Health Care Reform and Real-time Location Systems (RTLS): Third in a 3-Part SeriesThe first two blog posts in this series dealt with the first and second goals of health care reform legislation: 1) Expanding coverage to an estimated 32 million Americans without it now and 2) Reforming the delivery system to improve quality.
This post deals expands the third: 3) Lowering the overall costs of providing health care and focuses on a couple of key areas not touched on in previous posts.
]If you missed either of the first two posts, you can find them here: (Part 1 and Part 2). For a concise review of Healthcare Reform, see the following from Ernst & Young: 6 page quick-read review titled "Health care reform has passed: what now?"]
Previously, I discussed three specific things RTLS can do that help hospitals contain their costs. These are really the cornerstones of significant cost containment benefits of an RTLS system:
1. Reduce use of rental equipment
2. Increase utilization of hospital owned equipment thereby reducing redundant equipment purchases
3. Stop equipment “shrinkage” from loss, misplacement or theft
In going a little deeper than the obvious hard dollar savings we’ve already covered in the areas above, consider these additional scenarios – each of which impacts the overall cost of providing healthcare, but also the quality of care and ultimately, patient safety:
In a recent blog post [see RTLS and the Healthcare Value Equation], Valerie Fritz discussed two hospitals in the same IDN - or Integrated Delivery Network - that had a recall of infusion pumps. One of the hospitals had Awarepoint’s RTLS installed, the other did not. It took the maintenance staff of the hospital with RTLS a couple of days to locate and service 100% of the recalled units. It took the sister hospital (without RTLS) a couple of weeks to achieve the same thing. Well, not exactly the same thing - they actually didn’t ever find all of the recalled units, and simply have to assume the missing ones are no longer on the hospital grounds. Not only is there impact here from a patient safety standpoint, the staff time saved in increasing the efficiency of this laborious process can be easily converted into a significant cost avoidance (e.g., overtime) and thus expense reduction.
There is another capability most RTLS systems can uniquely provide: automated temperature monitoring. Today most temperature monitoring in hospital settings is conducted manually – by someone going to a refrigerator, freezer, incubator or warmer and checking the temperature – either by reading a thermometer that is in or a part of the unit or by touch. The latter isn’t far from a parent touching a child’s forehead to see if he or she has a fever, not very sensitive or accurate.
Often a temperature trending toward being out of compliance will be due to something very simple, like a door to a unit being left ajar, but it could be something more significant, heralding a unit that is verging on failure. In the latter circumstances, agents stored in the unit can be transferred to a properly functioning unit before they have been at temperatures for extended periods and rendered useless or even dangerous for patients.
Areas where RTLS temperature tags are now being widely used in hospitals include pharmacies, blood banks, laboratories, operating rooms, and nursing units. Significant cost avoidances can be realized in pharmacies because many agents now dispensed from them require rigid adherence to temperature storage conditions -- especially true for vaccines. Vaccines are expensive and exquisitely temperature sensitive, particularly the newer live attenuated viral vaccines. Should they not be stored at proper temperatures, they will lose their immunogenicity and vaccine failure will result. This may account for a significant portion of vaccine failure.
The same is true for blood banking where proper storage conditions are critical. Temperatures below freezing for liquid blood will destroy the stored cells, too warm and the chance of transmitting infection increase rapidly. Likewise for blood products stored in the frozen state, too warm and the cells will be destroyed. The time blood cells stored in a frozen state can remain thawed and safely infused into a patient is very limited. Proper and frequent monitoring of temperature of blood products is imperative.
The other areas mentioned, operating rooms and nursing units, have more to do with patient and staff comfort than with safety. Keeping these units comfortable for both staff and patients is important, but there are some applications already in use that bear on safety.
Take blanket warmers: too cold and the comfort of patients cannot be assured, too warm and harm could be done. One of Awarepoint’s clients is even looking at putting temperature tags on individual patient beds! This is not overkill, hospital HVAC systems cannot maintain a constant and similar temperature in all areas at all times. Individual bed temperature monitoring can provide information that a certain room is indeed uncomfortable, or that a patient is experiencing a chill or developing a fever.
Together, these RTLS use cases, along with the ones we previously wrote about, can result in significant cost avoidances for hospitals.
To recap, RTLS can provide cost effective, rapid-impact results at a time when hospitals need to be planning for the perfect storm: increased capacity and lower reimbursements. The conundrum: how to do more with less without comprising quality care? We believe RTLS is a critical tool to help hospitals operate efficiently and continue to provide top quality care as they navigate the stormy waters ahead.
What do you think about healthcare reform and the benefits that RTLS offer? We'd love to hear from you.
~ Harold Koenig, M.D.