IoT and RTLS: Providing Solutions to Smart Hospital Challenges

About a decade ago, we were introduced to the concept of “smart” devices. Phones, televisions, watches, and even some household appliances were suddenly “smart” and we quickly understood that it meant expanding functionality through connectivity with the internet. 

Now, with “smart” everything firmly positioned in the cultural mainstream, the same idea is extending to new, sometimes surprising contexts. Take smart buildings, for example, which use wireless technologies to gain digital insights into traffic flows and processes, which are then leveraged into better facility management and a more comfortable, productive, and secure environment for occupants. 

One particular subset of buildings has become a showcase for the advantages to be gained by implementing IoT-based technologies, commonly referred to as digital transformation — hospitals and other healthcare facilities. Smart hospitals are changing the way healthcare facilities operate and the nature and quality of care they deliver to patients, solving many challenges. Let’s look at exactly how they are applying IoT-based capabilities to produce better patient, staff, operational, and business outcomes.

"Smart hospitals are changing the way healthcare facilities operate and the nature and quality of care they deliver to patients."

What is a Smart Hospital?

These are facilities that use advanced technologies to create digitized versions of physical spaces to gain insights into things like workflows, asset utilization, patient care, and overall operational efficiency. Based on these insights, they can adapt and improve clinical processes, patient care policies, and general facility management based on the data they get from monitoring the location and movements of people and assets.  

The goal of “going smart” for hospitals is to provide the best possible patient-centered care more efficiently, cost-effectively, and safely than traditional methods allow which allows for solving common challenges. Much of this is enabled by a central feature of digitized workspaces, data collected from the location, and the movements of people and assets in real time. 

Technologies Driving Digital Transformation

The solutions that define smart hospitals are derived from multiple technologies working together. The challenges we’re focused on here are mostly the work of Real-Time Location Services (RTLS) and IoT. 

RTLS involves tracking the movements of a target. This can be anything from a medical device, a piece of equipment, or a person. This involves the use of wireless tags or badges that emit signals to connected devices, providing accurate real-time location data on processes. RTLS is used in healthcare in several ways.

In the context of healthcare, IoT involves networks of connected devices that generate, collect, and store data. In addition to location data provided by RTLS, IoT in healthcare may handle telemetry data, medical images, physiological and vital body signatures, and genomics data. A newer term called the Internet of Medical Things (IoMT) to describe connected MedTech products is being used. 

On top of this, various technologies need a way to communicate and exchange information. Many of the IoT deployments that make hospitals and other facilities smart are based on the use of  Bluetooth® Low Energy, which is an open standard RF protocol that allows secure communication across IoT devices. While there are other communications platforms available,  Bluetooth® has emerged as a leader in the field because, considering everything, it offers the best balance of benefits:

• It’s open-source, so it’s scalable into multiple use cases and works with most hardware vendors
• It is embedded in most infrastructure networking devices, which supports additional location detection.
• There is a massive, worldwide installed user base of Bluetooth®-enabled devices, like smartphones, which opens even more use cases.
• Battery life in Bluetooth® LE devices is much longer, meaning less maintenance and lower cost of ownership.

Smart Hospital Challenges & Solutions

The size and complexity of healthcare facilities often make it easy to lose organizational control over workflows, locate assets, and match resources with needs in real time. Many of these issues share a common thread — a lack of insight into the number, status, or location of those assets and the resulting need to rely on estimates, guesswork, and ad hoc solutions. 

Many of the most beneficial use cases of technology in smart hospitals are based on the ability to collect, store, and interpret location data to tackle challenges as they arise. They make it possible to tackle problems that erode efficiency, damage the patient experience, and lead to wasted resources.

Here are some of the most common challenges and ways in which that smart data is used to address them in hospitals.

#1: Medical Device Management

Ensuring the availability and ease of access to the equipment and devices needed for virtually all patient care, including patient comfort and safety, is a major influence on the overall workflow in hospitals.

Being forced to waste time searching for a device that is clean and ready to use is a frequent complaint of staff and concern to management for obvious reasons — time spent looking for machines or devices is time not spent facilitating the overall workflow and attending to patients.

Due to the difficulty involved with finding equipment, certain parts of the hospital may hoard particular devices to ensure quick access, worsening the problem facility-wide and contributing to further frustration for staff and substandard care for patients. With limited access to necessary equipment when it’s needed, properly streamlined workflows become impossible.

Solution

With real-time visibility into the location of all tagged assets, finding equipment is just the press of a button away. Staff can see the locations of all equipment of a particular type on a screen instead of wasting time searching for what they need. Also, used equipment that needs to be cleaned can be quickly located in the same way, accelerating their return to working rotation. 

#2: Inefficient Patient Room Utilization

With so many processes involved and patients constantly moving from one room to another, knowing exactly how many free rooms are available, and of what type, becomes a major problem. Bottlenecks form quickly and their source can hard to identify. Long wait times — the fundamental metric of the patient experience — quickly follow, fueling patient frustration and additional pressure on staff. 

While lines are getting longer, chaos can spread to patient intake, where decisions about where to send them are complicated by the guesswork involved in determining which and how many rooms are free. Every minute needed to verify room or bed availability is a minute that counts against the patient experience and possibly patient outcomes. 

Solution

With real-time visibility into room availability, decisions about where to send patients can be made immediately, avoiding patient frustration and starting the care process as quickly as possible. Maintaining stable, predictable workflows at the intake level is key for every healthcare facility. When staff is informed about changing availability as it happens, both patient experience and outcomes are strengthened. 

#3: Indoor Wayfinding

Hospitals and healthcare complexes can be massive, multi-floor, and often multi-building facilities, sometimes not unlike a university campus. Even long-time employees may be challenged to quickly locate a particular office or even an entire department that is not part of their normal routine.

Visiting or temporary staff, vendors, and others in the facility on business frequently have issues when trying to navigate their way around but this is nothing compared to the challenge often posed to the most important group of all — patients.

Navigating an unknown space can be intimidating anywhere, but in a healthcare setting, it causes additional anxiety. Hospital staff is frequently asked for directions, interrupting their work and often resulting in delays while they explain or show the way.

Solution

Patients, staff, vendors, visitors, and others all benefit from easy access to Bluetooth-powered applications that allow smart hospitals to offer real-time maps and even turn-by-turn directions, providing a Google Maps experience, but indoors. This not only improves the visitor experience, solving wayfinding challenges but also serves as a sign that the smart hospital is a modern, forward-thinking venue for tech solutions. 

Another benefit of digital wayfinding is cost savings on signage. Traditionally, hospitals have used physical signage, paper maps, and even a simple help desk to direct patients and their families to their destinations. Navigation apps can serve as at least a partial substitute for all of them. 

You may be surprised at the possible savings involved. Emory University wanted to know how much time staff members spent assisting in wayfinding — that is, offering directions. They found staff members—including doctors and nurses—spent over 4,500 hours per year giving directions to visitors. That’s two full-time staff positions just giving directions.

And what about physical signage? The Magazine has reported that an overhaul at the Children’s Hospital of Boston involved the installation of 15,000 new signs on their premises.

The cost of hospital signage is no trivial matter. Each year, hospitals have to update or refresh old signs across huge properties with numerous departments. It's unlikely physical signage will be done away with in hospitals any time soon but moving as much as possible to a digital form can decrease reliance on and the costs of signage.

Digital maps are easy to change and instantly updated. They can also include far more information than physical signs, including numerous languages, descriptions, or other directions that simply can’t fit on a wall.

#4: Staff Safety and Duress

The American Bureau of Labor Statistics consistently ranks healthcare workers among those most likely to be physically assaulted while on the job. Nearly all of these attacks come from patients and visitors to the healthcare facility. For safety challenges, smart hospitals can provide life-saving solutions. Security guards have a role to play in these situations, but they can't detect and immediately respond to staff duress cases in every room in such a large facility.

Often, there is not much time between the start of the problem and a full-scale assault. Complicating matters further is the fact that nurses, for example, are often in remote, isolated parts of hospitals alone with aggressive or unstable patients. When trouble starts, they have no way of easily calling for help. 

Solution

The same network infrastructure that supports the real-time location services listed here can also serve as a conduit for alerts sent by employees when a situation gets out of hand. 

Wearable badges — functioning essentially the same as tags that are fixed to assets — can be taken anywhere the employee goes and equipped with a panic button that sends a call for help directly to everyone involved. With room-level accuracy, the alert notifies other staff not only that someone needs immediate help, but provides their exact location as well. This is critical when every second counts and a volatile situation can escalate into something much more serious. 

With this digital security blanket covering them at all times, nurses and other staff can enjoy the peace of mind of knowing that they are never truly alone in the event of trouble. This, in turn, helps to alleviate some of the issues at work in related matters, like staff turnover and job burnout.

The Future of Healthcare is Smart

These are just some of the ways location-based solutions are supporting more efficient operations and better patient outcomes by solving challenges in IoT-equipped smart hospitals. These are the kind of solutions that are defining the modern hospital while being easy to implement, budget-friendly, and ready to scale into new use cases as the hospital grows. 

Digital transformation in healthcare is at the heart of a fundamental realignment of the operational side of health systems. The solutions it enables will continue to streamline disjointed care delivery processes, eliminate inefficiencies, and create a more comfortable and welcoming space for patients and staff alike.