Asset Management in the Fast Lane

HibbsIn this day of electronic banking over a wireless modem, very few hospitals can produce an accurate bill within 15 days of patient discharge. Healthcare spends a large percentage of revenue on medical equipment and information systems, but often the two do not communicate. When they are forced to communicate, as in picture archive and communications systems (PACS), the process is huge, complicated and expensive.

We have been trying to apply asset management in healthcare for a number of years. Numerous companies advertise their expertise. Hospital accounting systems have modules dedicated to asset management. This magazine publishes articles on asset management. But healthcare providers just don’t get it. Say “asset management” in an administrative meeting and everyone hears “accounting, depreciation, budget justification, paperwork.”

If you live in an area with toll roads, you probably have a “toll tag” on the windshield of your car. The tag establishes an account with the road’s administrator and allows you to zip through toll booths without rolling down your window. This doesn’t just save you the grief of fishing coins out of a sticky console at 30 miles per hour, it is a practical form of asset management. Toll booth staff is reduced. Back office expenses are reduced because five thousand pounds of nickels don’t have to be counted every night. The administrators also get statistics on road usage that previously required a very expensive visual survey.

But enough about toll roads, how can we use toll tags in healthcare? While sorting through all the neat gizmos at the massive computer show Comdex last fall, I found Axcess, Inc. (, one of several companies specializing in RFID, or radio frequency identification. I have seen other methods of asset management using bar codes, magnetic cards, infrared detectors and both passive and active RF devices (toll tags). The difference is that Axcess not only has a product, they are not afraid to think outside the box to apply it.

Let’s build a new hospital as a showcase for true asset management. Every mobile piece of equipment has an electronic ID tag. A typical asset management system could locate that equipment so the nursing staff can find wheel chairs and infusion pumps. The biomed department can complete scheduled inspections with minimal “hide and seek.” Everyone should be doing this already.

Now lets put an electronic ID tag on every patient so we can find them when they need medication, take them to physical therapy or retrieve them when they get lost looking for the cafeteria. This is as important to Nursing as finding that IV pump in a closet, so everyone should be doing this already, also.

Now lets put an electronic ID tag on every staff member. Now we can find nurses, technicians, dietary workers and biomeds during their hundreds of daily activities. We can locate the nearest person in an emergency and perform job motion studies of routine activities. This, some people think, crosses the line from management to micromanagement.

Axcess demonstrates the difference between micromanagement and automated operations. With rules-based software, these ID tags provide benefits without human initiation of activity or interest. The equipment ID tag is directly linked to the Biomed inventory and business office asset schedule. The employee ID tag is linked to Human Resources and Payroll. The Patient ID tag is linked to Admission, Discharge and Transfer for the medical record.

Under automated operations, when the system sees a tagged gurney moving through the hospital with a tagged employee assigned rights to move gurneys, everything is fine. Put a tagged patient scheduled for a CT scan on the gurney and when the combination of equipment, patient and employee approach the CT area, the door opens.

If a patient in a wheel chair approaches an outside door without an employee, the door doesn’t open. If the patient in the wheelchair has a baby that doesn’t match that patient, the door doesn’t open and security is paged.

A network of RFID badges, Bluetooth, local wireless networks and integration programs can automate and protect assets without increasing staffing, workload or decreasing the privacy of patients and staff. The secret is using the information in an interactive smart facility, not just using the system to look for something or someone.