Sensor technology, long heralded as the next big thing in high tech, is gaining purchase among mobile healthcare solutions.
RFID (radio frequency identification) tags are being retrofitted into older facilities and designed into the construction of new facilities around the country. Administrators are finding that these inexpensive and unobtrusive tags are saving thousands of dollars while increasing quality of care and patient satisfaction.
At the brand-new, 58-bed Texas Health Harris Methodist Hospital Alliance in Fort Worth, everything that moves is being tagged, including high-value assets, wristbands on patients and the badges of all staff members.
RFID tags are also playing a role in ensuring that a patient who asks for an extra pillow receives it in a timely manner. The pillow can be delivered quickly because the nurse call system is integrated with the wireless RFID/RTLS (real-time location system) communication system. The patient presses a button and the countdown to pillow delivery begins. Separate buttons can alert nurses to a call for assistance to the bathroom, a need for pain medication or a medical emergency.
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Rather than signaling a nurse, the RTLS system alerts the closest tech to the patient room. By sending a tech instead of a nurse, nurses have more time to practice at the top of their license, said Kathi Cox, a project coordinator at parent company Texas Health Resources.
Cox said building a wireless system into new construction is a once-in-a-career opportunity, allowing administrators to create a mobile health culture from the beginning. New construction makes deploying mobile solutions much less challenging. There are far fewer barriers to radio waves in a building designed with wireless in mind. No chicken wire in the walls and old MRI rooms to deal with.
Over the last year RFID has saved the Texas Health Alliance $65,000 per month in rental fees, Cox said.
All rental equipment is tagged. When a nurse rolls the equipment out of a patient’s room he or she presses a button that sends an alert to the rental company to pick up the item. In addition, thanks to RTLS, the driver from the rental company will know exactly where to find the equipment.
Running behind the CenTrak Gen2IR active RFID tags and readers are the software brains. Intelligent InSites software manages the collected location data. Now hospital equipment is tracked and reallocated to other departments when the need arises. In the future Texas Health intends to use this technology to share resources across all facilities.
Other RFID applications at Texas Health include automating the discharge process, locating patients when visitors arrive, and identifying staff members exposed to an infectious patient.
The University of Maryland Medical Center, a 750-bed hospital, is deploying passive RFID in an entirely different way. It is one of the first to use RFID tagging to track emergency medications found in a typical “crash cart.”
Using a unique “scanner box” invented by the founders of Kit Check, Kevin McDonald and Tim Kress-Spatz, UMMC staff can verify the contents of its crash carts and check on which medications need replacing, which are near their expiration date and which are missing from the cart. Each tag also contains its unique national drug code.
All crash carts - there are nine types in all, including adult, pediatric and labor and delivery - are tagged and programmed with the medications that the cart should contain. Since the largest carts house as many as 80 medications, all drugs are also tagged. A tray is placed into the scanner box and in five to 10 seconds a monitor displays a list of missing or dated items.
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Using the old, time-consuming manual system required a tech to do the first pass on a tray before handing it off to the pharmacist for the last check; Kit Check allows the pharmacist to devote more time to clinical work.
Despite manual checks and double checks, the error rate in carts averaged almost 1 in 20. With the scanner box, said Adrienne Shepardson, central pharmacy manager at UMMC, mistakes are 1 in 4,000.
The system also allows the pharmacist manager to see what cart might be carrying recalled drugs. Although not there yet, using an active RFID reader would also allow UMMC to locate those carts and remove the drugs more quickly.
The Kit Check system took only two weeks to roll out and about an hour per individual to train, Shepardson said.
Now in beta trials, Kit Check’s next application is called Anesthesia Check, in which all meds in the OR are tagged. An embedded RFID chip in the label affixed to a syringe turns it into a smart object, says Kit Check co-founder Tim Kress-Spatz. Using Anesthesia Check, the anesthesiologist simply taps the syringe up to a reader and the system records what was administered, as well as doing waste recording for controlled substances.
Projected to launch in the first quarter, Anesthesia Check will log in adherence to clinical rules, such as a prohibition against using two syringes on two patients but drawn from the same vial. If a syringe was prepared for a patient but went unused, it cannot be used on a second patient. Should that happen, the system would record the information and send an alert.
Because Kit Check considers itself a SaaS (software as a service) company, pricing is not typical. There is no upfront ticket and, instead, the company charges by the number of tags deployed, with the cost per tag lowered depending on number ordered. Kress-Spitz calculates the ROI at $4.07 per medication. Using the JSON format, similar to a text file, it is human and machine readable, Kress-Spitz said.
By controlling budget, sharing rather than duplicating resources, improving patient services and staff performance, mobile technologies like RFID give healthcare providers the opportunity to emulate the most successful of private industry’s enterprise-level companies.
Ephraim Schwartz is a freelance writer based in Burlington, Vt. He is a recognized mobile expert and columnist, having spent 15 years as Editor-at-Large for InfoWorld, half of them covering the mobile space. Prior to that he was Editor-in-Chief of Laptop Magazine.
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