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.

·         If you’re looking in each and every corner of your facility to find critical equipment…you might need RFID!

·         If 40% of a full-time employee’s work week is spent looking for equipment that needs to be PM’d…you might need RFID!

·         If you’re interested in an RFID solution to simply track your LEASED equipment since that is getting lost too…you might need RFID!

·         If you answer the question of “how many infusion pumps do you own” with “I don’t know”…you might need RFID!

·         If you state you have no budget, but are losing thousands of dollars per month in lost/misplaced assets and equipment…you might need RFID!

·         If you’ve ever found hospital equipment in a storage closet’s drop ceiling…you might need RFID!

·         If some of your patients think a wheelchair at discharge is something they can take home with them…you might need RFID!

·         If your telemetry units are spending a good share of time in the laundry and coming back clean but ruined…you might need RFID!

·         If you truly want to achieve greater results throughout your facility, with a system that provides instant ROI…you might need Dynamic RFID!

With all humor set aside, these are actual responses that we have heard from several hospital personnel.

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.

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?

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.

With the deadline quickly approaching for the implementation of electronic medical records (EMRs), one of the biggest concerns for physicians continues to be the amount of data EMRs require them to enter. Physicians, especially those who may not be particularly “tech savvy,” fear that the extensive data that will need to be entered will slow down the medical charting process.

In a recent guest blog post on KevinMD.com, Dr. Edwin Leap, an emergency physician in South Carolina, highlights frustration that both he and many other physicians are expressing about EMRs, primarily in regard to charting and improving patient care. Because EMRs offer the capability of holding so much information, beyond that of traditional charts, more data entry is required and can be time consuming if entered manually. While the industry as a whole can see the benefits of EMRs at the end of the day, if the process becomes too cumbersome, will it fail?

EMR data entry can be simplified by implementing RFID and RTLS systems alongside EMRs and creating interoperability. With RFID and RTLS working hand-in-hand with EMRs, a change or pause in work flow is not required in order to enter and share patient information, nor will it add extra duties to staff and clinicians. At Dynamic, we agree with physicians in that manual data entry is time consuming. Beyond taking valuable time away from the patients, manual data entry is expensive and prone to many of the same types of human errors found in paper records.

Another benefit to pairing the two technologies is accuracy, which is critical to EMR success. Automatic identification and data capture (AIDC) obtained through RFID solutions is accurate without requiring human intervention and seamlessly integrates with EMR systems. This addresses another concern Dr. Leap expressed in his posting, that he spends even more time confirming documentation from nurses and other staff are consistent and entered correctly.

A third benefit to using RFID and RTLS with EMRs is real-time updates. Most EMRs are accessible through Web browsers. Delivering information into the record immediately means that individual patient and facility summary data are available both through EMR systems and through the AIDC system dashboards. These executive dashboards allow clinicians to make informed decisions based upon the most current patient and facility data.

While EMRs require more information than traditional charts do, the result is better patient care if done correctly. While it still may be challenging for physicians who are not open to using the new technology, solutions are available to help make the process less tedious, allowing for doctors to be doctors and nurses to be nurses. Consider RFID and RTLS a form of a personal data capture assistant!

RE: Investing in IT Wont Reduce Healthcare Costs | BNET Intercom | BNET.

IT alone doesn’t address the root of the problem: financial incentives that lead to overtreatment for the well-insured and undertreatment (and overcharging) for the uninsured.
“To really save, you have to start rationing care,” according to Peter Gabriel, medical director of clinical information systems at the University of Pennsylvania Health System. “The reason we’re talking about technology is because the real problems are so hard to solve that no one wants to touch them politically.”

I agree that IT alone, won’t solve the problem, but using health IT to facilitate evidence-based medicine will in fact reduce costs to patients, payers, hospitals and Medicare/Medicaid. The incentives trend has already started shifting to a quality-not-quantity-based model to address the financial incentives issue. This can also be tracked and curbed using HIT. Not just EMRs or HIEs, but advanced IT that provides insight into hospital processes and clinical workflow in real time. Flexiblity, Interoperability & Scalability are key.

I agree with the previous commenter, Rich, about the “how” being missing from the discussion. Savings and Costs are not the same thing, nor is Reducing Costs the same thing as Cutting Costs though the terms are frequently conflated.

Much of the value of HIT investment is in the amount of cost REDUCTION that will result from eliminating the need for wasteful spending, and secondly from revenue generation as a result of more efficient operations. Streamlining processes, shortening treatment times, reducing LOS, routing patients to appropriate channels, avoiding costly test duplication, locating expensive assets that tend to be lost, stashed or stolen (and require overstocking and renting to combat loss), etc.

All HIT is not created equal. The investments need to be thoroughly researched and evaluated against the needs and goals of the facility under consideration. Due to budget, environmental and size considerations — the same IT solutions are not the best answer for everyone.

Consider using a vendor-neutral systems integrator to help you assess your needs and isolate the most appropriate solution with the best ROI outcome for your hospital/clinic instead of jumping on whatever is the hottest new trend. These trendy investments tend to be more hype than help at the end of the day.
In aggregate, when you start talking about millions of dollars in savings per facility the cost on the system WILL be greatly reduced and less of a burden overall.

Things like HAIs that can largely be prevented cost the system tens of BILLIONS of dollars annually (CDC). If we can start to get a handle of this kind of waste and error, we’re getting somewhere. There are now hand hygiene compliance (HHC) solutions to ensure that staff comply with proper HHC. Just one example of the potential for health IT to fundamentally change the way we deliver care and lower the cost significantly.

Modern Healthcare.com featured an article today entitled: Many hospitals will cut IT budgets, staff in ‘09: NAHIT. Here is an exerpt discussing what hospital executives reported:

“More than half, 55%, of the executives surveyed said their hospitals were experiencing delays in access to capital, and most, 74%, are delaying or extending the timeline on capital projects. More than half, 57%, said they are deferring IT equipment purchases and 52% said they are extending timelines for implementing health IT initiatives, according to the National Alliance for Health Information Technology. The Chicago-based alliance released a report of the survey results.”

This news demonstrates why HIT is so critical. Budgets are already tight and these tough economic times and are expected to “get worse before they get better” according to President-Elect Obama’s recent statements. As resources dwindle in terms of human capital and funding, hospitals need to look to health care IT solutions to improve productivity and to help create more efficient processes.

EHRs and E-Prescriptions are not the whole answer to the problem. A change in the culture of America’s hospitals must happen to improve patient care, reduce costs and reduce risks across the board. Advanced health care IT solutions, like Radio Frequency Identification (RFID), to automate information gathering and distribution to the proper systems on the location of hospital assets, inventory, staff & patients, medications, lab samples and so forth.

This type of automation allows clinicians to be patient-centered, and eliminates human error, among its other benefits. The cost of operating hospitals is significantly reduced when staff are more productive and assets are easily located. Costly legal issues are also avoided with the additional decrease in risks and “never events,” ensuring that hospitals can count on compensation from payers — who are increasingly refusing to pay for hospital-acquired conditions.

While infrastructure for advanced health care IT solutions requires an initial investment, the case studies have shown rapid ROI and long-term cost savings. Less money for IT should induce wiser spending moving forward.

For more information on RFID solutions for health care, contact Ralph Wagner at 866-257-2111 or rwagner@dcc-online.com.