The Health Care RFID Blog

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.

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!