A vision of the future
Will Mobile Indoor Location Become a Commodity?
Will RFID Technologies Start to Integrate with Mobile Location?
Will RTLS Tags Become Integrated into Devices?
Scott Phillips
Principal, RFID Portfolio Manager
Kaiser Permanente
HIMSS 2014
IEEE and RHCC/Intelligent Hospital
February 23, 2014
Conflict of Interest Disclosure
Scott Phillips has no real or apparent
conflicts of interest to report
Learning Objectives
Assuming ubiquitous adoption in Healthcare for RTLS, Passive RFID and
mobile indoor location, understand the future financial requirements.
Increase understanding of the feasibility and benefits of an enterprise
location infrastructure designed for many use cases.
Increase understanding of the feasibility and benefits of embedded
tags and the importance of infrastructure standardization.
Kaiser Permanente
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7 regions serving 8 states and the District of Columbia
9.1 million members
17,000 physicians; 175,000 employees (including 48,000+ nurses)
38 hospitals (co-located with medical offices)
600+ medical offices
$53 billion annual revenue
$1.8 billion invested in our community
68 years of providing care
Decision: Work with suppliers to embed RTLS tags into medical equipment.
What is RFID?
Radio Frequency IDentification is technology that uses communication through the use of radio waves
to transfer data between a reader and an electronic tag attached to an object.
Types of RFID
Examples
Passive
 Supplies
 Specimens
 Pharmacy
Active /
Real-time Location Systems (RTLS)
 Assets
 Patients
Mobile Indoor Location
 SmartPhones
 Tablets
GPS
 Specimen Temperature
 In-Transit Tracking
Visual
Current RFID Use Cases at Kaiser Permanente
1. Active RFID (RTLS)
2. Passive RFID
• Asset Tracking
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Retained Foreign Objects
• Equipment Maintenance
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Medication (Pilot)
• Rentals
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Lab Specimens (Pre-Pilot)
• Temperature Monitoring
Active RFID Tag Adoption
160,000
37 of 38 Hospitals &
337 of 600+ MOBs
140,000
120,000
• Infant Safety
3. Mobile Location
• Patient Activity (Pre-Pilot)
•
Wayfinding (Pre-Pilot)
Implementing
100,000
80,000
Active RFID Geographical Activity
60,000
40,000
Production
20,000
0
Total Asset Tags
~147,000
Temperature Sensors:
~6,000
Wireless Location Coverage:
~32,000,000 Sq Ft
Future Examples - More Infrastructure x3
Asset Tracking – Enhanced Location Accuracy
Nursing and Clinical Technology can quickly find needed equipment
by knowing the exact room the equipment is in. Accuracy enables
advanced equipment/patient workflows as well (e.g. par levels).
Medication Tracking
Nurses can track the location of on demand medications in
transit; plus know when and where they are delivered to.
Mobile Indoor Wayfinding
Members can find the facility using GPS, and
then once indoors navigate using indoor location
to their doctor’s appointment.
Today
Exploratory
Summary – More Infrastructure x3
Use Case
Today’s Infrastructure
Requirement
Tomorrow’s Infrastructure
Requirement
Sensors Type(s)
Asset Tracking
2-3 meters
Room, bay, alcove, more exact
coordinates and interactions
RTLS
Infant Safety
Unit exit points
Unit exits and beyond
RTLS
Retained Foreign Objects
(RFO)
Proximity/Wand
OR bed level, OR room level,
supply room, supply chain
Passive
Medication
Tray counts
Pharmacy, medication rooms,
patient rooms, en route
Passive
Mobile Indoor Wayfinding
N/A
Enterprise with points of
interest and area triggers
Mobile
(Consumer Wi-Fi, BLE?)
Patient Activity
N/A
Highly accurate distance for
very short walks (e.g. <20’ )
All
Could the Future be Room Level or Better for 3 separate location networks?
If not, what rooms would be excluded?
Room Level or Better RFID Infrastructure x3
Future hospital floor with room level coverage x3
Room with multiple sensors and RFID tags
Room Level Location Networks x3 - Estimated
Location Network
Active RFID / RTLS
Passive RFID
Mobile Location
Coarse Location
Yes
No
Yes
Room Level Location (All)
Yes
Yes
Yes
Unit and Building Perimeter (All)
Yes
Yes
Yes
Temperature Monitoring (All)
Yes
Yes
No
~$500K
~$340K
~$150K
~$23K
$23K
~$20K
Financial Approximations
Average Hospital Per Year
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Room Level or Better Hardware
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Installation and Support Costs
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Full Network Infrastructure
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Ubiquitous Tags (except Mobile)
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RFID Technology Refresh
Average Medical Office Per Year
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(same as above)
Option 1: Large Provider Potential Annual
Investment for 3 Location Networks (e.g. 38
hospitals, 600 MOBs)
~$75M+
Option 2: Same Large Provider Annual
Investment with Network consolidation and
embedded RTLS Tags.
~$37M
Note: These are not actuals. This is merely an illustration with rough approximations which includes several assumptions around widespread use
case adoption, coverage requirements, location accuracy and future support costs for all three infrastructures.
Sensor Consolidation Feasibility and Benefits
Traditional Implementations
Future Opportunities
1. Consumables  Passive RFID
1. Passive Remains + assist RTLS?
2. Assets  RTLS proprietary networks
2. RTLS – Standardized?
3. Mobile  Absent of Indoor Location
3. Will Mobile Dominate? ->
Consumer Wi-Fi + BLE?
Feasibility
• Which technology(ies)?
Bluetooth Low Energy (BLE) looks promising for mobile and retail
applications. iPhones are sensors too. Could it be used for more?
Benefits
• One Infrastructure = Cost
savings.
• Industry growth through greater
use and adoption.
• Increases attractiveness for
suppliers to “design in”.
Embedded Location Feasibility and Benefits
Progress - Examples
Feasibility
• Kaiser Permanente is deploying select
• Lacking a comprehensive
gauze with passive RF tags built in by
RTLS standard for sensors and
the suppliers.
tags.
• 6+ Years Ago, Kaiser Permanente
Clinical Technology Identified this as a
Benefits
future requirement for RTLS tags.
• Reduces initial and ongoing
• Today Kaiser Permanente is starting
costs for “tags”.
to address this issue with its strategic
• Doesn’t fall off.
medical device manufacturers.
• Small/Zero form factor.
• Intel announced an initial step
• Mobile indoor location applications are
emerging – using mobile embedded
location already.
Note: It is expected active tags will always be required for medical
equipment that doesn’t have a battery (e.g. standard wheelchairs)
Future Recommendations
Be Prepared and Contribute:
• Encourage the advancement of standards for embedded RTLS, making it
possible for standards to emerge more quickly enabling industry-wide embedded
RTLS.
• Where possible, encourage blending RTLS with passive and mobile, which can
increase the value of the infrastructure/sensors through reuse.
• Learn from mobile; plan for mobile users and encourage greater use of additional
onboard sensors for enhanced location accuracy (e.g. accelerometers,
pedometers).
• Help encourage integrated GPS location with indoor mobile location for use
cases such as seamless door to door wayfinding (e.g. home to parking lot to
doctor’s appointment).
Driving Value in the Present
• In the meantime, we will continue to use the technology to
create the most value:
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Make it easier for clinicians to do their jobs
Service more patients
Reduce the cost of equipment and supplies
Optimize asset utilization
Drive positive patient and family experiences
• Things to Consider
– What is the return on investment, given the facility’s current state?
– What technology best addresses the know use cases and the future use
cases?
• Passive
• Active
• Mobile
Summary / Lessons Learned
If ubiquitous location infrastructures are adopted (x3), the
financial benefits from consolidation are operationally
significant.
A technology approach that results in a single RFID / Location
infrastructure for all use cases which maximizes sensor reuse
is likely to lead to the lowest long term cost.
Location is embedded in mobile devices already for GPS, and
is an emerging reality for indoor location. RTLS could
accomplish the same providing standards are available.
Single Network + Embedded Tags =
Increased Value and Faster Industry Adoption.