Lessons Learned from an RTLS Program Manager

lessons learned from an RTLS Program Manager

We could not be more excited to welcome Mithun Mukherjee to the Infinite Leap family! Mithun has seven years of RTLS experience, including running an RTLS program for the last three years at the University of Rochester Medical Center as the Program Manager, Real-time Integration, Information Systems Division.

This month, Mithun joined us as the Senior Director, Enterprise Implementation and Support. As Mithun has extensive hands-on experience managing real-time technologies at a major academic medical center, we asked him to share the main lessons learned throughout his RTLS journey.

How did your journey with Real-Time Location Systems (RTLS) start?

Back in 2013, I joined the University of Rochester Medical Center as a Project Manager in the Information Systems Division’s PMO office. As part of two key projects (a new children’s hospital and implementation of Epic Optime), I was responsible for coordinating and leading overall enterprise device integration and alarm management strategies and implementations with a cross disciplinary team of IT staff, biomedical engineers, clinical nursing, and provider leadership. In addition to mobility and medical device integration projects, an RTLS-based infant protection system was implemented in the new children’s hospital tower, along with a small temperature monitoring pilot for the pharmacy. These projects exposed a gap in internal operational support for these types of new healthcare technologies (typically outside the EMR but often integrated with it) that spanned dedicated hardware, application software, and clinical workflow. This gap was addressed by taking a programmatic approach to these initiatives, ultimately culminating in the Real-time Integration program, which I had the privilege to create, develop, and lead. In this role, I managed a team of three analysts responsible for implementing, supporting, and optimizing a core suite of integrated real-time enterprise health IT applications, including RTLS ( wireless environmental monitoring, pediatric patient safety, asset management, staff duress), as well as apps in EMR device integration, alarm management, and clinical communication & collaboration – all building blocks of a Real-time Health System (RTHS) strategy as described by Gartner Research.

What was the main role of the Real-Time Integration team?

My team was responsible for managing a portfolio of health IT applications that included device integration middleware, alarm middleware, RTLS, and a clinical communication platform. The primary goal was to provide a scalable support model for these existing implementations and assume ownership of application support for break fix issues. In addition, by allocating dedicated resources to these key apps that supported critical operational and clinical business functions, we were able to maximize the institution’s investment by further optimizing and expanding their use across the enterprise. We did this by continuing to focus on crucial workflow-related discussions with clinical teams, partnering with clinical engineering, nursing informatics, and facilities, and helping business units make data-driven decisions by leveraging these tools to make the caregiving process safer and smarter.

How did the University of Rochester Medical Center start with the use of Real-Time Location Systems?

Prior to my involvement, URMC already had a legacy RTLS system for nurse/staff location at a couple of our hospitals for several years. The primary business goal for that RTLS infrastructure was to offer location-based call cancellations through an integration with our nurse call system. It had been supported primarily by the legacy vendor’s external local integrator. In 2015, with the construction of the new Golisano Children’s Hospital tower, we were asked to meet new requirements for a pediatric/infant protection system in the NICU/PICU and general care pediatrics units, as well as environmental temperature/humidity monitoring for the pharmacy. Those two initial use cases evolved into further expansion across the enterprise as the infant protection system grew to 5 additional OB units in 2019, and environmental monitoring gradually expanded to multiple hospitals and offsite clinics (1,200+ temperature/humidity sensors in 2020). 2019 also saw us roll out the asset management use case to track almost 6,000 infusion pumps and other critical medical devices like ventilators, PAPR masks, and renal therapy machines. Finally, we implemented RTLS-based staff duress at two outpatient behavioral health facilities (150+ staff) in 2020.

What have been the main benefits of using RTLS?

Gartner Research defines a Real-time Health System as “a conceptual, operational and technology paradigm for the next-generation healthcare delivery organization (HDO). The RTHS transforms the HDO into an enterprise that is aware, collaborative and smart. The RTHS assimilates real-time operational intelligence to achieve business objectives.” RTLS is a key building block toward the realization of a Real-time Health System strategy. For example, using wireless environmental monitoring across multiple hospitals and offsite clinics delivers enormous operational efficiencies, eliminating the documentation burden for front end pharmacy and inpatient staff. It resulted in at least one documented case of preventing spoilage of human milk worth $15,000. It has also been a valuable tool supporting compliance with regulatory requirements around monitoring medication and vaccines stored in freezers & refrigeration equipment. From a patient safety perspective, the RTLS-driven infant protection system addressed a key security need to keep pediatric patients safe and secure. From a patient safety and operational efficiency perspective, location awareness of critical equipment location and advanced asset management afforded by RTLS technology provides real-time insight into the supply chain and delivery processes of critical equipment like infusion pumps and ventilators at the right time to the right person. The staff duress use case has provided vital peace of mind to our front line workers, especially in behavioral health settings, by giving them the ability to summon help at the press of a button. Finally, RTLS enabled patient flow, throughput, and length of stay minimization benefits that are well documented in the RTLS literature and proven in the field.

What do you think attributes to achieving success with RTLS?

Most health IT implementations require some level of cross disciplinary collaboration for success. RTLS takes that collaboration to the next level. Spanning disciplines across hardware, application software, and wireless network engineering, as well as hospital business units and workflows (materials management, nursing, providers, pharmacy, and environmental services), RTLS truly requires an enhanced level of cross functional collaboration, trust, and understanding, and demands breaking down silos. This type of enhanced collaboration translates into end user adoption and satisfaction, and ultimately safe and efficient patient care.

What is the most important lesson learned from your experience with Real-Time Technologies?

Effectively implementing new technology that involves fundamental changes in clinical workflows is an ongoing process that relies on constant process improvement in order to truly reap its benefits. These tools, if implemented correctly, have the potential to transform organizations that wish to adopt truly data-driven process improvement and rapid cycle improvement techniques. Starting with the executive sponsor, a successful RTLS deployment requires continuous engagement at every level of the organization and a disciplined change management approach.

What is your advice for hospitals who are just beginning their RTLS journey?

Healthcare RTLS has been around for some time now but its time has finally come, heralded by a maturation of location sensing technologies, tag/sensor hardware, wireless network infrastructure, integrations, and application platforms that have unlocked dozens of new use cases to deliver seamless patient/staff experiences and more efficient/safer care. My advice for hospitals just getting started is: Don’t reinvent the wheel. Leverage the work that has already been done in that space. My motto is “stand on the shoulders of giants,” so learn from those who are much further down the road. And build a community – share your best practices and lessons learned. There will always be people who are just starting on their RTLS journey and who will benefit from your experiences – good or bad. That is why I am thrilled to join Infinite Leap so I can share, learn, and build on this truly strategic approach toward enterprise visibility in healthcare.