The Health Care RFID Blog

Dynamic Computer Corporation (DCC) has been named a 2010 innovator by the West Michigan Business Review for our Hand-Hygiene Compliant (HHC) solution for healthcare. Dynamic’s application enables hospitals to accurately track and report on hand hygiene compliance to monitor problem areas and identify additional training where necessary.

The Innovation Michigan award recognizes Michigan innovators for uniqueness of products, process, line of service etc. According to Candace Beeke, Business Review Editor, “Innovation Michigan is the premier event honoring innovation across the state. It’s invigorating to see what these entrepreneurs create. It’s also rewarding to see the established, larger companies in Michigan maintaining an innovative corporate culture.”

This award, coupled with the innovation award received at Premier Healthcare Alliance’s 2010 annual Breakthroughs Conference and Innovation Celebration, has recognized the innovative work that has gone into the HHC Solution.

On Tuesday the Office of the National Coordinator for Health Information Technology (ONCHIT) issued the “final rule” outlining the guidelines and standards of a successful EMR implementation. The leader of these efforts, David Blumenthal, MD, National Coordinator for HIT, stated that the rule is primarily intended to address financial barriers and benefits of implementing an electronic medical record (EMR) system.

With this rule came incentives for physicians and hospitals, extending some flexibility in criteria required to qualify for the billions in federal funding made available with the meaningful use initiative. In regards to flexibility, a “core” plan has been set. All healthcare professionals and hospitals will be required to reach a “core” set of mandatory objectives and then will have the liberty to pick and choose five additional objectives from a supplementary group. With the achievement levels and quality measures reduced, it will be much easier for physicians and healthcare organizations to gain access to grant funding for their IT projects. The goal here is to get everyone onboard quickly so that when more sophisticated uses of electronic records become available it will be easier to adapt. The Centers for Medicare and Medicaid Services (CMS) will be rewarding users of EMRs with monetary incentive payments made available through the 2009 economic stimulus funds.

Dr. Don Berwick, head of the CMS, mentioned that properly modernized healthcare can bring tremendous benefits to improving the quality of care and workflow processes creating a much smother shift while also reducing costs. Healthcare organizations staff and patients will all benefit with modern HIT in terms of improving safety, care, transparency while also reducing costs.

Kathleen Sebelius, United States Secretary of Health and Human Services, noted that the standards of the rule have been designed to work for all healthcare organizations large and small and that having better health information can save lives. The main concept of this rule is to improve the quality of care while keeping down costs. President Obama has a goal to have an electronic record for all Americans in 2014.

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.

In an article written by Stephen J. Dubner titled, “Is this the answer to Hospital-Acquired Infections?” , he mentions that it has been 10 years since first talks about the HAI (Hospital Acquired Infections) problem that the healthcare industry is now faced with and that in that ten years the problem has not gotten any better. But whose fault is it?

Many people like to place the blame on doctors, but in reality all healthcare workers should be held accountable. Trying to hold a single person and/or group accountable for something that is not tracked is impossible. Healthcare organizations need to start taking advantage of technologies that can aid in improving hand-hygiene compliance. Singling out one group, which will constantly be changing, will only be a temporary fix. Why not use technology as a tool to improve procedures?

Hospitals and other healthcare organizations should start implementing these new technologies in an effort to help change old habits and adopt new ones. Using technology to help mold a new culture within the healthcare industry would be a great start to improving the number of HAI incidents reported.

Now that the HAI problem has become visible to the public, hospitals, clinics and other healthcare organizations will need to start taking actions in an effort to improve compliance. RFID (radio frequency identification) and RTLS (real-time location systems) solutions have the ability to track compliance in real-time holding each healthcare worker accountable for themselves. Although there may be other variables involved in contracting nosocomial infections, improving hand-hygiene practices would show a significant increase in the annual improvement rate.

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.

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.