How do I quickly find a patient transport chair that has been taken off to another department? How do I help visitors avoid roaming about in the hospital? How can I assign data from different sources to time and space and link them together?
The key to answering these and many other questions is real-time localization using RTLS technology. It is already in extensive use in industry and has now been introduced to the radiology institute of University Hospital Erlangen, Germany, as part of a pilot project.
RTLS stands for real-time location solutions. It enables objects and even people to be precisely located indoors. Indoor tracking is already widespread in industry, where it’s used to locate workpieces on a production line or mobile inventory in a factory, for instance. People can also be located for safety purposes, such as to monitor the duration of their presence in a hazardous zone.1
At the Institute of Radiology in Erlangen, it was recognized early on that RTLS could also be a great help in a clinical work environment. That is why senior radiologist Professor Alexander Cavallaro, MD, was enthusiastic when Siemens Healthineers proposed an RTLS pilot project six months ago. "We experimented with this technology some years ago when it was not so advanced and the opportunities it offers were not yet apparent. With the technical progress that has been made since, we needed no persuasion by the project team from Siemens Healthineers."
RTLS technologies can provide information about where items and patients are located, helping to speed up and improve processes. In this way, providers can improve the quality of healthcare and increase efficiency – to an extent that has not been possible before.
Professor Alexander Cavallaro, MD, Institute of Radiology, University Hospital Erlangen, Germany
Where did I put those keys? The very thought makes many of us panic and start searching frantically. Not Stephan Kunzelmann: When the department keys go missing at the Institute of Radiology at University Hospital Erlangen, the head technologist can stay calm. "In theory, the bunch of keys is always handed over to the duty technologist, but it doesn't always work out like that – for example, if you're in the middle of taking care of a patient and are holding the key. It then often gets put down somewhere or stuffed in a pocket. And then we’d have to start searching high and low," Kunzelmann remembers. "Now if someone asks me where the key is, I just point to our RTLS."
At the radiology site in the Center for Internal Medicine of the hospital, the roughly 3,000 square meter department was equipped with 90 repeaters. They receive the signals from the approximately teabag-size tags that are attached to the various objects, and forward them wirelessly to a gateway, which is connected to the hospital IT network. In this way, the position of each tagged object can be read on the department's computers using browser-based software.
We were very excited about the project from the outset because we are familiar with the annoying situation in which we have to search for something.
Stephan Kunzelmann, Head Technologist at the Centre for Internal Medicine, Institute of Radiology, University Hospital Erlangen, Germany
Approximately 50 objects in the radiology department have now been fitted with tags. Besides the department keys, these include patient tables, wheelchairs, tablets, the CT cannulation cart, and a mobile monitor system. This saves the radiology staff a substantial amount of time. Kunzelmann estimates that his team spends an hour a day looking for objects – wasted time during which examinations are often held up because no gurney is available, or a positioning aid has gone missing. Kunzelmann would therefore like the pilot project to be rolled out to the whole Center for Internal Medicine soon, as planned. "If the system is installed in the whole institute, that would be perfect. It would save us a lot of long and unnecessary trips."
The RealTime Hospital Navigator can guide patients and visitors through the hospital using the RTLS technology and, for example, suggest certain routes for infection protection.1
One piece of hardware, multiple solutions
However, the use of RTLS goes far beyond locating objects. "Once the privacy issues have been sorted out, we could in future see when a patient from another department is on his or her way to the radiology department, allowing us to respond all the faster. This also works the other way around because RTLS can show patients how to get to us," Cavallaro explains. An app for this, the RealTime Hospital Navigator, is already in use. Patients can use the app like a navigation system for the hospital. It displays their location in the hospital and the route to their desired destination.
Once the hardware is installed, the RTLS software and the appropriate algorithms enable many innovative applications involving digital location, guidance, information, or analysis. Just as in industry, safety and security solutions using RTLS are conceivable. For example, the system triggers an alarm if an object leaves a certain zone or the RTLS system could automatically notify staff if a patient falls.1 Since RTLS is bidirectional, it could also be used for infection protection. The system would guide suspected cases along certain routes and warn against entering prohibited areas.1 The RTLS data could be used for planning purposes – for example, to better design clinical pathways or storage locations for systems.1 RTLS can also be integrated into communication processes so that, for example, parents receive a message when their child has left the operating room.1
Valid database for the next level of AI
Cavallaro, however, sees the greatest potential in merging the digital and the real world, which will be possible with RTLS. "We're already talking a lot about new digital applications and artificial intelligence. But for all the opportunities of AI that are being discussed at the moment, we need a clean database. RTLS delivers precisely these data – where things are, and how they are being used."
The pilot project has also begun attracting interest from other departments in the hospital, as Cavallaro reports: "I’ve presented our RTLS solution with the app to various committees, up to the workers’ council, and the response was often: When are we finally going to get this?" This shows that RTLS offers exactly what Cavallaro considers to be key in new technologies: "My main consideration with technical innovations is how they benefit people. RTLS does this to a large degree. It helps our team and the patients."
This service is under development and not commercially available. Its future availability cannot be ensured.
The statements by Siemens Healthineers customers described herein are based on results that were achieved in the customer’s unique setting. Since there is no “typical” hospital and many variables exist (e.g., hospital size, case mix, level of IT adoption) there can be no guarantee that other customers will achieve the same results.