Gaining traction as a way to increase efficiency and save money, active radio frequency identification (RFID) as part of a real-time location solution is finding its way into healthcare budgets.

The premise is simple: Attach tags to equipment, send signals to readers and update applications to inform clinicians and staff where equipment is located. The promise is compelling: Find what you need when it’s needed – whether for patient care or preventive maintenance. And the payoff can be dramatic, from saving countless hours of search time to eliminating hundreds of thousands of dollars in equipment replacement or excess rentals.

The slippery slope comes when hospitals must choose the technology platform. Wired or wireless? Active or passive? Line-of-sight or radio frequency? 433 MHz or 2.4 GHz? To find the right answers, a hospital should first consider five strategic questions that contemplate current and future needs:

It may be the application that starts the discussion, but asset tracking is the least demanding application for active-RFID and real-time location. This makes it the lowest common denominator for comparing technologies, any of which can reasonably claim to offer a return on investment. But there are even greater returns to realize when a location system can also be used to find people—the ability to improve patient flow, increase safety and collect objective measures for process improvement. Since not all asset tracking tags are appropriate in size or function for use on patients, be sure to select a system that won’t limit your expansion to track people.

Precision (where someone or something is located) and accuracy (how certain is the location) are less important if a hospital agrees that simply knowing what side of the wall or on which floor an infusion pump is located [is enough]. However, there are serious concerns when clinicians need to find an ambulatory patient whose monitor alarms, a fall-risk patient who has wandered, or a patient in need of time-sensitive treatment. A standard of precision and accuracy to consider when patient location becomes a requirement is the ability to resolve location to the bed level or within one meter of precision. Peer-reviewed data on accuracy should be evaluated.

When you evaluate a system, consider all costs rather than just the initial purchase of active-RFID tags, receivers and or exciters and additional access points, as well as location software. There are at least two areas of significant hidden costs. First are the tag and its battery. Tags can range dramatically in price, from $10 for disposable active tags to as much as $70. For patient tracking, battery life need only be greater than length of stay, such as a disposable tag that lasts up to 30 days. For assets, the lifecycle should be at least two and may be as many as seven years, allowing battery replacement to be done during normal maintenance cycles. Remember, new technology should streamline rather than complicate processes. Because assets move relatively slowly, active-RFID tag battery life can be conserved through less frequent location updates. But tracking patients and staff requires updates of 10 seconds or less to automate nurse call systems, document staff-patient interactions and measure clinical response times.

The large scale deployment of wireless LANs/WiFi in healthcare environments positions this existing infrastructure as logical for real-time location, just as it moves data and voice. Of course, hospitals hope to take advantage of standard access points rather than invest in another platform, even if it uses the hospital’s existing LAN. And there is a case to be made that a WiFi-enabled active-RFID location system is appropriate for identifying where medical equipment and devices are located within a 30-foot radius. But remember to price additional access points and exciters, which are typically required once the site survey process is complete.

You have every right to expect a return on investment in a reasonable timeframe, and there are documented cases of payback in as few as 18 months.

Real-time locations systems that use RFID for indoor tracking rely on specific radio frequencies. With the many competing devices that use radio signals within hospital walls, signal losses, noise and interference could cause interruptions in the delivery of location data. Before you decide on a specific system, survey your devices and the frequencies that they use. Don’t forget medical devices like telemetry systems as well as cordless and cellular phones, paging and Bluetooth devices. The 433 MHz radio location band has been approved by the Federal Communications Commission (FCC) for more than 60 years, is less congested and not as susceptible to propagation issues as 2.4GHz – from floor hopping to reflection off mobile carts, beds and other items in the healthcare environment. These issues can also affect accuracy.

Simple tracking is just the beginning. With the right technology, knowing where and when equipment, patients and staff interact across healthcare offers virtually unlimited opportunities to improve patient flow, workflow and overall safety. Forward-thinking healthcare managers are quick to recognize new ways to take advantage of a truly automated real time location solution. For example, you can measure the "who, when and where" of procedures objectively to determine whether and how to adapt processes. Configure an automatic alert sent if medical devices or patients move outside preset boundaries. Others see the transformational impact of facilitating and measuring urgent care based on care pathways, such as for stroke or acute myocardial infarction (AMI).

There are both operational and clinical considerations when investing or expanding a system to accommodate real-time location. Knowing the problems that need to be solved inside your organization, which typically range from equipment loss to quality of care, is an essential first step to answering these questions. By considering both short- and long-term needs, you will be best positioned to ensure today’s investment won’t limit future potential.

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