Healthcare technology management (HTM) professionals are among those tasked with finding medical devices for a number of reasons. One reason is the need to locate equipment to complete preventative maintenance tasks. Another reason an HTM professional might need to locate a device is to provide a replacement for an ongoing surgery. Those are just two examples.
TechNation reached out to several companies to find out the latest about asset tracking technology and devices. Participating in the roundtable article are ZulaFly CEO Stephanie Andersen, Kontakt.io Director of Healthcare Enterprise IoT Solutions Kapil Asher, Cox Prosight Director of New Growth and Development Jaiganesh Balasubramanian, Accruent Vice President of Healthcare Strategy Al Gresch, Nuvolo Vice President of Product Marketing-Healthcare Heidi Horn, Cognosos Chief Product Officer Adrian Jennings and Vizzia Technologies Chief Commercial Officer Dave Wiedman.
Andersen: What is the goal of the tracking system? Is the system simply to locate assets or would biomed most utilize a system that also included PAR level, asset utilization and rental dashboards, thus maximizing your investment and seeing the greatest return? Facilities should select an asset tracking system that has customizable dashboard views based on your role to eliminate constant clicking around to find relevant information.
Asher: There are four factors biomeds should consider while choosing an asset tracking system: total cost of ownership, ease of installation and maintenance, use case scalability and location accuracy. Modernized RTLS systems based on open standards such as Bluetooth+WiFi that leverage existing wireless infrastructure are best suited to meet all these criteria. These systems are cloud-managed, eliminating the need for physical or virtual servers and databases reducing burden on the IT teams. Open standards systems also offer biomeds the flexibility to choose location and environmental sensors from multiple vendors, breaking the shackles of monopolistic RTLS systems.
Balasubramanian: The factors to be considered include:
Gresch: First is, what is the outcome I’m looking for? Most only look for “dots on a map” (i.e., can I easily locate a device with a tag on it?). That’s great for being able to find things in order to help achieve your 100% PM completion, but if your organization is willing to invest in this technology, do not think small! Keep in mind the possibility of tracking people-to-people interactions and other IoT functionality to optimize processes and workflows.
Horn: As a CMMS provider that integrates with most of the major RTLS products, Nuvolo would recommend first that you choose an RTLS system that can integrate with your CMMS. This enables the HTM department to locate equipment from the CMMS rather than have to constantly flip between your CMMS and RTLS applications. This saves tremendous time locating equipment due for planned maintenance, repairs or other services while you have those work orders open. Another huge benefit to integrating with your CMMS is the ability to keep the data in both systems “clean.” For example, if your asset management system shows a device is no longer appearing in your hospital, you can update your CMMS and vice versa. Other factors to consider before investing in an asset tracking system: the HTM organization not only needs to understand how it plans to use the asset management system but should also consult with other departments about how the system can be expanded in the future. For example, in addition to asset management, will the hospital want to also track patient and staff location in the future? Contact tracing of potential infectious disease contacts with patients, staff and equipment is another growing use case for RTLS.
Jennings: Two important considerations when selecting an asset tracking system are:
Wiedman: Acute care facilities with active emergency departments and surgical operations require advanced tracking technology with a high degree of reliability. This encompasses chair-level location accuracy (<3 meters) and frequent data refresh rates (1–2 seconds). Advanced RTLS networks can support multiple clinical use cases (i.e., patient workflow, automated contact tracing, hand hygiene compliance), beyond traditional asset tracking. Lower cost technology such as Wi-Fi-based Bluetooth Low Energy (BLE) provides “zone level” location and may be more suitable for smaller settings like clinics or dentist offices.
Andersen: It’s important to find a system that allows staff to create the fields with information they would like to see; their verbiage. Customizable fields, along with only displaying dashboards and information that is relevant to each role, is vital in staff adoption and short ramp up time.
Asher: Modern RTLS systems offered by Kontakt.io are packed with features that not only address traditional biomed asset tracking use cases but also offer a wholistic Internet of Things (IoT) platform that integrates various environmental sensing capabilities such as temperature, humidity, air quality, light, motion, air pressure and carbon monoxide in a single box. The data is freely available with open source integration protocols that can be used by facilities management and security systems. Leveraging a robust Wi-Fi network for location detection and data backhaul, the system eliminates a maze of redundant networks purposefully built for a single use case.
Balasubramanian: Some of the new features and technology enhancements available include:
Gresch: Some of those that have been in this space for a while have created APIs to automate a number of things relative to the complete asset life cycle. An example is, one technology we used in the past had the ability to track current draw on a device, which provided actual utilization data. I mentioned IoT functionality. Some of these companies have sensors that can provide temperature, humidity and vibration data. If you’re someone who is intent on moving toward predictive maintenance (and you should be), these can provide early warning signs to impending failures, particularly on your big iron (CT, MRI, LINAC, etc.).
Horn: The ability to integrate with some CMMS systems provides organizations with that “single source of truth” for managing medical and facility assets. This enables HTM, facilities and other departments to locate equipment in real time directly from the CMMS rather than having to bounce between applications.
Jennings: Some features are:
Wiedman: Enhanced reporting and analytics software that provides actionable data in real time. Biomeds and the C-suite want a robust software platform that provides reliable, secure and high-performance data that helps hospitals reduce costs, streamline processes and improve patient care. Management dashboards with intuitive design and powerful built-in maps provide comprehensive visibility into a hospital’s most important assets (equipment, patients and staff).
Andersen: There are a number of ways that an asset tracking system can provide a hard dollar ROI: asset utilization, PAR level setup on supply closets, notifications on rental equipment when equipment is no longer in use and, most importantly, is understanding your facility spend prior to deploying an asset tracking system. This will become your benchmark to compare against moving forward. Utilizing historical reports also aid with reimbursement of equipment that was used for specific procedures.
Asher: Asset tracking systems help a health care facility save money on two major fronts.
Balasubramanian: Asset tracking systems can help facilities in the following ways:
Gresch: As the number of qualified staff continues to dwindle across all clinical and technical positions, using technology to optimize staff productivity will be imperative. Think about the time your staff spends looking for equipment to PM, or clinical staff spends running around trying to find something like a bladder scanner. Reducing the amount of equipment rentals or capital purchases for mobile medical equipment that are driven by the perception of shortage because they aren’t being managed properly is another way. Sometimes just the amount of money saved annually on not having to continually replace lost telemetry transmitters can literally pay for the system.
Horn: As the old saying goes, “Time is money.” Having the ability to quickly locate devices that are due for PMs, repairs or other maintenance, frees up your technicians’ time to work on other hospital priorities. In hospitals without asset tracking, technicians spend a significant amount of time trying to locate mobile devices like infusion pumps. Hospitals can also help avoid the significant cost of having to rent or replace devices that are lost (or hidden by the clinical staff) somewhere in the hospital.
Jennings: Asset tracking technology can help health care facilities save money by providing accurate data on asset utilization, guiding future asset purchases, adjusting rental needs and improving loss prevention. Here’s how: Do you have enough IV pumps, or too many? What about SCDs? In most hospitals up to 25% of equipment is sitting idle at any given moment. Asset tracking provides visibility into your equipment utilization, the data you need to make evidence-based purchasing decisions (or to avoid unnecessary purchases altogether). Likewise, if you rent equipment you already own, there’s a good chance that these rental costs could be eliminated. In order to make this determination; however, you need to know where (and what) your equipment is doing at all times, which requires room-level accurate location information. Finally, a lot of equipment is lost through trash collection and soiled laundry. Real-time alerting on these areas enables the quick recovery of equipment before it leaves your building.
Wiedman: RTLS offers health care providers dual savings for medical devices (optimize fleet management, reduce expenses) and increased staff productivity (reduce time wasted looking for medical supplies). An AAMI eXchange 2021 presentation featured RTLS results from eight national health care systems. The “go live” clinical case studies yielded $8.5 million in savings. As an example, a 500-bed acute care hospital can save approximately $696,000 and 365,000 staff hours annually.
Andersen: Security is a concern that should be taken very seriously when deploying any technology within a health care facility ensuring solutions are HIPAA compliant. ZulaFly takes cybersecurity seriously regardless of the application, asset or others, that we are implementing for our customers.
Asher: No, we are not seeing concerns over cybersecurity in asset tracking. Our data is completely encrypted both at rest and in-transit. We do not store any critical PHI or sensitive hospital data within our systems. Most of the data stored consists of unique identifiers of sensors and their payload, which does not mean anything outside of the systems they are intended for. As a matter of fact, we are helping biomeds respond better to cyber-attacks on medical devices by helping them find the affected devices in a faster manner as most vulnerability patches still require devices to be brought into the shop.
Balasubramanian: Absolutely. Cybersecurity should be top of mind of any IT solution. Some elements to consider include:
Gresch: I haven’t heard of any vulnerability concerns related to asset tracking systems. However, a comprehensive inventory and life cycle management program are two keys to proper ITAM. I recall an infusion pump remediation effort that took place in one of my organizations shortly after we implemented an RTLS system. The time it would have taken to find all those devices would have been immense without it.
Horn: All networked applications should be a concern to hospitals and thus require proper cybersecurity controls. However, on the flip side, being able to quickly locate a compromised asset that your OT cybersecurity monitoring application identifies, can reduce the negative impact of that cyber threat to the rest of your organization.
Jennings: It should not be. The location device (tag) on each piece of equipment should not be transmitting any hospital specific information. Look for a solution with a dedicated backhaul (not sharing your Wi-Fi or other wireless platforms) that’s hosted in a recognized health care-secure facility, like AWS.
Wiedman: Any technology within a health care environment should be concerned with cybersecurity, especially vulnerable are Wi-Fi networks. Vizzia applications meet HIPAA and HITRUST standards with our software and network architecture, supported by additional security controls from Amazon Web Services (AWS).
Andersen: I would suggest looking for a solution that is cloud hosted. Cloud-hosted solutions are much quicker to deploy, easier to support, require less IT resources and are typically more cost effective. Do your homework, understand the platform that the asset tracking system is a part of and if there are other applications you can add on at any time so that you continue to see the value of your investment. I would also include that deploying a system that has a platform designed and developed by RTLS experts will go a long way in integrating disparate systems, producing analytics from all data collected, providing real-time notifications and customizable dashboards for the end users.
Asher: The next two to three years are going to be very exciting for asset tracking and IoT in general. Many companies are working toward integrating multiple use cases and analytical dashboards into our robust location services platform that is developed on the principles of open source protocols. We are democratizing data sharing so end-users can benefit from real time location in multiple facets of patient care, including staff location, patient throughput, environmental condition monitoring and wayfinding. With hardware getting cheaper by the day and exponential advancements in cloud computing, the dream of a hospital of the future can now finally become a reality.
Balasubramanian: There has been considerable technological evolution over the last 10 years with Bluetooth Low Energy (BLE) leading the way. BLE provides significant cost savings while providing improved battery life of tags and ease of deployment and maintenance. Investing in an extensible IoT platform should be considered compared to a purpose-built asset tracking solution. A platform will provide extensibility to other problems the facility wants to solve in the future including wayfinding, staff duress, environmental monitoring and patient flow solutions without a significant reinvestment. With caregivers and clinicians on the go, a solution that provides the staff the mobility and visibility in the palm of their hands would be important to realize broader benefits.
Gresch: I often talk about the three-legged stool of people, process, technology. If you invest in technology without first having a good process in place, you will have wasted a lot of money (as many organizations have). Sometimes, you can even fix a problem without the use of expensive technology just by fixing a bad process. Make sure you partner with someone who understands that and will only leverage technology to support and sustain a good process.
Horn: Asset management technology is a significant investment for any hospital, so do your homework to make sure you buy a system that will meet your needs now as well as the future. The biggest reasons I’ve seen for these systems not meeting their full potential once deployed in a hospital is because the hospital doesn’t have the people dedicated to maintaining the data and the system itself. Once the data in the asset management system becomes obsolete, so does the application.
Jennings: Have your asset tracking partner provide the ROI for your project to support your business justification. Focus on the hard-dollar impact of the solution, not the soft value (staff satisfaction, staff productivity). Understand how your asset tracking partner will help you track and prove ROI throughout the life of the project.
Wiedman: It’s key to research RTLS vendors carefully for health care expertise. There are a myriad of companies that offer asset tracking technology (hardware and/or software) that are generically applied across multiple industries. Beyond the traditional validation criteria, biomed managers will want to seek relevant information on the number of “go live” deployments within health care, types of clinical solutions, reports and analytics provided and ongoing customer service.
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