One of the major innovations at the HIMSS2011 is the emergence of Radio Frequency Identification (RFID) and Real Time Location Systems (RTLS). Many have argued that it is about time that healthcare IT uses some of the technologies that are commonly used in other sectors, and RFID technology is a typical example. If Wal-Mart can predict exactly where their supplies are and when a customer checks out a pair of jeans, there is no reason for hospital supplies to get lost, misplaced or even stolen, or for patients to be “forgotten” somewhere between radiology and their room and left in the corridor for an hour before someone notices.
Regarding theft, I talked with a doctor/administrator from one of our Dallas-Fort Worth metroplex hospitals, who told me about a theft involving a van with signage from a major medical manufacturer. The van pull up to the loading dock, and a “technician” dressed in full company uniform went to radiology and removed a brand new portable X-ray unit, worth a few hundred thousand dollars. These types of events can easily be prevented, as anyone knows who has ever been “beeped” coming out of a department store because the RFID tag was still on the item purchased.
The RFID/RTLS showcase at HIMSS2011 demonstrated several applications of this new technology to construct a so-called “smart room.” Key to these applications is the connectivity between devices, patients, and care providers, including hand-held devices that can be integrated seamlessly. Some of the applications for this technology are:
- Pinpoint patient location with such preciseness that it can even detect patient falls with real time tracking of unusual patient movements
- Location and usage of equipment can be monitored throughout the hospital enterprise. (Needless to say, the hospital administrator I talked with was one of the first to implement this technology and that all movable medical devices in his hospital are now tagged).
- Supply management as manually scanned barcodes can be replaced with intelligent tags that are easier to track and identify
- Location and status of caregivers so that one does not need to track down a nurse or doctor in case of emergency
The “Hospital Smart Room” was designed and developed by the RFID Healthcare Consortium supported by healthcare technology companies. Some of the applications that were shown include:
Intelligent or “smart” beds that provide continuous information about the bed status, such as if the wheels are locked and the rails are up to improve patient safety. The status can be accessed from a central nursing station or from any hand-held device. This monitoring is typically integrated with the nurse call system.
A bedside monitor has a passive RFID reader integrated into the system which detects the presence of all RFID tagged medical devices. The caregiver can be prompted to confirm or deny each device association to the patient, who has a RFID wristband. This same computer also has a barcode scanner to accept any bar-coded medication, or, if the patient wristband still contains a barcode instead of the new RFID chips.
Imagine that a patient has been found to carry an infectious disease, this system also knows all of the people and assets that are or have been in the same location as this patient to allow actions to be taken to control the spread of the disease. In addition, the system can ring a private buzzer if a provider forgot to wash his or her hands prior to approaching a patient.
Smart cabinets provide real-time inventory, similar to many retail stores that need to know exactly what size and how many jeans they have on the shelf. The lot and serial number, as well as, expiration date are also registered. When supplies are used, they are automatically assigned to the patient’s electronic health record and, if applicable, the patient’s bill. This fulfills key requirements for achieving patient safety by ensuring the right medication is given to the right patient at the right time.
RTLS tracking of assets such as wheel chairs, infusion pumps, defibrillators, would facilitate optimal use of such assets. Reporting on idle equipment alone could result in major savings. Texas Health in Dallas reported a savings of $30,000/month on rental equipment alone. Equipment status can also be reported in real-time, for example, an equipment malfunction can be reported through a pushbutton, which could cause automatic collection of the faulty device and replacement delivery.
The RFID/RTLS HIMSS showcase demonstrated that we can indeed apply innovations and experience from other industry segments to healthcare. The good news is that this technology is proven and available as RFID chips are now getting very affordable and are ubiquitous for retail applications. It is just a matter of adapting it to the specific workflow needs and requirements in healthcare. The showcase demonstrations showed that this definitely can be done.
Herman Oosterwijk, VP OTech Media, live from HIMSS2011