May 23, 2011After three years of piloting a real-time location system (RTLS) and other automatic-identification technologies at a single U.S. Air Force Base health-care location, researchers at the Air Force Surgeon General's office have received approval for the expansion of two current projects at Keesler Air Force Base, in Biloxi, Miss., and the implementation of an asset-tracking deployment at Columbus Air Force Base, located near Columbus, Miss., in order to gather data over a longer timeframe, as well as compare information regarding the technology's benefits at a smaller facility.
Additional pilots were also approved, involving temperature monitoring, infant tracking, specimen tracking and the use of Global Positioning System (GPS) technologies to support the management of patients, staff members and equipment for mass-casualty events. The primary goal of this ongoing project is to find ways to increase the efficiency of health-care services through the use of RFID, ultrasound, bar-code and infrared technologies.
The pilots—part of a congressionally funded $7 million automatic-identification and data collection (AIDC) program for the U.S. Air Force Medical Service (AFMS) spanning several years—are being overseen by Larry George, the contract project manager of the Center for Partnerships in Research and Technology (CPRT), in the Office of the Assistant Air Force Surgeon General for Medical Modernization. George is also a retired Air Force clinical laboratory officer.
The pilots began in 2008, when the Air Force hired Shipcom Wireless to analyze opportunities for improving processes at Keesler Air Force Base's 81st Medical Group Hospital. The first project, launched that year as a proof-of-concept pilot, involved the deployment of RFID hardware from Awarepoint and RTLS data-management software provided by Shipcom Wireless, with the goal of tracking and managing mobile assets.
The hospital has found that a ZigBee-based, active RFID RTLS can eliminate the incidence of lost medical equipment and reduce the average time employees spent searching for equipment from 23.5 minutes per item down to 2.5 minutes. For the staff, that means saving 16,000 work hours annually that can now be focused on other tasks, thereby potentially leading to a reduction in some of the currently contracted equipment-maintenance expenditures.
The 81st Medical Group Hospital has 64 beds, a clinical research laboratory, the only genetics center in the U.S. Department of Defense (DOD) and a staff of approximately 1,600 workers. Altogether, the hospital and clinics associated with it see more than 18,000 patients each month. The Air Force Surgeon General's office selected the location as a test site for AIDC technology.
The hospital is continuing to use Awarepoint's RFID readers (sensors nodes), which comply with the ZigBee and IEEE 802.15.4 standards. The sensors, each about the size of an air-freshener, plug into 120-volt wall outlets and automatically create a mesh network, with the nodes placed one per 750 square feet. Within its five-floor facility, the hospital has installed a total of 1,121 sensors and 81 bridges, which receive signals transmitted by the equipment tags and forward that information to a back-end server.
Tags were attached to assets via high-adhesive double-stick tape; each tag's built-in battery has a lifespan of three to five years. The tag ID number is linked to data about that asset in the Shipcom software, while Awarepoint software pinpoints the tag's location through triangulation and location algorithms. The Shipcom software then displays that location on a floor-plan map in the system, Cobb says, within an accuracy of approximately 3 meters (9.8 feet) or less.
Initially, the hospital began attaching tags to such high-value mobile pieces of equipment as IV pumps, beds, thermometers, defibrillators and ultrasonic scanning systems. The facility tagged approximately 1,870 tags over the past three years, George says, with additional tags being placed on new equipment as it is acquired.
The system has saved Keesler's hospital staff significant time when searching for equipment, Baker says, though an actual return on investment is difficult to calculate, since unlike a commercial hospital, the military health-care center can not reduce staff levels, but rather enable employees to complete a greater amount of work and thus be more efficient. However, George notes, the labor savings over the course of one year have been half a million dollars. Preliminary measurements show equipment utilization at 31 percent, which means that in the future, the hospital can purchase less replacement equipment for misplaced items.
Data regarding the solution is stored and provided to the health-care facility by the Shipcom software on a system residing on the Air Force network. The software serves as an interface engine, providing the database with a common user interface for multiple AIDC technologies. In addition to data from the Awarepoint sensors, George explains, the system is also capable of managing information from bar codes and other real-time location systems, such as those employing Wi-Fi or ultra-wideband (UWB) technologies. "Any authorized user can pull up a browser and do a search [for a mobile asset]," he states.
In August 2011, the project is slated to be integrated with the DOD's Defense Medical Logistics Standard Support (DMLSS) system, which will provide equipment custodians and maintenance workers with visibility into an item's current location in that system and its standard reports.
The hospital conducted a patient-tracking pilot in November 2009, to determine whether patients wearing Awarepoint RFID-enabled wristbands could be tracked to determine how quickly they are treated, by automatically monitoring their movements through the treatment process. However, George says, while the location monitoring proved accurate, recovering tags from patients as they were discharged was a difficult task, and after losing about 50 tags over a period of two weeks, the pilot was ultimately terminated. This application may be revisited in another patient setting sometime in the future, he says.
Once a tray is loaded with surgical instruments prior to surgery, a special RFID tag is affixed to that tray before it is run through the steam sterilizer. The instruments are linked in the database with that tray, thereby providing a view into each item's location on that tray, as well as the tray's location within the operating room storage. The pilot launched in 2010 and is still ongoing.
With the projects approved last week by the Air Force, the Keesler base also intends to test the use of Awarepoint temperature tags to monitor conditions within refrigerators, freezers and warmers. "We've already got the infrastructure in place," George says, referring to the Awarepoint asset-tracking technology with readers that can capture data from temperature tags as well.
The hospital will install Awarepoint sensor tags in hospital refrigerators and freezers to capture temperature data this year, and also plans to undertake an infant-tracking system—an augmentation of its existing HUGS system, provided by Stanley Healthcare Solutions. By placing an Awarepoint RTLS tag on an infant, the hospital hopes to add visibility beyond the doors of the Family Birthing Center, track the child anywhere within the hospital and receive an alert if that infant approaches an exit. The Shipcom software could then issue an alert to interested parties in the event that a baby appears to be leaving the facility without authorization. These pilots are beginning now.
"We keep trying all sorts of things" as funding allows, George says. "We keep pushing the envelope," he adds, by testing applications for wireless technology.
