in only one location typically yields incomplete results.
Snowday: In a centralized approach, one team rounds on the soiled utility closets, making sure each unit has the equipment they need. The advantage here is that equipment is (hopefully) always available for patient care when it’s needed. But, without RTLS, rounding is an incredibly inefficient, manual process. A decentralized model, where each nursing unit manages their own inventory, saves the labor on rounding, but places burden on the nursing teams to find the equipment they need; this model often leads to the practice of “hoarding” – stashing equipment away where it can be found for patient care, but often hidden from the biomedical team who needs to preventively maintain the equipment. The good news is, an accurate RTLS can both monitor supply closets to save on rounding in a decentralized model, and accurately locate equipment within a nursing unit to reduce the need for hoarding. The key is choosing the right mix of RTLS technologies that provide both accuracy and cost-effective facility-wide deployment.
Q: What are some of the newest solutions/features available for managing assets?
Asher: With just a glance at the asset tracking platform dashboard – on your smartphone or computer – you’ll see exactly where your equipment is located, how it’s being utilized, where it’s needed most, and how much inventory you really need. Plus, Kontatk.io’s solution is future-proof. With open APIs and easy integrations, the platform can scale to include dozens of use cases to help optimize your operations while saving time and money. Legacy providers and point solutions often utilize proprietary systems and software, which can be extremely limiting when it comes to updates and improvements, new solutions, features, etc. And, of course, the hot topic of the day: Implementing AI as part of your asset management solution. At Kontakt.io, we use AI to analyze patterns and predict trends, scan for hidden waste and inefficiencies, protect devices and networks from malicious attacks, and integrate with user applications to get insights within seconds.
Call: Our company has initiated the use of our RTLS tracking capabilities as the “backbone” of our READI+ equipment management practices. As a result, everyone (our READI+ program staff as well as the affected nurses and support staff such as unit clerks) has visibility to available equipment and is on the same page with regard to better utilizing available equipment resources. Equipment productivity increases (a key output of successful equipment management programs), and patients and nurses receive the needed equipment more quickly, and in better condition.
Forrest: Although managing data is not new, I believe how a health system uses data to make capital planning decisions is becoming more important than ever, as hospitals continue to struggle financially. Medical device cybersecurity is not new, but continues to evolve and be a critical part of any HTM program. It is critical to ensure all medical devices are protected and the tools allow you to properly mitigate risks.
Hatcher: Vizzia continues its emphasis on innovation by collaborating with clinicians and technology leaders to further enhance its InVIEW software platform. The company has recently released several new integrations that power today’s smart hospital, to include Epic, Microsoft and CMMS applications. These integrations provide multiple benefits to med techs and clinicians alike, such as saving significant time by automating patient information data entry. Other features include secure access to applications with single sign-on (SSO) identity and visibility of all devices with a mobile single pane of glass (SPG).
Snowday: Though not new, periodic automatic replenishment (PAR) is gaining traction for effective mobile hospital equipment management. To achieve improved inventory distribution, whether in a centralized or decentralized model, an accurate RTLS can monitor inventory levels in each unit of the facility, so staff can ensure they have the equipment they need to operate efficiently. The biggest game-changer for asset management, though, is Bluetooth Low Energy (BLE) technology and the machine learning algorithms that make BLE useful for RTLS. BLE is easier and more cost-effective to deploy than traditional RTLS and can even leverage existing systems as a BLE-receiving network, such as the latest Bluetooth-capable Wi-Fi access points. It’s a fantastic technology for tracking assets (and by the way, for staff duress as well) – the tags have a great balance of size and battery life, the location accuracy is much better than using Wi-Fi signals. However, it’s not quite accurate enough to automate nurse call or drive patient flow optimization, so health systems looking at the bigger vision should be seeking out hybrid deployments of room-accurate technology, paired with the near-room accuracy of Bluetooth.
Q: How can asset management systems help a health care facility save money?
Asher: With Kontakt.io, it’s easy to calculate the ROI on asset management. Firstly, stop paying for equipment you don’t use, which you’ll understand on day one. So right away you can reduce your rental fleet, “right-size” your inventory, and defer future CAPEX purchases. This is in addition to the money saved on loss prevention. Kontakt.io’s solution automates PAR-level inventory management and increases mobile equipment utilization to over 60%. Unlock significant savings with an RTLS asset tracking solution that increases productivity, optimizes workflow and eliminates inefficiencies.
Call: With effective, productive mobile equipment management practices, a number of areas are positively impacted, leading to increased process efficiency, improved equipment cleanliness and maintenance, and better nurse and patient satisfaction levels. Direct financial impact can result in:
- Less lost equipment
- Reduction or elimination of the need to rent equipment
- More productive patient care (studies estimate more than 1 hour per day may be spent by nurses in managing and cleaning patient care equipment), meaning savings in overtime may result.
- Smaller quantities of mobile equipment to buy, lease or rent.
Forrest: An effective computerized maintenance management system (CMMS) is imperative for any successful HTM program. This allows for accurate inventory management, device tracking, service status, contract management, asset disposition, parts ordering, reporting and much more. These systems provide insight to help the health system better manage the life cycle of their assets, which will reduce total cost of ownership. A successful HTM program by design can significantly reduce a health system’s annual service spend by consolidating contracts, taking risk where risk is advised, effective parts sourcing and utilizing niche service providers that can achieve additional savings.
Hatcher: Advanced, enterprise-grade data analytics are now optimizing multiple workflows across smart hospitals. Real-time data is improving processes within multiple functions such as scheduling, maintenance and supply chain. Executive dashboards and utilization reports are now used in the C-suite to focus on financial and operational impacts. Legacy purchasing decisions to rent or buy expensive medical equipment are now enhanced with human capital planning.
Snowday: Health care organizations face a widespread problem. Despite having more than enough equipment, nurses and biomedical teams spend 10% of their time walking the halls, looking for equipment needed for patient care and preventive maintenance. Whether equipment is MIA, transferred with patients to other hospitals or simply stolen – asset fleets are increasingly difficult to budget for. And mismanaged fleets come at a hefty price tag – $7 million annually for a 300-bed hospital:
- $5.25M for non-value-added nursing wages, like time spent away from the bedside and instead looking for equipment needed for patient care
- $1.5M for missing equipment write-offs
- $125K for capital expenses including over-purchasing assets to ensure availability
- $100K for hidden operational expenses including individual nursing units replacing lost assets on department budgets
- $43K for biomedical technician wages that is time spent searching for equipment
- $3K for equipment rental costs to supplement missing assets
Q: What should an biomed department look for in asset management products?
Asher: Can your solution scale easily with open standards such as Bluetooth Low Energy and Wi-Fi? Can your solution provide room-level location accuracy without the need for physical servers or significant requests to your IT teams? Do you need additional power or cable pulls when it comes to deployment and installation? At Kontakt.io, we work closely with our partners and customers to help deliver the solution that’s best for them. We are outcome focused, which means we provide an end result and don’t nickel and dime on hardware. For us, and for any health care system, it’s important to know what questions to ask and what mistakes to avoid when considering asset management solutions. Keep the end outcome in mind and find a provider who shares your goals.
Call: Partnership: If an asset management program is to have real and lasting impact, the affected nurses/caregivers, distribution staff, supply chain staff, and infection control practitioners should be involved in its development and implementation, with a leader from the mobile equipment asset management program provider.
Transparency: We can only manage what we can measure. Set regular meetings during asset management program implementation, to develop milestones and track progress and trending related to KPIs developed by the stakeholders and asset the management program provider. Key KPIs tend to include:
- Delivery times – are they satisfactory?
- Inventory levels – do they meet patient/caregiver needs?
- Nursing satisfaction – with the revised practices. Are they buying in? Where is more education or direction needed?
Forrest: Not all providers are created equal and you get what you pay for. It is important to talk with references and understand their service delivery plan, especially for the more critical assets found in radiology, cardiology and oncology.
Hatcher: The health care industry is very collaborative and referral based, thus references remain a key factor. Conferences like MD Expo and AAMI serve as valuable learning opportunities to share best practices. Technology is always rapidly evolving and it’s important to validate where solutions are deployed “go live” at Vizzia collaborates with academic partners to test and evaluate new solutions, such as Georgia State University’s Lewis College of Nursing (which has a clinical partnership with Grady hospital).
Snowday: It’s important to consider that different locating technologies offer varying levels of precision. If a general asset location suffices, BLE will do the trick. If you’re considering RTLS for additional or future use cases that require room-level accuracy, infrared is the gold standard. When comparing apples to apples, both battery life and tag size are important factors. Battery life can vary from tag to tag, depending on the technology used. But be careful because even if a battery life says two years, it could mean that the tags are firing signals at a less-than-real-time frequency. If higher accuracy (more frequent) signal is important to you, you should choose a more real-time option and compare battery life accordingly. And consider tag size options, especially for small items like telemetry packs and other types of assets that are easily lost or misplaced.
Q: Is there anything else you would like to share with TechNation readers?
Asher: For a deeper dive into the industry use cases, benefits, and tech reviews of RTLS, Wi-Fi, UWB, BLE, take a look at our 2024 Buyer’s Guide for Asset Tracking or join our TechNation Tools of the Trade LIVE Demo of Kontakt.io’s Asset tracking platform.
Call: Effectively designed, implemented, and managed, a high-quality asset management program for mobile medical equipment will positively impact areas critical to a health system’s ability to attract patients, and retain their nurses and caregivers:
- Equipment acquisition expenses
- Equipment distribution process efficiencies
- Patient satisfaction
- Nurse/caregiver job satisfaction
Forrest: We are seeing some vendors offer service pricing that in many cases is “too good to be true” and figure these organizations will not be in business for long. We also understand that some of the OEMs are not willing to provide service on aging imaging equipment. This is requiring hospitals to look to alternative service options to keep their systems running optimally.
Hatcher: Staff safety is top of mind for all health care leaders. Incidents of workplace violence are four times more common in health care than in other professions. RTLS enable staff badges to activate a silent alarm, alerting security the exact location of where help is needed (accurately and quickly).
Snowday: Technology in health care is important, but it’s the people that are at the heart of everything we do. At Midmark RTLS, we believe the key to success is just as much about the right partner and process as it is the technology. With Midmark RTLS, you get the commitment, the people and the expertise for sustained success. Our RTLS experts – both in-house and regionally certified system integrators – lend a wealth of clinical knowledge and best-in-class support to optimize your RTLS investment at discovery, launch and beyond. We’re proud to serve as a long-term partner, leading health care organizations across the nation to RTLS success.
