The Health Care RFID Blog

With the healthcare industry in the spotlight; state, local and federal agencies have been spending the past year focusing on finding cutting edge technologies that will aid in improving care, reducing costs and minimizing risks.

Efficiency is going to be the key to improving the bottom line. A great place for an organization to start maximizing efficiencies would be to improve visibility. Using automated interactive electronic monitoring with RFID and RTLS technologies can greatly improve visibility. The image below is a snapshot of a unit map that is set up to refresh every 3 seconds.

Scenario

A patient in the emergency room is being discharged; the nurse (blue box) needs to locate a wheelchair (red boxes) which should be kept in the ”medical equipment storage” room. The nurse would then travel to the ”medical equipment storage” room and find that there is not a wheelchair present. At this point the nurse may end-up trying to locate the chair for several minutes. With an RFID/RTLS system in place the nurse can visit a central station (green box) and identify the location of the wheelchairs throughout the facility in real time. This process would then eliminate the time wasted and improve efficiency.

Snapshot of Unit Map

Visibility is a great place for healthcare organizations to start their quest to eliminating unnecessary steps and the costs associated with the time lost from taking the steps.  Using RFID and RTLS technology is the easiest way to make sure that every “trip” someone makes results in the procurement of the physical asset being sought.

Setting standards throughout the industry and within the individual organizations will prove to be a solution to maximizing efficiencies and reducing unnecessary costs.

How do “you” plan to account for the people that need your service when:

• Medicare reimbursements are falling?
• more people are projected to go through the system?
• no funds are available for expansion?

Why is it that in a high-tech environment low-tech is abundant? Some critics argue that Health Information Technology (HIT) has become stagnant as technology moves forward. In an article published by the Harvard Business Review, Has the U.S. Health Technology Sector Run Out of Gas?, writer Jeff Goldsmith says, “Today, our medical technology sector seems to have become mired in a lengthening period of creative menopause which not only threatens its economic foundations, but its global leadership position.”

The innovation behind EMRs has seemed to have stalled, why? Experts might say that this is happening due to the high industry failure rate (30-40%). With the 2015 goal for full implementation of EMRs the manufacturers of these systems will need to come up with a seamless solution. Changing the culture of any business is difficult for professionals that have been doing things the same way for a period of time. In order for any industry to change their operations a system will need to be tailored to fit the specific needs of each individual entity in order to have everyone on board.

With technology rapidly advancing it can be easy to overlook key capabilities of existing products that are used on a day to day basis. For example Smartphone’s are typically used to surf the web and check email, what about using them to improve the quality of management within an organization whether onsite or in the field?

Software developers have come up with a solution that can operate as the middleware for an RFID infrastructure. Middleware creates interoperability between applications and acts as a client for RFID technologies. With a place to launch the software, RFID has the ability to interact with a Bluetooth interface to capture, collect and store data in real time from a remote location while also communicating with the main server. Bluetooth technology acts as a personal area network for the mobile device. If a wireless network is absent, the mobile device can still collect the information and will sync to the main server as soon as the connection is restored.

Mobile enterprise software solutions are enabling mobile devices to act as a reader and as a display, therefore everything happening at the tag level can be viewed in near Real Time.

Potential Uses

·         Offsite employees will have the capability to interact with the enterprise software

·         Personnel can take a workstation capability with them offsite

·         Information needed to make business decisions are in the users pocket

Is this is the next generation of technology.

El Centro Regional Medical Center sits right along the fault line of last week’s earthquake that registered at 7.2, according to an article in Health Leaders Media. Fortunately the hospital only experienced minor damages and the safety of the patients and healthcare workers was not compromised.  It is important in situations, such as this, to have a system in place to aid in supporting the patient overflow. Safety is the principal concern when unforeseen disasters such as an earthquake occur. It is critical to immediately identify the location of staff, patients and equipment when in emergency situations. The time spent identifying the location of staff and equipment WILL compromise safety within the facility.

An RTLS asset tracking solution has the ability to rapidly gain location information on staff, patients and equipment in real-time. How does the solution work? With the ability to utilize an organizations current infrastructure, RTLS systems use enabled tags to send out a signal to an access point or sensor therefore identifying the location of the tagged “object” in real-time. This data is then passed on to the server where the data can be stored for current and future use.

In an extreme situation, such as a natural disaster, it is important to know the location of all assets on hand in order to execute a flawless recovery.  Other than the safety of patients and staff, a RTLS solution can also help identify loss of high valued inventory and equipment vital to the financial success of the organization.

As EMR systems gain population in the industry, there will be many different applications available for use in an effort to manipulate all of the data collected. The systems are platforms for many different applications that can drive the industry to interoperability. Each “healthcare worker” has something different that they are focused on tracking, whether it is a mobile asset, compliance by healthcare workers or patient vitals.

According to an article published this week in Healthcare IT News, healthcare technologies have the potential to transform the industry. Lisa Suennen, a managing member at Psilos Group stated, “EMRs are becoming a commodity, but putting applications on top of EMRs to deliver usable data creates value.” Suennen also mentioned that another area with growth opportunity is patient safety.

RFID and RTLS technologies have the ability to seamlessly integrate with EMRs. What are the benefits that come from implementing RFID and RTLS solutions into EMRs?

·         Eliminate the need to manually enter data – by eliminating manual entry an organization will improve work flow, minimizing human error therefore minimizing costs.

·         Improving Patient Safety – Tracking compliance of hand-hygiene as well as OR/ED patient tracking and medication tracking.

The more activities that can be tagged and tracked on a sensory network provide an opportunity to manipulate additional data and additional input without additional manual entry. With real-time updates each staff member will have the ability to gain visibility geared toward their own interests within the organization, from wheel chairs to IV pumps. With this we can work to improve care, reduce costs and minimize risks.

Hand hygiene is an incremental component that protects patients and healthcare workers from healthcare associated infections (HAIs). Dr Didier Pittet, professor of medicine, director of the Infection Control Department at the University of Geneva Hospitals in Geneva and the director of the WHO First Global Patient Safety Challenge: “Clean Care is Safer Care” , along with some of his colleagues, recognized hand hygiene as a growing problem in the healthcare industry worldwide in reference to high mortality rates and an increase in costs due to HAIs. According to Dr. D. Pittet, “healthcare workers practice hand hygiene less than half as often as they should.”

Together, the team came up with a list of critical moments of vulnerability during an interaction between a patient and a healthcare worker. Dr. Pittet and his team named these moments, “My five moments for hand hygiene.” The study focused on 2 zones, the patient zone and the healthcare zone, and the critical sites found within these zones. The team chose to separate these points into zones in an effort to geographically represent the critical points of contact in which hand hygiene is required.

The patient zone is noted as the area in which the patient has contact with his/her surrounding surfaces. There are two critical sites within the patient zone, clean sites and body fluid sites. Clean sites are the sites that must be protected from micro-organisms at all times. Body fluid sites are the areas were patient fluids are exposed. As noted in the study, clean sites and body fluid sites can co-exist, example: drawing a blood sample.

The healthcare zone is the area outside the patient zone. Theoretically, this zone is constantly contaminated with micro-organisms that can potentially be dangerous to the patient and/or healthcare worker.

Below is a list of the five critical moments resulting from the study:

1)      Before touching a patient… (example : shaking hands)

2)      Before clean/aseptic procedures… (example: wound dressing)

3)     After body fluid exposure/risk… (example: drawing  and manipulating and fluid sample)

4)      After touching a patient… (example: shaking hands)

5)      After touching patient surroundings… (example: holding a bed rail)

How can we use the results of this study to aid in changing the culture of hand hygiene?

As we all know proper hand hygiene in hospitals is an essential part in the prevention of hospital acquired infections (HAIs). Some physicians say that the use of gloves promotes poor hand washing practice within the organization. What are your thoughts?

A recent in-depth study conducted by Cummings, Anderson and Kaye indicates a 1% rise in hand hygiene compliance (HHC) equals a $39K savings for the hospital. Models were set up to simulate several occurrences of hand-hygiene noncompliance by a single healthcare worker. According to the article, “Hand Hygiene Noncompliance and the Cost of Hospital-Acquired Methicillin-Resistant Staphylococcus aureus Infection”, Hand hygiene noncompliance events are associated with significant attributable hospital costs. Minimal improvements in compliance lead to substantial savings. The study used two different models:

1.       Events of noncompliance with patients of an unknown MRSA status (results: associated with 42 MRSA infections (Cost resulting in nearly $1,000,000 in cost to the hospital)

2.       Events with a known MRSA patient followed by events of an unknown MRSA patient (results: associated with 980 MRSA infections)(Cost resulting in nearly $22,000,000 in cost to the hospital)

The cost savings involved with an HHC solution are immense. With the data collected by Cummings, Anderson and Kaye and an analysis of their findings by a partner of DCC below are the conclusions that have been discovered:

·         1% increase in HHC = $200 savings per bed / year; 100% HHC = nearly $10k savings per bed / year

·         A conservative 25% increase in HHC should equate to $5k per bed / year or $1M total for a 200 bed hospital

·         Assume 500k CCM beds in the US times $10k per bed / year = $5B / year CMS problem.

o     The Hi-Tech act “hopes” that EMRs will save $1.7B per year over 10 years

o     A 25% HHC increase would result in $2.5B savings per year (forever)

o    $2.5B is a 50% GREATER savings than Hi-Tech and saves 50,000 lives per year forever

RFID and RTLS technology has the ability to track each and every occurrence within a facility whether compliant or noncompliant. The HHC solution uses sensors in soap dispensing units that have the ability to read staff badges in real time in an effort to monitor each and every interaction with the patient. If a staff member is noncompliant one or more of the below actions can be taken:

·         Automatic email to a supervisor

·         Audible message in the room

·         VoIP “please wash hands”

·         Send message to handheld devices

·         Specific actions possible as requested

This solution is highly customizable and can be configured to work with each individual organizations needs. The HHC solution offered by DCC is highly reliable, affordable and beneficial to healthcare organizations seeking to improve care, reduce costs and minimize risks. “This is an example of how innovative technologies are transforming the way we deliver care. Everyone is a stakeholder,” Farida Ali, DCC CEO.

As HIMSS10 came to a close today there was a lot of buzz involving new technologies that can achieve measurable value and help improve care, reduce costs and minimize risks in the industry. Hospitals and other healthcare organizations are in major need of achieving “real” ROI from the software and hardware tools that they will be implementing in an effort to reach their 2015 goal for compliance. It is important for organizations to look at implementing the right technologies that can help them sustain ROI over time.

Patient tracking seemed to be a major buzz at HIMSS10. Patient tracking is a more unique solution than asset tracking in that it involves moving assets. (Patients) A patient tracking solution consists of granularity and a much faster refresh rate than an asset tracking solution. If a quick refresh rate and a high level of granularity are absent then the patients will be out of sight before the appropriate staff is notified. Dynamic Computer Corporation offers a variety of solutions using RFID (Radio frequency identification) and RTLS (real-time location systems) technologies that can automatically update location and status information of patients in as little as 3-second intervals. Healthcare organizations have options when implementing RTLS and RFID systems into their infrastructure. There are both wired and Wi-Fi technologies available to implement a successful patient tracking solution. Wi-Fi solutions use Wi-Fi-enabled tags that interact and communicate with access points within a building to define their location over an existing 802.11 wireless infrastructure. Wired solutions use IR (infrared) and RFID technologies that communicate to determine the ultimate location of a patient in real-time. Much like a wireless access point, wired solutions can either use IR and/or RF antennas to communicate with a tag in real time as a patient moves about the facility.

Another topic buzzing around HIMSS10 was how to get smaller hospitals and healthcare organizations on board with implementing EHRs. Data standardization is extremely important and will need to be clearly defined and seamless in order for the industry as a whole to achieve meaningful use objectives. The American Recovery and Reinvestment Act, as we all know, includes $19 billion in grants and loans available to healthcare organizations in an effort to aid in implementing an infrastructure and processes to improve care, reduce costs and minimize risks. Along with funding comes choosing the right solution for each individual organizations needs. Smaller clinics with less staff will have a problem keeping up with manual data entry processes. RFID and RTLS solutions can eliminate the need for manual entry and let the staff focus on providing quality patient care and sustaining financial stability and compliance with standardization.

With emerging technologies come advantages and disadvantages. It is important to determine what individual requirements fit your organizations needs when evaluating each solution. Dynamic has the ability to customize a solution that will not only take into consideration your current pains but will also help you plan for your future needs.