RTLS Techniques to Comply with CDC Guidelines for COVID-19

The CDC published a report, Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings, which highlights 11 areas healthcare providers should consider when dealing with people suspected of the virus COVID-19. There is a role for IT to play in each of the 11. In many cases RTLS technology has applicability. For healthcare providers that have an RTLS system in place, expanding that system to address these recommendations helps comply with the CDC recommendations and improve outcomes.

The report addresses the following general areas for prevention of COVID-19.

  • Limit how germs enter a facility
  • Isolate symptomatic patients
  • Protect healthcare personnel (HCP)

COVID-19 Prevention Recommendations

  1. Minimize Chance for Exposure: Recommendations for precautions when patients arrive at the healthcare facility
    • A common extension of AiRISTA Flow’s RTLS systems is patient tracking. Before the patient enters the facility, a tag is provided which is typically clipped to their clothing or worn like a wrist strap. The tag is associated with the patient and their records. Knowing patient location can help;
      • Manage efficient patient flow and identify bottlenecks
      • Geo-fence areas can warn when patients enter and leave areas and send alerts
    • Considerations
      • Does your RTLS system track location of outdoor areas where patients enter the facility
      • Establish a sanitization procedure for tags when reused among patients
  1. Adhere to Standard and Transmission-based Precautions: Recommendations for hand hygiene, PPE, facemasks, eye protection, gloves, gowns
  • The AiRSTA Flow RTLS solution supports hand sanitization Affixing a tag to Hand Dispensing Units (HDUs) will indicate each dispense. When tags are worn by the HCP, the dispense can be associated with an individual for compliance at an individual, group and department level
    • Considerations
      • The solution should differentiate between a successful dispense and a fake
      • The solution should support the wide range of hygiene protocols across all departments
      • The solution should differentiate between soap, gel and alcohol HDUs
      • The solution should be retrofit existing HDUs and apply to any HDU vendor
  1. Patient Placement: Recommendations for isolating infected patients and limiting their mobility and interactions
    • Once again, patient tracking can be used to monitor patient location and ensure quarantine.
      • A tag is worn by the patient as a wrist strap or attached to clothing
      • Alerts can be generated when the patient leaves/enters designated areas defined as geo-fence zones on the RTLS map of the facility
    • Considerations
      • Determine the level of accuracy required for the perimeters of a patient. Room level accuracy can be achieved with choke points using BLE or infrared sensors.
      • With a sufficiently dense access point grid, Wi-Fi can distinguish zones down to room level.
      • AiRISTA Flow uses patented RF fingerprinting to increase the accuracy of Wi-Fi environments
  1. Take Precautions When Performing Aerosol-generating Procedures: Summary of precautions for procedures like sputum induction and open suctioning.
  2. Collection of Diagnostic Respirators Specimens: Summary of precautions when collecting respiratory specimens like nasopharyngeal swabs
  3. Manage Visitor Access and Movement Within the Facility: establish procedures for monitoring, managing and training all visitors. Limit visitors to patients with known or suspected COVID-19.
  • Similar to patient tracking, visitors can be tracked using RTLS tags to ensure they avoid restricted areas.
    • A tag is worn by the patient as a wrist strap or attached to clothing
    • Alerts can be generated when the visitor leaves/enters restricted areas
  • Considerations
    • The RTLS system can be integrated with video signage to display a warning to patients in real time when approaching restricted areas. The sign can even display the name of the visitor to target its effectiveness.
    • In critical cases, the system can integrate with door locks and alarms.
  1. Implement Engineering Controls: examples include partitions to guide patients, curtains between patients, and air-handling systems.
  2. Monitor and Manager Ill and Exposed Healthcare Professionals: movement and monitoring decisions for HCP with exposure to COVID-19 should be done in consultation with public health authorities.
    • A tag worn by HCPs can provide a record of their paths over time
      • Specifying an individual by their tag ID can show their location on a floor plan maintained in UVS over a user definable time slider.
      • This helps trace their previous associations and areas of potential contamination
    • Considerations
      • The detail of the historic breadcrumb trail of a HCP depends an the tag’s chirp rate. The faster the chirp rate, the more detailed the trail, but the faster the tag’s battery drains.
      • AiRISTA Flow offers rechargeable tags worn as wrist straps or personnel badges
  1. Train and Educate Healthcare Personnel: ensure HCP are trained on preventing transmissions and proper use of PPE.
  2. Implement Environmental Infection Control: dedicated medical equipment should be used when caring for infected patients
    • Placing a tag on equipment will track the location and its use, and help increase the utilization rate of scarce equipment like ventilators. See associated blog TBD.
      • Tags can be applied with double sided industrial tape, Velcro, or zip tied.
    • Considerations
      • AiRISTA Flow has a line of tags which include an accelerometer for vibration sensing. Vibration can be used to determine whether the machine is currently in use.
      • AiRISTA Flow’s UVS platform also integrates with applications provided by machine manufacturers to do conditional searches like “on this floor” AND “ not in use” AND “calibration has been performed”.
      • When combined with patient tags, the UVS platform can track associations of patients and the devices they used. This automates record keeping and may spot trends through historic analytics.
  1. Establish Reporting Within and Between Healthcare Facilities to Public Health Authorities: communicate and collaborate with public health authorities and share information about known or suspected COVID-19 patients.
    • RTLS platforms include reporting capabilities that can automate reports and their distribution.
      • Reports track history of patient and equipment location, as well as patient-equipment associations in the case of AiRISTA Flow’s UVS
      • RTLS platforms can also automate reporting of hand hygiene compliance and enforce department specific protocols
    • Considerations
      • Evaluate canned reports as well as the platform’s ability for lay-people to create custom reports and dashboard mashups
      • Your IT organization might have license access to more sophisticated Business Intelligence tools to interconnect a variety of systems for richer data analysis. AiRISTA Flow’s reporting and analytics engine has many of the capabilities of these expensive BI tools as part of the UVS RTLS platform.

For the latest updates to the CDC report, visit

https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html