Recently, the Association for the Advancement of Medical Instrumentation rebranded the biomed industry with the term “health care technology management.” That nomenclature, specifically “management,” hints at an important part of a biomed’s responsibilities: tracking and maintaining a hospital’s assets, something that presents challenges in a complex and expansive environment like a hospital. In response to this task, real-time location systems (RTLS) have gained traction in the market. Ekahau Inc, Reston, Va, stands as one of the larger names in the RTLS industry, creating systems for hospitals and health care facilities, among other industries. 24×7 spoke with Tuomo Rutanen, SVP marketing and business development, Ekahau Inc, about how RTLS can assist biomeds and help streamline workflow in a hospital.
24×7: Can you tell me about the history of Ekahau?
Rutanen: The company was officially founded in 2000 in Helsinki, Finland. The first product introduction happened in 2002. The product offered the ability to listen to RF—or radio frequency—waves, and calculate location based on that.
When the company got started, a couple of things were beginning to happen in the market. One, Wi-Fi as an enterprise was starting to gain momentum and starting to go mainstream. The second thing was that RFID [radio frequency identification] was beginning to gain some momentum as well. Ekahau was kind of in-between those two big domains, where we had the ability to determine the location of things using a Wi-Fi signal strength measurement, and then also latching onto RFID, you are able to ascertain its location within an enterprise.
When we got started, after the company’s initial product introduction in 2002, we started developing a series of Wi-Fi tags that our software algorithms could locate over those networks. These tags communicate with the hospital’s Wi-Fi network and collect signal-strength information to locate these tags so that we can take them and apply them to various types of clinical equipment. Our focus was essentially going after biomeds or clinical engineers who needed to know where things were.
Since 2004, we’ve continued to evolve and develop our approach in terms of our tags and software to cater to that market and help them, primarily, to efficiently do asset management.
24×7: How have the tags changed through the years?
Rutanen: We’ve done various iterations of the tags so that we now have a whole portfolio of them. Some are meant for use on assets in the hospital and some are used for tracking patients, for example. Throughout the history of the company it’s been about understanding where something or somebody is, and then using that location to determine what the status of that object might be. For example, if I’m tracking an infusion pump and I know that it’s in a patient room, we can be pretty certain that the pump is being used. But if it’s in a utility closet, we know it’s not being used and that it’s dirty and should be cleaned. It really started from the premise of knowing where something is and then applying business logic to it to bring out more information about that particular thing you’re tracking.
24×7: Why did Ekahau officially relocate to the US in 2003?
Rutanen: There were some partnerships forming here, and the thought at the time was to get into North America and establish the company in the US. There are a couple of interesting dynamics there because the Wi-Fi market in the US was really picking up steam quickly, whereas in the other parts of the world Wi-Fi adoption was a little slower at that time. The US still leads in terms of adoption and use of Wi-Fi. For example, if you look at the hospital markets in the US today, it would be pretty hard to pinpoint a hospital that does not have a wireless network in place today.
24×7: Why was Wi-Fi expanding so quickly in the US?
Rutanen: There are probably a couple of things that have been driving that market. One, in the US, there are a lot of devices out there in the marketplace that can leverage and utilize Wi-Fi, I think probably more so than elsewhere. A lot of the pocket PCs and PDAs, and even cell phones that were being adopted here, were essentially using Wi-Fi radios. The other thing is that cell phone adoption was higher in Europe where it was lower in the US. Wi-Fi was a good way for enterprises to go wireless in their facilities versus using a cell phone, which, back in the day, tended to be more pricey in the US than it was in Europe.
But, we’ve seen from 2005 and beyond that the Wi-Fi growth continues to happen here. If we look at the hospital market and the devices out there, many of them that are going into hospitals today have Wi-Fi built in. They’re using that same Wi-Fi structure in the hospital to communicate to a management system in real time. From a central desk, you have the ability to see what’s happening with your patients without having to be at the bedside. There is the Wi-Fi infrastructure that is up there and growing all the time, and today, there are so many applications and uses for that.
A Quick Take
24×7: Can you describe your own professional career path and how you began working at Ekahau?
Rutanen: I was involved in the Wi-Fi business prior to Ekahau in a network management software company. In early 2003, I had an opportunity to meet with the investors of Ekahau, and they suggested that I join the company in the US. I joined and then became the feet on the ground here in the US market. One of the interesting dynamics was it started as a Helsinki, Finland-based company and became a Reston, Va-based company. The predominance of our customers are in North America—in the US, specifically— and what we’ve done is taken the roots of the company and transplanted them here. The majority of our executive team is in Virginia today. But we still maintain a development arm in Helsinki, Finland.
24×7: Is it difficult to integrate the services Ekahau offers with an existing Wi-Fi network?
Rutanen: Actually, no. The neat thing about it is that Wi-Fi is all standardized. How the access points and devices talk to each other and communicate are basically standard across the industry. So you might have a Wi-Fi handset from one vendor talking to a network supplied by another vendor. They have to communicate because of those standards. The same would apply to our tracking pieces in the sense that the tags can communicate in a universal way across these different networks from which you can pick information and calculate their location.
24×7: Other than Wi-Fi tracking, does Ekahau offer any other services to health care providers?
Rutanen: There’s one thing outside of the tracking system, which is not necessarily specific to health care providers, which is a set of tools to validate and verify the Wi-Fi network performance. Our partners and our service team use this when we go in to deploy a system. Its service is used to make sure that the network is operating properly and that there’s ample coverage. Obviously, tracking is predicated on having coverage throughout the location.
It’s not just for RTLS. For example, a lot of clinical device manufacturers use the same tool set to verify a network and say, “If I deploy my Wi-Fi-enabled infusion pumps in a hospital, will the network support these devices? Is there coverage in all the patient rooms? Is there sufficient signal strength in all of the patient rooms for these wireless pumps to communicate back to the central console?” So that’s our secondary business because a lot of our engineers and PhDs come from a wireless engineering background. This tool was kind of born out of a few ideas we had early on. We call it the Ekahau Site Survey.
24×7: Is Wi-Fi’s ongoing expansion due to health care reform and the impending switch to electronic health records?
Rutanen: Hospitals going paperless and digital—from bedside registration to bedside administration of medication and scanning a patient bar code—all of that data and information is being collected and delivered wirelessly. The other big driver, at least in many of the hospitals that we service, is the use of something called voice-over Wi-Fi. It’s basically a cordless handset, but instead of having your traditional cordless handset with a base, you talk through the Wi-Fi network and use it to make phone calls. When you think about the hospital environment, people don’t sit at their desks all day. They’re always mobile and moving around, and communication is paramount to what they do. That drives the Wi-Fi adoption.
24×7: How does RTLS benefit clinical engineering?
Rutanen: There’s the old adage that says, “If you can’t measure it, you can’t manage it.” When we start looking at what some of the routines are that biomeds have to follow, they’re responsible for all of the PMs on the equipment in the hospital. Obviously, if you can’t find it, you can’t PM it. If you can’t PM it, the device itself can pose a liability in terms of patient care. So RTLS allows the biomeds to understand and know where the equipment is so when they start to do PMs, they know where to find the devices. It reduces their search time in the hospital by telling them where everything is. It also tells them whether or not a certain device is in a patient room so that they can swap that device out for one that has been PMed.
It also allows the clinical folks to communicate back to the biomeds. If, for example, a caregiver is trying to set up an infusion pump with a patient and something is wrong with the pump and it doesn’t work, the tags have buttons on them to press that will send a work order to a biomed. That work order will say that you have a device that doesn’t work and needs a replacement. It essentially creates that work order so the biomed can bring a replacement device to that caregiver.
Also, the system allows the department to understand where the devices are and what their utilization profiles are. If I don’t have enough patient monitors but the system tells you that you have 14 of them that have been sitting in a storage room for 2 months, you don’t need to buy more. You can redeploy those in your system.
24×7: Are there other benefits?
Rutanen: Another big thing that the system can do for biomeds and the hospital overall is eliminate rentals or reduce them significantly. That’s a big ROI [return on investment] that we’ve seen. That typically justifies the purchase of an RTLS very quickly, because if you’re going to rent, for example, several hundred infusion pumps because you can’t find the existing ones, then the RTLS system, by increasing the utilization of the equipment you already have, will eliminate those rentals. We’ve seen customers take their rentals from half a million dollars a year down to tens of thousands of dollars within months. The other thing about the rental equipment is if you rent devices and the company comes back to pick them up but the hospital can’t find them, the facility ends up buying those assets and still doesn’t know where they are.
24×7: How has the growing mobile device market changed Ekahau?
Rutanen: Mobile devices can also get lost, so we track those devices as well. When you lose a $700 voice-over Wi-Fi handset, the RTLS system can tell you where it is. If you’re trying to walk out of the building, it can alert someone or send a message saying that you have the phone in your coat pocket.
There is also more integration with these devices. When an RTLS system is deployed successfully, it’s not something you go to for information. It’s something that communicates out to you and tells you to do something. These mobile devices are on the network and receiving information from the RTLS system. That could be as simple as an RTLS that’s monitoring temperature in your cryogenic freezer. If there’s a temperature breach, the RTLS will sense that, understand it, and send a temperature alert to the person responsible for managing those freezers. Sending that RTLS information to people on the go is a big part of the value proposition. Mobile devices are an ideal platform to send the information.
24×7: What new products do you have planned for the future?
Rutanen: We continuously innovate, so we have new versions of our software coming out with new and more elaborate dashboards. But also, we’ve gone beyond the RTLS-only approach to a broader asset-management direction, meaning that we’ve also integrated the use of passive RFID with the RTLS because there are some items in the hospital that the form factor wouldn’t allow putting an active tag on—it’s too small or oddly shaped, or the value of the item might not justify putting a tag on it. So we integrated passive RFID, where the tags can be just a few dollars, to allow biomeds and material management stakeholders the ability to see where these lower-value items are.
We also just released a new version of our asset tags that can not only be used as Wi-Fi for the location, but also have the capability to leverage infrared (IR). What that means is the Wi-Fi system can tell the user what room something is in. But if you need to go to a smaller section of that room—let’s say a shelf or one part of a room—you can receive additional input from the IR transmitter that will tell you it’s on “shelf number three” and not “shelf number five,” for example. It has foot-level accuracy in terms of delivering the location of that item.
In the RTLS business, the way these traits are measured is by how accurate the system is. A system that tells you that you have a patient monitor in the building—but there are 10 floors and 200 patient rooms—is not very useful. But when it tells you what room something is in, or the subset of a room, it makes that search time a lot shorter.
Chris Gaerig is the associate editor of 24×7. Contact him at .