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RFID, Radio Location Service Use Soaring at Hospitals

A new study shows hospitals are aggressively deploying a range of active and some passive radio-frequency identification systems.

The payback no longer is simply being able to find medical equipment including wheelchairs. Increasingly, wireless identification and location data is being used to streamline and repair a range of healthcare workflows and business processes.

The study, "Trends in RFID 2008," is based on 100 telephone interviews earlier this year with IT professionals and clinical and nursing directors at hospitals with typically 300 or more beds. It was carried out by Greg Malkary, founder and managing director of Spyglass Consulting Group, a market-intelligence and research firm in California.

A previous Spyglass study was done in 2005. Since then, the number of RFID-based applications has tripled, Malkary found. "A few years ago, they were trialing [RFID] technology, with a few hundred objects being tracked," he says. Now there are large-scale product deployments rolling out, tracking thousands of objects in multiple locations.

Harrisburg Hospital in Pennsylvania deployed a patient-tracking system from PeriOptimum for surgical patients, then expanded the 433MHz wireless infrastructure from Lawrence, Mass.-based Radianse to track wheelchairs and a wide range of portable medical gear. By the end of 2008, the hospital plans to have nearly 10,000 wireless tags deployed. As at Harrisburg, many of these applications are "active RFID" -- with a radio embedded in a tag that's able to transmit a signal on its own. These products use a variety of frequency bands, and in some cases are Wi-Fi based. Passive RFID tags lack a radio: When they come near a tag reader, the reader's radio activates the tag, which reflects some of the signal's energy back to the reader, carrying with it the tag's unique ID number.

Early applications, such as infant-tracking systems, are giving way to staff tracking, combined with time-motion studies to optimize workflows in such areas as radiology and surgical departments. "You can see where people are and figure out how they're spending their time," Malkary says. The 2008 interviewees linked RFID data to quality-improvement programs, such as Six Sigma.

One notable technology shift is healthcare's willingness to embrace multiple wireless technologies. The 2005 Spyglass study found that 90% of respondents were unwilling to invest in wireless that didn't use their existing wireless LAN (WLAN) or corporate backbones. "Today they are much more open to multiple technology investments to get increased levels of [location] accuracy," Malkary says.

Accuracy varies. Wi-Fi location systems are accurate enough to place tagged objects or people in general areas. However, some applications need more precision or more control, or both: to determine whether high-value drugs are in a refrigerator, for example, or whether high-value medical equipment is in a sterilization room. Using proprietary radios in other frequency bands, or passive RFID systems are alternatives.

One example is a project from the University of Wisconsin-Madison RFID LAB, which has partnered with a trio of national blood centers to use RFID to manage the complete blood-supply chain for blood used in transfusions, as well as associated medications. The goal is to improve the safety, efficiency and accuracy of the U.S. blood supply.

RFID investments still tend to focus on department-level problems, not hospitalwide ones. One hospital Malkary covered in depth is Christiana Hospital in Newark, Del., where the emergency department has 76 treatment rooms that handle more than 100,000 patients yearly. The problem was that triage nurses were losing track of where patients were in the treatment process as they were moved among diagnostic and treatment facilities. The result: The overall length of a patient's stay was spiking above normal levels, and about 4% to 5% were leaving without any treatment at all.

Christiana Hospital combined a tracking system from Patient Care Technology Systems with an infrared-sensor network for locating hardware assets from Venus Technology. The Web-based application shows tagged patients, staff and various medical assets; and creates a visual workflow for patient progress. The data is filtered through various subset views so departments can anticipate and manage the number of patients and streamline their progress. With accurate data, the length of patients' stays has been reduced, especially for admitted patients; and patients leaving without treatment has dropped by 24%.

Malkary sees this department-oriented approach expanding to track anything wirelessly that "touches" the patient, including drugs, intravenous pumps, wheelchairs and so forth. "We want to be able to collect this information from anywhere and associate it with the patients," he says.

Location data gathered wirelessly is likely to become a key element of the move toward hospitalwide electronic patient records. A WLAN at Swedish Medical Center in Seattle allows doctors to update and access patient data anywhere, and it will support a broad range of location-based services in the future.

This higher-level view could lead hospital CIOs to see the wider benefits in hospitalwide, wireless location and identity data: improved clinical outcomes, more efficient operations and increased financial benefits in terms of cost savings, cost avoidance and improved revenue.

These higher-level benefits are becoming more visible as large healthcare-application vendors and systems integrators turn simple location coordinates into "meaningful knowledge" by combining location with other data, and creating Web-based dashboards that bring departmental systems into a hospitalwide view of trends in patient care.

"This next level is not for the faint of heart," Malkary says. "You need a full embrace of these technologies, better partnership with vendors and a new level of middleware that can glue everything together. Right now, this is done with custom code to bring all this together. It's a big investment."

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