Vendors are consistently upping the ante in terms of their systems’ capabilities, too – and increasingly these upgrades and updates are offered inexpensively (and, in some cases, even free of charge). The goal is to provide more scalable solutions that allow healthcare customers to push their tracking and data capture capabilities to new heights – as quickly as they are able and as far as the technology will allow.

"In order to provide a completely scalable solution for our customers, we introduced several new entry-level products that are focused on specific areas of traceability and management, such as endoscope tracking, count sheet management and electronic sterilization record-keeping," said Creason, adding that these products are economically priced, easy to learn and quick to implement. "The new modular design of Censitrac allows the customer to upgrade into expanded functionality whenever they are ready."

Getinge’s T-DOC Instrument & Asset Management System also undergoes frequent scheduled releases, the latest of which focuses on the user interface and live connections to even more equipment. "We offer a wide variety of modules and integration options to enhance our product line," said Hana Scheichenost, national manager, T-DOC Instrument & Asset Management System, Getinge USA, Rochester, NY.

At IMS, automating proactive maintenance schedules and alerting customers when their instruments need service has been a top priority. The company has built in audible and visual alerts for each upcoming maintenance requirement – and the same information can be found in a report on the administrative side (although the alerts really serve the critical end user). "That information, at the fingertips of the staff members who handle the instruments every day, can greatly improve compliance with scheduled maintenance," noted Hartley. "It can ensure that the surgical team never has the frustration of instruments not functioning as expected because they haven’t been maintained."

One of Lawson Software’s latest enhancements also helps ensure proper instrument maintenance. One new feature, for example, tracks the number of times an instrument was used, which gives staff insight into inventory use and helps ensure that devices are properly rotated and maintained.

As part of Microsystems’ technical support agreement, customers are provided an annual upgrade that includes all enhancements since their previous upgrade. "Perhaps the most significant upgrade relates to case cart management capabilities that are also an important element in enhanced surgery scheduling integration tools," Cannady explained.

TGX Medical Systems’ Alex Gold instrument tracking system recently released several new modules – all offered at no additional cost to customers. The case management module, for example, interfaces with all major OR management systems and provides case conflicting for requested instrumentation. It also provides SPD staff with real-time priority lists based on case volume to ensure all required instrumentation is processed and ready for use on time for each scheduled case. Additionally, a new loaner tracking module lets the hospital check if instrumentation is complete upon delivery. Beyond that, it stores images of a particular tray or trays, and records case time, procedure name, physician name, and case number. Loaners can then be tracked through sterilization and dispatched to the case. Upon completion of the case, the trays can then be tracked through decontamination and to where it is stored while it awaits vendor pick-up.

CareFusion has also introduced a new loaner instrument module, along with one that tracks sterilization and repair management functions. Each quarter, CareFusion customers receive enhancements and new product releases, according to Jennifer Anderson, vice president of marketing, medical specialties, CareFusion. "Instrument tracking systems that have fully developed modules for both the central sterile supply and operating room processes have afforded great efficiencies in the central supply department within hospitals in three ways. First, tracking systems have provided automation to manual processes, therefore ensuring the correct instruments are available for the procedure. Also, tracking systems ensure accurate management of capital equipment, driving reduction in hospital expenditures related to replacement of lost equipment. Finally, but most important, tracking systems help reduce the need for flash sterilization, therefore helping reduce infections within the hospital and increasing patient safety," explained Anderson.

Greensboro, NC-based SurgiDat has recently added its loaner set and implant management systems, which can be used in concert with the company’s Serenity system or independently. "Serenity will track receipt, return, reconciliation, and expiration with the ability to easily trace to the patient," noted Brian Newton, SurgiDat’s vice president of sales.

Additionally, SurgiDat added to its upgrade lineup the Serenity Audit & Recall solution, a free, web-based software solution that replaces manual paper record systems. The expandable electronic system provides audit, recall and tracking of sterilized goods with full reporting, count sheets and compliance. "There are no license or maintenance fees and the system provides an immediate cost savings over paper record systems," added Newton. Further, SurgiDat recently upgraded its Enterprise Activity-based Costing platform, which simplifies user and administrative menus and increased interface capabilities with preference cards, OR scheduling, purchasing, and other instrument management systems. "SurgiDat is now capable of sitting on top of all touch points and managing all requirements of interoperative data or costing of sterilized and soft goods to a patient and procedure."

Lawson Surgical Instrument Management

Healthcare organizations that haven’t yet embraced instrument tracking solutions will likely find themselves joining in soon thanks to some key regulations and standards on the horizon.

"The Unique Device Identification regulations and the use of GS1 standards should encourage instrument and tray/set tracking," predicted Keith Lohkamp, product strategist for Lawson Software, Minneapolis, MN. "For example, if the FDA requires serialization for instruments as part of the UDI regulations then instrument manufacturers will be uniquely identifying instruments and likely marking these instruments. Data about these instruments from the manufacturer can then be used to help pre-populate surgical instrument management systems, and for automated data collection, simplifying adoption and implementation." And because UDI information will be used for things like recalls, Lohkamp said there will be even more incentive to track at a very detailed level.

Some anticipate a trickle-down effect that begins with surgical instrument manufacturers before flowing to the rest of the supply chain. "From our discussions with the FDA, we know the timeline is within five years from the regulations becoming final for Class I medical devices," Creason said. "Ultimately, it will be the Joint Commission or the hospitals themselves that will push the requirement to track individual instruments to the patient level."

In the meantime, though, some facilities are predominantly tracking at a tray level and reserving unit-based tracking to higher-dollar, more intensive devices, such as neurology instruments and endoscopes. "We’ve certainly seen a greater interest in the concept of instrument-level tracking, but implementation has not always kept up with interest. The average healthcare facility has an inventory of 1,500 instrument trays, and it takes commitment and coordination to put the technology in place to track each instrument," said Whitney Ligon, director of corporate software, IMS. "The staff must be trained so they are comfortable with the technology. It requires a commitment from administration, the manufacturer and the end user alike."

Alex Gold’s new Loaner Tracking Module (TGX Medical Systems) lets CSSDs create a loaner label that identifies the doctor’s name, vendor name, date of procedure, presence of implants, and the number in the series, (i.e., 1 of 6).

Newton is also seeing a greater movement toward tracking loaner sets, implants, trays, peel packs, and wrapped goods, and he stressed that the primary drivers are reduction of liability and requirements to measure information and increase productivity. "Approximately, 80 percent of the US market still utilizes manual records and date/load stickers to track sterilization," he added.

Some instrument manufacturers are already taking steps to assist customers with unit-based tracking, however. The majority of Aesculap surgical instruments, for example, are already manufactured with a data matrix code that includes an individual code – the UNICOS-Code – for each instrument. "This means each instrument marked with an UNICOS-Code is uniquely identifiable," pointed out Michael Chow, senior product manager, services marketing, Aesculap Inc. The instrument carries the UNICOS-Code both in plain text and encoded in a machine-readable data matrix. The information that can be read consists of the article number (part number) and a five-character unique identifier. "This data matrix code can be read with a 2-D camera system and tracked individually through a hospital’s instrument management system," he said, adding that customers that purchase instruments that already have the data matrix on them will save time and money because they won’t have to etch the individual devices themselves.

Radio frequency identification could also play a critical role in simplifying unit-based tracking – and it’s a capability that numerous vendors predict is just around the corner. "The current limitation of instrument tracking is that it takes too long to scan all of the instruments in a set," said Chow. "We believe that the next big improvement for instrument tracking will be the use of RFID technology on individual instruments. [This] would significantly improve the time it takes for the individual instrument to be read and quickly identify the set, the contents – and determine if any instruments are missing."

Enhanced interface and data capture capabilities have made today’s instrument tracking systems more robust, but like other software-based systems, the degree of benefits and rewards are dependent upon proper, consistent use. As vendors were quick to point out, many customers still aren’t taking full advantage of their investment.

"Incomplete utilization and poor compliance from hospital staff are some of the biggest shortcomings we see," confirmed IMS’ Hartley.

Because of the inherent training challenges regarding full-scale implementation and compliance (or, in some cases, even basic compliance), vendors have become more committed than ever to stepping up their educational offerings.

Microsystems, for example, is creating an educational platform that consists of monthly webinars. These will cover a range of related topics, some of which will address connectivity and help customers drive maximum value from their system – and their collective processes throughout the department. Other webinars being developed will help customers build a value case for tracking and connectivity solutions.