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Speeding Patient Throughput with RTLS

Gienna Shaw, for HealthLeaders Media, August 15, 2011
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‘It’s all automated’

When a critical patient is en route to your level I trauma center, alerting the right specialist takes only a phone call or a page. Gathering the equipment and materials that specialist will need to treat that patient is a little more complicated. Increased efficiency doesn’t just save time; it saves lives.

“Whether it’s a stroke patient or they have a ruptured aneurism and they need to be treated, we need to know we have the right-size coils or the right device to deliver that high-level care,” says Robert M. Sheridan, director of interventional radiology at the 508-bed Massachusetts General Hospital in Boston.

The organization estimated it had about 90% accuracy when it came to keeping track of supplies using a bar-code system and manual inventory counts. It turns out that estimate was wrong; after deploying RFID tracking, MGH discovered its accuracy rates with manual counting had actually been about 80%.

RFID has all but eliminated manual counts, and now accuracy rates are 99%, Sheridan says.

The technology itself sounds pretty simple: RFID-enabled supply cabinets track items that are removed or replaced—and add or subtract them from specific patient records—every time the door is opened and closed. It’s a lot like the electronic minibars you find in some hotel rooms. And staff can pinpoint the exact location of each item—down to a specific section of a specific cabinet—from work or by logging on to the system from home. “So you would never be caught without a piece of equipment that you need to treat a patient. We never were able to do that,” Sheridan says.

“When you have that accuracy rate and real-time data capture, you’re able to make decisions more agilely in terms of what you should be ordering and how to manage your finances in terms of revenue and expenses,” he adds. “In healthcare we’re not in the business of making money. But certainly we’re not in the business of not losing money.”

Another benefit of the tracking system is that it improves clinicians’ workflow, whose primary goal is to take care of patients, not manage inventory, Sheridan notes. When physicians dictate reports, the tracking system helps them determine which products they used to treat that patient. The information is imported directly into the patient’s medical record, including lot numbers. “And none of it is done manually; it’s all automated,” Sheridan says.

The system also improves security. To access the cabinets, staff must scan a badge or enter a unique identification code. You can keep track of each person’s activities and employ rules as to who can access which cabinet. “There’s no more getting away without having your hand caught in the cookie jar, so speak,” Sheridan says. 

But after implementing the system and analyzing the data it produced, MGH started to see how it could take the system to the next level. 

‘Round-trip ticket’

“We decided we really needed to integrate this to what we call the Holy Grail of inventory management, which is the full electronic round-trip ticket—from the time that the product comes in, to the time that the product gets consumed, to the time that the product gets back on the shelf—95% of that is automated.”

The second phase was integrating the cabinets and the reorder system.

“Rather than having manual eyeballs or running arduous reports, there was a consumption file that was sent to PeopleSoft, the organization’s order management system. Our inventory manager would then look at that for a minute or two to see if there were any gross inequities or things that just didn’t make any sense, and then they just hit send and it goes.”

The final phase was integration with the billing system.

“Many payers will absolutely not pay for specific bills if you filed for a CPT code that required you to use an angioplasty balloon. If they don’t see that angioplasty balloon, they will potentially hold the bill. And they won’t pay for it,” he says. The charge capture also jumped from 80% to all but 100%. The result of that 20% increase: roughly $1 million added to the bottom line.

“Data is great,” Sheridan says. “Right?”
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