Monday
June 12, 2006
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| Tracking equipment is a difficult task that taxes both nurses’ time and materials management’s budget, especially when items are never found. RFID is an up-and-coming, technological solution for this issue, but simply implementing it won’t solve hospitals’ problems. Only when an organization fully understands its business processes can RFID be truly effective. Also, determining implementation costs, the type of tags to be used and how the system will run on the network are only a sampling of the necessary decisions to be made. |
The health care industry has begun to gradually explore radio frequency identification (RFID) technology for tracking critical medical equipment, patients, medications, lab specimens and other processes and products. But the adoption has been slowed by a number of factors ranging from the success of existing technologies to meet existing needs to a lack of clarity around RFID standards.
The slow response to RFID in health care may have much to do with the success of a tried-and-true technology—bar coding—for such patient safety applications as patient ID wristbands, unit-dose labeling in the pharmacy, specimen tracking and management in the laboratory, and automated medication administration and specimen collection at a patient’s bedside. Bar coding provides an established, efficient and economical means for capturing data that works well in many environments.
But the prospects for more RFID projects in health care seem a certainty. The FDA issued a recommendation last year suggesting pharmaceutical companies look at RFID to help prevent drug counterfeiting and reduce medical errors. As RFID takes hold in the pharmaceutical space, it also is spreading to other areas in the hospital such as materials management. In many respects, it can be argued that RFID represents the future of materials management in health care. Hospitals in Illinois, New Jersey, Massachusetts and Virginia, to name just a few, have implemented RFID solutions in materials management and found great savings and even greater efficiencies. There is a clear advantage to using RFID tags in departments where tracking supplies, beds, trays, plasma bags and thousands of other items remains a major challenge for health care institutions. As prices for RFID technology gradually decline, more health care organizations are likely to invest in it and see the kind of productivity gains early adopters have experienced. Frost & Sullivan, San Antonio, believes the health care market for RFID will more than double from $300 million this year to $658 million in 2007.
A greater use of information technology can reduce waste, fraud and redundancy. Government studies suggest strong IT investment could cut health care costs by 20 percent each year, and RFID can definitely contribute to these health care cost reductions. Why is RFID such an important technology advancement? The tags are wireless and hands-free. They can be reprogrammed, which allows users to add data to support specific processes and to decrease time for stocking, reordering and managing supplies. They also offer choice, coming in two varieties: Passive tags, which require proximity to a reader and are effective for tracking supplies; and active, battery-operated tags that allow continuous monitoring and serve as an ideal solution for tracking equipment, psychiatric patients, newborns and more.
While RFID readers need to be strategically located to read tagged materials, benefits include giving users instantaneous real-time data on the status of items being tracked. As a result, health care organizations can capture an entire pallet of products in the same time it takes to scan a bar code on a single box.
In a survey last year, the consulting firm, BearingPoint, McLean, Va., and the National Alliance For Health Information Technology, Chicago, identified a number of potential RFID applications, including tracking mobile assets such as infusion pumps and other equipment found in emergency rooms. The report suggests that RFID applications can save nursing and clinical engineering staff as much as a couple days each week, per staff member.
One example comes from a Feb. 13 online article of RFID Journal. By using RFID, a nurse may find an infusion pump two rooms away from a patient she is treating. Before RFID, she may have looked around her floor or called materials management to bring one, which would take several minutes, or more. RFID removed the need for materials management’s involvement, and the nurse has served the patient more rapidly.
This increased efficiency led more than 80 percent of corporate executives who responded to the survey to cite RFID as important aspect of their business strategies. The major barrier, as always, continues to be a lack of funding (57 percent) and the cost of the technology (46 percent). Additionally, more than half of the respondents want government and industry to agree on standards before they invest in RFID. While survey respondents cited patient safety as the No. 1 reason for interest in the technology, materials management departments stand to gain a great deal from RFID as well. Better managed inventories will lead to improved asset use, lower rental costs and reduced theft.
Misplaced assets, such as wheelchairs, can be instantly located with RFID. And, by having such a high degree of content available, materials management departments can reduce the time required to manage equipment inventory while also using the information to fine-tune future purchasing decisions. For example, a bar code will have a numbering system identifying a product, manufacturer and a unit of measure, as in “MedSupplyCo 2-inch sterile gauze.” An RFID tag could include the following content: “MedSupplyCo 2-inch sterile gauze, serial number 070767321, lot code ABC12345, use by May 15, 2007.” Such additional information in the realm of materials management can lead to more precise supply orders and more accurate delivery of appropriate materials to physicians and patients.
RFID has been implemented in several major hospitals around the country. Their experience shows how RFID can decrease inventory loss, increase time devoted to patients and improve the accuracy of instruments required for surgeries and other treatments. Among the best examples are:
For these early adopters, the savings and improved patient care far outweighed the cost of RFID installation and maintenance.
It is important to have a plan for joining the RFID evolution. Begin by studying the impact of the technology. Ask what problems RFID will solve. Will bar coding fulfill some or all of these needs more cost effectively? What measurable contributions can be made in terms of time savings, accuracy and safety? What operational efficiencies can be gained? What kind of improved decision-making would you ultimately like to see?
Next, gather allies. Identify possible constituents who would benefit from an RFID project. Look at the potential that exists in all departments, not just in materials management. Getting the support of top management is critical as is getting support from admitting, billing, laboratory and patient care areas; build a committee of supporters from these departments. Understanding your business processes is the key to future success. The materials management department should evaluate how materials are received, dispensed, counted and reordered. It should study the frequency of items out-of-stock. By studying each business process, the department can take the next step and determine how automating information through RFID would increase productivity and decrease downtime or supply shortages. By targeting how it can work in the materials management department, based on an analysis of business processes, it will become apparent how it could improve equipment and asset tracking, materials management, staff identification and charge capture.
At this stage of the research process, look at whether you want to use bar code technology, RFID or a combination of both. Many health care providers use a mixture, especially in the initial phase of pilot projects. There may be equipment that can be adequately tracked with passive tags, while equipment that is moved will probably require active tags.
The next step is to evaluate vendors. Look for companies with a background in RFID deployments in an environment like yours. Make certain the partners offer a measurable return on investment and will work with other products. RFID implementations require multiple components such as readers, printer/encoders and middleware, which must be integrated into a complete working solution. Note closely whether vendors have an upgradeable solution and an established quality assurance program.
Inquire if vendors have a familiarity with the evolving standards in RFID. EPCglobal Inc., Lawrenceville, N.J., a joint venture between GS1 (formerly EAN International) and GS1 US (formerly the Uniform Code Council, Inc.), is entrusted by the industry to establish global standards for RFID technologies. The organization has developed a “Class 1, Generation 2” protocol for supply chain and compliance initiatives. Generation 2 protocols are considered superior to past efforts and will allow greater interoperability among printers/ encoders, readers, tags and interrogators.
Industry experts believe Generation 1 protocols will stay in place at least until 2007, so organizations building their RFID infrastructures will want to buy multiprotocol equipment. Narrow the list of potential vendors and create a pilot implementation in a defined, limited area of materials management. After the trial period, look at the impact of new data on existing information systems and how RFID worked when teamed with existing materials management applications.
The final step is to initiate an aggressive training program to prepare your department for a more global RFID rollout. Train your staff on a different way of doing business—one that will lead to greater productivity.
A degree of caution should be involved in any decision to implement a relatively new technology. Standards developed for RFID are not as evolved as standards for bar coding. Standards are particularly important for supply chain applications where trading partners can share information by using RFID media to identify goods. However, a lack of clear standards is not a critical impediment for some closed-loop applications.
One example of this would be RFID asset tags on hospital equipment that are only read within a particular facility. Some organizations fear that the amount of information available through RFID will be too much of a good thing and overload their materials management departments with unnecessary and duplicate content. By working with an experienced RFID integrator, users can control the type of data they collect and how often they collect it.
Other challenges exist as well. Consumer groups and the American Civil Liberties Union, New York, have expressed fear over RFID’s surveillance ability; and the return on investment remains elusive.
One company, Radianse, Lawrence, Mass., suggests RFID costs between $500 and $2,000 per hospital bed. Though bar coding is ahead of RFID in terms of hospital use, less than 10 percent of hospitals deploy it for patient safety solutions—an area where both technologies should have the opportunity to flourish.
The 17th Annual HIMSS Leadership Survey showed that patient safety and medical error reduction are top priorities for hospitals. Both bar coding and RFID technology provide effective and proven ways for hospitals to achieve these goals.
Bar codes can be used to produce patient identification wristbands to ensure accurate patient ID, print labels for unit-of-use medications, conduct the five rights of bedside medication administration, print labels for specimen tracking and management and much more. RFID can be used for monitoring elderly and disoriented patients, tracking mothers and babies in the maternity wards or tagging surgical patients to ensure the right procedure is performed on the right person at the right time. RFID also is making inroads in health care via track-and-trace solutions, helping to ensure medications are legitimate and can be easily traced in the event of a recall.
Most likely, RFID will become part of a combined technology strategy that shares duties with bar coding and gradually becomes a larger part of the health care landscape over the next four to six years. Hospitals using bar coding will continue to reap the benefits of the technology, favoring RFID for applications such as asset and inventory management, where the potential for return on investment is the greatest. In either case, the key to success is using technology in a way that complements each organization’s unique business processes and objectives.
Debbie Murphy is the global practice leader, life sciences, at Zebra Technologies, Vernon Hills, Ill.