South Carolina health system uses RFID to eliminate runarounds

But as of late last year, the system’s materials services group teamed up with perioperative services to make it that much harder to do.

They implemented an active and passive radiofrequency identification (RFID) tracking program for portable devices and equipment. By simply touching a computer screen clinicians and staff members can locate tagged items on a visual diagram of the OR within 10 feet of their actual location. Consequently, such items as arm boards, table attachments and even C-arms no longer go missing. In fact, even disposables and less expensive non-disposable items sport passive tags so that when they inadvertently end up in the trash cart, which rolls through a portal at the trash exit door, an alarm sounds and an e-mail is sent to the appropriate supervisor.

Greenville’s initial foray into RFID was much broader, according to John Mateka, executive director, materials services, but some limitations forced them to scale back the effort for more targeted results.

"Originally, we were planning on a system-wide active tag RFID program for portable devices," Mateka said. "We selected a company and product but discovered our internal wireless network was old and insufficient for what we were trying to do. IT was and is in the process of upgrading their wireless network and completed a few major areas. An area that was recently upgraded happened to be the OR. After a brief meeting with OR staff and OR administrator, it became apparent that they are constantly running around looking for something. Considering the major devices in the area and complicated operational processes it quickly became a likely candidate for our initial implementation."

Greenville’s busy OR operations performs more than 33,000 inpatient and outpatient procedures per year and records approximately $52 million in supply and supply-related expenses annually, accounting for slightly more than half the total medical/surgical expense for the entire system, Mateka noted.

Eugenia Harvey and Donna Hobson locating required equipment

So perioperative services represented materials services’ "biggest customer and largest challenge," he added. And after two years of investing time and effort into collaborating to improve supply and service performance the two groups saw the RFID opportunity as a notable and innovative project to test their mettle.

Mateka indicated he presented the idea to the OR administrator who in turn shared the prospect with OR management and staff. "They were more than excited about this technology," he recalled.

Under Mateka, materials services worked with a core group of key players who moved the process forward. They included Kathryn Becker, senior administrator/ACNO; Carol Holloway, director, perioperative services; Donna Hobson, nurse manager; Mel Redick, system director, logistics; Adrian Corbett, director, materials services, Memorial Campus; Pam Shirley, manager, network infrastructure; Adrian Thompson, information systems; and David Arnold, manager, bio med.

Greenville reached out to four prospective vendors, before choosing one: Integrated Business Systems and Services Inc. (IBSS) and its SynTrack for Healthcare product.

"We had limited funds for this project so cost was a major criterion," Mateka said. "Therefore, we needed a system compatible with our Cisco wireless network. Also, and more importantly, we were concerned about being on the leading edge – or bleeding edge – of this technology for hospitals. We wanted to make sure we didn’t get locked into new technology that was outdated in a year or so. [We found that the] IBSS program is more than a tagging-an-asset tracking program. It is essentially a software program that has the ability to use virtually any company’s RFID tags and provides custom management reporting."

John Mateka

Furthermore, Mateka cited IBSS’ comprehensive reporting programs with national airports that automatically arranged wheelchair requirements when each plane arrived. "By choosing IBSS, we met our budget constraints, achieved a somewhat neutral position relative to technology and have report writing capabilities through [the] Pertaho [report writing tool]," he added.

Mateka’s team originally identified 45 mobile or portable devices and pieces of equipment for tagging and plan to add 20 to 30 more every few weeks or as needed. One example is the "Wireless computers On Wheels" or WOWs, formerly known as "Computers On Wheels" or COWs. "Because of the portable nature of these computers on wheels, staff was always running around looking for them, he added. At press time, more than 100 items sported active tags. In fact, each installed location device can track up to 2,500 tagged items, Mateka said.

So how does it work? End users click on a link to access SynTrack via browser on any PC and log on. They can then search for equipment by entering any type of identifier related to that equipment and a summary of results will appear. End users can then select all or any one of the results to view on the displayed map, which shows the equipment’s location, a descriptive location and also a picture of the equipment. In addition, end users and managers can generate custom reports that show usage and history of tracked assets because all data is written to a database on the server, according to Mateka.

Passive tag

Active tag

Hand-held dispatch device

Equipment with active tag

WOW with active tag

From a technical perspective, the active RFID system consists of a location appliance, active tags, and an 802.11b wireless local network. The location appliance incorporates a map of the facility and uses signal strength to determine the real-time location of the tags. The X/Y coordinates of the tag are sent to the SynTrack server to display the location of the tag on a visual tracker.

Meanwhile, the passive RFID system comprises readers, antennas and passive tags, which provides the last-known location of an asset, and can be wired or use an 802.11b adapter to transmit to the SynTrack server. When the tag passes by an antenna, the tag reflects the signal back to the reader identifying the tag, which is sent to SynTrack to be displayed with the location of the tag on the visual tracker.

Hand-held dispatch units enable more detailed tracking to the patient level, if necessary, and for automating response commands to alarms and notification and reporting on the efficiency of the dispatch operation.

"We can virtually see and record every movement made by the tag and person if they are wearing one," Mateka indicated. "We can see and record the icon on the screen wherever the tag may go, including the bathroom. Furthermore, with the software, we can write a report to summarize the tag’s travel and location over a period of time. Imagine the options and opportunities this brings to equipment utilization and tracking."

While some may recoil at the inherent costs of an active and passive RFID program, even with a projected long-term
return on investment, Mateka never wavered – and with good reason.

"Surprisingly, the program was inexpensive for the software and implementation because we had a suitable wireless infrastructure," he said. "Because we choose to use active tags – they are expensive and range from $60 to $100 each – our costs were more than if we planned on just using passive tags and portal readers."

But with those high costs comes high expectations. "I expect through labor savings, equipment tracking/loss prevention, physician satisfaction and improved productivity that we will achieve a [return on investment] of less than one year," he said. "A big advantage of the program will be time saved by staff and improved productivity, not to mention reduced frustration due to lost or misplaced equipment. We will eventually need less equipment by being able to track and record utilization of current devices."

Given the controversy surrounding RFID signals potentially interfering with OR devices and equipment, Greenville early on tested the system "and found there was virtually no interference with equipment when using the RFID tags and readers," he noted. In addition, there have been no reported issues about RFID with the wireless communications network as both use the same infrastructure.