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Overcoming Common Issues of RTLS Systems in Hospitals

MedWrench recently talked to Adrian Jennings from Cognosos about real-time location systems (RTLS) and their application in healthcare.

Thu Sep 01 2022By Cognosos

Hospitals make massive investments into mobile medical equipment like infusion pumps and wound vacs, but given the constant flurry of activity within them, this equipment can be easily misplaced, lost or even stolen.  Over the years, hospitals have grappled with how to effectively locate and manage equipment– but with varying degrees of success. Luckily, a new generation of RTLS is helping them solve this difficult challenge.  

What is RTLS for healthcare and how has it evolved?

RTLS  tracks the location of people and mobile medical equipment in real-time. By no means a novel concept, RTLS dates back to the early 2000s, often referred to as the RTLS 1.0 era. The technologies that emerged into the healthcare limelight were ultrasound, infrared and also Wi-Fi to some extent. Both ultrasound- and infrared-based solutions required very dense installations of ceiling-mounted infrastructure, with equipment installed in every room and hallway, including patient rooms. These solutions proved effective but were not completely reliable, not to mention very expensive to install. For it's part, Wi-Fi held great promise as a cost-effective solution but never reached a useful level of performance to be adopted.


The 2010s marked the RTLS 1.5 era and the rise of Bluetooth Low Energy (BLE) and resurgence of Wi-Fi technology. These systems used radio frequency identification (RFID) to track tagged objects and equipment. While lightweight and inexpensive, Wi-Fi and BLE RTLS are unreliable, often producing large “circles of uncertainty” around each asset – meaning that it is difficult to create room-level accuracy. In this era ultra-wideband systems were commercialized promising very high performance but at an untenable price-point.

What are some of the major flaws of the various RTLS models/solutions?

Over the years, infrared and ultrasound operated fairly well in hospital settings – provided all the necessary conditions were maintained. However, these RTLS solutions are highly sensitive to changes in their environments. To maintain accuracy, light and sound cannot escape a room, forcing staff to keep doors closed as much as possible – something that is not feasible in a hospital. To counteract this, further expensive infrastructure was required pushing the price-point beyond realistic viability. During installation and any further modification of these systems hospitals must undertake considerable construction effort placing patient rooms, hallways and other common areas temporarily out of commission, and resulting in significant loss of revenue. Moreover, construction, renovation or demolition in hospitals can put patients at risk of a myriad of issues, including mold infection, Legionnaires disease and even sleep deprivation. It is estimated that hospital acquired infection due to construction results in a staggering  5,000 deaths per year in the U.S. 

Ultimately, the costs associated with these RTLS installations do not deliver enough of a return to justify the investment. Meanwhile, the lighter-weight Wi-Fi and BLE RTLS alternatives are not much better due to their chronic inconsistency, unreliable data output and strain they place on hospitals' internet and data networks. Unfortunately, as a result, these challenges have tarnished the reputation of a technology that, when properly implemented, can deliver real value.  

How does Cognosos overcome these common RTLS flaws?

Cognosos technology spearheads the next generation of real-time asset tracking technology: RTLS 2.0 eliminates the traditional barriers to real-time asset visibility and breaks the “high-performance = expensive-infrastructure” paradigm. First, we leverage advancements in both cloud and AI to drastically reduce the hardware footprint required to gain room-level asset visibility and insights: by applying AI at the very core of our sensor technology we deliver high-quality tracking using only sparse, low-cost devices.  In addition, we employ our patented long-range wireless networking technology to eliminate the need to pull wires through ceilings or perform construction to deploy RTLS. The combination of these innovations minimizes the time and cost of deployment, thereby reducing the installation timeline and significantly increasing the potential ROI. 

Once installed, important data generated from genuine room-level visibility captures actionable insights that enable hospital teams to reduce effort spent on mission-critical tasks, and to make data-driven decisions that improve workflows and save significant amounts of time and effort.

Why should hospitals consider Cognosos’ RTLS solution?

Currently, hospital workers are stretched to the limit – doing more with less every day. As far as the human element goes, asset tracking technology, like Cognosos,’ helps teams recover much needed time while drastically reducing the amount of physically taxing work. With RTLS from Cognosos, employees no longer need to scour hallways and supply closets searching for that last piece of equipment needed to complete an asset class’ PM cycle. That said, the improvements a successful RTLS implementation can bring extend far beyond people, and can also address another chronic issue encountered at the vast majority of hospitals: the under-utilization of assets.  With the facility-wide, room-level visibility provided by Cognosos, teams can see a complete picture of how assets move throughout a facility. Technology that allows you to map (with precision) and measure over time, translates into the ability to identify problematic areas and make tweaks to improve workflows and increase your utilization rate. 

What are some additional benefits Cognosos offers healthcare organizations? 

Beyond providing facility-wide, room-level asset tracking , Cognosos’ data and analytics empower hospitals to holistically understand the movement of their assets, enabling greater workflow efficiencies and improved utilization of equipment. With complete visibility, hospital staff receive a data-driven picture of how equipment moves (or sits idle) throughout its facility, helping teams improve utilization, right-size their fleet, reduce rental costs, and save their employees valuable time.  For more information about our unique RTLS solution for hospitals, visit

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