"Where's My Defibillator" part 3
The great debate
The relative merits and demerits of 433 megahertz RFID systems versus 802.11 Wi-Fi systems have been the subject of some considerable debate. Radianse and other vendors tout the superiority of 433 technology for room-level accuracy.
“Several competing RFID platforms have solid performance,” Mathans says, noting that both Wi- Fi and 433 are finding their place in the market. The 433 systems have the edge at the moment for room-level accuracy, but that could change, he says. He likes the Radianse system but says it is theoretically possible to achieve room-level accuracy with Wi-Fi.
It does matter whether 433 or Wi- Fi is used. Some hospital administrators have concluded that the most cost-effective solution is to piggyback a tracking solution on top of their existing Wi-Fi network. That may or may not be the case, as Mathans and others have noted. Achieving acceptable accuracy may require installing more antennas than are currently available on an existing Wi-Fi network. A site survey is required to ferret out coverage problems, such as the lead walls that line X-ray departments, Mathans says. If existing Wi- Fi antennas every 100 yards don’t meet desired performance, or if an access point needs to be installed in every room to achieve room-level accuracy, administrators may not end up saving money.
"At some point, you will want to track patients, whether or not you believe that today."
There are other problems to consider. Adding too many Wi-Fi antennas can cause interference within a Wi-Fi network, PinnacleHealth’s Morley says. In his case, he chose 433 over Wi-Fi because he already was encountering interference problems stemming from the previous addition of access points to handle mobile computers. Also, heavy metal objects affect radio signals, which is primarily a Wi-Fi problem, he says.
As a 433 vendor, Radianse leaders unsurprisingly are quick to point out further problems with Wi-Fi. It can only place an object somewhere within a 30-foot sphere, Pantano says. This means that a Wi-Fi-based system could report a device as being in room 302 when it actually is in room 202. Second, some hospitals have bought equipment tracking solutions only to find they could not use the solutions for patient tracking later. (Where in the hospital is Carmen Sandiego?) “At some point, you will want to track patients, whether or not you believe that today. It’s absolutely where all this is going,” Pantano says. Finally, “Wi-Fi standards are very power hungry, so they chew through the batteries fairly quickly,” he says, raising total cost of ownership issues.
Where’s the payoff?
Radianse systems typically cost $1,200 to $1,600 per licensed bed, Pantano says. The price includes tags, receivers, software, implementation, and training.
While some administrators narrowly focus on the price of the tags, Morley takes a total cost of ownership approach. When he initially did his analysis, he found Wi-Fi vendors had lower infrastructure costs, but much higher software maintenance (debugging) costs. In addition, shorter battery life for thousands of tags and the fee for adding tags to the system made Morley choose Radianse over competing systems. “You can’t only look at what it costs for the hardware or only for the tag, you have to look at every component,” he says.
Morley has no strict formula for calculating return on investment (ROI), but figures his system will pay for itself in less than two years based on the following three factors: equipment purchases, rentals, and theft.
Statistical analysis will tell Morley how often the hospital’s equipment— for example, an infusion pump—is in use, giving him visibility into whether pleas for additional equipment are justified.
The same type of analysis will tell Morley how often the need for bariatric beds and other rental items exceeds the number on hand. “Before we had locating systems in place, typically the rental companies were called right away,” Morley says. He expects to save hundreds of thousands of dollars a year in rental equipment alone.
Lastly, four expensive ultrasound probes were stolen from the hospital a year ago, Morley believes, and the insurance company denied the claim because the hospital could not prove the items were stolen. The insurance company representatives suggested the items instead could be lost. In future incidents, Morley will be able to pin down the time the system sent an out-of-bounds alert, pull video footage from the camera system, and document the theft to the insurance company’s satisfaction.
BearingPoint’s Mathans agrees that theft prevention is an important part of the ROI case. “[With] the amount of high-value assets that disappear out of hospitals, the ROI there is very favorable,” he says.
Radianse executives report their systems pay for themselves within 12 to 24 months. A pilot project of 100 beds in two units at Boston’s Brigham & Women’s Hospital paid off in 15 months. The system is being adopted throughout the hospital as a result, Pantano says. Also, he reports executives there have seen equipment usage rates increase and overtime costs decrease at other Radianse installations.
