When we think of hospitals, we don’t usually think of theft. After all, it’s a place for the sick and injured. Most doctors and nurses are focused on helping them get better and don’t have the time nor the inclination to waste any time counting the silver, so to speak.

But given the sheer size and operational complexity of most facilities, disappearing inventory — what hospitals sometimes call “shrinkage” — is an inevitable problem that hits hospitals hard. It’s not uncommon for losses to run into six-digit dollar figures.

“The number we see on average is hospitals losing about 15 percent [of lost inventory] on an annual basis,” says Joel Cook, director of health care solutions at Stanley Healthcare.

Ismaela Swanson, regional manager at operational solutions firm VIZZIA Technologies, was enlisted to help Orange County-based Mission Hospital curb its shrinkage using CenTrak’s real-time location systems. “I can tell you when we got here, the hospital was losing $150,000 a year in lost equipment,” she says. Thanks to VIZZIA’s efforts, that number later went down to around $5,000.

Interest in products that manage and deter loss is clearly growing at a brisk clip. Marketing firm Global Information Inc. projects the RTLS market to grow more than 1300 percent over the next decade, reaching $4 billion by 2022. The study says that much of this growth will be driven by increased demand from health care facilities.

This growth makes sense when considering the challenges hospitals face. As they work to trim their budgets, investing in a system that prevents equipment loss is a relatively straightforward solution that will save them money in the long run. “There’s greater awareness around it now, given health care reform and reimbursement rules,” says Adam Peck, director of marketing at CenTrak.

Pop a wheelie
When we asked experts to name the most commonly stolen item in hospitals, the answer was unanimous: wheelchairs.

It’s a familiar story to any harried hospital administrator trying to keep track of supplies. Families wheeling discharged patients to the parking lots typically fold up their chairs, put them the trunks of their cars, and drive off. Whether they do this with the intention to steal is difficult to know, though most of the experts we talked to said they believed many patients do it out of ignorance, not dishonesty.

“Lots of wheelchairs have tall poles in the back of them — the main reason being so they don’t fit in the trunk of cars,” says Cook.

Regardless of why it’s done, wheelchair thievery is no laughing matter. Wheelchairs can cost hundreds of dollars each, and having them regularly roll off can add up to a hefty loss. Hospitals frequently ask RTLS companies to tag wheelchairs so they have a way of tracking down the patient to ask for the wheelchair back without causing undue commotion or embarrassment.

Under the scope
This is not to say that intentional equipment theft doesn’t happen as well. Mobile electronic devices tend to be a popular draw for purloiners looking for something light, quick and valuable-looking.

“One of our customers had a shrinkage of mobile medical equipment of 13 percent every year — it added up to being a few hundred thousand dollars,” says Peck, who also noted that the provider was able to get that number down to zero after installing an RTLS system.

Of course, sometimes this can backfire when the thieves aren’t familiar with the technology they’re stealing. “We have patient tracking tags, and sometimes a lot of the patients at inner city hospitals are actually stealing the tags and trying to sell them in the street until they realize there’s no value in them because they only work with that hospital’s system,” says Peck.

On the other hand, hospitals are justifiably worried about protecting instruments that are light, hard to tag and very expensive. Stethoscopes, for example, run $800 on average and can be relatively easy to steal.

“We’ve even had reports of people stealing flexible endoscopic equipment,” says Bryant Broder, senior product manager at Skytron.

Endoscopic equipment in particular presents a challenge for hospitals to track, since they’re small, are used to look inside the patient, and must go through a harsh, punishing disinfection process after use.

It’s not feasible to track them with battery- powered active tags that track them in real time, but they can still be tracked with a passive tag, which is activated when the instrument approaches certain areas they shouldn’t be in, such as near doors leading out of the hospital.

But this begs the question: who’s buying this equipment off the thieves? A black market does exist for ill-gotten medical equipment. A cursory search on eBay will return pages of endoscopic instrument listings — not all of it gotten through legal channels.

“It’s not uncommon for the manufacturer of the instrumentation to call the hospital because an unauthorized person asked for a repair and the instrument wasn’t assigned to them. Titanium instrumentation for hips, knees, backs — that kind of stuff — it’s a huge loss,” says Broder.

One man’s trash
All told, however, thievery only accounts for a small portion of the total inventory loss in most hospitals. It’s more common for equipment to get lost after an operation, for example, when the room is being cleaned and prepped for the next patient. In fact, it’s surprisingly common for equipment worth tens of thousands of dollars to end up in the trash by mistake.

In one case, one of Peck’s customers eventually located a missing wound vacuum in the trash using his company’s tracking system. Wound vacuums are a prime example of equipment that benefits from being tagged: they’re relatively small, easy to misplace, and very expensive, running around $20,000-$25,000. “So, a biohazard group was called in to sift through the trash can,” Peck recalls with a laugh.

One of Cook’s customers actually stopped the same $8,000 HoverMatt mattress from going out with the trash twice in one week. “They used the tracking system to figure out that it was the same department both times,” he says.

This actually gets at another useful function of tracking systems: not only do they prevent valuable equipment from being lost, they can also allow providers to track certain patterns of loss over time so they can pinpoint why certain losses keep happening.

Furthermore, keeping better tabs on supplies can break bad work habits. Nursing staff often resort to hoarding equipment so they don’t have to scramble for it later.

“We hear a lot about that from our customers, particularly with infusion pumps,” says Arvid Gomez, president of Sonitor Technologies, a manufacturer of ultrasound-based RTLS systems. “Before a hospital installs RTLS and tags these devices, nurses would spend a lot of time hunting for the pumps and would often hide them to ensure that they had access. With RTLS tracking, that problem goes away.”

Tracking lost equipment enables hospitals to save not only on replacement costs, but lost productivity as well. “We know that in a typical facility some six to eight hours per day of clinical staff time is spent looking for equipment,” says Gomez.

But nurses aren’t the only staff members throwing a wrench in the works.

“In one case, we had one physician who was telling patients they could take their sequential compression pumps home with them — so they lost 100 over a couple of years,” says Marcus Ruark, vice president of marketing for Intelligent InSites, a software company that focuses on operational solutions for hospitals.

Such information can give hospitals the insight they need to take action to prevent loss in the long term. “If the data shows you that a lot of items have gone missing down a certain hallway, you may question why that is happening,” says Ruark. Sometimes, the solution may be as simple as putting up a sign in that hallway reminding employees to make sure they’re putting items back in their place. “It’s something you put in place based on what the information is showing you.”

Like stealing candy…
Hospitals are also making use of tracking technology to protect a rather unlikely asset: babies in the neonatal unit.

Baby stealing is extremely rare. Only 271 cases have been reported since 1983. But when it does happen, it makes national headlines, leaving the hospital in question open to liability — not to mention a huge PR nightmare.

Stanley Healthcare created their Hugs system to address these concerns. When the baby is born, it’s fitted with a tag around the ankle that syncs with a system that alerts personnel when the tag may be leaving an authorized area, or comes into contact with the wrong mother.

In fact, the system was responsible for preventing an infant abduction just last year. A woman disguised in scrubs had somehow made her way into the hospital, sneaking in until she found a mother alone with her child. She convinced the mother to step away for a shower, and then tried to make off with the baby. “Our system was in place, and they caught her before she got to the door,” says Cook.

Such technology isn’t confined to protecting infants, either. Manufacturers are now creating automatic lock protection systems that are triggered when a piece of tagged equipment gets too close to a door. “This can easily be used with people, too. You could restrict access to an elevator or an exterior door or some area of danger where they shouldn’t be,” says Peck.

The latest locking security technology actually takes timing into account as well. “If I’m a psychiatric patient with an authorized handler, and two of us arrive within five seconds with each other, the door unlocks. If I arrive a minute before the authorized handler and it assumes that she’s chasing me, the door will lock,” says Cook. “On the other hand, if the system senses that too much time has elapsed after the authorized handler goes through the door, it will treat it as a hitchhike event and will lock.”

Seamless surveillance
Just because hospitals want to protect and secure their assets doesn’t mean they want to do it at the expense of convenience, however. “Hospitals are more and more looking to leverage their existing Wi-Fi infrastructure rather than putting in a new infrastructure,” says CenTrak’s Peck.

As tracking technologies become more common, they’re also becoming more integrated with security systems. “We’ve started to collaborate on security video analytics so that instead of looking through hours and hours of video, we can pinpoint the event exactly when it happened,” says Stanley’s Cook.

“There’s definitely a trend in trying to integrate RTLS systems with security systems — lots of organizations don’t have security folks at every exit, so they integrate it with the security system so they can alert somebody if someone is nearby,” says Carlene Anteau, vice president of product marketing at RTLS/RFID firm Awarepoint.

RTLS and RFID technologies are also increasingly being used to meet Meaningful Use requirements and track data on equipment usage. And someday, they may even be used for monitoring patients.

“Now there’s clothing that has embedded RFID sensors that can read your physiological well being — that’s where the technology is definitely going,” says Skytron’s Broder. “There are lots of things like that in the pipeline right now. You’re only limited by your imagination and the size of your wallet. “