The Application of Auto-identification Technology in Healthcare

1. The Application of Auto-identification Technology in Healthcare LIS4930 – Health Informatics Fall 2007 November 26, 2007 David Kuder | Andrew Parks | Shawn Reiss | Emily Rosenthal | Alex Rosete | Kris Suchdeve | Jachima Taino

2. Overview Introduction to Auto-identification technologies Radio Frequency Identification (RFID) Biometrics Smart cards/Health cards Advantages & Disadvantages of Auto-identification Costs

3. Introduction “Information technology holds enormous potential for transforming the health care delivery system, which today remains relatively untouched by the revolution that has swept nearly every other aspect of society.” The Institute of Medicine

4. What is Auto-identification • A broad term that covers a number of technologies that are specifically designed to improve identity verification • Applied primarily to human identification, but also can be applied to goods for equipment tracking or inventory control • Also used to track procedures • administration of blood products or medications

5. Adoption of Auto-identification Auto-identification technology adoption is anticipated to increase dramatically over the next few years.

6. Radio Frequency Identification (RFID) • RFID technology allows for the communication of health care information between a tag and a reader across an RF signal. • Tags can be placed on people or objects • Contain a unique identification number for security and privacy

7. Types of RFID Passive - have no power source and rely on the reader for communication Semi-passive - communicate the same as passive tags, however they contain a battery which powers the tag’s sensors that monitor factors such as temperature. Active - emit their own signal to communicate with the reader, have their own power source and have the largest range of operation.

8. Advantages of RFID • When implemented within a healthcare setting, RFID can: • Improve patient safety • Increase the hospitals’ overall operation and efficiency • Assist in patient identification • Help track or locate equipment • Monitor patient’s condition, especially in critical care settings • Ensure that patient’s receive the correct drug and dosage • Prevent duplication of procedures

9. Applications of RFID • Blood product administration • Drug administration • RFID embedded patient wristbands • The VeriChip system • Implanted RFID chips • Newborn tagging

10. Potential Problems with RFID • Security • Data stored and transmitted on RFID’s can be protected through encryption and transmission protocols, but a clear security standard is not established. • Individuals can listen in on the communication between a tag and a reader, reference the ID to a database and gain sensitive patient information. • Existing forms of auto-identification are proven and established while difficulties and error rates in the operation of RFID’s remain.

11. Biometrics • Biometrics is defined as “the study of methods for uniquely recognizing humans based upon one or more intrinsic physical or behavioral traits.” • Biometrics is making its way into the healthcare industry as a means of identifying patients and/or healthcare workers. • The technology is becoming more accessible as costs decrease.

12. Advantages of Biometrics • Protects patient information & identity • Can eliminate the use of SS# as an identifier • Increases efficiency • Patient hospital admissions process • Reduces duplication of paperwork used to identify patients

13. Types of Biometric Identification Physiological Behavioral face fingerprint hand iris DNA keystroke signature voice

14. Health Cards/Smart Cards • Health Cards are a type of storage device, usually plastic, that store a patient’s administrative and medical details. • Smart Cards are MUCH similar • Compared to a credit card • Embedded microchips store information • Can be used either in an ATM-like machine or scanned from a distance (passing through a toll booth)

15. Advantages of Health Cards Can be used for security access Data on cards can be encrypted for security purposes Used as a quicker way of “waiting in line” Reduce administrative costs Decrease healthcare fraud

16. Adoption of Health Cards Belgium is about to launch a smart ID card to provide information about healthcare functions and social security information.Other Countries adopting Smart Cards: • Romania • France • Italy • United Kingdom

17. Potential Problems with Health Cards Identity Theft Paper-based record keeping unreliable Unorganized

18. Advantages of Auto-ID • Based upon the Institute of Medicine’s (IOM) six aims of healthcare, auto-identification has the potential to improve the following areas: • Safety • Effectiveness • Timeliness • Efficiency

19. Potential Problems with Auto-ID • Potential problems are minimal • Privacy Issues • Implementation costs • Most issues can be addressed and prevented with careful planning

20. Costs of Auto-ID Technologies • Estimating the costs of medical errors • 44K-98K medical error related deaths annually • 7000 caused by medication errors • Extra costs in money, time, labor, supplies, and malpractice lawsuits • May cost hospital as much as $5.6 million annually Annual ADE cost = Doses/year X 1.3% X ADE Cost -Doses/year = number of medication doses administered annually -1.3% = 7% of 19% -ADE cost = figure between $2260 & $5000 decided as the average cost of each ADE

21. Estimating Implementation Cost • Implementation of BPOC system estimated between $337,000 and $2 million • Servers, scanners, software licensing, consulting, etc. • May differ by medium (RFID vs. BPOC)

22. Easing Implementation Partial infrastructure may already exist Phased implementation Ability to run multiple technologies FDA estimates 28.4 ADE daily in average hospital 19% medication doses administered mistakenly – 7% could have adverse affects ADE costs $2260-$5000 each

23. Conclusion Auto-identification technologies have the potential to meet the six aims of the IOM as outlined in the report Crossing the Quality Chasm. For each of the technologies discussed the advantages of implementation in a healthcare setting far outweigh any possible disadvantages. The adoption and implementation of auto-identification technologies will increase rapidly as healthcare providers and other stakeholders recognize its potential to change the face of health care.

24. Questions?