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PRESIDENT’S
CORNER
IN THIS ISSUE RFID
in
Healthcare
Consortium
The past three months have demonstrated great growth in the
Letter from the president RFID in Healthcare Consortium as we continue to strive in our efforts
RFID in healthcare consortium.............P.1 to raise awareness and research into the deployment of wireless
technologies in healthcare. Our partnership with RFID Journal Live in
Letter from the editor...........................P.2 April 2010 was widely attended and has helped build the foundation for
a forum in which industry leaders, innovators, and healthcare
professionals can come together and discuss the potential uses and
The missing key “a killer app” Part I.....P.3
benefits of these technologies while bridging the gap in understanding
the unique needs and challenges of the healthcare environment. Over
Integration of RFID Positional Information the ensuing year, we will seek to further build on these successes as we
with Clinical Device Data....................P.4 partner with the Healthcare Information and Management System
Society (HIMSS) at the upcoming 2011 national conference and further
Book Review: The Checklist Manifesto by engage with our international partners in identifying new educational
Atul Gawande....................................P.6 and research opportunities to support our common mission.
Improving knowledge in the area of RFID, RTLS and wireless
Which Asset Tracking System Guarantees communications amongst healthcare professionals has and will
Hospitals Superior ROI?......................P.7 continue to allow for improvements in our ability to integrate new
technologies into the clinical setting and to offer the advantages in
RFID Efficiency throughout Pharmaceutical safety, efficiency, and cost-effectiveness that these technologies have
Manufacturing....................................P.8 provided in other industries. However, success will require engagement
of not just business and thought leaders, but the continued education
Supplementing Fall Prevention Tools with a of the end user. Our ultimate goal is to identify the potential of
Falls Detection System.......................P.10 technology to improve the healthcare landscape, with the hope that
systematic adoption will improve processes and the ability of the
clinician to focus on safe and effective patient-centred care.
Integrating RFID in Hospitals as Part of the
Healthcare Chain..............................P.11 We are excited as the RFID in Healthcare Consortium attracts
many new and energetic members. Through a group of individuals with
References........................................P.12 a wide variety of expertise and backgrounds, the RFID in healthcare
consortium continues to stand at a crossroads where we are able to
uniquely respond to the challenges that exist with the adoption and
integration of new technology into healthcare systems. While more
institutions than ever are adopting wireless methods of caring for
patients both at home and in the hospital, adoption is inconsistent
across systems and the economic realities are often difficult to assess.
R F W A V E S! ! 1
These issues arise from both a dearth of systematic healthcare communities may freely contribute, interface,
research into the field and of awareness on the part of discuss, and debate the issues that we face. Over the
the end user about the potential these ensuing months, through a number of
technologies hold. Furthermore, concerns activities, including surveys,
remain regarding issues ranging from newsletters, and live sessions, we will
electromagnetic interference with existing « Our ultimate goal is seek to build the discussion to foster a
healthcare technology to the costs of greater tomorrow in healthcare.
to identify the
deployment of these wireless systems. However, none of this will be possible
These issues are real and require open potential for without the continued support of our
forums amongst all of us to properly technology ... improve colleagues, members, and
engage in discussion if we hope to realize collaborators. Thus, we look forward to
the future that these technologies would processes and the finding new avenues in which to work
appear to offer. ability of the clinician with you toward these common goals.
With these successes and persisting to focus on safe and Thank you for your continued support
issues in mind, we look forward to your effective patient- and interest. ∞
support as we continue to build the
Consortium into a forum in which all centred care...» Suraj Kapta, MD
members of the RFID, RTLS, wireless and
R F W A V E S! ! 2
The
missing
key
“a
killer
app”
Part
I was a runaway success, which was later transplanted
with Lotus 1-2-3. It was such a useful tool but only
by Mayank Trivedi
available on Apple and PCs. My job in those days as a
I became interested in RFID/RTLS systems a few systems programmer on IBM mainframe required me to
years ago. My 20+ years of experience running process tons of performance data from dozens of
healthcare software companies gave me instant vision of mainframes everyday. Being frustrated by the limitation
the benefits attainable through the integration of this of Lotus 1-2-3, I wrote a version for the mainframe for
technology, including improved patient safety, workflow my personal use.
efficiencies, asset and specimen tracking, etc. I got to
The spreadsheet and then the word processor
know the industry from a dizzying array of acronyms,
sealed the fate of the personal computer as the staple
buzz words and technologies. We have 1D barcode, 2D
for businesses. Individual users though, still had very
Data Matrix, passive RFID, LF, HF, UWB, battery
little to justify the expense and the learning curve
assisted tags, IR-RF, Ultra Sound-RF, Dual RF, WiFi and
(VisiCalc not withstanding). But the Internet changed all
the list goes on. There are rumors of nano technology
that. The proliferation of the Internet finally raised the
with nano antennas, nano-batteries and nano-tags.
stature of the PC itself as the essential hardware for this
Further, there are temperature sensors, cryogenic
killer app.
sensors, vibration sensors, motion sensors, light
sensors, tamper resistant tags, tags the size of buttons The Internet and Email was invented in the 1970’s,
for laundry, paper-thin tags and embedded tags. however, it was not publicly available. Even after it
Definitively, there is a large array of choices and became accessible to the general public, most people
possibilities. had no use for it or did not know about it. Then came a
killer app. Not just a killer app, but also an enabler of
But with so many smart people trying for so long,
humongous proportions—the web browser. The browser
why has RFID not become a staple of healthcare
was invented in 1994 and made the Internet a must-
industry like barcode is today? Sure, there are early
have. The Internet spread across the globe like a wild
adopters who have had their successes and case
fire. I remember driving through a farm valley outside of
studies. But why is it not an industry essential today?
Bratislava, capital of newly free ex-Soviet bloc country of
Slovakia in 1996, and seeing billboards advertising the
TECHNOLOGY ADOPTION
Internet.
This industry seems to be taking a typical
So what does this mean for RFID? Why has RFID
technology evolutionary path. All technology from TV,
not become a ‘must-have’ for every hospital despite
Computers, Cell phone, GPS and Internet itself have
taken a similar path. Each was an invention that decades of innovation and successes in other
struggled until two things happened: The technology industries? Where is this industry on this well-defined
had to get mature enough to be reliable, and had to path that every technology takes to mass market?
deliver solutions to the end users. The final key to the
puzzle is a killer app! RFID HARDWARE / RTLS
Computers were around for decades or more, yet There is a dizzying array of incompatible
largely unknown to the masses. The computer industry technologies available today, and nanotechnology holds
exploded with the home computer revolution, a great promise in the near future. The hardware
revolution where everyone would possess and use a technology has matured, but has way to go before a
computer. The two machines that almost ignited such a single set of standard emerges a winner - ala the famous
revolution were the IBM-PC (1981) and the Apple VHS vs. Betamax battle (Blue Ray vs HD-DVD in recent
Macintosh (1984). The problem was the lack of any days).
killer apps. The industry kept harping that the
machines were very useful; everyone could use them. Hospitals consist of complex environments, which
With functions from storing recipes to storing bank need multiple types of RFID technology. For instance,
balances. Never mind that the recipes are better stored for patients and high value assets like medical devices,
on a notebook and bank balances noted on the ledger. we need active tags. For inventory management we
need lower cost passive tags. We need temperature
Arguably, the earliest killer app was a program sensors, cryogenic tags, laundry tags, paper thin tags,
called “VisiCalc” (1979). VisiCalc was the first tamper detection tags for fixed assets, and we need all
spreadsheet, before even anyone used the word this to work without emitting EMI that can interfere
spreadsheet. In fact, the phrase killer app itself was with medical equipment or patient’s heart pacemakers.
coined in retrospect from the success of VisiCalc. The Moreover, I do not yet see the event horizon when
concept was simple in hindsight; the program opens a barcode technology will vanish from use.
screen containing rows and columns of cell, much like a
rather large ledger. INDUSTRY LANDSCAPE
VisiCalc revolutionized the business planning and
finance arena. Complex financial calculations that took Today no single vendor provides all these solutions.
hours to work out could be done in matter of minutes. It There is no one stop shopping for your entire RFID
R F W A V E S! ! 3
infrastructure needs like there is for computers (Dell, on, primarily from RFID hardware vendors. Hospitals
HP etc). The computer industry matured, and went from who have implemented these systems with success are
dozens of computer makers with competing offerings now looking beyond the basics. What else can I do with
that did not inter-operate well, to just a few this location data?
companies that manufacture everything from
What is your killer app? What will
desktops, laptops, tablets, servers, networking
make you say, “I need this!”? Is it
equip men t, as well as p rin ters. T h is « What is your killer asset tracking, patient safety or
consolidation happened in response to the
app? What will make something else? Or is it all of those
end users need for standardized hardware
you say, “I need on a single system? This is a
from a single vendor. I believe that RFID will
groundbreaking time for our
go through the same path and eventually will this!”?... what will industry, and I can't wait to see
evolve to where all these types of tags are
emerge as our "killer what will emerge as our "killer app"
inter-operable and available from the same
app" launching RFID launching RFID as a "must have"
vendor.
category for healthcare. Obviously
as a "must have" there is lot more in applications but
Like PC, RFID/R TLS is an enabling
technology. It is not a solution and like a PC category for that is for the next column. I
or iPhone, it will become a "must have tool" welcome your responses to this
only when there are one or more killer apps critical question. ∞
that customer cannot live without.
APPLICATION SOFTWARE About
the
author:
Mr.
Trivedi
is
a
22-years
veteran
of
healthcare
IT
with
keen
interest
in
bridging
leading
edge
technology
and
The simple answer is that there is no ‘killer app’ healthcare.
He
is
Chief
Executive
OfAicer
of
Indralok
Healthcare
yet. Asset tracking is the darling of every vendor and it Systems,
which
provides
hardware
independent
enterprise-class
has given foothold in the market. But there is larger location-aware
software
solutions
to
improve
operational
promise of RFID technology, which is not yet realized or efAiciency,
workAlow
automation
and
patient
safety.
Before
delivered. It is not yet clear whether there is a single founding
Indralok,
Mr.
Trivedi
was
Founder/Chief
Executive
OfAicer
killer app like VisiCalc or whether a critical mass of of
Sysware
Healthcare
Systems,
a
leading
provider
of
laboratory
applications like the Apple iPhone's App-store will be the information
systems.
Under
his
leadership,
Sysware
grew
in
to
a
key. multinational
company
with
over
150
employees
in
3
countries
End user experience by far has been with single and
was
acquired
by
Eclipsys.
application like asset tracking, patient tracking and so
Integration
of
RFID
Positional
Information
with
nursing operations and materials management and
Clinical
Device
Data
increases the potential for increased costs via redundant
equipment purchases and/or leases. RFID systems can
by Paul Booth, MS, and Paul Frisch, PhD provide real time location information for devices and
Using RFID to provide location information alone help with this process. While knowing the location of
does not maximize the potential advantages that RTLS specific asset types is good, knowing the use status of
systems can provide to clinical applications in a the asset alongside the location is ideal. As the infusion
healthcare institution. Many times it is the integration pumps talk to their host server via the hospitals wireless
of location information with relevant data from other infrastructure and provide a wealth of information
clinical systems that provide the caregiver with more relevant to the operations and status of individual
efficient and potentially safer methodologies in providing pumps, the required status information can be
patient care. In our institution, one such example of extracted from the server and incorporated with location
this integration is in combining data from our smart information from the RTLS system. Through the
infusion pumps with real time location information for automated combination of the data from the two
nursing, patient safety, materials management, systems, in this case location data and infusion pump
financial, and clinical engineering applications. “in use” data, the information is presented in real time
on a singular display to facilitate optimized location of
NURSING APPLICATIONS the nearest available infusion pump.
R F W A V E S! ! 4
These formularies are updated on a regular basis and for the device in the first place and there was no
it is critical from a patient safety perspective to ensure guarantee that the subsequent attempt to locate the
that every pump is operating on the latest formulary device later on would in fact be successful. Through
version. The process by which the pumps acquire the combining the data, the devices that require PM can
formulary and subsequently are activated is both an now be prioritized based on their real time use status
automated and a manual process. The formulary is and their respective locations. This system allows the
automatically sent to the individual pumps via the technician to more effectively manage their time as well
wireless network and receipt of the download is as to address the important patient safety component of
verified and recorded. To then activate the downloaded their operation of ensuring that the pumps are all
formulary, the pump needs to have its power serviced within their required PM interval.
manually cycled and only then is the process
completed. While the process is straightforward, with CONCLUSION
a large pump distribution over a medical campus, it is
a challenge to identify all of the pumps that need to be RTLS systems alone provide valuable information
cycled and then to locate the ones that have been to clinicians and supporting personnel regarding the
missed. To accomplish this goal, the formulary location of equipment. To effectively maximize the
information, stored in the infusion pump server, is effectiveness of this information and to truly enable
combined with location information from RFID to personnel to maximize their process efficiency, this
provide a listing and location of pumps that have information must be augmented with supporting data
either not been uploaded with the current dataset or from the individual devices that are being located. As
have not be recycled to activate the current dataset. we have seen, only when we have the right tools that
Only with this combined information can the enable us to go beyond the boundaries of current
questionable pumps be accurately and timely located processes can we look for new ways to improve
to insure uniformity of the formulary across the operations and maximize our quality of patient care.
institution. Combining Location with device specific data is one of
those enabling tools. ∞
MATERIALS MANAGEMENT AND FINANCE
About
the
author:
Paul
Booth
is
currently
the
Section
Head
of
the
Equipment pur chases and distribution is Biomedical
Systems
group
of
Biomedical
Physics
&
Engineering
at
constantly a challenge, with the administration trying to Memorial
Sloan-Kettering
Cancer
Center.
Paul
Booth
has
Masters
find the optimal balance between purchasing or leasing Degrees
in
Computer
Science
and
Electrical
Engineering
from
the
the minimum number of devices while ensuring that the Stevens
Institute
of
Technology,
a
Masters
Degree
in
Finance
from
clinical needs of the institution are met by always Texas
Tech
University,
and
a
Bachelors
Degree
in
Electrical
having equipment available. Through the integration of Engineering
from
Bucknell
University.
He
is
currently
working
location information and use statistics, a more complete towards
his
PhD
in
Technology
Management
from
the
Stevens
picture of the equipment distribution, use patterns, and Institute
of
Technology.
His
speciAic
areas
of
research
include
utilization statistics can be taken. While overall use microprocessor
design,
display
integration,
robotics,
and
RTLS
statistics can be identified from the pump server alone, methodologies.
when we combine this information with location, we can
break down the utilization profile down to the unit level. Paul
Frisch
is
currently
an
Assistant
Attending
and
Clinical
This process allows us to identify bottlenecks in the Member
in
the
Department
of
Medical
Physics
and
Chief
of
system and more effectively distribute resources Biomedical
Physics
&
Engineering
at
Memorial
Sloan-Kettering
throughout the institution. Specific areas can be Cancer
Center.
In
addition
he
has
an
appointment
as
Visiting
identified and targeted to optimize the process of Assistant
Professor
in
the
Department
of
Bioengineering
at
the
redistributing the pumps to needed areas. From a State
University
of
New
York
at
Binghamton.
Paul
Frisch
has
a
financial perspective, we are now able to examine use Doctoral
degree
in
Biomedical
Engineering
from
the
State
statistics throughout the day, week, or year to get an University
of
New
York
at
Binghamton
and
Masters
and
Bachelors
accurate assessment of number of pumps required to degrees
in
Electrical
Engineering
from
the
State
University
of
New
satisfy the clinical needs of the institution. York
at
Stony
Brook.
He
currently
serves
on
the
technical
advisory
boards
of
CISCO,
Philips
Medical
Systems,
Health
Systems
Solutions
CLINICAL ENGINEERING and
acts
as
the
Chief
Technical
OfAicer
for
the
RFID
Consortium.
He
has
published
more
than
35
reviewed
publications
and
several
Clinical Engineering operations can be streamlined
book
chapters.
His
speciAic
areas
of
research
include
through combining information from individual
electromagnetic
Aield
induced
gene
expression,
robotic
surgery,
systems. When devices are due for PM, they can now be
and
clinical
applications
of
wireless
technology.
Previous
effectively located anywhere in the system through
experiences
include
research
in
human
biodynamics
investigating
RFID. This information alone however tells the
human
response
to
transitory
acceleration,
such
as
crash-impact
technician nothing about the status of the device.
and
aircraft
ejection
and
robotic
applications
in
pharmaceutical
Historically, many devices due for PM have been located
development.
only to find the device in use and unable to have the PM
performed at that time. Wasted time was spent looking
R F W A V E S! ! 5
Book
Review:
The
Checklist
Manifesto
by
Atul
Gawande
By Emily Sopensky, co-founder RFID in Healthcare
Consortium
The kitchen is the heart of the home. At least it
was when I was growing up. Before I was old enough to
ride a bicycle, I was already reaching for the measuring
spoons and sifting the flour. Then, when out of college,
working and living in a one-bedroom with a kitchen the
size of a postage stamp, I served gourmet meals to
friends. (Only the best of friends were invited for the
handpressed duck citroen, a two-day labor of love.)
Judging from the cookbooks that line my
bookshelves, you might appreciate how much I enjoy
cooking. You would be half right. I enjoy the adventure
of cooking; I enjoy finding a good recipe. I enjoy
anticipating the first taste as the food is cooking. I enjoy
proof that the recipe works.
However, I’d rather not follow the recipe slavishly.
After years of practice and experimentation, I am
comfortable modifying a recipe on the fly. Rarely, does
the cook go wrong.
<Ok. Maybe some experiments are trashcan
doomed. But I confess, my experiments are solely self-
inflicted. When I do cook for more than one, the balance “freedom and discipline, craft and protocol,
cookbook is open.> specialized ability and group collaboration.” While
following a recipe slavishly is not interesting to most,
My fascination with controlling fate in the kitchen saving lives is.
is matched only by my interest for Atul Gawande’s best-
selling, brilliantly focused treatise on checklists. Yes, A prolific and well-respected surgeon with
that’s right. Checklists. Harvard’s Brigham and Women’s Hospital, Dr.
Gawande’s credentials embrace the academic, surgical,
Dr. Gwande’s short book relates his exploration of public health and journalistic worlds. He is on the staff
a simple proposition in medically saving lives: We have of The New Yorker and an associate professor at
an abundance of information but, as he writes in his Harvard Medical School and the Harvard School of
book, “the volume and complexity of what we know has Public Health. He is the director of the World Health
exceeded our individual ability to deliver its benefits Organization’s Global Challenge for Safer Surgical Care.
correctly, safely, or reliably. Knowledge has both saved As recent as April 15, 2010, the THE CHECKLIST
us and burdened us.” For example, the World Health MANIFESTO: How to Get Things Right (Metropolitan
Organization classifies more than 13,000 different Books; January 4, 2010, was sixteen on the New York
diseases and symptoms, and gives procedures for Times Bestseller Hardcover Nonfiction list. That’s pretty
dealing with them. According to Gawande, research has amazing for any how-to book written by and for
consistently demonstrated that nearly half of the annual surgeons. (It dropped to 28 by the end of April.) His last
150, 000 deaths following surgery are avoidable. book, BETTER: A Surgeon’s Notes on Performance, was a
Technology in the surgical suite adds another New York Times bestseller and one of Amazon.com's ten
dimension of complexity. best books of 2007.
Recognized as an expert in patient safety, Gwande Despite Dr. Gawande’s star status, his research,
was tapped by the World Health Organization to lead a initiative and experiments with checklists were
global project to find ways to reduce deaths in surgery. rewarded only after following protocol experiments with
Because many of the avoidable deaths occur because of adequate trials, (Trial sites included Tanzania, Delhi,
miscommunications among the surgical team, Gwande and New Zealand.) but the WHO now has a basic
focused on methods to ensure better communication checklist for operating theaters that is accepted by most
among team members. The checklist was a natural who have worked with it.
solution. But in such simplicity lies complexity.
Researching checklists that work, Gwande visited For anyone who has worked with RFID systems, it
airplane manufacturers and construction sites, learning is easy to see the value of a workable checklist. RFID
that there good checklists, like that in the cockpit are a systems require sophisticated knowledge of engineering,
melding of science and high art. He learned that physics, psychology (people and how they interact and
checklists must allow for people to learn and adapt; to use a system). Underestimating the value of good
planning can wreak havoc on a company’s net profit.
R F W A V E S! ! 6
As with any complex system, investing in a good principal, Leo Rohlinger, writes in the next issue of RF
systems integrator is paramount in ensuring that an Waves. See his checklist of what makes a good client.
RFID system works well and is reliable. Many successful
RFID systems integrators often find themselves
educating their clients, to the point that the cost of such About
the
Author:
Emily
Sopensky
is
co-founder
of
the
RFID
on the spot education is embedded in the way they Healthcare
Consortium.
Emily
began
her
involvement
with
radio
work. Understanding the technology and the systems, frequency
identiAication
in
1996
with
Texas
Instruments
(Dallas,
learning how to be a well-informed, engaged client is Texas).
As
an
active
member
of
IEEE
and
board
member
of
IEEE-
only good business for both the client and integrator. USA,
she
chaired
the
Airst
two
international
IEEE
technical
conferences
on
RFID.
Currently,
she
is
intrigued
by
the
complex
Kitchens vary in design, utility, and personality, as issues
regarding
the
use
of
wireless
devices,
including
RFID,
in
do RFID systems. Let a successful systems integrator health
care
delivery.
give you a recipe for your installations success. InCode
R F W A V E S! ! 7
Entire Room Inventory System
by Gary Andrechak and Jeffrey Johnson Most people in the RFID technology space will
readily identify some of the earliest implementation
RFID is a powerful traceability technology, that successes for RFID technology in manufacturing control
when carefully and properly implemented, greatly and automation. RFID tags are instrumental in better
assists in managing healthcare related assets. The need managing and automating complex manufacturing
to track infusion pumps, wheelchairs, consignment processes, from automotive bumper painting booths to
inventories of surgical tools and implants, and even computer hard disc drive assembly. Pharmaceutical
newborn babies has fostered innovative, practical uses manufacturing is similarly process-complex and also is
for RFID. In hospital pharmacies, RFID applications subject to recordkeeping requirements imposed by FDA
have improved patient safety by verifying the correct regulatory compliance. Pharmaceutical and medical
drug is being administered to the correct patient at the device manufacturers are now realizing the same
correct dosing schedule. Pharmaceutical companies benefits that RFID brought to traditional
have elevated visibility and traceability of prescription manufacturing.
drugs with RFID integrated packaging, lessening the
R F W A V E S! ! 8
In phar ma and biophar ma manufacturing the contents, movement from one process to the next,
automation, RFID’s greatest strength is its ability to and other manufacturing data can be recorded onto the
monitor all process equipment involved with a RFID tag traveling with the bag or other vessel. After
particular batch of product from start to finish. When the production process is complete, the tag data is
every process equipment item and raw material downloaded off the tag into a database for permanent
compound that touches a particular production batch storage and retrieval.
bears its own uniquely coded RFID tag, the production
Some industry insiders may comment that the
batch can be near faultlessly documented--
same unique identification process can be implemented
electronically. RFID tags easily attach to components
equally as effectively with barcodes, eliminating the
such as sample and production bags, tanks, storage
added cost of RFID tags. The main benefit of RFID over
vessels, filters, manifolds, container closures, tubing
barcode in the production environment is ease of use,
and hose, and complete single-use systems.
which leads to better user compliance and time
RFID reduces reliance on handwritten logbooks, efficiency. Also, barcode readers must be visually
leading to a reduction in transcription errors and aligned with the barcodes. In some cases, the alignment
illegible records. It delivers a much more precise audit is not always practical or fast. Barcodes have a limited
trail that can be queried in a fraction of the time it takes number of characters compared to some RFID tags
to retrieve data from handwritten logbooks. Those same which hold kilobytes of writable data. Write-ability is
RFID tags perform a second duty by tracking usage and the key to enabling electronic stamping of events into
cleaning cycles of the various production items to the RIFD tagged item during the life of the product. It
ensure timely maintenance and replacement before provides an on-board traveling history for the item.
parts begin to fail, risking product integrity and labor. RFID tags have the ability to secure this data as most
common air protocols such as ISO 15693 have
If a question or concer n about a specific
permanent data lock commands. Today, RFID tags can
production batch should arise, the electronic records for
survive sterilization processes such as autoclaving, EtO,
that batch can quickly generate a list of all materials
VHP, gamma and e-beam, as well as other harsh
and process equipment items that touched the
environmental factors as required.
production batch under review. Production batch data
can be linked to filling and packaging data of the final Although we are at the early stages of RFID
drug product to provide complete traceability in the enabled process control, suppliers to the
event of a recall. pharmaceutical manufacturing community are already
leading the way to establishing basic data structure and
Realizing the power of positive item identification,
core standards for pharma-use RFID tags. IT systems
some suppliers of critical manufacturing components
and software are evolving to manage multiple types of
are providing pre-RFID-tagged versions of their
RFID tag frequencies and protocols. Data interchange
components to the pharma industry. The RFID tag on
between tags and software is becoming more and more
the item arrives at the customer site with relevant item
transparent. No matter what tags are applied to items,
details such as part number, lot number, manufacture
systems can accommodate for their differences and
date, expiration date, as well as key information for the
make sense of the data the tags contain, creating
supplier, should the item be returned to the supplier for
harmonized databases and production records. ∞
any reason. This supplier data typically includes
manufacture plant, assembly operators involved, and About
the
author:
Gary
Andrechak
is
the
Leader
of
Auto-ID
the equipment used in the part’s manufacture, Solutions
Business
Development
for
NewAge
Industries/
essentially providing an even deeper layer of vendor AdvantaPure.
Gary
has
been
in
the
RFID
industry
for
10
years
traceability. The RFID tag permits all parties to gain including
over
5
years
as
RFID
Product
Manager
at
Hitachi
rapid access to part details such certificates of America,
Ltd.
before
joining
NewAge
Industries.
Gary’s
prior
compliance, validation documentation, approved prints, positions
in
auto-ID
include
client
service
and
marketing
with
etc. Moreover, existing ERP, BES, and MES software can Towne-Oller/Information
Resources,
Inc.,
a
syndicated
retail
sales
manage process equipment items by utilizing the pre- tracking
information
service
for
the
consumer
packaged
goods
attached RFID tag data. industry
built
on
store-level,
item
UPC
scanner
data
combined
with
warehouse
shipment
data.
Single use disposable systems, especially those
used in biopharma manufacturing are shipped today
with pre-attached large memory RFID tags that can Jeffrey
Johnson
is
the
Director
of
Software
Solutions
at
NewAge
store production batch data on the tag for improved Industries/AdvantaPure
where
he
manages
the
development,
lifecycle analysis. For instance, production facilities can installation
and
support
of
the
company’s
RFID-based
products.
optimize system utilization, supply chain and Jeff
is
an
RFID+
certiAied
developer
for
the
Hose
Track™
and
P*E*T
maintenance with the addition of RFID tags on single Process
Equipment
Tracking™
software.
use disposable vessels. Ingredients added to a
bioreactor bag, tests and measurements conducted on
R F W A V E S! ! 8
Supplementing
Fall
Prevention
Tools
with
a
Falls
corner of the lab). Ten trials each of three positions
Detection
System (standing, sitting in a wheelchair, laying in a bed) by
subject (mannequin/human) were examined and
by Mary Elizabeth (Libbey) Bowen, Ph.D. Receiver Operating Curves were used to analyze the
At the HSR&D/RR&D Center of Excellence (COE) sensitivity and specificity of the tool. Kappa values were
in Tampa, FL, which includes a translational research calculated to determine the inter -rater reliability
center (the Patient-Safety Center of Inquiry), Dr. Bowen between the tool and the observed fall. For example,
is interested in using real-time locating RTLS significantly detected 94% of falls
systems (RTLS) to detect falls in the from a bed and was 88.5% more likely to
Veterans Health Administration (VHA). provide a false positive (detect a fall when
R TLS is a passive unobtrusive radio it did not occur) than a false negative
frequency system that can be used to (miss a fall that occurred). Results were
monitor many patients at once, recording similar across positions and subject. The
their location and movement over time.1 next phase of this research will test the
This is accomplished with sensors (placed ability of RTLS to detect falls in a clinical
throughout the room/facility) and RTLS setting. The author has received funding
tags embedded in wristbands and worn by from the National Center for Patient-Safety
the patient. This article briefly discusses to continue this exploratory research in
the feasibility of RTLS as a fall detection the JAHVH Community Living Center. The
system. Contact the author for additional author is also involved in a falls detection
information on this system. project ongoing in a polytrauma unit of
the JAHVH.
Background
Implications
Falls are the most frequently reported
adverse event in the VHA with an The VHA prioritizes fall prevention;5 fall
estimated 10% of residents in VHA nursing prevention tools (e.g., hip pads) have been
facilities experiencing a fall. It is likely
2 shown to effectively reduce the risk for
that this is an underestimate of the actual injurious falls.6 RTLS would supplement
number of falls; some non-injurious falls these tools. For example, when properly
may go unreported. Non-injurious falls are integrated into an alarm system, RTLS
important because they may indicate a may be used to alert staff, reduce fall
change in the cognitive/functional status response time, and injury severity.
of the patient or an underlying Example wristband Because RTLS also records the time and
vulnerability that should be addressed. In location of a fall, RTLS may be used to
embedded with identify when/where a fall is most likely to
the VHA, long-term care residents are
RTLS tag occur, helping to identify environmental
given a fall risk assessment on admission.
If found to be at risk for a fall, staff use a (e.g. obstacles) and other factors (e.g.
variety of market products including hip periods of low staffing) that increase fall
protectors, fall mats, and fall alarms (on wheelchairs) to risk. RTLS may also be used to track
ensure the safety of the resident and alert staff of an changes in fall rates over time and determine whether
adverse event. Despite these efforts, reducing falls and fall prevention tools and policies are effectively reducing
injuries due to falls continues to be a top priority the rate of falls by facility. ∞
throughout the VHA. Falls are associated with hip
fractures, head injuries, and mortality. Older adults About
the
Author
Mary
Elizabeth
(Libbey)
Bowen,
PhD
is
an
who fall undetected or have long response times OfAice
of
Academic
Affairs
Patient-Safety
Research
Fellow
at
the
experience more severe injury, have higher healthcare HSR&D/RR&D
Center
of
Excellence
in
Tampa,
FL.
Dr.
Bowen
is
a
costs, and are at an increased risk for death. Older men social
gerontologist
with
interests
in
population
health,
aging
and
have higher fall-related mortality than older women. the
life
course,
longitudinal
research,
and
innovative
technologies
This is particularly important here as older men are the in
healthcare.
She
received
her
PhD
from
Virginia
Polytechnic
majority of residents in nursing facilities in the VHA.3-4 Institute
and
State
University
(Virginia
Tech)
in
2006
and
her
dissertation
was
funded,
in
part,
by
a
national
award
from
the
American
Association
for
Retired
Persons.
Dr.
Bowen
came
to
the
Current Work
VA
after
a
3-year
(2006-2009)
NIH
funded
postdoc
at
the
Institute
In this research, approved by the Internal Review of
Gerontology
at
Wayne
State
University.
There
she
analyzed
Board at the University of South Florida, Tampa, FL and various
mental
and
physical
health
outcomes
using
nationally
the VA Research and Development office, the author representative
data.
She
has
published
on
the
relationship
and COE colleagues fitted RTLS tags embedded in between
depression
and
cognitive
decline
in
later
life,
childhood
wristbands (Figure 1) to a mannequin and a healthy conditions
and
adult
disease
and
disability,
and
racial/ethnic
human subject in the lab. The exact location of the fall differences
in
the
use
of
health
care
services.
At
the
VA,
Dr.
Bowen
was determined by comparing coordinates to a known focuses
largely
on
the
relationship
between
wandering
and
fixed location (e.g. from the 4 sensors mounted in each changes
in
functional
status
over
time.
R F W A V E S! ! 9
Integrating
RFID
in
Hospitals
as
Part
of
the
Healthcare
Chain Technology is advancing quickly
Key
to
reducing
the
risk
of
using
wrong
pharmaceutical
The introduction of microchips in our lives
represents an opportunity and a challenge. It is an
treatment
opportunity because it allows improving the
by Mikos (Michael) N. Pesmatzoglou effectiveness and efficiency of several daily activities,
Healthcare organizations within the international however, using this technology in order to capitalize its
community are facing various challenges in order to usage is very challenging.
deliver quality care to all its citizens, at an affordable RFID systems belong to the emerging technologies
cost. The ageing society, the relentlessly rising cost of area. Using RFID tags (e.g. active and passive),
medical operations, the demand for better health installing tracking and scanning systems at specific
treatments, the increased pressure to reduce places (antenna and readers), and integrating the
expenditures and cut applicable costs through the appropriate software solution permits to retrieve and
whole chain of operations are some of the factors send several pieces of information that will assist the
influencing the daily operations of healthcare business at all levels. In the health care area, systems
institutions. We must understand that healthcare which will immediately provide details on patients
spending is very significant, standing at an 8.5% level of condition without the need of tedious procedures,
the GDP on a European average, whereas the tendency facilitate the secure monitoring of medical
is to keep on the rising. This is certainly something that transportations (e.g. blood and medicines at specific
must be treated carefully. temperatures, etc), allow a real-time tracking of medical
Further, these factors are driving the financial records, placenta and DNA specimens information for
pharmaceutical environment to find the best possible future usage, patients and clinical staff, as well as
solutions, quality and cost wise, to cope with these monitor the correct treatment and the appropriate
issues. Information and communication technologies usage of pharmaceutical products (per patient and per
(ICT) practices are able to play a key role to tackle these bed), etc. give certainly a positive pace to our lives.
issues since they seem to have the potential to provide
the necessary solutions and improve the existing
situation. However, ef ficient and ef fective ICT RFID technology is certainly a part of the ICT
applications have to combine both sides: the pharma applications in Hospitals
environment and its participants, as well as the
Real time visibility of pharmaceuticals can be
patients. Some of the main target applications in this
achieved by placing suitable and effective (according to
sector will be to improve illness prevention and safety of
the type drug and drug-package) RFID tags on each
care. For instance, by using remote medical care and
individual item. Through GPRS, Internet, and WiFi
remote diagnostic systems to monitor patients not only
connections any information contained in the RFID
inside the hospital, but when the patient is at home as
tag's memory or stored in a database where the ID of
well, it will be possible to boost the effectiveness of the
the tag is being held could be accessed. For instance,
medical treatments and increase their success. Through
the information retrieved can be matched either to
the usage of specific applications at hospitals we can
patients’ historical data, or to doctor's prescriptions. At
reduce the occurrence of medical errors resulting from
the same time, all information can be disseminated to
wrong medical treatments, enhance medical devices
anywhere is required, including hospitals, doctor’s PDA
monitoring management as they are move inside the
or Laptop, pharmaceutical companies, National Health
hospital, or offer patients a quick response and reliable
system, insurance companies, ministry of Health, etc.
service.
In general, the main objectives of integrating ICT Within the context of a hospital, patients could be
practices to the pharmaceutical chain will be to: furnished with a RFID tag (e.g. RFID bracelet) as they
enter the hospital. The tag can be updated either by
• Increase patient safety programming its memory or via the server's database.
• Reduce Adverse Drug Events as much as Scanners or readers (fixed or handhelds) will recognized
possible the tags and capture data contained in the tags in order
• Provide continuous and more personalized
to have real time information on medication reactions,
healthcare solutions
• Save lives and resources by focusing on as well as treatment and historical data. This
prevention and prediction rather than on costly i n f o r m a t i o n c a n b e u s e d w o r l d w i d e f r o m
medical interventions after symptoms and authorized participants so a patient can be treated
diseases have developed according to his historical data when ever and
• Improve productivity of healthcare systems wherever there is a need.
• Promote leadership of the e-Health and medical
imaging/devices industry It is evident that the correct usage and matching of
• Facilitate international cooperation between information related to prescriptions will assist the
health care authorities, hospitals and environment to avoid the usage of unwanted medicines
pharmaceutical companies. or treatment, while updating statistical and informative
R F W A V E S! ! 8
data. Interoperability to the patient's health benefit will lead us.
be the ultimate target.
The world we live in and where we operate as
RFID technology is being strongly promoted managers or scholars, etc, as well as the tasks and
especially by USA and EU, during the last few years. opportunities that we are called to face, permit us to
Through RFID the costing systems can be improved derive the optimum solutions on a daily basis. Although
dramatically too. If we integrate RFID for in some cases acting deterministically, we are compelled
pharmaceutical products monitoring, then we can to trace a solution based on heuristic patterns,
expedite the time to perform procedures like recalls, understanding that the theory of Chaos is all around us
have a better pharma e-pedigree monitoring, eliminate continually!
counterfeit by combating it continually, monitor
So using in the best possible way the
prescriptions and usage of medical or para-medical
accoutrements, which knowledge, technology and
products within the hospital, manage devices used at
experience offer to all of us, we can improve and
home treatments, etc.
enhance our daily lives. RFID starts to play a
In addition the total supply chain (referred in the significant role in our daily opportunities! ∞
main objectives of many companies in order to reduce
their expenses) will be greatly assisted in a better and
About
the
author:
Mr.
Pesmatzoglou
holds
a
Mathematics
degree
more efficient and accurate way of monitoring
from
Athens
State
University
and
a
MSc
degree
in
Industrial
transactions. Installing RFID applications we will
Mathematics
from
Aston
University
in
Birmingham,
U.K.
For
many
monitor the product from the suppliers shelves
years
he
worked
at
planning
departments
of
leading
industries
(warehouses), through transportation, to its delivery to
including
the
refractory
bricks
and
mining
industry,
consumer
and
the customer.
healthcare
companies,
etc.
Mr.
Pesmatzoglou
was
for
several
years
the
Supply
Chain
Director
at
Bristol-Myers
Squibb,
a
leading
Conclusion pharmaceutical
company
in
Greece
with
exposure
to
several
European
projects.
During
the
last
few
years,
he
is
been
dealing
“When electricity was invented, people become
with
supply
chain
technological
applications
and
he
is
closely
discontent with oil lamps. And so our missionaries
involved
with
RFID
applications
in
Greece.
He
is
also
a
lecturer
on
employ this sound business principle: Show the people
new
technologies
and
Supply
Chain
at
BCA
College
in
Athens.
He
something better and they’ll want it” (Horage B.W.
participated
as
speaker
at
several
conferences
and
seminars
and
is
Donegan). So how do we proceed? Just have vision, and
the
author
of
several
articles
revenant
to
technology.
spot a benchmark opportunity. Technology will then
References
1
Kearns WD, Algase D, Moore DH, Ahmed S. Ultra wideband radio: A novel method for measuring wandering in persons with dementia. Gerontechnology. 2008;7(1):48-57.
2
Stalhandske E, Mills P, Quigley P, Neily J, Bagian J. VHA's National Falls Collaborative and Prevention Programs: AHRQ;2007.
3
Poor G, Atkinson EJ, Lewallen DG, O'Fallon WM, Melton LJ, 3rd. Age-related hip fractures in men: clinical spectrum and short-term outcomes. Osteoporos Int. 1995;5(6):419-426.
4
Quigley PA, Palacios P, Spehar AM. Veterans' fall risk profile: a prevalence study. Clin Interv Aging. 2006;1(2):169-173.
5
Quigley P, Haley JA, Sarduy I. A guide to fall prevention: understanding a Fall Prevention Program. Director. Winter 2005;13(1):38, 40, 42-33.
6
Quigley PA, Bulat T, Hart-Hughes S. Strategies to reduce risk of fall-related injuries in rehabilitation nursing. Rehabil Nurs. May-Jun 2007;32(3):120-125.
R F W A V E S! ! 11
RHCC Management Team
Co‐Founder, Chairman & CEO - Harry P. Pappas Vice President and Chief Technology Officer – Dr. Paul Frisch
President and Chief Medical Officer - Dr. Suraj Kapa Vice President and Assistant Chief Technology Officer – Mayank Trivedi
Co‐Founder, Executive Vice President – Emily Sopensky Vice President for Conferences, Trade Shows, and Special Events – Debra Braun
Executive Vice President - John C. Shoemaker Vice President of Medical Device Integration & Interoperability – Dr. John Zaleski
Executive Vice President of Finance – TBD Vice President for Medical Devices, Sensors, and Wireless Technologies – Dr. James Fonger
Vice President and Chief Operating Officer – Troy Reiff eNewsletter Editor-in-Chief – Linda R. Castro
Our editorial team invites you to subscribe to our bi-monthly enewsletter. Please send your request to:
editor@rfidinhealthcare.org
R F W A V E S! ! 13