New RTLS Use Case of Staff Duress Joins Old Standard of Asset Tracking, Say KLAS Researchers

In this interview, Anthony Guerra, Founder and Editor-in-Chief of healthsystemsCIO, sits down with Don Seamons, Research Director for Patient Accounting & RTLS at KLAS, and Dallin Seely, Insights Manager at KLAS, to delve into the dynamic world of Real-Time Location Systems (RTLS) in healthcare. With technology constantly evolving, Anthony explores how RTLS, a critical tool for asset tracking, staff safety, and infant protection, is broadening its use cases across healthcare organizations. Don and Dallin share their expertise on the latest trends, challenges, and innovations in RTLS, offering valuable insights for CIOs and healthcare leaders navigating this complex and rapidly advancing field.

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Anthony: Welcome to healthsystemsCIO’s Interview with Don Seamons, Research Director for Patient Accounting & RTLS with KLAS and Dallin Seely, Insights Manager with KLAS. I’m Anthony Guerra, Founder and Editor-in-Chief. Don and Dallin, thanks for joining me today.

Don: It’s great to be here.

Dallin: Thanks for having us.

Anthony: We’re going to talk about RTLS today. I think the readers and listeners need to know what’s going on. This is technology that moves quickly, if you looked at it a few years ago you need to look at it again.

Let’s start off, Don, if you want to give us a little bit about your organization and role.

Don: KLAS is an organization that is meant to serve providers. We talk to providers on a daily basis about the services and solutions they use, mostly around healthcare IT. We want to get their perspective on what’s working for them, what’s not working for them and why, and we want to share that with providers. We do that for free. Any provider who has a desire to learn about a service or a solution can come to klasresearch.com, set up a free account and delve into the data. That’s what we do.

My focus is on RTLS and on a lot of patient accounting type of services, patient financing for the most part and it’s a really interesting job. I get to talk to people who want to improve healthcare and it’s good to be part of that.

Anthony: Dallin, you want to just tell us a little bit about your role. I know obviously you’re looking at RTLS, any other sort of beats that you follow or technologies you focus on?

Dallin: I’ve been bouncing around in KLAS in different segments. I was covering staffing for a while, some business solutions, RCM and now, I’m settling on the team of the RCM realm.

But as Insights Manager, we’re the ones that dive into the customer commentary, building out the PowerPoints and items that we share with vendors about what customers are saying, this is where you can improve, this is how you can help make healthcare better. I’m the person diving into the data, showing the presentation, presenting that to the executive teams along with Don and other research directors to help push healthcare forward.

Anthony: Great. Thank you. The title of the report is how organizations are broadening their use cases. Don, what are some of the highlights that you want to offer around that concept of broadening use cases? Where are they using it that they hadn’t been in the past?

Don: It’s a good question. RTLS has a number of use cases that are traditional like the asset tracking and staff tracking, infant protection. Those are use cases that have been around for a while. We’re starting to see a lot more interest in staff safety and in staff duress, staff tracking and flow. Hand hygiene is sort of a new and interesting use case for the RTLS folks. Temperature and environmental monitoring, not really a location services type of a thing but the technology can do that sort of use case and people are using it.

Anthony: Let’s talk a little bit about the staff safety and the staff duress. Obviously, very interesting for a use case. I don’t know if you got this sense but is this a bigger problem in healthcare than it used to be? Is this something that people are saying “our incidents are going up and up. We need to find the technology.”? Or is it sort of the technology is there and it seems to fit with the problem?

Don: I’m not necessarily saying that this is what the data is saying. But in the conversations I’m having with providers and vendors, vendors are seeing a lot of interest in staff duress.  When I have discussions with providers who use RTLS, almost all of them are using it for staff duress, for emergency type of buttons.

Anthony: That’s really interesting and it’s certainly a way to communicate to your employees that you care about their wellbeing, right?

Don: Yeah, one of the interesting things we’re finding is as we talked with providers, there used to be some reticence with staff tracking, with using these RTLS beacons and tags to track staff. People felt like it was an invasion of their privacy. That’s going away a little bit due to this problem.

Again, I can only speak anecdotally but in chatting about this use case with vendors and providers, it does seem like nurses are in a dangerous position and oftentimes feel threatened and need this sort of solution. There are definitely things that vendors and providers have done to minimize the concerns that their staff has with privacy. That’s much less of a concern now than it has been in the past.

Anthony: How does this work? Is this a physical tag that the employee puts on their uniform somewhere?

Don: Tags, it’s part of their uniform. There are some solutions coming out that use phones and personal devices. But for the most part it is tags that are provided by the vendor.

Anthony: You know it’s almost like a tradeoff, some reticence about having a tag on you may go away if you feel like your safety is improved. Sometimes the staff levels are pretty low so I can get the comfort that might provide.

Dallin: Just to add on to some of that, once they leave the facility if they are using personal devices it cuts off the tracking.

Anthony: So even if they don’t take the tag off it’s going to stop tracking them when they leave the facility? Is that the idea?

Dallin: More so with personal devices. I can’t say on the tags per se.

Don: What I’m hearing from the vendors is that there is a need and a desire from the providers to have coverage not only inside the building but in the parking lot as well. But to Dallin’s point, once they’re outside of the property, then there’s no more tracking.

Anthony: My wife works in a hospital and I worry more between leaving the building and getting in the car. That’s where I’d like her tracked.

Infant security is another thing in your report. That’s almost similar to the staff duress. I supposed that you put a tag on an infant nobody is going to grab the baby and make it out of there, which is another issue they’re sensitive to in hospitals, right?

Don: It absolutely is. I don’t know that it’s as much of a problem as it has been. I think it’s due to hospitals, providers putting an emphasis on that. I can’t say how many providers use infant security solutions with RTLS. But for those who do, everyone that we’ve spoken with hasn’t had an issue with it. The only issues that they have with these systems is sometimes they are too accurate and can cause false alarms. But in terms of losing a baby or misplacing a baby or having one baby go to the incorrect mother, they’re not seeing those problems after using these solutions.

Anthony: Why would being too accurate cause false alarms?

Dallin: If they get too close to sensors it will trip an alarm. But again, Don, I don’t know if that’s the depth of the false alarms.  I’ve had some conversations and I know it happens all the time.

Don: One example I have heard is when a new mother still has a tag on their wrist and they’re leaving the facility and there’s a false alarm.

Anthony: Okay. Right, that’s a workflow thing.

Don: Right.

Anthony: But the technology is working quite well. Let’s talk about this accuracy issue. I think that’s one of the big things people are looking at when they try and pick between vendors. You need accuracy to line up with the use case. If you have a use case that requires extreme specificity and you don’t get a technology that lines up with that, you’re going to have a problem. Do you want to talk a little bit about that concept of lining up your use cases with the effectiveness or specificity of the technology you’re selecting?

Don: That is a really good question and that has been a limiter from my own perspective as I’ve looked into RTLS and how people are using. There are certain technologies that are very accurate but they’re also very expensive because you have to have a number of tags, a number of beacons. You have to have a lot of the technology hard wired in place to be super accurate.

Then other technologies like Bluetooth low energy and Wi-Fi that have been shown to be less accurate but they also take a lot less infrastructure to put into place. They don’t need to be wired in place. You don’t need to shut down a room to set it up. You can just plug in a beacon and connect it to the network and you’re good to go.

There are other technologies like RFID that are also inaccurate or very accurate. Passive RFID is less accurate and an active RFID solution that can be more accurate. Anyway, there’s many different vendors in the space, they use many different solutions. For the most part there are both the highly accurate solutions and the lower accuracy solutions.

Most vendors provide a continuum where they use the solution that takes a lot of infrastructure but they also offer the Wi-Fi solution, the Bluetooth types of solution and it’s getting to the point now with most of the vendors that you don’t have to choose between something that’s highly accurate and something that’s easy to install. If you have a use case that needs both accuracy and wide use, you can combine those two. Vendors are starting to combine multiple technologies to match that use case, and that’s not something that we saw 5 years ago but it’s definitely something that’s being promoted, at least within the last year or two.

Anthony: Dallin, anything you want to add?

Dallin: Some of the accuracy piece in the use cases is the asset tracking and obviously infant protection and staff duress, especially staff duress. Making sure that we know exactly where the nurses or the provider is rather than having a broad level view of ‘well, we know they’re on level 3 but we don’t know what room.’ So really honing in on the asset tracking, mainly for time saving and efficiency, for workflows and nurses. If they need to find a piece equipment, they know exactly where it is. For infant protection, just making sure the infants are where they’re supposed to be and then staff, security or other personnel can get to them as quickly as possible rather than having a broad level view of things.

Anthony: Don, would you say the number one use cases is still asset tracking, pumps, things like that, things that are expensive and can go missing and nurses sometimes hold on to them because they’re tired of looking for them so they put it in the closet and they know where it is but no one else knows where it is. Is that still the number one thing? Then, my larger question is, is almost everybody using it for that. Like if you’re a health system of any size, are you definitely going to be at least using RFID for that type of asset tracking?

Don: That is my sense and it’s not just RFID, there’s plenty of other technologies that do that. But for the most part, if you want an RTLS system, you want it for asset tracking regardless of the other use cases that you have. To the points that you were making, the infusion pumps are expensive and sometimes you don’t own them, you rent them, and you need to keep track of these really expensive high value solutions and RTLS is the way to do it.

Anthony: I think I mixed up RTLS and RFID when I was talking before. But yeah, RTLS is the general broader term and RFID being one of the options. Everybody is pretty much using it for this type of asset tracking. We talked about this a lot – as a CIO you don’t want to buy the next shiny thing and then figure out how to use it, right.

You start with the use case, you start with what you are trying to do as an organization, what’s the problem and then let’s find the technology and that has never seemed like a better plan than in this case. Because there are so many options, there are so many ways to go, so many vendors, so many different options in terms of the specific technologies that you really need to have your use case first and then do your research and find what’s appropriate. Does that make sense?

Don: It does make sense. Some organizations are a great fit for specific vendors and a similarly sized organization may not be the right fit for that vendor. There are a lot of technologies, vendors, third party resellers out there who are involved in this. A CIO should focus on the use case first and then figure out what organization is going to help you with that use case and hopefully KLAS research can give you some data that will help guide your decision.

Anthony: It’s a really interesting concept and we came across this when we covered patient communications. The idea that you don’t want to have in a dynamic where under your patient communication needs umbrella, you wind up with 8 vendors because everyone touches the different use case really well. That’s not ideal. It would be better to go with a bigger vendor that had more under their umbrella so down the road so I don’t have to deal with another vendor. Is that something that can factor into the thinking when looking for a solution provide?

Don: Dallin, I’ll let you answer this as well. But that is the sense that I get – organizations want one hand to high five and one throat to choke in a lot of cases. We just encourage people to look at the data, to look at what makes sense to them, to talk to organizations that have a similar problem, similar challenges and see what they’re doing.

Dallin, any thoughts?

Dallin: Yes, a lot of provider organizations are really trying to consolidate, so with RTLS specifically the conversations I had and the data we went through, I don’t know that I had seen using multiple systems other than using hardware from say Sonitor specifically where they only provide hardware and so they have to have a software from another firm. But that was really the only case; it wasn’t like ‘we’ve got four RTLS vendors all doing different things.’ They typically have the one or hardware from one and software for the other, that’s probably the most complex it would get in terms of number of vendors. But then they would use that for their different use cases – asset management or asset tracking as being one of the biggest things and then trying to expand the use cases into other areas as well.

Anthony: Some of the issues that were mentioned in your report, things that differentiates one vendor from another, things like initial training – these are things that the customers weigh in on whether or not they thought it went well or not. Initial training, maybe they thought it wasn’t what it could have been, on-going training as opposed to initial training.

Another issue, maintenance cost, battery life, false alarms which we touched on, equipment design, badges being too big, possible need for manual intervention and broken tracking tags. These are some of the issues that the customers mentioned to you. Anything you want to drill down on that would differentiate one vendor from another?

Dallin: Battery life is something that they’re all well aware of and something that they’re working on improving. When it comes to the badge sizes, vendors have been trying to streamline, make a little more comfortable, easier to wear.

One of the more unique things were some of the buttons. Wearing them around and doing normal workflow, they’d hit the buttons constantly. That’s something they’re trying to improve so they won’t have false alarms from doing the normal everyday work things.

A lot of these we’ve been able to push back to the vendor. They know we need to make these smaller, easier to handle, better to work with, the less false alarms and definitely the battery issue. That was one of the complaints – is there’s not even an indicator; whereas most electronic things these days is like my watch, for instance – hey, you’re 10%, you need to go charge it.

Don: Maintenance is always an issue. The providers who are the most satisfied with their RTLS system are the providers that have dedicated resources to maintenance. Whether that is a service contract or they hire someone internally to focus on their RTLS system. That really is a key to being successful in this space, make sure you got a great handle on what it takes to maintain your system.

Now, there are some vendors who are talking about their systems as being easier to maintain and we haven’t been able to validate those stories. But I think there’s room for innovation in RTLS and there are vendors who want to innovate and to make things easier for the provider. But currently, from what we have been able to validate, most systems do take a significant amount of care to maintain.

Anthony: Some of the other concerns people had is high staff turnover on the vendor side. Poor project management, reactive communication, insufficient training.

I don’t want to give the impression that this sector is not doing well and there aren’t vendors that are doing well, but when there are complaints, these are the typical complaints that you’d hear from someone. Again, it’s do your homework, find your use case and move forward. But it certainly is an area, and this is one of the biggest things we talk about all the time, is the importance for IT executives like CIOs to deeply understand operations, so they can come with proactive suggestions on how technology can help with operational problems.

To do that, you need to understand operations and you need to understand what’s available on the market and RTLS is an area that you need to do your research.

Don: I do think that proactivity is something that providers want. They want their vendors to act as partners with them. They want them to share helpful communication, to let them know if there’s something that’s happening with their system that they need to be aware of and to do it in a proactive manner rather than a reactive manner. That’s something that we see across the board. And as we work with vendors and share customer feedback with them, that is a consistent theme, not only in this space but in all sorts of spaces. So yes, expect your vendors to be proactive. Demand that. That’s going to improve your experience and that will help improve the vendors themselves.

Anthony: Dallin, any thoughts there on what it means to be proactive as a vendor? I was also talking about being proactive as a CIO with your customers in the hospital, the people you’re serving. Don touched on the idea of your vendor being proactive with you. Any more thoughts there on what it means to do that as a vendor?

Dallin: Sure. Some of the research and commentary that I’ve been going in other segments is really, especially in software, communicating any sort of issues or bugs or downtime that have either been experienced by others or you know it’s going to be coming down the line. Reaching out to everyone whether that’s a mass email, mass communication of some sort and being really proactive about these things are coming your way.

It doesn’t always have to be bugs or downtime but even upgrades. Mass communicating what it’s going to look like. If you need additional training, please reach out to us. If you have new people, please reach out to us. Let’s get them trained up. Let’s make sure everyone is good and streamlined.

Then, on the partnership piece, really doing everything you can to meet their needs. Their success is your success, that’s where we find the equal success of both organizations and their relationship and their customer satisfaction, both providers and patients.

Anthony: We’re about out of time. But again, I just want to touch on this theme of as a CIO you need to educate yourself on the market, you need to know what’s out there, things are changing all the time and you need to be in the position to know what’s up and RTLS is a very intricate area that is moving quickly. I’m not trying to see your report, Don, and I don’t think that CIOs pay for it anyway, right.

Don: No.

Anthony: They don’t pay for it anyway. But you need to sit down with the RTLS report because your CEO or the board is going to ask you about it and you need to know what’s up. Don, any final thoughts and then Dallin, I’ll kick it over to you.

Don: It’s a really interesting space. There’s definitely some innovation going on in the space, some new ways of thinking that make it easier to apply the use cases that you want to apply. I think in the age of AI there is so much data that can be gathered from an RTLS system. It really is an untapped resource and we’re starting to see some efforts from the vendor side to help organizations use their data for better processes, better workflow, to really improve what’s happening on the clinical side and on the operational side. There’s a lot of movement in the space. It’s really interesting and there’s going to be more information coming from KLAS in this regard over the next few years.

Anthony: That’s a really interesting point, Don, about AI before collecting large amounts of data, then you had to figure out what to do with it. But that’s one of the things AI really helps you with. Now, if you collect the data, you throw some AI at it and now you can get some information out of it. A very good point. Dallin, any final thought?

Dallin: On the idea of innovation. I feel like it comes from both sides. Obviously, the vendors are looking at ways to improve things for the providers. But as the providers get into it, use it for the use cases, they can also spark a lot of innovation themselves. I would love for RTLS to do something and then communicate that back to the vendor so it’s a reciprocal innovation of moving forward and really progressing since their frontline is having those insights. It could really help push it forward and not leave it all to the vendors to try and come up with all the new unique use cases.

Anthony: What you said just made me think that these are probably very long relationships, especially if you’re talking about installing significant technology as opposed to just software. You don’t want to be two years, you want this to last a while.  Does that make sense?

Don: Right.

Dallin: Yeah, 100%.

Anthony: Don, Dallin, thanks so much for your time. I really appreciate it.

Don: Thanks so much for having us.

Dallin: Yeah, we appreciate it. Thanks, Anthony.