By Bob Proctor, CEO of Link Labs

A Real Time Location System (RTLS) solution helps identify and track people, equipment and supplies in real-time for businesses across diverse industries, from transportation and logistics to manufacturing and agriculture. Some of the more advanced and critical RTLS use cases lie in healthcare.

Healthcare facilities can be some of the most complex environments in the world. With a RTLS, we now have the technology necessary to provide unparalleled visibility into a hospital’s operations, equipment and staff. Specifically, a RTLS has nearly-limitless opportunities for healthcare organizations to track medical equipment for both utilization and calibration/recertification management, personnel and patients for more effective patient care and experience, and supplies for better inventory management..

Today, many hospital CIOs are aware of the benefits and critical use cases of a RTLS, but many still struggle to identify the RTLS solution best suited for their organization. To help them make a confident and informed decision, below are five critical factors to consider when selecting a RTLS.

1. Budget and ROI

For healthcare organizations, a RTLS budget is multifaceted, complicating the process of choosing a RTLS. It’s vital to understand the components of cost and how they evolve over time, in order to build a credible business case and ROI.  The costs for asset tracking tags, infrastructure costs, installation costs, IT integration costs, and standard operating costs.   

Tag costs – The tag is the physical device that records and transfers the movement of an asset (think Tile or AirTag but for healthcare environments). At first glance, a $50 price per tag may seem reasonable, but if a hospital needs to track 10,000 assets, the cost of a tag can dominate the overall system cost.  A $10 tag can be the difference between a viable business case and non-viable one.  Tag costs need to be thought of across time and further break down into two sub-categories.  Cost of the physical tag initially, and also the cost of replacing batteries or disposable tags at some future time.  When selecting a RTLS, it’s critical to consider how long the battery of an asset tracking tag will last and the cost of a replacement cycles. Additionally, some RTLS solutions force organizations to use a proprietary tag technology instead of allowing them to choose from a variety of open-source technology. This raises costs significantly. 

Infrastructure costs—Tags need to send data through a network back to the cloud.  They also typically rely on additional infrastructure to determine their location.  The costs of this infrastructure varies considerably depending on the technology chosen, by as much as an order of magnitude in some cases.  Systems with loads of expensive infrastructure can provide some functional advantages, for example increasing location accuracy from ~1 meter with advanced Bluetooth LE systems to something as low as 30 centimeters for advanced ultrawideband (UWB) systems.  The question to ask is if the increase in location accuracy is necessary for capturing the benefits of RTLS. 

Installation costs—Infrastructure needs to be installed, and in a hospital setting the differences range from system requiring a day or two of installation of simple, easy-to-install infrastructure (no cabling, no electricians, no IT) to requiring a multi-month installation process touching permitting, unions, IT security, and more.  

IT integration costs—systems vary between stand alone and operating outside of the IT function, to requiring IT integration in order to deliver on the promised use cases.  

Standard operating costs—All RTLS vendors have pricing that reflects ongoing recurring costs.  It is useful to understand the drivers of those costs, as that can lend insight into overall costs.  One major driver of standard operating costs is data intensity.  Systems that push high volumes of data to the cloud incur much higher backhaul and data processing costs.  Underlying IOT data fee structures are often much higher per MB of data than standard data fees, for example.  Additionally, there are ongoing costs for providing software and data.  Do those costs vary by the number of tags, by the functionality provided, or both?  This is critical to understand when considering how investment in a RTLS system may expand into additional use cases over time.  

2. To integrate with IT, or not?  

Not all technology integrations are the same. Working with an IT department to implement a new asset tracking and monitoring network can be a frustrating experience that necessarily involves lengthy security questionnaires and reviews.  The review efforts alone can take six months or more. Implementation and ongoing monitoring adds ongoing management costs, complexity, and risk.  Hospital IT departments regularly fall victim to cybercriminals and are rightly cautious of introducing possible vulnerabilities to their systems. However, some healthcare RTLS solutions require no IT integration whatsoever, which is important to keep in mind when purchasing a solution.  This makes the overall system far lower in cost both initially and to operate, and faster to gain approval.  

3. Facility coverage  

If a healthcare facility is only focused on tracking a few items in a limited area, implementing an infrastructure intensive solution may not be viable.   Those leading a RTLS project must carefully consider what they need to track, how many total items are potentially included, and how much of their hospital or healthcare system needs system coverage before choosing a solution.

4. Location Accuracy 

Healthcare decision makers should ask themselves, “Does it matter whether we can triangulate an exact position of an item, or do we just need to know its general location?” For example, a materials management team sees immediate benefit from reducing the search zone for a machine or tool from an entire hospital to just a couple of rooms. However, it’s unlikely they need to know the exact location of an item.  

Proximity-based systems, which track the position of an asset to within a meter or two, are typically far simpler and more affordable than systems promoting centimeter level location accuracy.  Therefore, if an organization can meet its use case needs with a proximity-based RTLS, it can enjoy a high ROI, and a streamlined installation process that leads to a short time from system selection to impact.  

5. Assets for Tracking and Monitoring

If a hospital only needs to track expensive capital assets, like an infusion pump or ventilator, spending $80 on a RTLS tag might be wise. On the other hand, what if a nurse needs to track down a wheelchair, or maybe a particular item that has a replacement cost comparable or less than the cost of the tag itself.  In these scenarios, a system that utilizes tags that cost $10 or less may be the only viable alternative. There are also RTLS solutions that use several different types of tags while connecting to one network. These systems allow hospitals to locate and track both expensive and inexpensive assets.  

Additionally, are there monitoring applications that are also needed?  There are many potential monitoring use cases, such as monitoring doors for security, refrigerator temperatures, sanitizer fill levels, or surgical instruments going through a sterilization cycle.  System extensibility to additional use cases, and the associated costs of adding tags and user interface functionality, needs to be considered.  


From asset and personnel tracking to legal compliance and inventory management, a RTLS allows hospitals to cut costs and, more importantly, improve patient care and outcomes. Even so, countless healthcare organizations have yet to implement a RTLS because evaluating disparate systems can be confusing or daunting. By examining the key factors outlined above before selecting a RTLS, healthcare leaders can make an informed decision on the solution that’s right for their organization.  

Link Labs

Written by Link Labs

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