— TECHNICAL DETAILS
RTLS in hospitals and care homes
Choosing the right indoor tracking system (RTLS – Real-Time Location System) for hospitals, care homes and psychiatric hospitals is a complex process. There is no single ‘best’ RTLS solution – the optimal technology depends on the specific requirements of your organisation.
Was ist ein RTLS (Real-Time Location System)?
An RTLS is a system for the real-time tracking of people or objects within a building. It is used in hospitals, care homes and psychiatric institutions to locate patients, residents, staff and medical equipment, and to automatically trigger alarms when necessary – for example, in the event of a risk of a patient wandering off, an emergency call or the unauthorised removal of a device.
Selection criteria for indoor positioning systems
The following factors play a key role in the selection of an RTLS system:
Environmental stability
Under laboratory conditions, localisation is always straightforward. It becomes more difficult when the environment is constantly changing due to moving equipment and people.
Purpose of the tracking
When using a tracking system to protect a person, different factors must be taken into account than when minimising the effort involved in locating devices.
Accuracy requirements
Even though many manufacturers are trying to outdo one another when it comes to millimetre-precise positioning, this is actually relevant in only a few cases.
Comparison of different positioning technologies
There are a wide variety of approaches to indoor positioning. Each solution has its own advantages and disadvantages – particularly when it comes to indoor tracking, there is no one-size-fits-all solution.
How it works: Bluetooth positioning by measuring the signal strength at existing Bluetooth access points.
Advantage: Existing Bluetooth infrastructure can be utilised.
Disadvantage: Access point manufacturers often charge high licence fees, and a very large number of access points are required. Bluetooth is completely blocked by the body and does not penetrate it – so it is not necessarily suitable as a purely indoor positioning solution.
How it works: Battery-powered Bluetooth transmitters are mounted on the wall and transmit the location to the mobile device. This enables the device to determine its own location and can also be used for indoor navigation.
Advantage: Cost-effective installation.
Disadvantages: Batteries need to be replaced regularly – resulting in higher maintenance costs. Higher energy consumption in mobile devices means that usability is heavily dependent on energy management. With a smartphone, the user charges it regularly themselves – but with a wristband for patients, this cannot be reliably ensured. Charging management by nursing staff is usually rejected, as it involves extra work and significantly reduces the benefits of simplified location tracking.
How it works: Location tracking via Wi-Fi triangulation using Wi-Fi access points.
Disadvantages: It works in the same way as BLE triangulation – the signal does not pass through the body. Around three times as many access points are required for good coverage as for communication alone. Access point manufacturers often charge high licence fees for the use of location data.
Advantage: Extremely precise positioning, accurate to the millimetre.
Disadvantages: The device in question has a relatively high energy consumption, resulting in a correspondingly short battery life. This rules out solutions that would require staff to repeatedly recharge devices or change batteries. An alternative would be a larger tracker – but this would mean that neither people nor larger devices could be tracked effectively.
Advantage: No trackers are required on the devices.
Disadvantages: This assumes that continuous CCTV surveillance is accepted – which is not usually the case in hospitals or care homes. It requires a relatively stable environment without significant obstructions. The devices to be located must not look too similar, and coverage must be complete.
How it works: Passive RFID tags are detected by readers – as with active RFID, this is only possible locally, and therefore this is also a proximity tracking approach.
Advantages: Can be manufactured in very small quantities. Excellent value for money; can also be used as a disposable product.
Disadvantage: Tracking is only possible via local readers (Proximity Tracking).
How it works: Some providers, like Care2Graph, combine RFID and infrared technology. The mobile device transmits or receives an infrared signal from fixed devices in order to determine its own position. As the infrared signal remains within the room, positioning accurate to the room is possible.
Advantages: Precise room-level localisation. Relatively low energy consumption by mobile devices, thereby avoiding excessive staffing costs associated with energy management.
Disadvantages:This technology is not widely used, so most smart devices are excluded – only specialised trackers can be located. With Bluetooth, smartphones and tablets can also be located via the relevant app.
The Care2Graph solution from Martin.Care
Requirements in the healthcare sector
In hospitals, care homes, psychiatric wards, etc., location tracking is generally only required to the level of a specific room. Millimetre-precise tracking offers no significant added value for process optimisation – what matters is which room a device or person is in. At the same time, there is a need for systems that can also track smart devices, for example to support location-based care documentation or to enable navigation within the building via smartphone.
Combination of technologies
That is why the Martin.Care system relies on:
1. Bluetooth proximity tracking as a basic positioning method
Mobile devices act as beacons, and devices with a fixed power supply can be used for positioning.
2. Active RFID at critical points
As Bluetooth is not reliable enough due to body obstruction, active RFID is also used at locations where an alarm or a switch is to be triggered.
3. Sub-GHz radio for communication
A sub-GHz frequency is used to ensure reliable transmission of position and alarm data – it penetrates buildings better than Wi-Fi or Bluetooth, yet can still be encrypted.
References: Over 2,500 systems installed in hospitals, care homes and psychiatric hospitals.
Competitive analysis: approaches in the market
Tracking and call systems commonly found on the market often rely on a single technology rather than a combination of technologies. In practice, this has noticeable consequences:
Hard-wired call systems with bed-only detection
Many traditional call systems only recognise calls made from the bed. As soon as a resident or patient leaves the room – whether into the corridor, the bathroom or the communal area – it is no longer possible to make a call. For the majority of everyday call situations, this is impractical, as it does not take into account the caller’s mobility.
Bluetooth-only or Wi-Fi-only tracking systems
Systems that rely solely on Bluetooth or Wi-Fi reach their limits as soon as signals are blocked by the human body – a significant risk, particularly in the case of safety-critical alarms (e.g. anti-wandering protection, emergency calls). Furthermore, many access point manufacturers charge licence fees for the use of location data.
Care2Graph overcomes these limitations by combining BLE, active RFID and sub-GHz radio: mobile calling capability regardless of location, reliable alarm transmission even when the device is obscured by the body, and no reliance on third-party infrastructure requiring a licence.
Hardware monitoring
A tracking and alarm system is only as reliable as its infrastructure. Care2Graph therefore continuously monitors the technical condition of all installed devices:
Heartbeat monitoring
All installed devices send a heartbeat signal every 30 seconds to confirm to the system that they are operational. If this signal is not received, the system automatically detects a failure – the alarm threshold can be configured individually.
Battery monitoring
All mobile tags and trackers regularly report their battery status. This means that low battery levels are detected at an early stage, before a device fails – rather than only realising that a tag is no longer working once a problem has arisen.
This two-tier monitoring system – covering operational functionality and power supply – ensures that technical faults do not go unnoticed, but instead trigger an alarm themselves.
DIN VDE 0834: Status and classification
DIN VDE 0834 is a German standard for alarm systems in hospitals and care homes. There is currently no direct international equivalent to this standard. Martin.Care does not currently hold DIN VDE 0834 certification.
We are actively addressing the issue of our system’s functional safety equivalence with the requirements of the standard and are consulting with experts on this matter. A revised version of the standard is expected; we are monitoring this development and will adjust our assessment accordingly.
If DIN VDE 0834 certification is a deciding factor in your procurement process, please contact us directly – we will provide you with clear information on the current status and the technical background.
Decision-making guide
| Use case | Technology recommendation | Reasoning |
|---|---|---|
| Wandering prevention for people with dementia | Tracking: Active RFID Communication: Sub-GHz |
Reliability in body shadowing |
| Mobile nurse call system with location tracking | Tracking: Bluetooth Low Energy Communication: Sub-GHz |
Sub-GHz ensures reliable call transmission; location tracking is carried out via BLE. |
| Staff emergency call with location tracking | Tracking: Bluetooth Low Energy Communication: Sub-GHz |
— |
| Larger medical devices | Tracking: Bluetooth Low Energy Communication: Sub-GHz / Bluetooth |
Items such as beds can be easily tracked via BLE. |
| Anti-theft protection for larger medical devices | Tracking: Active RFID Communication: Sub-GHz |
Reliability when triggering alarms at the exit – these devices usually also come with a high purchase price. |
| Small medical devices | Tracking/Communication: Passive RFID | — |
| Disposables and clothing | Tracking/Communication: Passive RFID | As these are single-use items, the price of the tag is the determining factor. |
| Equipment that is disinfected using heat | Tracking/Communication: Passive RFID | Most rechargeable and non-rechargeable batteries cannot withstand the disinfection temperature – battery-free technology is therefore the best choice. |
Frequently Asked Questions
Was ist ein RTLS (Real-Time Location System)?
An RTLS is a system for tracking the real-time location of people or objects within a building. It is used in hospitals, care homes and psychiatric institutions to locate patients, residents, staff and medical equipment, and to trigger alarms where necessary.
What is the difference between BLE and active RFID?
BLE is suitable for energy-efficient basic tracking, but is blocked by the human body. Active RFID penetrates the body’s shielding more reliably and is therefore used at critical points, such as for anti-walkaway protection or anti-theft alarms.
Why does Care2Graph use several wireless technologies at the same time?
Care2Graph combines BLE for basic positioning, active RFID for safety-critical locations and sub-GHz radio for reliable communication. This combination avoids the weaknesses of individual technologies.
Is Care2Graph certified to DIN VDE 0834?
Martin.Care does not currently hold DIN VDE 0834 certification. There is no international equivalent to this standard. Martin.Care is actively assessing functional safety equivalence in consultation with experts.
How does Care2Graph monitor its own system reliability?
All installed devices send a heartbeat signal every 30 seconds to monitor their operation, as well as regular battery status updates. This enables faults to be detected before a device actually fails.
Which technology is right for your organisation?
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