TechNation reached out to several companies to find out the latest regarding asset tracking technology and solutions. A variety of companies responded with insights from their in-house experts to shed light on the different types of asset tracking technology, benefits of these systems, what HTM professionals should know when purchasing and more.
Participating in the roundtable article are ZulaFly CEO Stephanie Andersen, Sonitor Technologies Inc. President and CEO Anne Bugge, CyberMDX Vice President of Product Ido Geffen, Nuvolo Senior Solution Consultant Dustin Smith, Medigate Director of Pre-Sales Engineering Simeon Utubor and Vizzia Technologies Chief Commercial Officer Dave Wiedman.
Q: What are some of the different types of asset tracking systems for the health care space?
Andersen: ZulaFly is partnering with multiple different asset tracking systems that are available in the market today, such as Wi-Fi, BLE, ultrasound, RFID and RTLS technologies. The primary advantage of ZulaFly is that the platform can take in data from any technology, or multiple technologies, that the customer has chosen. It’s important to select a hardware vendor that can fulfill the goals that the customer has in mind.
Bugge: Facilities often consider both passive and active tracking technologies depending on what assets they want to track. RTLS is an active technology and continuously emits signals so that moveable equipment, such as IV pumps, bladder scanners, workstations on wheels (WOWs), etc., can be tracked in real-time and with situational context – how long the asset was in a location, it’s disposition, what else or who else was in that same location at the same time or over time, etc. Active, RTLS asset tracking solutions include ultrasound, infra-red (IR), Wi-Fi, ultrawide band (UWB) and Bluetooth low energy (BLE). RTLS technology selection is dependent on accuracy requirements, use cases, total cost of ownership, scalability, ease of deployment and customer support. In contrast, passive technology such as RFID, as its name implies, does not report in real-time, typically requires bar-coding and mainly captures individual data points. This technology is often used for small specialized assets such as surgical instruments and consumables.
Geffen: For healthcare delivery organizations (HDOs), an asset tracking system is a must-have in order to be able to monitor and manage equipment and supplies with the aim of improving efficiency. It’s critical for HDOs to adopt the right management system in order to really improve efficiency, asset optimization and cybersecurity posture. The four most prevalent types of asset tracking systems in the health care space are: Traditional pen-and-paper approach (not recommended and only works for very very small facilities); spreadsheet-based tracking methods (only suggested if the organization is limited with budgets and resources); barcode-based asset tracking systems (the basic suggested one for really starting to manage more than a small size inventory; and radio frequency identification (RFID) tagging.
Smith: RFID Passive and Active, Bluetooth, AP connections, etc.
Utubor: Health care asset tracking technologies (RFID, RTLS, Scanning, Wi-Fi, etc.) are typically integrated with some degree of inventory management, maintenance support and, if the devices are networked, cybersecurity functionalities. Obviously, there’s not much value in tracking the location of an asset without having an up-to-date and actionable record of the asset’s identity, configuration and utilization specifics. For example, maintaining assets that connect to patients and constantly move is challenging, as these devices present safety risks and entirely different management challenges than devices that don’t. Therefore, the ability to identify and track the location of an asset, while very important, is only one aspect of the information that biomed and clinical engineering professionals need to be effective.
Wiedman: “Tracking” has evolved into “management,” as simply locating a device isn’t adequate. Stakeholders need systems that alert and direct personnel based on business rules and streamlined processes. Health care executives want service providers who can offer hardware agnostic solutions that support traditional RTLS (infrared and ultrasound) infrastructures as well as new IoT technologies that use Bluetooth Low Energy (BLE), especially as their facility’s needs change over time.
Q: What are some of the benefits and challenges of the different technologies?
Andersen: It’s imperative that the technology that is chosen can fulfill the goal of the asset tracking implementation. Different use cases can require different technologies.
Bugge: Wi-Fi and BLE, 2.4 GHz technologies, are predominantly communication tools and were not designed for navigation or accurate positioning and location. Based on radio frequency (RF), they use received signal strength for triangulation and are absorbed and reflected by building material and therefore can give unpredictable and inconsistent results. Wi-Fi and BLE are not recommended when room or sub room (bay, bed or chair) accuracy is needed or for use cases such as PAR level management, contact tracing (including assets), patient or staff safety or workflow automation.
IR also penetrates walls, floors and ceilings, requires line of site for accurate positioning and can affected by light, so can be challenged by the same interferences and can give the same unpredictable and inconsistent results such as Wi-Fi and BLE. To compensate, these technologies require a significant number of devices to contain the signal and block any interferences for positioning. This can add significant cost and have a negative impact on the aesthetics of the healing environment – something that is very important for patient satisfaction. In addition, when battery powered, IR devices require expensive and non-environmentally friendly lithium batteries.
Sonitor’s ultrasound-based RTLS, unlike any of the above technologies, does not penetrate walls, glass or floors, and therefore its signals are contained. Therefore, only a single device is required to provide the most reliable and consistent accuracy at room and sub-room (bay, bed and chair) levels. When battery powered, ultrasound location transmitters use four, D cell, alkaline batteries that are both cost effective and environmentally conscious.
Geffen: The biggest challenge is determining what asset management system suits your organization in terms of needs as well as resources. One must first enlist goals that he/she want to accomplish with it. Most HDOs aim to realize the following objectives and subsequent benefits by implementing an asset tracking system: streamlined equipment maintenance processes; consumables management; and regulatory compliance.
Smith: RFID can become costly and it would require readers in the appropriate areas for a passive set up. Active RFID would require a high outlay and battery replacements would likely be needed every 2 to 5 years. A lot of strategy needs to be discussed when it comes to determining everything you’d like to track. Bluetooth would have some similar battery concerns. Oftentimes this would be combined with upgraded access points. AP connections are not going to be extremely accurate, but can often get locations within 30 yards. However, you’d have to have all devices tracked on the network. Certain devices that you’d like to track may not be on the device.
Utubor: For connected assets in health care (i.e. IoHT devices), clinical network specialized asset management software integrated with cybersecurity capabilities are proving to be game-changers. Because the data can now be captured directly from the host networks, essential asset management and cybersecurity workflows (e.g. preventative maintenance, remediation, vulnerability management, threat detection/response and replenishment) can be integrated and, where appropriate, outdated routines can be safely automated. For non-connected assets, tracking systems can also be automated, along with time-based triggers/alerts for maintenance and replenishment. These processes tend to rely more on disciplined on-boarding processes for initial inventory, including scanning devices, otherwise, it tends to be based on manual data entry.
Wiedman: Great accuracy comes with traditional RTLS solutions, however along with a higher price point. Newer IoT offerings provide general zone level accuracy with a reduced infrastructure cost. Advanced IoT technologies are empowering “smart hospitals,” that integrates location tracking, lighting, HVAC and building automation. This intelligent, connected IoT platform provides a compelling ROI model that yields increased savings and productivity.
Q: What factors should biomeds consider to determine which type of asset tracking system is best for their facility’s needs?
Andersen: Ease of use of the dashboard! Biomed staff gets asked for equipment that is needed now, so the ability to quickly find equipment, and understand if it’s available for use, is vital. Real-time PAR level and rental management are extremely beneficial for biomed groups to help control inventory costs. A mobile app that can provide search capabilities while moving around a facility is also valuable.
Bugge: There are a number of factors to consider when selecting the best tracking system for a facility. These include:
I. Location accuracy – what are the use cases?
A. Many use cases require consistent room and sub-room level accuracy
II. Total cost of ownership – over the lifetime, what will it cost to maintain?
D. Effort/time to support
III. Scalability and flexibility – can the technology grow with the facility’s needs?
A. Adding more use cases
B. Adding more sites
Geffen: Key aspects that are important to take into consideration:
Smith: First it needs to be determined what is in scope of the tracking: beds, stretchers, pumps, monitors, modules, will you go as far as thermometers? What is available in terms of funds? Do you want an active or passive system? What is the object of tracking: loss mitigation, utilization, preventing excess capital purchases?
Utubor: As mentioned, the first question stakeholders must answer is what types of assets they’re responsible for managing. Connected and non-connected landscapes are entirely different, as asset management nuances vary across asset categories, subcategories and classes. Additional considerations should be equally practical and include questions around the numbers of facilities involved, how the assets are distributed geographically, what service lines they support, the potential consequence of failure to patients and the operational costs if the asset is taken out of service. Regardless, disciplined asset onboarding processes that are as mobile, automated and “open” as possible (from an integration perspective) should be a major consideration for non-connected assets. And for connected assets, passive, network-based asset profiling (i.e. real time, dynamic inventory capability) must be integrated with cybersecurity capabilities that detect, alert and support security policy enforcement.
Wiedman: Effective asset management systems start with service providers who understand process improvement, change management and apply technology that supports the health care system’s needs and budget. Biomeds should understand the importance of a managed service that includes ongoing support, training and on-site maintenance, which will save them time and labor costs. Finally, don’t underestimate the importance of a robust rental equipment module that can lead to additional savings and allows a health care system to become their own rental company without the rental costs.
Q: What are some of the newest features available?
Andersen: One feature is the ability to take in data on assets from multiple data sources. For example, we can provide accurate utilization rate of IV pumps by knowing when they are actually running compared to just being in a location. PAR level locations can also be grouped as needed to help reduce overstocking of supply closets. Proactive alerts on rental equipment that is no longer in use will also quickly help with a return on investment.
Bugge: Sonitor continues to advance its ultrasound technology to improve tag and device battery life and by combining multiple technologies into a single device in order to be able to reduce the number of devices required to support even the most complex indoor environments and use cases.
Geffen: The most advanced solutions have innovative new features such as:
Automated identification and classification that provides dynamic inventory of all assets with granular, context-aware asset classiﬁcation including model number, MAC address and serial number.
Asset utilization and asset purchase expenses so that HTM can now know exactly where and when critical devices such as ventilators and infusion pumps are being used, and therefore which are available for redistribution to other departments as demand fluctuates.
Optimized service, patch scheduling and recalls that allows staff to identify ideal maintenance windows for updates or patch installs, helping streamline maintenance schedules based on actual device usage. This also helps avoid unplanned downtime and lost availability. Another benefit is to match recalls to the right devices based on real-time data.
Device error and configuration detection that will automatically detect devices that suffer from operating and configuration errors.
Smith: Really the newest “feature” is that these technologies are coming down in price and integrations with other systems have become more prevalent.
Utubor: Biomed professionals should be thinking in terms of their workflows and how accurately the vendor’s featured use-cases map to their particular needs. Finding data-driven ways to enhance workflows and automate outdated routines is where all of the vendors are focused. This is why solutions that capture the right data and drive connections between asset location histories, status/utilization and inventory management/maintenance are seeing rapid adoption. These innovations are generally evaluated based on how the data capture is accomplished, what additional enrichments are available and how meaningfully they integrate this data with other systems and processes that can benefit (e.g. network security and procurement).
Wiedman: Contact tracing is an easy and flexible add-on if your system utilizes a powerful business intelligence (BI) engine for reporting. The key metrics include not only who but what devices have been exposed to an infectious person and the duration of exposure. Quarantining rooms or areas to ensure proper device cleaning processes are followed enhance patient safety as well.
Q: What else do you think TechNation readers need to know about purchasing and using a asset tracking system?
Andersen: If producing a return on investment is part of the project plan, have a plan in place prior to deployment so that can be accomplished. Find an easy-to-use and flexible software solution that staff can easily adapt with minimal training. And, lastly, find a hardware solution that can provide the level of accuracy that is required to fulfill the goal of a RTLS system.
Bugge: When evaluating and comparing technologies, not all solutions behave the same way. It is imperative to understand how the technologies work and to understand all of the use cases that will need to be supported. Engage with your vendor and ask for specific floor plans and designs that support the facility needs so that you can verify exactly what coverage is being provided and how many devices will be required. If there are discrepancies or concerns, ask for a side-by-side comparison. This will confirm that its performance will support your objectives and justify your investment.
Smith: Have a plan. Oftentimes RTLS implementations are not guided sufficiently and the data is not appropriately managed. It is likely that the system would ideally be linked to the CMMS. Make sure that ideal linkage is a possibility before committing. Also be sure to factor in the maintenance costs when choosing your technology. As for building out a solid ROI, think through alternate use cases the technology could be used for simultaneously once infrastructure is in place i.e. newborn tracking (prevent code pinks), hand sanitation and be sure to factor in clinical time saved when thinking through cost savings.
Utubor: HTM professionals should have a clear vision of what newly available data will be used for, how they fit into their current programs, the programs they hope to implement and what success looks like to the other stakeholders who can benefit. The ready availability and good working order of health care assets has a direct impact on patient outcomes, so the job is highly important. That’s why many providers of traditional asset tracking solutions have expanded their functional footprints and are deeply integrated with emerging complementary asset inventory management/maintenance and cybersecurity systems. That said, solution evaluators should be wary of the differences between systems that simply exchange data via APIs and those which meaningfully integrate and enhance their workflows with use-cases that genuinely solve the business problems they’re facing.
Wiedman: Asset management solutions should have a proven ROI of a year or less with multiple “Go Live” references that can speak to the ongoing support, scalability and responsiveness of the service provider. Experience and on-site resources matter and lead to a higher probability of reaching your desired outcomes.
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