Tracking: an asset to the NHS?

Medical and allied technology equipment is a major item of expenditure for most hospital trusts, with the appropriately-named minor capital budgets being liberally tapped for a variety of mobile equipment, ranging from the ubiquitous patient wheelchair all the way up to expensive portable X-ray and ultrasound machines. Tracking those assets - in order to improve patient and staff convenience, as well as an improved return on investment (ROI), and, of course, helping to prevent theft - has become a lot easier, even in a busy clinical environment such as a hospital, health centre and clinic. This is largely thanks to the widespread use of bar codes and growing use of RFID (radio frequency identification) systems, along with WiFi networks across hospital campuses. It comes as a surprise, however, that the same supplier names keep popping up in the hospital kit and patient tracking systems, such as Airetrak, Aruba, Barcode Warehouse and Motorola. Hospitals are tracking patients as well as equipment: being able to locate them as they move around wards also helps to ensure the best ROI from increasingly stretched NHS resources. If the consultant, for example, is almost ready from Mrs Smith but she is still in X-ray, the receptionist can push her place back in the out-patient queue by 25 minutes exactly, if Mrs Smith's estimated time of arrival in outpatients is around 20 minutes. This level of accuracy is only possible if the patient's location can be tracked and tied into the medical records, electronic health records and allied systems, generating an estimated treatment time which, when added the travel time back to outpatients, gives an accurate ETA. Large taxi bill According to Roger Wilmott, managing director of Airetrak, asset tracking can do a lot more than improve staff and equipment ROIs - it can also save a lot of grief at the sharp end of patient treatment. "There was an incident recently at one PCT where a lad with a broken leg turned up in a taxi, accompanied by his parents, and it took the porter 45 minutes to locate a wheelchair to take him to A&E. The parents ended up with a large taxi bill and, understandably, complained to the trust," he says. "The end result of this was that the PCT - which was looking into the technology anyway - implemented an asset tracking system to stop this sort of thing happening again," he adds. Airetrak has been selling to the NHS for about five years and, in that time, has spoken to around 80% of trusts, most of which are now starting to understand the need for asset tracking and the ROI issues at stake. "It's a bit like satnavs were ten years ago. Most people (in primary care trusts) are only now getting their heads around the technology," he says. Airetrak's main focus in the NHS is on passive RFID technology, where the tag needs a scanner, and active, where the tag transmits its location to the network. As trusts install asset tracking systems, Wilmott says they are beginning to learn about the benefits of patient tracking systems as well. "In five years time you're going to start to see people being tracked - and not just in hospital, but also in the workplace, as there are clear health and safety benefits. At the moment, it's very early days," he says. The problem with patient tracking, he adds, is that there are a lot political and privacy hurdles to be crossed before we see a widespread deployment. Then there's the question of what happens if a patient removes their tag for any reason. Barcode Warehouse, another asset tracking specialist which claims to support more than 40,000 hand held mobile computers for a portfolio of organisations, says it is working with around 160 trusts. The firm has just deployed at thermal wristband system for Basildon & Thurrock University Hospitals (BTUH) NHS Foundation Trust that helps to reduce the risk of patient misidentification. According to Michelle Smith, BTUH's project manager, it was important that the trust compiled with the National Patient Safety Agency guidelines on printed wristbands. "The use of electronically printed wristbands greatly reduces the risk of mis-identifying patients and administrating incorrect medical care," she says, adding that handwritten wristbands are often difficult to read, as details begin to rub off the longer the patient stays in the hospital. When a patient is admitted to a BTUH ward, clinical staff access patient information from the PAS (patient administration system) and print out a wristband that uses anti-microbial ink. With 63,000 inpatients and day cases annually, plus a further 90,000 in A&E cases, the wristband system has had a rapid payback in terms of patient welfare and administration efficiencies. Clive Fearn, Barcode Warehouse's marketing director, says that RFIDs are also useful in the patient care environment, in situations such as neo-natal care, where they can ensure that a baby is where she or he should be and helps to prevent any problems. Both barcode and RFID systems can also be extended from the hospital to the ambulance environment, which also helps to improve resource efficiencies. On the wireless Gloucester Hospitals NHS Foundation Trust recently deployed a WiFi network at both of its main sites – Gloucestershire Royal and Cheltenham General – supplied by Aruba Networks. "Gloucester is just one of 30 NHS trusts that have deployed, or are deploying, our technology," says Bob Vickers, sales director at the firm. "It's still early days. We roll, for example, into a customer's office and explain what we can do. Assets can be tracked, and so can patients." "And once the trust's staff realise the potential, they really start to see many different uses for the technology. Yes, hospitals can 'lose' a patient temporarily, but they always surface in another department. This is where WiFi tags really come into their own," he adds. Once a trust installs a WiFi-based tracking system for assets and/or patients, they then start to realise other applications, such as voice over IP. Vickers points out that this can often require increasing the number of WiFi base stations, so before a system is installed, he says his team talk at some length to the trust about their future plans for the network. "It all comes down to planning. You talk to the trust about what they want and then work out a solution, whether it's barcodes, RFID or WiFi, or a mixture of all technologies," he says. "You must, however, plan for expansion and enhancements, as it's only when the system goes in do trusts realise the potential for asset and patient tracking systems."