Cambridge Health Alliance (CHA) is a three-campus public health care system serving Cambridge, Massachusetts. With fifteen additional stand-alone outpatient facilities, CHA has a significant number of temperature-controlled storage devices that require internal temperature monitoring. To ensure we are able to react quickly to any system breakdowns that could compromise the viability of often quite valuable products, we decided to implement automated, wireless temperature monitoring (WTM) throughout the CHA system.
Challenges of Manual Monitoring
Previously, all equipment was monitored manually, twice a day using individual glass thermometers. Multiple staff members in each facility would check their department’s equipment and note the pertinent data in a paper log. With no compiled legacy database, it was impossible to establish a historical record to benchmark trends in temperature monitoring activities. Although the logs were maintained regularly, as with any manual process, there were holes in the reports and there was no way to manipulate the data to allow it to govern our storage policies and procedures. Perhaps of greatest concern was the fact that without an automated system, it was impossible to have real-time alerting when refrigerators or freezers exceeded set ranges.
Choosing a New System
In order to alleviate concern over manual temperature monitoring issues, CHA’s quality management department requested that the information technology (IT) department research options for automated systems. The selection team—comprising pharmacy, laboratory, nursing, facilities, and IT members—ultimately proposed a solution and requested the funding for the project, and posited a few requirements necessary to choose the right automated system. We needed a budget-conscious way of connecting the temperature probes in all of our refrigeration equipment such that all monitoring information could be wirelessly relayed to a central system. The system also had to be capable of real-time alerting via e-mail or pager and record when and what actions were taken to address the problem.
After going through a formal request for proposals, CHA considered three different vendors that met the bulk of our needs. Ultimately, we decided on TempTrak from Cooper-Atkins because it was favorably priced and capable of health-system wide wireless integration. Although the administration at CHA was completely on board with this project, there are two points that any pharmacy director or IT manager can use when approaching administration for funding for an automated, WTM system. First, consider the financial disaster that can be avoided through real-time temperature failure alerts. A single refrigerator can contain upwards of $100,000 worth of vaccines or medications and a breakdown can result in a total loss of those products. Second, an automated system will reduce or eliminate the significant labor involved in manually checking every device multiple times a day. Whether manual logs can be completely eliminated depends on various state regulations that govern temperature monitoring. In Massachusetts, for example, the storage of immunization vaccines may benefit from automatic monitoring and reporting, but still requires manual logs.
Installation and Training
Representatives from Cooper-Atkins’ IT/engineering staff led the implementation process. They analyzed our footprint and assessed the wireless communications throughout the health care system. They also helped us deploy the system and properly place and calibrate the probes, including specialized probes for water temperature and humidity. CHA was responsible for installing cables and some electrical services to accommodate the TempTrak wireless equipment, but given the efficiency of the frequencies employed, this was not a daunting task.
Once the system was in place, we needed to configure a notification and alert schema for the approximately 250 devices we monitor. Cooper-Atkins offered a template configuration, but we needed to run tests within all facilities so the application analysts could tailor it to our specific needs with the greatest efficiency. Our IT application analyst and biomedical teams were trained on how to add new alerts to the system and laboratory, nursing, and pharmacy staff were trained on how to acknowledge and resolve alerts, and create proper documentation. Additionally, we reemphasized best practices for storing products inside refrigerators and freezers and how to access those products in order to quickly regain proper temperature conditions.
TempTrak offers a number of customizable features including individualized alarms for different refrigerators depending on the time of day and/or the types and costs of medications stored within. In addition to time-sensitive alerting, we benefit from the online documentation available to each department. At any time, designated users can login to the online database and have access to all of their equipment information at once, including what has been done to check and fix any alerts. The ability to view every piece of monitored equipment at once is particularly useful during electrical outages at outpatient sites that do not have emergency power.
It is worth noting that instituting a precise measuring tool will expose any faulty refrigeration equipment you may be using and help determine whether you need new or more sophisticated temperature control devices; information you would otherwise not have access to. At CHA, TempTrak has saved money on medication losses, allowed our employees to use their time in more efficient ways, and helped pinpoint faulty equipment in order to prevent future problems.
Bob Lewis is the chief information security officer and senior director of networks, telecommunications, and biomedical services at Cambridge Health Alliance.
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