Forget hunting for mobile equipment and begging hoarders not to hide their favorite ultrasound in a closet. Today’s asset-management technology saves hospitals time and money and could even save lives.
It is 2:55 pm, a patient has scheduled an ultrasound for 3 pm, and the physician wants that exam stat. Since there is no sign of an available machine anywhere, three imaging department staff members hunt the floor and individual rooms and finally find one ? in a closet. They find out later that it was being horded by a physician who always complains that he can never find any ultrasounds.
Scenarios like these happen every day in hospitals. Some reports indicate that as much as one-third of medical center equipment is lost, hidden, or stolen. As a result, hospitals spend extra time and money on equipment or rentals that they would not need if they could efficiently keep track of their portable assets.
To recapture these expenses, more hospitals are turning to wireless asset-tracking systems that can not only pinpoint the ultrasound’s location, but also reveal its brand, serial number, and whether it has been serviced. While these systems are not inexpensive, their return on investment can be calculated—and recouped—in around 2 years or less.
|More and more hospitals are turning to wireless asset tracking systems that can pinpoint the location of equipment and also identify its brand, serial number, and whether it has been serviced.|
There are several reasonable explanations for why mobile assets are getting lost, horded, and forgotten in a closet. First of all, there are so many mobile assets these days. In radiology departments alone, there are ultrasounds, ultrasound probes, C-arms, and more. On top of that, hospitals are increasingly expanding their infrastructure, with new buildings spanning across several city blocks. Finally, there is the human factor, where equipment is unintentionally misplaced, horded, or mistakenly transferred to another building, floor, or department that also has found itself losing track of equipment.
“Keeping track of equipment and resources in a complex hospital environment can be challenging, said Valerie Fritz, vice president of marketing for asset tracking firm Awarepoint Corp, San Diego. “The sheer magnitude of the number of employees that impact a patient, the number of patient admits, all with different medical equipment needs, and tens of thousands of pieces of equipment that is either owned or rented by a hospital can be an overwhelming thought. Combine that with effectively moving patients throughout the enterprise, and you are faced with a logistics nightmare.”
Despite this challenge, most hospitals still manage their equipment in relatively old-fashioned ways, using simple databases or even a white board for checking out particular devices. To find equipment, there are spot checks, and wheelchair roundups, with overworked staff taking time to literally walk the halls to find idle equipment.
Aside from the tracking nightmare, there is the maintenance of that equipment. For Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requirements alone, bio-engineers spend a good deal of time inputting maintenance records and repairs, and corralling any devices that may have been recalled.
The Basics of Asset Management
With hospitals turning more and more to technology to improve efficiency and increase workflow, wireless asset-management technology is becoming a natural step to better management of assets, reducing costs, and inevitably improving patient care.
Many asset-management products are on the market today. Although their specific technology and software are different, they all have several basic components in common.
Tags: Tags are transmitters that are attached to the ultrasound, C-arm, infusion pump, etc. They are generally affixed either by adhesive or by a wired loop. Tags generally have some type of anti-tampering system. If someone tries to remove it, cut it, or damage it, an alert is sent through the system by e-mail, phone, or page to a designated individual. Tags are often disposable and contain internal batteries that can last around 5 years, depending on how often the tag generates its signal.
PDAs: Systems typically utilize some type of handheld personal digital assistant (PDA) that can wirelessly read tag data or transfer and update tag data.
Wireless technology: Tags communicate to the vendor’s software by sending a consistent signal through some type of wireless communication system. Some vendors use the hospital’s existing Wi-Fi networks. Others use a form of radio frequency identification (RFID), where receivers are placed throughout the hospital, mounted on a wall, or for wireless receivers, plugged into an electric wall socket. In addition, there are infrared systems, ZigBee RF systems, ultrasound, ultrawideband, and other types. All have advantages and disadvantages in terms of room accuracy; costs; and installation, interference, and range.
Software: Each vendor has proprietary software that processes the database of tagged equipment. The software is partly Web based, so any authorized user can log on and use the system from a computer or even a Web-enabled handheld device. Once logged into the system, the user can typically sort by the equipment type, brand, serial number, location, maintenance reports, and other individual parameters. Users can track devices with a real-time visual map of the facility, showing where the sorted device or devices are located inside the hospital compound. Vendors aim for room-level accuracy, and because tags send out a consistent beacon signal, users also may see devices on the go, moving from room to room or building to building. Most software packages keep a log of equipment locations with time and date as well.
“This is primarily about running your business more effectively,” said Gerhard Kschwendt, senior director of Siemens Integrated Service Management, Cary, NC.
“[Asset tracking solutions] really optimize the amount of the equipment, the type of equipment that you have and how fast you can find that equipment on a day-to-day basis. There’s a lot of statistics out there that talks about the utilization array of mobile equipment being only 40% to 45% in hospitals. What that means is that you have twice as much equipment standing around as you really need. The hospital bought too much equipment or is renting extra equipment, and the reason why is because they cannot find it when they need it.”
By reducing equipment purchases, the cost of an asset-tracking system, which is typically based on the size of the facility and the number of tags, can quickly pay for itself.
Kschwendt said, “This is very easy to quantify in dollars and cents: You have an investment, you buy the tags and the software that drives the system, and you can calculate how much you can save in terms of reduced rental programs and reduced capital expenses. That by itself will already give you a return on investment in less than a year. But that doesn’t even include staff efficiencies, because suddenly the nurses and biomedical engineers don’t have to spend 30% of their day looking for equipment, but maybe only 10%. So, it’s a phenomenal return on investment.”
There are many ways that asset-management systems can increase staff efficiency. Awarepoint’s tags can be programmed to not only show where an asset is, but also alert staff whether the device needs maintenance is in use or out of use.
Asset tracking also can aid accreditation mandates that require validation of equipment inventory and service. Fritz said, “Annual work orders associated with inventory can number in the thousands for an average-sized hospital. Some items need maintenance only every couple years, others may be on a monthly or semimonthly maintenance schedule. Imagine the time it takes to locate hundreds of pieces of equipment when your only alternative is simply to walk the floors with your equipment list.”
Furthermore, a manufacturer’s recalled equipment can be quickly located, and staff can verify that the product is off the floors and not hiding in a hoarder’s office.
Paul Tessier, executive vice president and chief strategy officer for Radianse, an asset-management company based in Andover, Mass, added that asset tracking can help hospitals measure the quality of patient care. By showing when and where a piece of equipment is in real time, staff administrators can immediately tell whether a technician has arrived in a patient’s room. Later, the administrators can review the amount of time that the device spent with patients or between patients.
The same asset-tracking technology has many applications, from patient tracking to the safe and accurate dispensing of medications. A new application for radiology is Bayer HealthCare’s VistaTrak, a new system specifically designed to improve the safety and management of imaging contrast media. (See sidebar.)
Ask the industry about the future of asset-management technology, and all agree that the concept reaches far beyond managing equipment.
“Tracking assets is where these systems start, not end,” Fritz said. “Patient location tracking and movement is quickly emerging as an important strategic initiative.”
Down the road, Fritz also sees the technology being applied to employee location tracking, which advocates believe will improve staff safety, personnel productivity, and operational workflows for transport, housekeeping, and patient support services personnel.
Employee privacy issues will have to be addressed, but Tessier believes that physicians and staff will see the benefits in better communication and workflow.
He said, “Emergency departments measure certain care parameters, like door to doctor time. So if the patients and doctors are tagged, you’ll know when the patient has come in, that they’ve been through the triage processes, that they’ve been moved to a treatment room, and when the doctor comes in. There are lots of reasons why a person showed up on time or didn’t, but this helps us understand whether your care processes are on track.”
Tor Valenza is staff writer for Medical Imaging. For more information, contact .
A Cabinet that Watches Your Back
Aside from managing assets, RFID technology also is being utilized to improve patient safety and the management of medications. Recently, Bayer HealthCare, Wayne, NJ, introduced VistaTrak, a contrast agent storage system that helps prevent human errors in patient dosing, as well as improves contrast media billing and inventory management.
VistaTrak is comprised of a storage cabinet with RFID technology and an outside display pad that communicates with a hospital’s EMR. The system works exclusively with specially tag-embedded bottles of Bayer Magnevist contrast media.
VistaTrak helps reduce human error by eliminating contrast agent logbooks and data entry. Instead, when the factory-tagged Bayer product is loaded into the cabinet, the unit captures the NDC number, expiration date, and log number.
Then, when a technician logs in to the cabinet’s display pad, a patient worklist appears on the screen. After the technologist selects the patient and dosing, VistaTrak checks the inputs against the EMR data. If there is any inconsistency, such as the patient’s Glomerular Filtration Rate (GFR) level being off, the cabinet will warn the technician.
Peter Holnberg, director of alliance management at Bayer, said, “We can verify by whatever parameter that the hospital sets up for us that this patient is safe to receive contrast. Then, based on that protocol, the [hospital] determines what bottle size the technologists should collect. The technologist then confirms all of that information, and the cabinet door unlocks.”
Likewise, if the technologist removes too large a bottle or a bottle that has been open for more than 24 hours, the system will give out a warning as soon as the bottle leaves the cabinet.
VistaTrak also works with billing systems to confirm the CPT code and that the administered dose is billed correctly. In addition, the system helps administrators to easily comply with JCAHO requirements and documentation for contrast media.
Holnberg said, “The way in which contrast is handled and administered today is simply inconsistent and substandard to the way in which the rest of the department is managed. Everything in radiology is digital or electronic and captured in a very efficient manner, but contrast [data] is still being captured manually.”
VistaTrak comes in large and small cabinet sizes. The list price for the small unit is $55,000 and $68,000 for the large one, and includes HL7-compatible software that integrates with hospital information systems. Installation and service contracts are additional.