Enabling Technologies - Integration that Drives Patient Care

Speaker 1:           Welcome to Patient Flow Podcast. Today we're very pleased to have Jon Poshywak, VP and General Manager of RTLS with TeleTracking join us. Jon is an expert in how patient flow technology can improve care and increase capacity when integrated with RTLS and other enabling technologies.

Speaker 1:           Today, Jon is going to share three key considerations when choosing an RTLS solution. Jon, welcome.

Speaker 2:           Thank you! Thanks for having me, I appreciate it.

Speaker 1:           Jon, with so many RFID and RTLS options available on the market today, how do TeleTracking’s enabling technologies team help clients, and perspective clients, navigate the market and make a decision that best meets their needs?

Speaker 2:           It's a really interesting question. The enabling technologies team over the past seven years at TeleTracking has really evolved. It's interesting, our focus early on was RTLS real-time location systems. Primarily, active RTLS based on costs, the ability to design, configure, and install quickly for our clients, and quickly get to a point where we're executing against used cases, and delivering an ROI. It's interesting because today the market is really rich with different locating technologies. So much so that we've re-branded a little bit over the past several years to call our team the Enabling Technologies team as opposed to the RTLS team. Because it can be confusing and misleading, right?

Speaker 2:           There's active RTLS, there's passive RFID. Within the active RTLS market, there are a number of different technologies that can be used to execute against a number of different use cases, but each technology doesn't always work so well with each use case. Passive, right? Very different. Passive is traditionally higher cost infrastructure in devices, but much lower cost tags. So we've been spending a lot of time over the past couple of years evaluating, researching, testing these technologies. Not only for speed and accuracy against specific use cases like asset tracking, staff, and patient tracking.

Speaker 2:           In addition to speed and accuracy and the overall competency of a technology, we've been spending a good bit of time building data around total cost of ownership for these technologies. Meaning as we're making recommendations for our clients, we want be confident and stand in front of a recommendation that allows our clients to be able to plan and scale for the future. So if we start with a specific technology, say for asset tracking, will that same technology scale for patient and staff? Is there a better technology from a cost perspective for specific use cases? Patient tracking, depending on what the client wants to do.

Speaker 2:           We spend a lot of time working with clients before we rush into a specific technology recommendation. Based on exactly what they want do, not only now, but what they want do potentially two, three, five years from now. One of the biggest things that we've worked on in TeleTracking is ensuring that our platform is neutral, or agnostic, if you will, from a data consumption perspective. Meaning, if we start with one technology, does that handcuff or limit our clients into only being able to use that technology. Or as new technologies become available, or if a different technology better meets a specific use case requirement or need for a client, can we add that technology to an existing platform, consume that data, and allow the client to continue down the path and our platform or other platform is making use of that data?

Speaker 2:           Really, one of the biggest opportunities that we see in the marketplace today is understanding roadmap, understanding our clients need to be scalable, and really not limiting clients to any one locating technology to meet their needs now and in the future.

Speaker 1:           Jon, as a location services system integrator, how do TeleTrackings Enabling Technologies team assist hospitals with integrating RTLS into the other solutions that they have? I know health systems are made up of a multitude of solutions that are a part of their IT platform.

Speaker 2:           You really hit the nail on the head when you asked about location services as a system integrator. Obviously, TeleTracking has a long history. Over 27 years in the patient flow space, from a capacity and access perspective, in the way that we help our clients.

Speaker 2:           We could very easily focus on enabling technologies only to automate our core applications and platform. That would provide more than enough work for our team. But when you're working with clients around enabling technologies like RTLS and RFID solutions and technologies, you absolutely need to be sensitive that there are various disparate systems within their IT ecosystem that could take advantage of the same data. The same location services data that we're recommending to automate different applications in our platform.

Speaker 2:           Whether it's asset tracking or temperature monitoring, or whether we're integrating a location services technology into a platform around patient and staff use cases, and workflows. A great example is nurse call. There are various nurse call systems in the market today that many, many of our clients have instilled. Whether it's Rauland, or Hill Rom, or Ascom, or West Call. There's any number of nurse call providers.

Speaker 2:           As a matter of fact, nurse call applications, and use cases with the nurse call, those systems were one of the first applications and systems to take advantage of RTLS data, specific to staff locating around rounding, right? So, a nurse or a caregiver goes into a patient's room, the patient asked for assistance with the use of RTLS, the system recognizes when that nurse entered a patient's room, and some cases even turns off the call light outside of the patient's room. So that activity's been recognized as being completed.

Speaker 2:           That's just one great example of when we're working with clients and beginning to make recommendations around location technologies, we're absolutely cognizant and sensitive of opportunities like that. For a couple of different reasons. We're making recommendations around a location technology. In most cases, depending on what the client wants to achieve, it's a decision around a capital investment for hardware, and installation of that hardware, that's not to be taken lightly.

Speaker 2:           When we can leverage that same technology and infrastructure against multiple applications in that client's ecosystem, they begin to see value much more quickly, right? And it's not just an investment for asset tracking, it's an investment against multiple applications that they can take advantage of. A good system integrator is going to look at that in a client's ecosystem and begin to make recommendations on how the technology that's being recommended can impact other systems or solutions that they have in place already.

Speaker 1:           I imagine that must really make things run much more efficiently for the nursing staff, if for instance, an IV stand is tagged, they're able to tell it's on the second floor in section B, versus trying to look everywhere and try and hunt something down, they're able to identify it immediately and get it to the patient that needs it.

Speaker 2:           No, that's exactly right. That's a great point, and it's one of the things that we were lucky enough at TeleTracking to see early on. From a patient flow perspective, and from a user interface perspective for TeleTracking’s core clients, excuse me. So, TeleTracking caregivers who are using TeleTracking to best manage capacity, occupancy, right? Making certain our patients are moving through their length of stay timely, safely, so that they can create capacity based on be availability. That's what TeleTracking really does well.

Speaker 2:           It's a great point that you make, because we actually incorporate and integrate a number of pieces of functionality directly into that platform that our clients are already using. As an example, if we're implementing asset tracking for one of our clients, there's a stand-alone asset tracking and asset optimization application that if you think about teams and hospitals that are primarily responsible for movable medical equipment, clinical engineering, materials management, supply chain. The folks who live and breathe equipment and supplies, making certain that their caregivers and patients have what they need, where they need it every day. There's that group of end users.

Speaker 2:           Then there's nurses, as you just articulated. In most accounts, a nurse doesn't have time, or a caregiver doesn't have time to log into a separate asset tracking solution to look for an asset. So what TeleTracking has done is, we've actually integrated the functionality of our asset tracking application. Key components, I should say, functionality-wise, into our broader platform that allow caregivers and nurses right from the application that they're already using. So a caregiver doesn't have to log into a different system, they simply have icons and functionality that are embedded into what they're already using to help them do quick equipment searches. Or even patient and staff searches. So it's a great point you make and I really appreciate you saying that.

Speaker 1:           Jon, how will location services technology further help improve patient throughput and patient safety? I mean, I imagine if you are tracking the patient you're able to see as how they're moving through the system, knowing when they're ready to be discharged, and knowing when that bed's available? And I would think too, from a safety perspective, you're able to track if someone is a fall-risk, for example- can you expand upon that, and give us some more detail on how that works?

Speaker 2:           Yeah, I'd love to. It's something that we spend an awful lot of time focusing on. Location services data, RTLS, RFID, those terms, can be somewhat ambiguous in today's market. So what does that mean? It can be as simple as visibility and dots on a map, right? Meaning, I've tagged patients, I've tagged staff members, I know where they are, maybe I've built a floor plan, I can understand patient location.

Speaker 2:           To your point, fall-risk, or isolation, or elopement risk, based on very simple location rules. You can establish parameters and rules within an RTLS system that create the appropriate visibility and alerts for caregivers to understand where their patients are, and if they're in a location where they shouldn't be. From a staff perspective, the ability to understand where your staff is quickly without making phone calls, without creating a lot of noise, or making folks aware that you're looking for somebody. Doing quick searches.

Speaker 2:           Those are all pretty basic use cases from a workflow perspective, right? That's what our team really refers to is that sort of map. Any good, accurate, fast, enabling technology, coupled with the right applications or solutions, should be able to provide basic functionality like that. When you really begin to evaluate and discuss specific use cases, or maybe even more accurately, outcomes with your clients, that you understand process and workflow and what you want to drive.

Speaker 2:           It's one thing to know where a patient is, but from a milestone perspective, based on where that patient is moving through their length of stay, what type of milestones does that trigger that would allow caregivers to understand where they are in their actual length of stay, and when they may become a pending discharge, and a confirmed discharge, and ultimately ready to go, right? And based on location awareness, depending on where that patient is, does that mean that we can automatically alert service personnel, caregiver services, whatever the case may be, to that patient's location because they know they have an activity around that patient?

Speaker 2:           Some of the things that we do just around location awareness is helping our caregivers, right? The staff that we work with in hospitals work as smart as they work hard. From a confidence perspective, it's interesting, one portion of my team focuses on asset optimization and healthcare. And again, when you think about caregivers, physicians, nurses, staff, and their ability to secure the asset that they need, quickly, timely, to care for a patient- maybe it's an infusion pump- they just want know that that device is where it should be when they need to get it, right? And if they lose confidence in the process, then all of those symptoms that we hear about in the industry today happen. They hoard, they hide, they keep things for themselves. It's not malicious behavior. They want care for their patients, right?

Speaker 2:           Our ability to create workflow around who does what based on location accuracy of these devices, and the people that are responsible for then, that's what really establishes confidence with our caregivers. To allow a workflow process to work the way that it's intended to work, and not maybe compromise that process by taking something, hiding it, saving it for later. As long as they see a process that works, meaning if they put assets that are used in a storage utility closet, and not too long after they do that they see people show up and collect those assets without any phone calls being made, those assets are taken to a central location and cleaned, and then re-deployed to par-level areas.

Speaker 2:           And the same goes for a par-level area, right? A caregiver in a high acuity unit knows that they have X number of devices that they can go to a par-level area for, and when it falls below a threshold, they see the appropriate people come up and replenish that par-level area without any phone calls being made, that's what establishes confidence, right? That's what allows the caregiver to go upon their day and not worry that they'll have what they need when they need it, right? Just kind of quiet workflow based on location accuracy and speed from a good, well implemented locating solution. RTLS or RFID. It helps our caregivers be confident. Make sense?

Speaker 1:           You're letting the caregivers be caregivers and be at the bedside and deliver the compassion that's a part of their job.

Speaker 2:           That's exactly right. It's one of the biggest things when you look at hospital surveys and what caregivers are frustrated about, it's the time that they don't spend at the patient bedside that they know they should be there. And that's exactly right. We want give that time back.

Speaker 1:           Jon, could you share a recent example of what you're witnessing first-hand regarding how patient flow improves through the use of location services technology?

Speaker 2:           I'd love to! It's something we're really excited about and candidly, we feel that we're helping to make some changes in the industry about how clients are looking at location technologies and they're adoption of location technologies.

Speaker 2:           Early on you had your basic, or core use cases, around asset management, potentially temperature monitoring. When you think about the industry today, RTLS is still no more than 15%-18% penetrated in the US market, as it relates to location technologies in hospitals. It's even less when you look at hospitals that have adopted a location technology enterprise-wide. Meaning they've designed, configured, and installed an RTLS infrastructure as an example throughout their entire hospital to manage multiple use cases.

Speaker 2:           One of the things that we've really focused on is looking at specific use cases that require less investment, are less complex, and deliver real tangible value to our clients. One of the things that TeleTracking has been doing over the past couple of years with great success, is introducing our clients to the use of a locating technology to trigger discharge notifications for patients who are leaving the hospital. And what I mean by that is in many cases we work with hospitals that aren't using- or speaking to hospitals, right, who aren't using a solution like ours to manage patient flow occupancy.

Speaker 2:           What I mean by that is caregivers are busy. In a high occupancy hospital, a caregiver's responsible for two, three, four patients depending on the type of unit that they're working on. What happens when a patient's ready to leave or has left, is the caregiver has to finish their clinical documentation and trigger the discharge of that patient in their ADT system. Depending on how busy the caregiver is, that activity may not take place for anywhere from one, two, three hours after that patient's actually physically left the hospital.

Speaker 2:           So what happens? You know how have a room and a bed that are sitting there idle and dirty, because the EVS team hasn't been made aware that that patient's been discharged. One of the things that we're doing with great success for our clients at TeleTracking is the use of RTLS and enabling technology, and we're doing this with both active RTLS and passive RTLS. We're creating simple discharge locations in hospitals, based on where patients are leaving the hospital once they're discharged. Typically that's just a handful of locations in a hospital based on proximity to parking lots, or transportation services, where patients are being picked up.

Speaker 2:           So we're creating these discharge locations and then we're using low-cost patient tags, right? And so what happens is when a patient who's wearing one of these tags is seen at one of the discharge locations we've configured, they're automatically discharged from the TeleTracking system, and a workflow notification is sent to the EVS team to make them aware of patients discharged, and what room and bed are now vacant and need to be cleaned.

Speaker 2:           The outcome of that is that notification gets to that EVS team much more timely, that room and bed are turned much more timely, and what happens for our clients, patients who are waiting in ED, or patients who have been slotted and are waiting for that room and bed, they're placed much more timely, and begin to get the care that they need in a much more timely manner.

Speaker 2:           There's another of things that happen around that, right? So first the patient has to be identified in our system as a confirmed discharge. They've got to be recognized that they're ready to leave. What we absolutely don't want to happen is, we don't want to have a patient who's going downstairs who's ambulatory, and may be able to visit the gift shop, or visit the lobby to get some fresh air, some sunlight, and be inaccurately discharged. So there are safeguards in our system to make sure that doesn't happen.

Speaker 2:           But the outcome is significant, right? Our ability to help decompress ED’s, make certain patients are placed in a much more timely manner, the upstream and downstream of a effect of a simple workflow like that is really significant, and we're seeing tremendous results in our client base by deploying RTLS for that simple use case and workflow.

Speaker 1:           Jon, that's exciting. Combined, caregivers are giving care, patients are receiving caring compassionate care, and easily moving onto the next step in their recovery, or moving on home. Just a streamlining of the entire system is just very, very exciting, and exciting to see what the future will continue to hold. I hope you'll join us again as these things develop.