Hospitals are among the most complex, active and often sprawling facilities serving the public. It follows that there are unique deployment challenges for connecting such facilities. One technology gaining traction is real-time locating systems (RTLS), such as asset tracking with Wi-Fi, Bluetooth or RFID sensors, and wayfinding through phones and tablets.

When it comes to RTLS, each case is unique. Every hospital has specific demands based on its services, the community it serves and the facility itself.

A key need is simply to know where things are, and materials management is an ongoing challenge. According to a 2024 report by Zebra Technologies Corp., 84% of nonclinical hospital leaders believe integrating automated and digitized inventory (or RTLS) tracking systems is a priority for their organizations. 

Additionally, a report from McKinsey & Co. this year indicated that nurses seek to spend less time on documentation and “hunting and gathering” and more time on patient care.

When RTLS is adopted for tracking vital equipment, care can be delivered in a more timely manner. That increases patient throughput and capacity, and reduces time spent on non-value-added tasks, said Kassaundra McKnight-Young, Zebra Technologies’ healthcare CNIO industry principal for North America.

One example of using RTLS to better manage equipment is the installation of a system that wirelessly monitors items such as bariatric beds (designed to carry people over certain weights). Due to storage limitations and costs, many hospitals rent these specialized, high-value beds. RTLS tracks the hospital-owned beds, showing where the rented beds are and how they are being used, thereby keeping rental costs within check, McKnight-­Young said.

RTLS

How assets are tracked varies from one hospital to another. A facility’s Wi-Fi system can establish a RTLS with limited location granularity using Bluetooth Low Energy (BLE) beacons, ultrasound or long-range wide area network (LoRaWAN) technology. Typically, received signal strength or angle of arrival enables a gateway or software system to calculate where a sensor tag on an asset is, down to the building, zone, room or even a specific patient’s bedside.

The hospital’s inventory management team can track the movement of that sensor, whether it is worn by a patient or staff member, or attached to a high-value asset such as an infusion pump or wheelchair. If the data is received often enough, and the location is granular, users can simply watch the sensor move on a facility map. That data provides the hospital with alerts when an event needs to be addressed, such as a patient being delayed as they are being checked out, or a large number of pumps stalled in the sterilization area.

Beyond real-time notifications, hospital managers can learn from software algorithms or artificial intelligence what causes bottlenecks, when assets are being over- or under-used and even when staff members are spending too much time walking the aisles to fetch equipment or medications, rather than caring for patients.

Assets don’t have to be moving to need a close eye. Temperature­-
sensitive goods such as medicine, blood or tissues require conditions tracking.

“Imagine if the temperature goes outside of spec” for chemotherapy drugs, said Bryan Mitchell, vice president of marketing and business development at sensor technology company Sonicu, Greenfield, Ind. Hospitals could lose hundreds of thousands of dollars’ worth of the life-saving medication if a freezer fails without being detected. 

Sonicu offers environmental management software and monitoring solutions using RTLS asset-tracking devices from companies such as TrueSpot, Irving, Texas. The systems include LoRaWAN gateways and sensors in freezers or refrigerators. A network can then capture the temperature reading and variations in real time for alerting, and historically for analysis, Mitchell said.

Such systems protect the quality of the assets and “help meet regulations from the FDA, the CDC and the Joint Commission,” Mitchell said.

Security and duress

There are other benefits to RTLS data, including security. Today, some staff members feel less secure in hospitals due to rising rates of incidents with the public or patients that can lead to injury. Technology is one way for facilities to support the safety of its staff and patients.

“Some of the biggest challenges that we’re hearing about is definitely on nursing staff safety,” said Marci Bennafield, clinical instructor of health informatics, Georgia State University’s Lewis College of Nursing and Health Professions. Bennafield recently wrote a white paper related to RTLS technologies in healthcare, funded by Atlanta­-based company Vizzia Technologies.

RTLS technology offers ways to locate nurses when they or a patient require emergency support, and such systems can even identify and route help requests to the closest authorized responder, Bennafield said. She stressed, however, that technology needs to solve clinicians’ specific problems at that hospital. Additionally, she said, nurses and clinicians need tools that don’t require extensive training to use. 

“They need something that’s intuitive,” she said, especially as a new generation of professionals are coming into the healthcare field.

While cost is a consideration, the real challenge is ensuring the right type of system is used. McKnight-­Young said that RTLS technology types have evolved from costly infrastructure-laden technologies to more agile solution types such as passive RFID, BLE or Wi-Fi location solutions that ease adoption by requiring less infrastructure and are more cost-effective.

“These solution types enable faster deployments across a greater number of use cases, providing insight [and] value more quickly,” she said.

For those installing such systems, McKnight-Young added, “our advice is to start with the clinician in mind. Work collaboratively with your frontline teams to understand their challenges and gaps in their workflows today, where better understanding of critical assets would enable them to provide better care to their patients.” 

She urges end-users and integrators or installers to select one main pain point to measure the effectiveness of location technologies within the organization. 

“Involving clinicians in technology definition and solution selection ensures success,” McKnight-Young said.

RFID tracking

A less-expensive alternative for tracking assets is radio frequency identification (RFID), passive systems with tags that don’t require batteries and only responds when it is interrogated by a local reader. Facilities can apply sticker-style ultra-high-frequency RFID tags to the goods they want to identify and install RFID reader portals at key choke points, such as the entrance of the surgical suite, the doors to cleaning and sanitizing areas or elevator doors.

These low-cost tags can be applied to everything from patient wristbands and staff badges, to high-value equipment, medications, implants and supplies, and track their movement in and out of specific areas. With this data, the users see the tag’s “last seen” location, and can understand when goods need to be resupplied, or when a vulnerable patient such as an infant is being moved through an elevator from the hospital. 

For integrators or low-voltage installers, that means connecting the RFID fixed readers in doorways or portals, or even desktop readers at places such as registration or supply rooms.

Wayfinding

Most smartphone owners use map apps as driving aids. That capability, however, drops away inside a building. Finding an X-ray room, lab services or a patient’s room requires additional technology that can identify where the person is and then direct them to where they want to go inside buildings that are often spread out and complicated to navigate.

BLE beacons can be installed in hospital hallways, clinics and even cafeterias to transmit to those using their smartphones to navigate what can be a confusing building. Beacons that interact with a phone can often be wireless, so they use batteries or plug into outlets to power their transmission to phones and send data back to a server.

Because most phones come equipped with ultra-wideband, which is used for purposes such as keyless entry into newer model cars, such sensors around a hospital can also provide wayfinding, which can prove valuable in the spread-out premises.

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