The Health Care RFID Blog

As healthcare reform continues to be debated, the role of health information technology continues to evolve alongside it. Hospitals are expected, now more than ever, to meet a growing list of requirements and hot button issues including compliance with various regulatory organizations and federal legislation such as HIPAA, Medicare and Medicaid; and the creation of comprehensive electronic medical records (EMR) and legal health records (LHR). Above all else, the objective on which every member of the health care community must place the most emphasis is increasing patient safety. Today’s healthcare providers are held more accountable and required to provide an environment that improves, and in no circumstance compromises, patients’ health. This, of all mandates, is the one that should not be viewed as ‘policy’…for the dedicated healthcare institution; it is the inspiration for doing what it does.

To help the healthcare industry maintain focus, on January 1 the 2010 National Patient Goals went into effect. Issued by The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO or the Joint Commission), an independent, not-for-profit organization that accredits and certifies more than 17,000 health care organizations and programs in the United States, the NPSGs were established to help accredited organizations address specific areas of concern in regards to patient safety. Half of the 2010 National Patient Safety Goals are directly applicable to healthcare organizations like yours, and those goals are as follows:

Goal 1 – Improve the accuracy of patient identification.

Goal 2 – Improve the effectiveness of communication among caregivers.

Goal 3 – Improve the safety of using medications.

Goal 7 – Reduce the risk of health care–associated infections.

Goal 8 – Accurately and completely reconcile medications across the continuum

Goal 9 – Reduce the risk of patient harm resulting from falls.

Goal 14 – Prevent health care–associated pressure ulcers

Goal 15 – The organization identifies safety risks inherent in its patient population.

Are these your organization’s goals? If so, how do you plan on achieving them? Dynamic works with healthcare providers every day to integrate RFID solutions that address several and sometimes all of JCAHO’s stated goals. We work hard to stay in front of industry issues and enlist technology partners that can help our customers address them head on – which is why we don’t feel like we need to ‘catch up’ to these goals each year. In fact, it feels a bit as though they’re catching up to us.

“Studies suggest that only 50 percent of caregivers actually wash their hands when they’re supposed to before patient contact, although 90 percent think they do it when they should.”

According to an article posted on HealthLeaders Media by  Cheryl Clark, a CDC video is now being shown to hospitalized patients and visitors urging them to insist they witness providers washing their hands by the bedside, even if the doctor or nurse says he or she already washed just before entering the room. The five-minute video portrays a patient asking her doctor to wash his hands before being examined to reduce the risk of acquiring infection. According to the Center for Disease Control and Prevention (CDC) Healthcare-Acquired Infections are a top 10 leading cause of death in America — killing about 100,000 people a year and infecting about 2 million. One of the simplest ways HAIs (Healthcare Acquired Infections) can be prevented is by medical personnel properly washing their hands. 

A before-and-after survey conducted by Premier Inc. Healthcare Alliance showed that after patients watched the video, twice as many were willing to ask their doctors or nurses to perform hand hygiene than before the video was provided. Nearly 1,000 nurses and 611 physicians were also shown the video at points in time both before and after the video was widely shown throughout the hospital. Both doctors and nurses said they were much more likely to get reminded by patients about washing after the video was shown.

According to the article, HAIs are estimated to affect more than 1.7 million patients, kill 99,000 patients, and cost between $35 billion and $45 billion annually. And, under the new federal reimbursement policy, payment for care required as a result of hospital acquired infections will no longer be approved, making prevention quite influential on the bottom line.

Our recent announcement about the RFID pilot to track handwashing at University of Miami UM-JMH Center for Patient Safety has attracted a lot of attention and also has generated much confusion among readers of second- and third-hand reports. Today, I will clarify many of these misconceptions. I will answer a few of the comments/questions posted on various social media sites and in response to the news reports.

I would also be happy to address questions submitted here on my blog or via email at mlofton@dcc-online.com. Hospitals or health care organizations interested in the solution can contact us using this simple web form or call 866-257-2111 to set up a conference call or webinar.

The blog will be updated throughout the day as I add questions and answers. Subscribe here for updates.

In other news: The final section of the blog series on RFID for infection control will also be posted today. This series compares the various RFID technologies available to prevent HAIs from a vendor and brand neutral perspective.

Dynamic is a technology-agnostic and vendor-neutral RFID systems integrator. We ensure that the best technology for a particular use case is what we provide for our customers. We partner with manufacturers and vendors across the industry to provide the best available technologies at competitive prices — adding value to your RFID project without added cost. Learn more about Dynamic.

Questions from LinkedIn:

Question from Tomas:

1) How does the system track that you are in the toilet and hence be able to tell if you forgot to wash your hards (it obviously knows when you are actually washing your hands)
2) Wonder how hospital workers like the idea of being tracked about how many times they go to the toilet

Best,
Tomas

Answer:

Hi Tomas, thank you for your questions. I think the RFID Journal story and the press release answer your questions, but to summarize:

1. The system uses Infrared-Radio Frequency (IR-RF) - enabled ID badges and retrofitted soap dispensers to identify and capture hand washing events. It does not track “that you are in the toilet” per se. It tracks hand washing compliance before and after each patient interaction. If you approach the patient without first dispensing soap at the nearest sink, you would be reminded to wash your hands.

2. It does NOT track how many times people go to the toilet. The retrofitted soap dispensers are in patient rooms to facilitate accurate performance monitoring, compliance reporting and shared accountability when it comes to improving staff hand hygiene compliance and reducing HAIs.

Tomas, if you have any questions, I would be more than happy to answer them for you.

Question:

Can it really tell if people are washing their hands? How do you know they rinse the soap off?

Answer:

The system uses logic. It can’t actually track if the person wipes the soap off and doesn’t bother to use water to rinse it off. It can however track the soap/sanitizer dispensed and record who activated the device and when.

Comment from Todd – whom I’m not sure even read beyond the headline:

Most of the hospitals I have been in lately have sanitary foam or jell dispensers at almost every door or in every room. I see the staff and docs constantly using the canisters.  I really do not see the application, the roi, or how you would manage it. Maybe some dept has budget money to get rid of.

Response

We’d be more than happy to discuss the benefits and ROI with interested folks. There are many scientific studies you can review at CDC.gov, AHRQ.gov or APIC.org for starters that address two key factors.

1: The problem and cost of HAIs to hospitals, patients and the US healthcare system. It is a top 10 leading cause of death in America — killing about 100,000 people a year and infecting about 2 million. It costs the system about $45 billion annually. Up to 70 percent of cases are preventable with proper hand hygiene. Each HAI costs an average of $15,275 — at (on average) 4.5 HAIs for every 100 hospital admissions. How’s that for context?

A hospital with 50,000 annual admissions stands to reduce their direct HAI costs of about $34,368,750. This is in direct costs of care alone.

2: Discuss the importance of the role surveillance technology can play providing a mechanism to accurately track and report hand hygiene compliance and also facilitate shared accountability and responsibility around HAI prevention. Finally it frees up infection control professionals to focus on prevention efforts rather than trying to manually track compliance.

Unfortunately, despite the many dispensers hospitals put up, study upon study prove that clinical staff just don’t comply well for a number of reasons. Not because they want to sicken their patients, but they are busy, distracted and sometimes unaware. What’s scarier is that the more critical the situation (ICUs for example), the less likely staff will wash their hands.

Finally — this is NOT a niche solution. I’m not sure where you got that impression but you probably didn’t read the RFID Journal story or the press release. It’s based on the patented IR-RF technology used by Versus Technology. This technology has been around for over 15 years and is installed in over 500 hospitals. It can be used as an enterprise system or can be installed for smaller units/purposes depending on the needs of the facility.

Still not convinced?

I would encourage you and anyone else interested to read the very thorough RFID Journal story. I would be happy to answer any informed questions via email at mlofton@dcc-online.com.

Question from Richard

I can confirm that HCAI (Healthcare aquired infections) is a major public concern. This is not a trivial issue and whatever the rights and wrongs of people’s hand-washing behavior it is absolutely a healthcare priority to find effective ways of reducing cross-contamination threats.

One thing to consider though, is that cross-contamination is not just occurring from staff/patient contact, but spore based pathogens can cross-contaminate from uncleaned equipment and research shows that in multi-bedded wards, staff traffic to store areas or utility areas can increase the probability of cross-contamination in bed-spaces adjacent to the route so strategems should consider this. The reality is that RTLS may be one part of the solution.

I would welcome information on how this pilot addresses the wider issues of cross-contamination and if they have done the microbiology to prove that pathogen levels are reduced and that their monitoring actually reduces incidences of cross-contamination.

ANSWER:

Hi Richard,

You are correct that hand washing compliance is not the only factor in reducing HAIs, but it is one of the most straightforward and effective lines of defense. The CDC estimates that anywhere from 30 up to 70 percent of HAIs are preventable with proper hand hygiene compliance. That equals a tremendous amount of infections prevented, lives saved and costs eliminated from the system.

The UM-JMH Center for Patient Safety is in the process of testing this solution in a research study how effective the solution is in a clinical environment for improving hand hygiene compliance and ultimately for reducing incidents of cross-contamination.

You are correct in that many payers — both public and private — will not longer pay for preventable conditions, including HAIs. This is a factor in incentivizing technology surveillance options to prevent them.

The Association for Professionals in Infection Control and Epidemiology (APIC) recently published a paper recommending the use of such technologies to support infection control efforts.

You can download or link to resources from the CDC, APIC and more here.

Feel free to continue sending/posting in your questions and comments.

***If you are interested in how this solution could help your hospital, sign up for an Informational Webinar to learn about the Miami case study and other ways RFID can improve patient care, reduce costs and minimize risks.***