This article attempts to examine the improvement of hospital logistics using IoT.
UMC Utrecht uses tags and decentralised mesh network to enable on-demand dispatched equipment.
Not knowing where things are, can be inconvenient at best. In hospitals, not having wheelchairs, beds and infusion pumps available at the right time can impede the required daily care. But as patients are frequently on the move, says Liam van Koert, keeping track of hospital assets proves challenging in practice.
BACpress,University Medical Center Utrecht initiated the pilot project UFOund to tackle this problem in a user experience centre. They first tagged their equipment and connected it to a mesh network. Then they gave nurses and technical staff real-time information on the whereabouts of equipment. Better yet, they can ‘beep’ whatever they need with the push of a button.
It is not often that an opportunity, such as the one at the Children’s Hospital in Utrecht, presents itself. But as the ward, which owes its name to the ample, cheerfully painted green frogs on the walls, is due for some serious renovation work, UFOund’s Project Manager, Wiko Lamain and Clinical Informatician, Thijs Dijkgraaf have turned the Second floor into a playground of their own. Having installed network ‘anchors’ and tracking tags, they can freely experiment with moving beds and pumps around and check various set-ups for accuracy and robustness, without interfering with daily hospital logistics.
They have also equipped a dedicated information centre which people from all over the world can visit to see what they are up to. Hospital logistics are complicated everywhere. And UMC’s novel IoT-based approach towards tracking & tracing, amongst other things, has received the medical community’s attention.
“UFOund delivers the fundamentals for the MAtriX project which aims at improving the quality of care provided in UMC Utrecht for both patients and staff” by improving the availability and employability of medical equipment, explains Lamain, who has been connecting lots of possible IoT dots for UMC for almost a year now.
“One of the things we try to achieve with the project is to better align workflow processes with the standard equipment used by our staff to nurse patients on a daily basis. We do so by first looking at our current processes, and then seek ways to improve them. Secondly, we investigate new technological opportunities that have arisen to support them.” According to Lamain – like in many other fields – hospitals nowadays face having to provide higher quality care for less money, with fewer people.
In the search for bottlenecks to eliminate, UMC Utrecht found that not having immediate access to standard equipment was an unnecessary hindrance that could in theory ‘quite easily’ be dealt with. Not knowing where beds, wheelchairs or infusion pumps are when you need them? It happens more often than one might think.
A wheelchair might be displaced or borrowed by a colleague for an emergency. Maybe a bed is broken, and it has been sent to the technical staff for repair. Whatever the reason, too much valuable time is wasted in the searches that inevitably follow.
Lamain comments, “When delving deep in the whereabouts of hospital equipment, you’ll find that you might think you know where things are, but in many cases you actually don’t. Now you could – for improved tracking and tracing – introduce a system where all equipment is dispatched from a central location. Here you can check the equipment’s technical status, plan maintenance and keep stock of the inventory in general. But you don’t want nurses to walk a mile and a half every time they need something. They have patients to take care of.
“Wouldn’t it be much easier if you could see where the closest available bed is in real-time on your phone? Or even better: have one delivered to you with the push of a button? The solution we are researching within project UFOund aims to have the best of both worlds, using one or multiple IoT technologies as the enabler,” says Lamain.
Improved patient experience
There is, according to Lamain, a lot to be gained by using such a system, and not just from a logistics perspective. Patients will experience higher quality care due to more personal hands-on time from nurses and smoother transitions from one ward to another. “One of the bottlenecks when moving patients is getting them hooked up to the right infusion pump. Every department has its own type, with its own settings. This results in patients having to switch pumps multiple times when going in and coming out of surgery. Using IoT for getting the right pumps at the right place at the right time will help to significantly improve the patient experience. And who knows what future IoT developments will bring in terms of negating settings and functionality, so that switching pumps can be a thing of the past altogether.”
Finding the right IoT technology for project UFOund was no easy feat. There are ample different technologies to choose from, each with their own plusses and minuses. You can use active or passive RFID tags, barcodes, QR codes, and vision, to name just a few.
In terms of visibility, how accurate are these different methods? You can place scanners in doorways, so you know where things are at room level. You could also add cameras with image recognition software to know the exact position, but alongside the privacy issues, you would of course be limited to the line of sight.
When considering the price tag, passive RFID might seem the more affordable option, but the reading equipment is expensive. A better method could be using active – battery-powered – tags that send asignal to a mesh network. By measuring the distance between the tag and a minimum of two nodes, you can calculate the exact position using triangulation. But how precise is exact? And do the high electromagnetic frequencies produced by the tags interfere with hospital equipment? How often should I send a position signal to the network for the logistic applications to run smoothly? How much data does this generate? How do I handle this? And what does this mean for the battery life of my tags?
These are just a few questions that Lamain and his team sought answers to. And they fortunately had an entire ward to use as an IoT playground to come up with some promising results.