By Michael Maurer

The benefits of a real-time locating system (RTLS) are expansive and particularly important in the Veterans Health Administration, given the intense public scrutiny the system has been subjected to in the past few years.

While it is admirable that the VA has recognized the potential benefits inherent in RTLS, they have unfortunately chosen to standardize on a Wi-Fi-based infrastructure that does not realize many of the benefits above due to its limited accuracy. Simply put, the VA Wi-Fi system was designed and installed to improve communication and connectivity to the secure network. It was never envisioned as the backbone to a reliable and accurate RTLS system, and even if it were, Wi-Fi is not an ideal technology for such a use. But newly developed technology has proven that a highly accurate and reliable RTLS system can provide substantial benefit in the health care environment. If implemented and utilized correctly, such a system can improve access, organizational efficiency, patient and staff experience, and most importantly, staff and patient safety and security.



Specifically, Wi-Fi operates at a very high frequency (2.4 GHz and higher). The higher the frequency, the smaller the electrical sine wave. The smaller the sine wave, the more resistant to penetrating various materials used in hospital construction. Additionally, Wi-Fi operates at much too high a frequency to reliably communicate with RFID tags. Even in cases of the densest Wi-Fi infrastructure, it cannot meet the minimum requirements for use as an RTLS medium. RFID tag locations derived from Wi-Fi triangulation are less than 50% reliable with best possible accuracy in the 10-meter range when tags can be located.

In practice, if the required level of specificity is building level, a lower level of accuracy due to these barriers might be acceptable. For instances where specific location is required within the building – as is the case for patient elopement, staff duress, accurate patient flow studies, and functional asset tracking, Wi-Fi simply does not perform.

The attraction to utilization of Wi-Fi for RTLS is the potential cost savings associated with running multiple functions off a single infrastructure. It would be, in some ways, difficult to argue this point if a Wi-Fi network were able to provide accurate location data. Given that it cannot, it is relevant to point out some additional system concerns.

Wi-Fi uses Access Points. In the best case, they are spaced approximately 60 feet apart and require network cabling from each access point to an IP port on the network switch wherever it may be housed (e.g. network communications closet). Installing home runs for each access point adds significant infrastructure costs and associated labor. The fact that Wi-Fi provides wireless communications is in no way to be misconstrued that there is no additional infrastructure needed. There is more infrastructure required when used for RTLS solutions compared with RTLS technologies specifically designed for such purposes.

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