Follow That Wheelchair

By Gerry Blackwell

May 25, 2006

Adding wireless positioning lets companies like Emergin improve health care workflow and asset tracking, and even makes it quieter in the hospital.

A quiet revolution is underway in hospitals, and it’s partly thanks to Wi-Fi. The cacophony of public address announcements and equipment alarms that once disturbed the rest of sick people is being replaced by blessed silence as hospitals turn to wireless communications – increasingly Wi-Fi – for paging clinicians and sending them alerts.

Now hospitals are leveraging those Wi-Fi systems by adding positioning and asset tracking to the mix, and generating important cost savings and improvements in efficiency and patient care as a result. The recently announced partnership between Emergin, maker of an enterprise service bus widely deployed in hospitals, and Ekahau, the Finnish company that makes Wi-Fi positioning systems, is a response to, and will likely escalate, the trend.

Emergin has been at the forefront of the quiet revolution. Its Event Management Platform receives data from nurse call and patient monitoring systems, as well as medical equipment such as infusion pumps used for feeding and medicating patients intravenously. It then transmits alerts and messages wirelessly to clinicians with mobile devices, based on rules and assignments set up in the Emergin client software.

“Wi-Fi is not essential,” explains Emergin Senior Product Manager Michael Rost. “[The system] can also send messages to traditional pagers or to cell phones. There’s a wide variety of end devices that can be used. But especially now with so many customers implementing Wi-Fi [for other applications], it tends to be Wi-Fi devices.”

In addition to turning down the volume in hospital wards, the Emergin system can generate significant productivity increases and improve patient care, Rost says. In the past, when clinicians were paged over a public address or paging system, they often didn’t know if it was a critical alarm or just a patient wanting their pillows fluffed. Now, nurses carrying Wi-Fi phones or PDAs can see what kind of alarm it is and respond accordingly, including talking to a patient over a bedside speakerphone from wherever they are.

“A nurse now has the comfort of knowing that if she leaves a patient, and if an issue arises, she’ll be immediately notified,” says Emergin spokesperson Bridgette King. “She can look at her mobile device and know exactly what’s going on – she can see if it’s a critical alarm or not. It means nurses are no longer constantly running back and forth between rooms.”

The Emergin system also has built-in reporting and auditing functions. It tracks each alarm – where and when it originated, where and when it was sent, and how the clinician responded. That means that if there’s a breakdown in communication or procedure, the hospital can do root cause analysis to find out what went wrong. Hospitals can also analyze trends in alarm traffic to help them figure out ways to streamline processes and optimize scheduling.

The Event Management Platform makes it easy for the hospital and clinicians to set up rules for how alarms from different systems will be handled, and to which devices they’ll be sent. One strength of the Emergin solution is the variety of systems with which it can be integrated, Rost says.

Many hospitals end up with multiple, incompatible clinical systems from different vendors – sometimes even different nurse call systems in different parts of the facility. Emergin can integrate them all into one cohesive whole. The company has developed “adapters” that integrate more than 200 different products from over 120 vendors.

The Ekahau partnership is by no means Emergin’s first or only foray into Wi-Fi positioning. In the past, it has integrated positioning technology in customer implementations, including products from vendors such as PanGo Networks, AeroScout, Cisco Systems, Radianse and Vocera Communications. Ekahau is not even the first Wi-Fi positioning vendor to forge a formal partnership with Emergin. The company announced a similar agreement with PanGo earlier this year.

The Ekahau positioning technology, which can triangulate the position of a Wi-Fi laptop, PDA, phone or Ekahau Wi-Fi tag to within three and a half feet, is now tightly integrated into the Emergin Event Management Platform. The Ekahau Positioning Engine, a server-based software-only solution, uses existing Wi-Fi infrastructure to find, track and log the presence of Wi-Fi devices or people and assets with tags. The information can then be used to generate alarms and alerts that go to the Emergin platform for distribution.

Positioning will help solve several problems hospitals face, Rost says. One is disappearing equipment. A press release from Emergin on the Ekahau partnership quotes a recent study by the Government Accountability Office (GAO) showing that hospitals buy 20 to 50 percent more equipment than they need because so much is lost, misplaced or stolen. Wheelchairs frequently stray because discharged patients use them to get to transit stations and parking lots, and then leave them there.

“When it comes to an audit of inventory, they often send out nurses to look for wheelchairs,” King notes.

Using the Ekahau technology with the Emergin platform, a hospital could set up the system to automatically generate an alert if a wheelchair goes beyond a certain perimeter point defined by the Wi-Fi infrastructure. That alert could then be passed by Emergin to a mobile device carried by a nurse or administrator. At that point, presumably, the chase is on.

Just being able to quickly find a needed piece of equipment – an infusion pump, for example – can save clinicians and other staff valuable time, and hasten treatment of a patient.

Hospitals can also use the positioning technology to streamline workflows. For example, the system could be programmed to automatically send a busy surgeon an alert when all the members of her team and all the equipment needed for an operation have been assembled in the operating room. Rather than cooling her heels at the OR waiting for equipment or personnel, she can carry on doing other work until everything is ready.

Or the system could be used to expedite turnaround of beds in over-booked emergency rooms. If the patient intake system shows that the patient in an ER cubicle has been discharged or transferred to a ward, and all the needed equipment and the bed are present in the room, the system generates a message to ER administrators or clinicians letting them know the room is available.

Emergin hasn’t completed any joint implementations with Ekahau yet. The relationship is too new for that, King says. But it will. In fact, the Ekahau positioning technology will improve the value proposition of the Emergin solution.

“It’s definitely another piece of the puzzle that customers are asking for,” Rost says.

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