I have two customer discussions going on at the moment – both require real time asset tracking, one is looking at a WiFi solution (plus software and appropriate tags) and the other is looking at a tag-centric solution with it’s own radio network running alongside their WiFi (concerned about traffic). Aside from the cost differences – what does the group think about the perceived “competition” between these two approaches. No plugs for your own company’s solutions please ! – objectivity appreciated.

The thread is very lively, with folks from different camps (and manufacturers) defending their point of view. As respectful as the tone is here, there is a bit high tech mud slinging going on here that is telling regarding the state of the industry. All too often when talking to customers, the conversation starts with infrastructure. And the predominant marketing messaging out there is that the infrastructure is the solution. This can be pretty dangerous thinking.

In fairness to Shoalib, his query was specific to RTLS from an infrastructure perspective, so it’s fair that the thread is about infrastructure. As we work with customers we often find that technology buyers all too often want to boil it down to A or B. I would suggest that by not focusing on broader applications and “solutions,” the industry has seriously confused and kept away customers through slugfests like this. Overall adoption rate is nowhere any of us expected it to be at this point. Why is that? As some of the folks in thread suggest, there has been lots of over promising going on, and the technology needed to improve. But in spite of the improvements, the reality is that infrastructure alone will not deliver the results that customers are looking for when purchasing an visibility solution. One of the responders, Trish Messiter, smartly tries to reel all this in by suggesting:

The real question here is what is best for requirements? The answer, unfortunately, is “it depends.”

I’m with Trish on this one. While everyone is piling on regarding whether WiFi is a good solution or not, we don’t really get to hear what Shoalib’s customer is trying to accomplish, nor do we have a good enough understanding of the environment. In many cases, WiFi will make sense, or the infrastructure may be a hybrid one, with a location engine listening to different types of sensors used for different purposes.

Note: this is actually the most popular link on our website, so based on market demand, we’ve updated it for Version 4.1. Thanks for stopping by. While you are here, can we interest you in our customized Vocera headsets, Vocera training and implementation services, or Vocera support services?

So what are some good examples of passive RFID in healthcare and what should you look out for? First, think of passive RFID as EZ-Pass in a hospital. The technology is very good for capturing the incidents of a tag that passes by it and when. It does not do a good job of knowing your location on the highway or bridge after you pass the toll. This is where active works well.

Here are some good examples of passive RFID in a hospital :

• Patient elopement (walk-outs) in the ED.
• Equipment containment within a floor or a unit
• Securing equipment at entrances and exits.
• Tracking cardiac catheters in and out of inventory.

So, what should you be aware of prior to exploring a passive RFID solutions?

• The big issue is that if you begin to tag equipment, it’s likely that you will not be applying an active tag in the future. It’s certainly possible, but highly unlikely for the next few years.
• Make sure that the technology you choose can detect motion and directionality. Up until recently, passive RFID systems could only tell if there was a tag within its reading zone. Given the use case, you’ll want to know if someone is going out, or going in and also whether the tag is moving or just happen to be near the reader.
• Choose tags wisely. It’s a bit of an art to determine the right tag for different applications. Factors such as metal content, water content, distance and orientation to antenna all play in determining the right tag solution.
• Know what you are going to do with the data collected. Example: Do you need an audible alarm each time an IV pump walks off the ICU? Or maybe to record the event? Do you need security to get an immediate message that a wheelchair leaves the building? Or maybe the control center should get a pop-up on their screen.

There’s no question that active RFID is much more evolved in healthcare applications. There are many active RFID vendor solutions that are well documented. Awareness and education of another possible solution could save you time and money.

There were some earlier explorations with Sprint and Blackberries, but nothing that has taken hold to date. While hospital customers are not necessarily doing widespread enterprise adoptions of iPhones, physicians and executives are either showing up with their own devices, or pushing their IT organizations to allow them, in essence forcing the issue. The Vocera iPhone app is a further disrupter, especially because it begins to tear down the walls communication wise between home, office, and hospital facility. This is an especially interesting development in light of the work that Voalte has done in bringing voice and alarm notification to the iPhone,  iPad, and Blackberry. Whereas Voalte first took and alarm notification starting place, then added in voice, Vocera has come at this from the other way around. Alarm notification is likely not far behind.

We are in line for some messiness as enterprise IT tries to work through the management of these new multi-modal devices; however, given widespread consumer adoption of smartphones, this is precisely the competitive innovation the market is hungry for.

Ongoing loss and replacement of these durable assets can become a large cost burden on hospitals and biomedical equipment suppliers, with even small-to mid-size hospitals reporting the loss of dozens of units per year. The typical replacement cost of a cardiac telemetry transponder can range from $2,500 to $7,500; pulse oximeter probes are in the $100-$200 range. Protecting these assets with a passive RFID-based Asset Rescue will reduce or eliminate this loss and associated financial impact.

In this application, assets at risk of accidental discard are tagged and protected with passive RFID tags. One or more fixed RFID readers are deployed at places in the facility where laundry is processed (either in-house or dispatch to a laundry service) and trash is handled. The system is parameterized with the RFID tag identities of the tagged assets (either individually or by a range of identities, depending on user application requirements). One or more detection zones are logically defined at the laundry and trash egress doorways and routes.

Interested in finding out how you cut down on loss? Read our Mobile Asset Rescue for Biomedical Equipment Solutions Paper.

TPC Healthcare today announced a partnership with Patient Care Technology Systems (PCTS), a subsidiary of Consulier Engineering, Inc. (NASDAQ: CSLR). The partnership brings PCTS’ location-enabled workflow applications to TPC Healthcare’s growing portfolio of healthcare solutions. Under the agreement TPC will market PCTS’ automatic tracking and workflow automation solutions for healthcare with specific focus in New England, the New York Metropolitan area and the Mid-Atlantic.

With over a decade of experience in healthcare specific workflow application, PCTS’s platform gives TPC the opportunity to bring high performing, location-enabled workflow applications to new and existing customer alike. PCTS comprehensive Amelior 360 degrees Enterprise Visibility Platform™ includes products for hospital emergency, perioperative, interventional cardiology and diagnostic imaging departments, as well as facility-wide asset and patient tracking.

“In these times, results matter. As we looked to bring the right location-based solutions to our customers, PCTS’ proven ability to deliver measurable financial and operational impact to hospitals in the ED, OR, and across the enterprise really caught our attention,” says Kenny Schiff, founder and President of TPC Healthcare. “PCTS is our kind of solution. They are focused on providing the right applications to deliver customer success and not on any one specific RFID infrastructure,” he says.

“PCTS and TPC Healthcare have a similar solution-oriented approach to healthcare,” says Tony Marsico, President and CEO of PCTS. “All too often these types of solutions are not given the upfront or aftermarket attention they require. TPC Healthcare has a reputation of truly delivering what the customer needs, from pre-sale to implementation and beyond.”

About TPC Healthcare
Headquartered in Wilton, Connecticut, TPC Healthcare provides mobile point-of-care communication technologies, such as RTLS/RFID, wireless voice, alarm notification, and workflow automation to hospitals and healthcare organizations in the New England and Mid-Atlantic regions. TPC Healthcare’s unique blend of technology expertise, exceptional service, and years of experience successfully delivering point-of-care solutions help hospitals and healthcare organizations improve clinical workflow, increase patient safety, and provide better utilization of patient care equipment. For more information about TPC Healthcare and/or its services, call 888.427.2215 or visit www.tpchealthcare.com.

About Patient Care Technology Systems
Patient Care Technology Systems, a subsidiary of Consulier Engineering, Inc. (NASDAQ: CSLR), helps health care providers to improve patient flow, increase capacity and improve patient and staff safety by visualizing the real-time location and status of people and equipment throughout their facility. Each year PCTS solutions support over 2 million patient visits managed through its various solutions and has shown a proven return on investment in high turnover, high-acuity units such as the emergency department and perioperative suites. The Amelior Enterprise Visibility Suite™ is interoperable with all leading locating technologies, including active-RFID, infrared, ultrasound, ultra-wideband, Wi-Fi and ZigBee. PCTS customers have been recognized nationally for improvements in efficiency and clinical excellence. For more information, visit www.pcts.com.

Here are some key points to consider from my recent article in EnterpriseMobileToday.com.

1. Usability matters. A NICU nurse whose hands are busy diapering a baby has very different needs than someone dispatching code teams, or an anesthesiologist. In pointing out the difference between purpose-built healthcare devices like those from Ascom, Vocera or Cisco (and say a BlackBerry or an iPhone), Emergin often talks about “buttonology.” Visualize code team members fumbling for the Chiclet-sized keys on a BlackBerry Bold when needing to respond to an emergency situation. When seconds matter, better to have a single button push on a Vocera badge, or a simple soft key on an Ascom Medic handset.

2. Where are the applications? Healthcare-specific applications do exist for the BlackBerry, and Palm and Windows mobile smartphones, but they are far from perfect, often without true device/application integration. And mobile healthcare professionals require devices with deeper and tighter integration between hardware and applications.

While software providers like Globestar have smartphone-ready, hospital-friendly applications for alarm notification, escalation and dispatch, they lack tight device integration, making them imperfect. Again, the purpose-built applications, like Ascom phones or Vocera badges, currently have the leg up on the competition, though this may not last for long.

3. It’s the Network. If you don’t have a reliable network that can handle mobile communications, you’re going to run into problems. And in a world where medical professionals traverse from office to hospital to home, that network may really be a network of networks. While it may be okay to drop a call mid-conversation when chatting out on the street with your buddy, it’s not okay when a nurse misses a critical alarm from a fetal monitor.

In spite of significant efforts, the medical grade network (even purely at the building level) is not a reality yet. And while fixed mobile convergence (FMC) vendors like DiVitas (or the big PBX players like Nortel, Siemens and Avaya) have solutions that manage the transitions between networks for multi-mode devices (e.g., in-building wireless’3G), they can’t really fix the network of networks problem. And even if they could, the purpose-built, multi-mode device with true application integration has yet to appear.

4. What about workflow? Spend time in an Emergency Department or Operating Room suite recently? This incredibly fast moving world doesn’t lend itself well to ad-hoc asynchronous communications like email or text messaging that is de rigueur with normal consumer smartphones, especially given all the possible sending and receiving points. Reliable communication starts first with designed workflow and an understanding of the journey information must take from inception to delivery, to acknowledgement and response. Once you have a workable flow, then software applications and devices can be considered.

For more information, see In Healthcare Communications, One Device Does Not Fit All … Yet

Kenny Schiff is a contributor to Internet.com’s EnterpriseMobileToday.com. He is founder and President of TPC Healthcare, a specialty provider of real-time location and point-of-care communication technologies to hospitals and healthcare organizations.

So indeed it is an unusual thing to get competitors together respectfully, and that’s what Intelligent InSites did at their first annual partner summit last week in Fargo, ND. And while Aeroscout was conspicuously absent from the proceedings, the four other key players in the sensory network/RFID/RTLS infrastructure space (I realize that’s a mouthful): Centrak, Ekahau, Sonitor, & Awarepoint were there in full force. No insults, put downs, or barbs. It was refreshingly civil.

A More Open Sandbox

As a relative newcomer to the RTLS space, InSites is taking a decidedly open approach to location enablement (or “Enterprise Visibility” as they like to refer to it). With so many potential applications in the healthcare enterprise that can benefit from location intelligence, InSites’ true differentiation is the platform, and not just a collection of their own applications. This is a more open sandbox than you would typically see in healthcare (traditionally a rats nest from an interoperability perspecttve) and this bodes well for customers who realize that technology tribalism is counterproductive. Their vision is one of location smarts, inbound and outbound, framed by business intelligence: not only good data, but the tools to make sense of that data. And indeed that’s why it made sense for all the infrastructure players to be there together.

Hmm… Beta, VHS, Blue Ray

The summit provided a very well-rounded look at a relatively new industry. Maybe it’s the sports fandom that’s in us, but we looked forward to having a chance to see the infrastructure players all together at the same time. To that end, Vi Shaffer, Gartner’s Research Vice President and Global Industry Services Director for Healthcare, led a lively roundtable with Ekahau’s Tuomo Rutanen, Centrak’s Mark Nowakowski, Awarepoint’s Matt Perkins, and Sonitor’s Terry Aasen. This was followed up on Day 2 by each of the player sharing the unique aspects of their product.

What was very striking to us as we listened to the pitches was how widely different each of these companies’ approaches to providing precise location information is. Nothing apples to apples about it. It’s rare to see key infrastructure players approaches so radically different in approach (this is more than Beta vs. VHS). One does wonder how this shakes out as the industry matures.

And while as a business TPC Healthcare has its own preferences, as a technologist, I was jazzed about what they are all doing for different reasons:

• Ekahau for continuing to refine what’s doable with Wi-Fi
• Centrak for their ability to provide great precision using a very practical and simple architecture
• Awarepoint’z ZigBee based solution for thinking big regarding reaching beyond just the healthcare institution and into the home (and small with their convenient wall socket plug-in readers)
• Sonitor for the promise of 1 meter accuracy, 2D or 3D (kudos to Terry for being brave enough to demonstrate USID in front of a potentially rough crowd)

An interesting to note is that  we are beginning to see the some degree of the competitive vendors applying aspects of each other’s technologies in the effort of meeting the market needs (e.g. Ekahau’s introduction of IR-based room level beacon). Perhaps this is an indication of some future consolidation/collaboration on the horizon.

RTLS Infrastructure Now Poised to Really Deliver Anticipated Benefits

Keynoter Vi Shaffer’s lunchtime presentation was careful to give context to the state of RTLS in healthcare. The good news is that Gartner’s view of RTLS is very bullish, and places it clearly in their hype cycle chart on the upswing from the trough of disillusionment (where technologies fail to meet expectations and quickly become unfashionable) and moving towards the “plateau of productivity” (a technology’s benefits become widely demonstrated and accepted).

The timing of InSites summit was not accidental, as much is finally coming together that is making RTLS actionable (including platforms like Intelligent InSites that recognize the diversity of potential location consumers). Real, measurable, and game changing productivity is practical in ways that were never before possible. While the true results will no doubt be the sum of the parts, the backbone of the productivity end game will be the practical, affordable, and accurate location infrastructure that Ekahau, Centrak, Awarepoint, and Sonitor are driving towards.

Some takeaways from the event… it seems that there are enough forces to motivate the market away from WiFi solutions. Second, creative funding models are really what are helping the adoption of enterprise solutions along with managed services. The shift away from capitalized purchases for RTLS and RFID systems may be what moves deployments of these solutions out of the early adopter realm.

The other take away is that passive RFID definitely has a place in healthcare. We heard some compelling case studies regarding high impact, yet lower tech applications of more traditional (if there is such a thing) passive RFID. So even thought there are massive initiatives for enterprise RFID based on active technologies, customers are getting great return from less pervasive and more specific passive technologies. UMass Memorial has such an initiative in the Cath and EP labs. Also, Ray Lowe, the IS Director of Providence Health (a major west coast hospital group) talked about how he will be using Reva Systems (make applications to manage and integrate RFID readers) and ThingMagic (makes readers) as part of workflow in a new facility that will have a WiFi-based RTLS system.

The real story here is that no one auto-ID or location-based solution is going to fit all needs within the enterprise. And that’s not a bad thing. Continued innovation and product maturity, along with more open systems are making this all doable. For hospitals, there are opportunities small and large to take advantage of RFID and RTLS to immediately impact productivity and the bottom line.

I’m not always a great fan of white papers as I often find them manipulative point of view wise, but I think this piece (except for a couple of paragraphs at the end) gives a very impartial read on the whys and hows of RTLS/RFID in healthcare. While it details eloquently the short-comings of WiFi and zonal “good enough” approaches, it more importantly couches them properly against the larger more practical business cases for RTLS in healthcare. David’s piece is less a condemnation of WiFi, and more of a call to making this about business not technology.

Hoglund developed this whitepaper for AwarePoint (whose RTLS technology uses ZigBee), but the conclusions could have just as easily pointed to Sonitor (Ultrasound), or Centrak (IR/RF).

The good news is that customers have some solid choices in powering the critical applications that are so desperately needed to help improve healthcare business performance.