The Health Care RFID Blog

Can using a checklist help prevent infections and even deaths? According to Dr. Atul Gawande, author of, “The Checklist Manifesto: How to get things right,” implementing a checklist in healthcare for undertakings as large as surgery can help prevent healthcare acquired infections (HAIs) and therefore reduce the number of patients admitted to the Intensive Care Unit (ICU) because of infections and even prevent deaths. According to the Center for Disease Control and Prevention (CDC), HAIs account for about 1.7 million infections and 99,000 deaths each year and annual costs to U.S. hospitals (adjusted for inflation) range from $28.4 -$33.8 billion to $35.7-$45 billion.

A recent New York Times article appropriately titled, “A hospital how-to guide that mother would love,” gives great background on how Dr. Gawande’s book came to be.  Dr. Peter Pronovost, a critical care specialist at Johns Hopkins medical center in Baltimore borrowed the concept of using a checklist from the aviation industry. He began by first having physicians use it for inserting central lines to prevent subsequent infections and after discovering its great success, applied the same concept to other situations in the ICU, achieving similar results.

Following Dr. Pronovost’s lead, Dr. Gawande launched his own study along with a team of public health experts and surgeons and applied a very similar 19-point checklist to test whether  it would improve surgical care. The eight hospitals involved in the study saw the rate of major postsurgical complications drop by 36 percent in the six months after the checklist was introduced; deaths fell by 47 percent.   

While the results obtained in Dr. Gawande’s study are impressive and prove a very critical point, is the traditional checklist too fundamental? With cutting edge technology at our fingertips, that can go above and beyond reminding healthcare providers of steps to take when administering care, why stop at the checklist? 

Healthcare providers work in incredibly fast paced environments and missing vital steps, such as washing their hands, can lead to HAIs and even deaths. RFID can be viewed as the evolution of a checklist and embraced by the healthcare community as a ‘next generation’ best practice.  For example, the Dynamic hand-hygiene solution serves as an advanced form of a checklist, reminding care givers to wash their hands by not only tracking that they in fact did, but administering an audible signal if they fail to do so before approaching a patient. In addition, RFID applications for patient identification, error reduction at point of care, medications management, and asset and employee tracking ‘check the box’ with every move a provider, patient or asset makes. And, in addition to utilizing RFID as a means to more precise healthcare ‘to do’ management, the RFID is driven by a chain of data conversion events – each one a checkbox in and of itself – resulting in more intelligent and actionable information than a static checklist allows. If Dr. Gawande’s implementation of a checklist helped prevent so many HAIs and save so many lives, imagine what an RFID-enhanced checklist could do!

This is the first in a series of blogs devoted to understanding how the establishment of common standard across the healthcare industry can benefit all the parties that participate in the industry whether they know they participate or not. The reality is each and every citizen has a vested interest in the establishment of additional healthcare standards because each will benefit multifold.

Why Standards?

Throughout history clinicians have realized that the establishment of healthcare standards will save lives and improve patient out comes. Accurate reporting and record keeping are key elements for any business to be successful, this is especially true in healthcare. To be useful, data needs to have common meanings to all involved parties and to be meaningful requires a reference point associating it to where it came from. This statement of fact: “Jane Doe’ temperature was 100″ degrees” has no meaning until you reference who Jane Doe is, the date, time, recent temperatures and medical condition and medical history of Jane Doe.

The Healthcare industry like every other industry relies heavily on IT to perform routine everyday reports and tasks that where at one time manually performed. The medical field relies heavily on the gathering of data which takes valuable time away from staff for patient care. Data haphazardly collected and entered incorrectly can have dyer circumstances and affect the out come of a patient’s wellbeing and open the provider to adverse legal consequences.

Road Blocks?

IT in Healthcare has yet to reach the adoption rate of other major industries. This is partly due to the lack of industry standards. In defense of healthcare the establishment of industry standards is a little more challenging due to the nature of the business. But here more then anywhere else the benefits will be so great. The power of passively collecting and disseminating data gathered across thousands of data points at the speed of light will allow knowledge to be created on it own with the benefits being immeasurable.

What’s Needed?

Understanding standards is important because it forms the basis for understanding how each type of standard effects the others use. Having a common set of vocabularies without a universally excepted way of exchanging them diminishes their value greatly. Remember we are creating standards that will mainly be shared or exchanged between machines. HL7 has established standards that allow interested parties to exchange information using a standard protocol. This is a start but the pace and involvement of industry leaders needs to accelerate greatly. Industry standards are developed through donated time by interested parties that may or may not realize a direct benefit in the standards development. It is VERY helpful to have involvement of people that have previous experience in the development of similar standards.

In the next entry we will discuss different types of standards that are needed to move healthcare into a true information age allowing faster development of standards based solutions that store and can exchange meaningful data.

Please add your thoughts and comments to strengthen the impact and depth of this blog.

Ralph Wagner

Health Care Solutions Manager

Dynamic RFID Solutions

Dynamic Computer Corporation

rwagner [at] dcc-online [dot] com

866-257-2111 x105

“We are the experts in improving health care, reducing costs and minimizing risks using advanced data capture technologies.”

Radio Frequency Identification (RFID) is increasingly being used to automate the transfer of PHI within and between EHRs, EMRs, HIEs, etc. It has been proven to reduce errors and create more efficient processes, as well as improve productivity. This results in Improved Patient Care, Reduced Costs and Minimized Risks.

With the move toward standardizing and certifying electronic health information products and HIEs, it is important to include solutions that facilitate this exchange of information in the certification process. RFID solutions are located together with the security protocols, document routing infrastructure and sending systems used to share electronic health information.

RFID automates the identification of people, objects and events that can be integrated with hospitals’ existing systems, including EHRs, HIEs, security, patient flow systems, bed occupancy, asset utilization and so forth.

By certifying RFID solutions, health organizations can make better decisions about which solutions have met the criteria and received the stamp of approval from certifying authorities for electronic PHI exchanges. This will facilitate better interoperability and accelerate standardization across the industry as RFID solutions providers strive to meet the same standards as the systems with which they must communicate.

It is critical that this happens sooner rather than later, especially in light of the climbing number of adverse medical events and progressively more limited funding across the board.

[A note of clarification: It is the RFID solution's application software, which interacts with the hospital's electronic record systems, that I am suggesting should be eligible for certification. Another level of standardization and perhaps future certification needs to occur at the RFID middleware and edgeware level.]

For more information on RFID in health care, please contact Ralph Wagner, RFID Solutions Manager, at 248-473-2200 or rwagner@dcc-online.com.

Dynamic Computer Corporation has been providing IT solutions for health care entities and other enterprise level companies since 1979.

This comment was submitted for consideration to the Certification Commission for Healthcare Information Technology (CCHIT).