RFID in Healthcare

1. RFID in Healthcare Presented By : Lauren Gunn and CONNoR ZALE

2. RFID Technology • Radio frequency identification (RFID) is a technology that allows for the transfer of data using radio frequency electromagnetic fields. • Data is then used for identification, tracking and security of people, animals and objects. • RFID can be useful in a clinical setting by enhancing patient identification, managing assets and equipment, securing newborns and reducing drug and blood administration errors.

3. History of RFID • In 1915, Robert Watson-Watt employed radio signals to track thunderstorms. • During World War II, radar was introduced to track enemy aircraft. • Modern RFID use • Tracking and timing marathon runners • Electronic Identification for payment at toll roads • Public transit smart cards, identification of retail items to prevent theft • Manage library collections and patron registration.

4. RFID vs. Similar Technology • Bar codes and associated technology are being replaced with RFID tags and readers in hospitals. • Unlike other technology, RFID has no line-of-sight requirement, which means it provides wireless unique identification at the item level that can be seamlessly retrieved at the group level. • The radio waves are able to penetrate many materials and therefore can be employed where tags are not readily visible. • Information storage capacity is much less limited than with bar codes, with as much as 2 kilobytes of data stored by a microchip in a RFID.

5. RFID Properties • Silicon-based memory chips with a copper or aluminum antenna (referred to as tags) and signal readers. • The tags are smart labels and have a chip and an antenna as their main components. • RFID enables tracking and monitoring of items over distances that range from about a centimeter to hundreds of meters. • Healthcare RFID, considered to be in its trial phase in 2004, is now one of the fastest developing Types of HIT. • A market research firm in Cambridge, UK, estimates that the market for RFID systems in healthcare will rise from $90 million in 2006 to $2.1 billion in 2016.

6. RFID Classification • Whether the RFID tag is passive or active • This distinction also determines the size and strength of the signal. • The data-transmission frequency (e.g. low/high frequency, ultra wide band) • If the transmitted data operates solely within a single application (closed-loop system) or are shared across applications or, possibly, across institutions (open-loop systems) • Whether the tag is read-only or read-and-write

7. Passive vs. Active • Two types of RFID tags are utilized in RFID systems: • Passive- has the ability to store and transmit information, but does not have its own power source. It can only be read by a nearby RFID scanner when the tag is within 18 inches to 30 feet of it, depending on the frequency employed. • Active- can transmit information on its own because of its integrated battery. Active tags can continuously transmit and receive signals over long distances, and can store larger amounts of information.

8. RFID components • Hardware (i.e., RFID tags, readers, collectors, and servers) • Software (i.e., middleware and software system applications) • Hardware components are tasked with the unique wireless identification and physical location at the item/person level. • Software components transform the rough data into meaningful and usable information and then feed it to different intranet web-based applications.

9. Current Issues in Healthcare • The Institute of Medicine estimated that between 44,000-98,000 deaths occur each year due to medically related errors. • It is difficult to estimate expenditures in the Medical Industrial Complex. • Five Identified problems that cause healthcare operation failures • Medical Mistakes • Increased Costs • Theft Loss • Drug Counterfeiting • Inefficient Work Flow

10. Medical Mistakes • Medical errors are the leading cause of death, which kill more people each year than AIDS or airplane crashes. • IOM estimated that “tens of thousands of deaths and injuries are caused by medical mistakes each year.” • FDA has estimated that half of the drug errors are preventable by adopting appropriate information technologies. • Medical malpractice can occur due to patient misidentification, adverse drug events, infant missing or mismatch and accidents that involve inclusion of surgical tools in a patient body after an operation.

11. Increased Costs • Healthcare providers are focused on reducing costs and increasing efficiency especially in managing supplies and medical equipment. • Inefficiency affects inventory management and the average hospital “over spares” many consumables such as dressings and instruments by approximately 30% which reduces usable capital that can be used for patient care. • A hospital pharmacy can use up to 40% of expenditures on rush order, non-contract items and costs can be reduced if those purchases can be anticipated. • Conservative estimates project that a good health information system could save the economy $140 billion a year which is about 10% of the total health-care spending.

12. Theft Loss • Loss and theft of equipment and supplies costs hospitals $4,000 per a bed each year which is a loss of $3.9 billion annually with over 975,000 beds in the U.S. • Medical organizations are interested in reducing costs due to theft and loss by tracking equipment and supplies better, in order to reduce the overall cost of care.

13. Drug Counterfeiting • FDA estimates that up to 40% of the medicines shipped from countries such as Colombia and Mexico may be counterfeit. • Pharmaceutical Industry reported that it loses $2 billion per a year due to counterfeit drugs. • Pharmaceutical Industry and healthcare providers are searching for new ways to track medications and verify authenticity in the most cost effective method.

14. Inefficient Work Flow • Hospitals experience inefficient work flow when allocating resources in real time becomes difficult. • Reduce search time for staff • Locate equipment quicker to allow for regular maintenance

15. RFID Uses in Hospital • Can track inventories, mobile equipment, and people in real time as the tagged item travels around the hospital. • Such mobile equipment includes wheelchairs, infusion pumps, and blood supplies. • RFID bracelets can be used Help to prevent infants from being switched in hospital nurseries, to track Alzheimer's sufferers and to link patients to their medical records

16. RFID Uses in Hospital • According to one previous study in Massachusetts, foreign objects were left in the body in one out of every 10,000 surgeries. • In another study, those objects added four days to an average hospital stay and resulted in 57 U.S. deaths in 2000. Two-thirds of all objects left in the body cavity were sponges. • RFID chips can help surgeons avoid leaving sponges inside patients • A study done at Stanford used sponges that were rigged with a 20mm diameter radio-frequency ID chip. • Surgeon accurately located the inserted sponge or sponges in less than three seconds.

17. RFID Uses in Hospital • Improving the overall efficiency of care delivery by virtual map • Allows staff to better communicate with each other, more quickly assign rooms and care providers to staff. • Done by tracing mobile assets, patients, and medical staff within departments/hospital floors. • Uses easily recognizable icons, symbols, and event- designated color coding, the application can provide visible, accurate, and timely data available at a glance to users without requiring any technical competency.

18. RFID Uses in Hospital • Software/middleware data analytic functionalities • Based on aggregating the individual event data to achieve better hospital management • The figure to the right is a snapshot of such an RFID system tool that delivers daily/weekly/monthly hospital-wide assets utilization data for accurate cost and financial analysis.

19. Table of RFID applications used or being installed in US hospitals as of Jan. 2009

20. Why Use RFID for Humans? • There are 45 million at-risk patients in the US today • Risk is that patients with previous health issues could wind up in an emergency room, unconscious and unable to communicate for themselves • Those patients at risk include those with: • diabetes, cancer, coronary heart disease, stroke, chronic obstructive pulmonary disease, cognitive impairments, seizure disorders and Alzheimer's, and people with complex medical device implants, such as pacemakers, stents, joint replacements and organ transplants.

21. Human Implantation- Verichip • A company known as VeriChip and its parent company Applied Digital have been developing implantable RFID chips for the past 15 years primarily to tag livestock and pets. • The company began marketing its technology for humans after the US Food and Drug Administration approved its VeriMed™ RFID system as a medical device in 2004. • VeriChip's efforts to implant humans with chips have been highly debated.

22. Human Implantation • The chips measure less than 12 mm by 2.1 mm. • Treated with a chemical before implantation to discourage their migration within the body. • The procedure costs US $200–400 and recipients must pay an annual fee to maintain their records on VeriChip's password-protected online database. • The company charges US $20 a year for a basic record, and US $80 a year for a complete personal health record.

23. Case Study • In May 2006, William Koretsky made medical history when he became the first emergency patient to be identified from an implanted radiofrequency identification (RFID) chip. • Koretsky, a 44-year-old sergeant with the Bergen County Police Department had crashed his car into a tree during a high-speed chase. • An emergency-room scan revealed an RFID chip in his arm, which had been implanted in 2004 for identification purposes. • Doctors retrieved the ID number, identified Koretsky using an online database, reviewed his health history and learned that he had type 1 diabetes. • While treating his other injuries, physicians quickly began monitoring Koretsky's blood sugar level. • The RFID chip, which was manufactured by VeriChip might have saved his life.

24. Worries over RFID technology • Hackers could retrieve and copy medical information from an RFID chip. • There is concern about the potential hazard of electromagnetic interference (EMI) to electronic medical devices • Has potential to interfere with pacemakers, implantable cardioverter defibrillators (ICDs), and other electronic medical devices. • Ethical, privacy, legal issue potentially associated with human RFID implantations

25. Legal Concerns of RFID • The U.S. State Department has announced that it will be adding RFID chips to passports while states such as Virginia are considering adding the chips to driver’s licenses. • Worries over unknown searches • Two states, Wisconsin and North Dakota, recently passed laws prohibiting the forced implantation of microchips in humans. • A common agreement for the ethics of implanting individuals with RFID technology has still not been reached. This debate will be important in determining the future of RFID.

26. Conclusion • RFID has the potential to improve healthcare by decreasing medical errors, decreasing costs, decreasing theft and loss of medical equipment, decreasing the drug counterfeiting problem and bettering work flow • Though there are some issues associated with this technology especially in regards to human implantation, the benefits seem to out weigh the risks

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