iRISupply from Mobile Aspects

Wireless technology, particularly radiofrequency identification or RFID, may be turning heads in healthcare but it’s not necessarily loosening the purse strings, despite all the marketing efforts and media hoopla that by rights should have inspired long lines of eager customers by now.

For clinicians, the patient care benefits have been clear for some time.
"The benefits in improved patient care really come from linkages that are enhanced by wireless access to medical information at the bedside, such as direct access to medical records and lab results and the elimination of redundant manual entry," said Richard Perrin, president, AdvanTech Inc. (Annapolis, MD). "It is noteworthy that certain areas of the hospital – cardiology – have already had widespread implementation of wireless capabilities to monitor patients." Physicians increasingly are using wireless devices, be they personal digital assistants (PDAs) or tablet PCs, to order procedures, prescribe drugs, update patient medical records and maintain schedules, all in the name of preventing medical errors and becoming more efficient and productive.

Facility managers have been using wireless technology for years to track assets throughout the hospital, such as those errant IV pumps, stretchers and wheelchairs that maneuver their way into hidden cubby holes.

Even pharmaceutical companies are jumping on the bandwagon, thanks to Food & Drug Administration scrutiny over counterfeit drugs and retailer Wal-Mart’s fiat that products sport RFID tags starting January 1 or non-compliant vendors won’t be doing business with the market leader.

But what is seemingly ubiquitous in the purchasing arenas of non-healthcare industries has yet to gain a toehold in hospitals even as many companies scramble to figure out how to best position themselves to deploy their technology in the hospital market.

For materials management the most logical place for wireless technology is the receiving dock or even the distribution or storeroom area but those aren’t the only locations where wireless technology is making inroads. In fact, a small but growing number of hospitals are implementing pilot projects in costly clinical areas like the cath lab to build an effective business case for expansion and more widespread implementation.

When it comes to technology like this that may be the smartest route to take, according to Lydon Neumann, vice president of consulting firm Capgemini’s health supply chain practice. "Materials management needs a success story in one area before they can develop a strategy and get ambitious," he said. "They should demonstrate a successful development in one area before trying to do it on a larger scale. Typically, top executives demand high performance out of an existing system or process before they’ll go for upgrades."

Wired before wireless?
Wireless may be the ultimate strategic objective for hospitals but being wired is what they’re striving to achieve today, Neumann noted. Much of that is driven by the information technology professionals who want to establish a single standard and a single computing model that serves all the needs of an institution before migrating up to the next level.

"You don’t want to be buying wireless applications without IT support," Neumann said. "Materials management shouldn’t be pressing IT to make a decision without appropriate funding. Certainly materials management should press to be an early adopter when funds are available. They should be one of the first on the list to try out the technology, which would give them a good economic story to tell.

"Materials management generally and historically is not in a strong position to do this," he continued. "They are the least wired. If materials management has limited experience with bar coding what is the department’s capability in handling wireless technology?" If materials management has been reluctant to work with bar coding for any reason other than it found no value in it then it shouldn’t be pursuing wireless at this point, he added.

Perrin attributes slow adoption rates to a lack of available capital. "Adaptation has been hampered by the need for lots of capital in many other clinical and capital intensive areas, but the convergence of technology and the growing use of DIN/PACS and CAT/MRI, as well as increased investment in all IT capabilities will continue," he said. In fact, he foresees hospitals potentially leapfrogging some of the older IT technologies, thanks to President Bush’s healthcare IT initiative.

Because hospitals are notoriously risk-averse they are not likely to try something new unless they have a sound business case in favor of it or some high-ranking executive recognizes the value of it and makes the decision, Neumann noted.

Still, hospitals have to be able to make sure all these disparate systems – whether wired or wireless – talk to one another "or you end up with some very expensive ‘soup,’" Perrin said.

But real time interactive access to data from anywhere, real time tracking, reduced duplicate data entry, which leads to reduced labor makes for a compelling story for wireless technology adoption and implementation. You can track patients and supplies, consumption patterns, charge capture, billing, receiving, assurance and other factors up and down the supply chain. However, that requires supplier cooperation and costly customizations, Neumann said.

Dehumanizing the process
One of the key business cases for wireless technology and RFID is productivity, according to Neumann. "You can do inventory counts with less labor because you don’t need a line of sight for bar code reading and you don’t have to worry about people scanning the bar codes incorrectly," he said. "You avoid human intervention. It’s not needed."

That’s how Suneil Mandava, president and CEO, Mobile Aspects Inc. (Pittsburgh, PA) markets his iRIS (intelligent radio-frequency inventory system) system and related tracking products.

"Wireless systems are those that give free flow of information anywhere in the hospital," Mandava said. "To become truly wireless the operations have to become transparent." Mobile Aspects’ products eliminate the need for bar coding, scanning and keying in data, tasks that require human intervention and end user compliance. "Other technologies require people to scan or type or push a button or other kinds of manual manipulation," he said. "If you rely on the clinician to do this then that’s where the system breaks down. Basically, these technologies require them to physically do something. Our system is designed to handle all of that in the background."

IRIS and other Mobile Aspects products are "plug-and-play" technologies that can integrate with other internal hospital systems, including the materials management information system (MMIS) and the enterprise resource planning (ERP) system. It also automatically tracks consumption, expiration dates and reorder points, as well as bills patients and updates electronic medical records. The company has targeted key clinical areas, such as the cath lab, the operating room and radiology to deploy its systems because they deal with high-cost products that require stringent inventory control measures.

The patient safety component is equally as important as efficiency and productivity, Mandava said. "One reason for the slow adoption of wireless technology is that hospitals want to make sure these systems don’t interfere with other systems, such as EEG machines and imaging equipment, which would compromise patient safety," he said. Mandava assures that his company’s technology emits no signals that would interfere with other devices and equipment.

iRISupply from Mobile Aspects

So far Mobile Aspects has recruited 10 hospital customers and anticipate adding one or two additional customers per month in 2005, Mandava said. "When I started this company four years ago nobody knew what RFID was," he said. "Now, everybody knows." Hospitals typically lease the equipment for $4,000 to $5,000 per month. Thwarting the loss of only one or two stents (from either missed patient billing or theft) tends to generate a satisfactory return on investment for customers, he added.

No crossed signals
Still, Mandava encourages hospitals to weigh patient safety and cost efficiency before deciding to invest in a wireless system for clinical, financial or operational tasks. "These are not opposing forces," he said. "You can ensure patient safety and reduce costs. Just start with a small area, such as the cath lab, an OR suite or radiology to show ROI."

Neumann agreed but insisted that any pilot project be easy and flexible, allowing for manipulation or restarts. He also advised piggybacking a materials management pilot with nursing and finance, centering the project on consumption, charging, billing and supply replenishment.

"You really need to do a survey of the application, infrastructure and system needs followed by a careful assessment of the building infrastructure to determine the numbers of antennae and placement of hardware components," Perrin said. "Of course, there are all sorts of bandwidth questions and use of the appropriate technology within the healthcare environs so that there are minimal conflicts with patient monitoring equipment, let alone conflicts between competing systems. For example, software tracking IV administration should not be in conflict with the wheelchair tracking system, and there will certainly be lots of pumps in the ICU/CCU areas where you really do not want any telemonitoring interference."