RFID Technology Introduction Radio Frequency Identification (RFID) is a subset of a group of technologies, often referred to as automatic identification, that

are used to help machines identify objects, and which include bar codes and smart cards RFID refers to the subset of automatic identification that uses radio wa!es to automatically identify bul" or indi!idual items RFID has been around for a long time, one of its original uses being the identification of aircraft during the #econd $orld $ar %ntil recently it was !iewed as being too e&pensi!e and too limited in functionality for many commercial applications 'd!ances in technology ha!e both reduced the cost of indi!idual system components and pro!ided increased capabilities, to the point where numerous organi(ations are either using or considering using RFID technology In fact, some organi(ations, notably $al)*art and the %# Defense Department, ha!e mandated the use of RFID by their business partners $hile RFID technology offers numerous benefits for manufacturers, for instance, certain characteristics of the technology also raise a number of pri!acy concerns $hat is Radio Frequency Identification Technology+ 'n RFID system consists of three components, a tag (or multiple tags), a reader or interrogator and the necessary supporting infrastructure (both hardware and software) 'n RFID reader, or interrogator, is a de!ice to communicate with the RFID tag It broadcasts a radio signal, which is recei!ed by the tag The tag then transmits its information bac" to the reader Readers can either be portable handheld terminals or fi&ed de!ices that can be positioned in strategic places such as loading bays in shipping and recei!ing facilities, or the doors in transport truc"s RFID tags, also "nown as transponders, are usually small pieces of material, typically comprising three components, an antenna, a microchip unit containing memory storage and an encapsulating material Tags can be either read)only or read)write tags These terms refer to whether or not the information stored on the tag can be changed or erased ' Read)only Tag is a form of RFID tag that has an identification code (more specifically, an -lectronic .roduct /ode) recorded at the time of manufacture or when the tag is allocated to an object 0nce programmed, the data on the tag cannot be modified or appended but it may be read multiple times ' Read)$rite Tag is a tag that can ha!e its memory changed, or written to, many times 1ecause their ID codes can be changed, they offer greater functionality albeit at higher price $hile commonly seen as a replacement for the %ni!ersal .roduct /ode (%./), or bar code, RFID tags differ from bar codes in se!eral ways *ore than one tag can be read at a time Tags do not require a direct line of sight for reading and may be read through hard material such as boo" co!ers or other pac"aging material -ach tag can uniquely identify the object to which it is attached, e!en if that object is one of a multitude of identical items It is these latter characteristics that are the cause of any of the pri!acy concerns associated with the use of RFID technology In addition to the tags and readers, an RFID system also includes other software and hardware The most important component is the RFID)specific software that translates the raw data from the tag into information about the goods and orders that are represented by the tags This information can then be fed into other databases and applications (e g , in!entory management) for further processing In the case of read)write tags, software is also required to control whether data can be written to the tag, which tag should contain the data and to initiate the process of adding data to, or changing data in the tag .otential %ses of RFID Technology *any public and pri!ate sector organi(ations are either using or planning to use RFID technology 1ecause the technology basically turns an inert object into one capable of communicating, the potential for use is enormous and limited only by our imagination and the capabilities of the technology in!ol!ed .otential uses include, #upply /hain *anagement (monitoring and controlling the flow of goods from raw materials through to finished product, from manufacturer to consumer)2 .roduct Integrity (ensuring that products (e g , pharmaceuticals) are authentic and ha!e not been altered in any way)2 $arranty #er!ices (mar"ing durable goods with a tag incorporating a product registration code to facilitate warranty ser!ices)2 ID, Tra!el, and Tic"eting (pro!iding a means to !erify the identity of the tra!eler and to ensure that the documents are genuine)2 1aggage Trac"ing (monitoring and controlling the mo!ement of baggage from chec")in to loading on an airplane)2 and .atient /are and *anagement (pro!iding a means to rapidly and accurately !erify information concerning patient allergies, prescription history, etc to pre!ent surgical errors) .ri!acy /oncerns 3otwithstanding the current state of RFID technology or current practices, certain aspects of the technology 4 notably the small si(e of the tags and the ability to uniquely identify an object 4 pose potential threats to indi!idual pri!acy These include, but are not necessarily limited to the following

#urreptitious collection of information RFID tags are small and can be embedded into5onto objects and documents without the "nowledge of the indi!idual who obtains those items 's radio wa!es tra!el easily and silently through fabric, plastic, and other materials and are not restricted to line of sight, it is possible to read RFID tags sewn into clothing or affi&ed to objects contained in purses, shopping bags, suitcases, and more Tags can be read from a distance, by readers that can be incorporated in!isibly into nearly any en!ironment where human beings or items congregate It may not, therefore, be readily apparent that RFID technology is in use, ma"ing it !irtually impossible for a consumer to "now when or if he or she is being 6scanned72 b) Trac"ing an indi!idual8s mo!ements If RFID tags are embedded in clothing or !ehicles, for e&ample, and if there is a sufficiently dense networ" of readers in place, it becomes possible to trac" those tags in time and space 'pplications to do just this, using a combination of RFID and 9lobal .ositioning #ystem technology, are being proposed by RFID !endors If the tags can then be associated with an indi!idual, then by that association the indi!idual8s mo!ements can be trac"ed For e&ample, a tag embedded in an article of clothing could ser!e as a de facto identifier for the person wearing it -!en if information about the tagged item remains generic, identifying items people wear or carry could associate them with, for e&ample, particular e!ents li"e political rallies or protests2 c) .rofiling of indi!iduals $hen using bar codes, one bottle of water has the same barcode as all other bottles of water of that particular brand RFID technology potentially enables e!ery object on earth to ha!e its own unique ID (i e , each bottle of water would ha!e a unique identifier) The use of unique ID numbers could lead to the creation of a global item registration system in which e!ery physical object is identified and lin"ed to its purchaser or owner at the point of sale or transfer If these unique identifiers are associated with an indi!idual (by lin"ing through a credit card number, for e&ample), then a profile of that indi!idual8s purchasing habits can easily be created2 d) #econdary use (particularly in the sense of limiting or controlling such use) The creation of profiles and the trac"ing of mo!ement can re!eal a great deal of additional information For e&ample, the re!elation of personal information such as medical prescription or personal health histories could ha!e an impact on the a!ailability of insurance or employment2 and e) *assi!e data aggregation RFID deployment requires the creation of massi!e databases containing unique tag data These records could be lin"ed with personal identifying data, especially as computer memory and processing capacities e&pand This, in turn, could facilitate any of the practices listed abo!e 'pplication of Fair Information .ractices to RFID Technology The ten principles of the /#' #tandard, attached as schedule I of the .ersonal Information .rotection and -lectronic Documents 'ct, pro!ide the basis for a pri!acy management framewor" that can be applied to RFID technology It is important to clarify to what the principles would apply In the conte&t of RFID technology, this means that, If the chip has had the personal information of the indi!idual written to it, then it is a repository of personal information2 If the tag is unique, and can be associated with an indi!idual, it becomes a unique identifier or pro&y for that indi!idual2 and Information about possessions or purchases which can be manipulated or processed to form a profile is personal information, whether gathered through multiple !isits to a facility or organi(ation, or through access to the data base of RFID purchase information During the past decade, patient safety and high)quality patient care ha!e increasingly become the focus for healthcare organi(ations across the country 0pened in :;<: with :=> beds and one of the nation?s first post)operati!e reco!ery rooms, 1aptist @ospital is now the largest hospital in the 1aptist @ealth /are 3etwor" with more than =;> beds This award)winning hospital pro!ides a full range of medical, surgical, and obstetrical ser!ices #peciali(ed critical care is pro!ided by the hospital?s emergency center and three intensi!e care units, coronary, surgical, and neurological intensi!e care 1aptist @ospital has been frequently recogni(ed for pro!iding a quality wor" en!ironment, as well as demonstrating a commitment to quality care by implementing processes, procedures, and technology to reduce medical errors, eliminates inefficiencies and errors, and impro!es quality patient care and safety 'cti!e)RFID I.# has been shown to streamline patient flow, impro!e equipment management and staff efficiencies, and deli!er a return on in!estment in less than a year These tags transmit a consistent signal o!er a long range, which ma"es them effecti!e for identifying and locating people or items that mo!e frequently and o!er large distance indoors .assi!e)RFID systems are effecti!e for uniquely identifying things and people in controlled settings For e&ample, the technology might be used to identify and manage

a)

the in!entory of narcotics For hospitals using acti!e)RFID I.# to optimi(e surgical wor"flow and patient throughput, the ability to automatically "now and use real)time patient location throughout the comple& phases of surgery enables a smarter perioperati!e care en!ironment /linicians achie!e greater efficiencies, patients reali(e a better o!erall surgical e&perience, and waiting lo!ed ones are engaged with rele!ant surgical status information @er decision paid off with a return on in!estment within the first year based on increasing 0R utili(ation, reducing o!ertime, and impro!ing in!entory management Date published, A>>B)>A)AC Date modified, A>>B)>A)ACImportant 3otices
Using RFID technology, WaveMark CIMS collects, reports, and manages usage and inventory data in real time. his in!ormation allo"s hospital sta!! to accurately manage supply levels, easily monitor e#pired products, and e!!iciently track product usage. With WaveMark CIMS, clinical environments can improve operating e!!iciency and reduce costs. $aving the right products, !or the right doctors, at the right time, is increasingly complicated and challenging, potentially trade%o!! patient sa!ety, sta!! &o' satis!action and overall productivity. surgery centers are recogni(ing the need to more e!!iciently manage and control the !lo" o! their high%value physician pre!erence items. RFID technologies offer benefits such as improved operational efficiencies and enhanced health care services, but where such systems involve personal health information, then obligations under the Personal Health Information Protection Act (PHIPA may be engaged Taking an Infrastructure Approach to RFID !any hospitals are implementing one"off systems to achieve a specific goal, such as trac#ing assets and managing inventory$ Find out how Hamilton Health %ciences and the Hospital for %ic# &hildren are leveraging RFID today to improve product and asset controls, and hear their thoughts on how RFID can support healthcare facilities in the future$ Medication sa!ety is an area o! great concern !or consumers and health care providers. echnology is a strategy to enhance patient sa!ety

hospitals can also use it to ta"e in!entory of hospital resources 'ccording to @ermann, many hospitals ha!e a 6bro"en process6 for their equipment and often claim a shortage when there isn?t one, which can lead to e&cessi!e orders for supplies they already ha!e in stoc"

Inventory control is concerned "ith minimi(ing the total cost o! inventory. In the U.). the term o!ten used is stock control. he three main !actors in inventory control decision making process are*

he cost o! holding the stock +e.g., 'ased on the interest rate,. he cost o! placing an order +e.g., !or ro" material stocks, or the set%up cost o! production. he cost o! shortage, i.e., "hat is lost i! the stock is insu!!icient to meet all demand

Inventory control is concerned "ith minimi(ing the total cost o! inventory. In the U.). the term o!ten used is stock control. he three main !actors in inventory control decision making process are*

he cost o! holding the stock +e.g., 'ased on the interest rate,. he cost o! placing an order +e.g., !or ro" material stocks, or the set%up cost o! production.

he cost o! shortage, i.e., "hat is lost i! the stock is insu!!icient to meet all demand

'y monitoring the status and whereabouts of critical medical e(uipment used in the operating rooms, doctors and nurses can ensure that e(uipment and rooms are ready for surgical procedures

Integrated R-ID technology allows capture of the information coded on the unique R-ID tag on the sponges, pads and towels
RFID technology has great potential in healthcare to significantly reduce cost, and improve patient safety and medical services$

-aper"ork is time consuming, patient trans!ers are o!ten poorly coordinated, and 'usy providers &uggling multiple responsi'ilities do not al"ays communicate "ell "ith each other or "ith the patient and their !amily. hese system ine!!iciencies create opportunities !or medical errors and sa!ety gaps, potentially harming a patient.
Medical Technology in the Fast Lane

RFID Is Making Rapid Inroads in the Healthcare and Medical Device Markets

Christopher Delporte Group ditor

.roposal for RFID in surgical units In this pre)conference, you will learn about the way hospitals and health care pro!iders are using RFID today as well as insights into how to mo!e from one)off applications to an infrastructure approach to RFID The system reduces the time nurses spend entering data about the patient, lea!ing them more time to pro!ide care The system also reduces misidentification of patients and allows for more accurate, automatic billing for procedures *any hospitals are using RFID to trac" high)!alue assets within their facility so that care gi!ers spend less time loo"ing for assets, utili(ation is impro!ed and routine maintenance can be scheduled and managed automatically Dearn how one hospital achie!ed a return on in!estment in an asset trac"ing system in less than a year *any hospitals are implementing one)off systems to achie!e a specific aim, such as identifying patients or trac"ing one type of assets $hile these system can achie!e significant benefits, implementing RFID infrastructure that can be used to trac" patients, assets, surgical instruments that need to be decontaminated and other applications can profoundly impro!e a hospitals bottom line They can help pre!ent sponges and other materials from being left inside a patient during surgery 'ccording to a recent study at the #tanford %ni!ersity in /alifornia, in!ol!ing eight patients who underwent abdominal and pel!ic surgery, RFID)tagged or untagged sponges were placed by a surgeon 'nother surgeon, who did not "now which of the sponges contained the tags, ran a wand o!er the patients? abdomen to loo" for the sponges The wand could identify all the tagged sponges and ne!er reported the presence of a tagged sponge when there was none It too" just three second for the tagged sponge to be identified This manual process is time consuming and subject to human error $hen there is a discrepancy in the counts, at most hospitals, an E)ray is required before lea!ing the operating room 'dditionally, many hospitals call for E)rays for high ris" cases such as emergencies, transplants and surgeries greater than fi!e hours in order to assure no retained objects

application of RFID for counting surgical instruments which would impro!e safety, time and in!entory control $hy not put rfid tags into all the instruments and sponges Then after surgery, run a scanner o!er the patients body ) anything left inside should show up quic"ly 'ccording to /lear/ount, recent studies ha!e estimated that cases of retained foreign bodies occur between : out of e!ery :>> to : out of e!ery <,>>> surgical procedures, and studies ha!e shown that two)thirds of all retained foreign bodies are surgical sponges #mart#ponge, surgical teams will be able to scan the patient with an RFID interrogator in the form of a wand during postoperati!e safety chec"s to find any sponges mista"enly left behind The technology could supplant time)consuming manual counts done by at least two nurses se!eral times during the course of a surgery, or costly and time)consuming E)rays that can detect threads sewn into the sponges

Surgical Equipment to Contain RFID

This seems li"e a really cle!er use of RFID The idea is to embed chips in surgical equipment, and then wa!e a detector o!er surgical patients to ma"e sure the doctors didn?t accidentally lea!e something inside the body 'nother ad!antage is that the technology may help minimi(e staff time in the operating room not dedicated to patient care through use of RFID for instrument counting before and after procedures
!any of them are not discovered until years later$ Infections around the sponge cause them to be detected earlier$ )his re(uired an additional operation, causing unnecessary worry to both doctors as well as patients$

'nyone facing surgery gets the jitters 'mong the fears are a mista"e such as the doctor operating on the wrong leg or performing the wrong procedure 'lthough such mista"es are rare in the thousands of operations that ta"e place in the %nited #tates each day, they do happen 9o!ernment estimates indicate that fi!e to eight wrong)site surgeries occur each month 3ew RFID technology appro!ed by the Food and Drug 'dministration last 3o!ember is starting to help some patients rela& and doctors and surgical staff to be more secure that the correct operation is about to be performed on the right person and on the correct place on the body The new RFID !erification system, called #urgichip, is being sold by '*T#ystems as part of its suite of .atient#afe patient)safety systems, which also include medication)!erification products #urgichip is an RFID tag that gets encoded by medical staff with the patient?s name and other identification such as date of birth and medical)record number, as well as information about the type and site of procedure and other surgical instructions The tags also are @I.'')compliant and meet national patient safety standards of the Foint /ommission on 'ccreditation of @ealthcare 0rgani(ations, says Todd #tewart, '*T#ystems? G. of business de!elopment The A)inch)by):)inch nonallergenic label gets stuc" to a patient?s s"in near the surgical site, such as a left "nee, before the operation 1efore surgery begins, the tags are read by operating)room staff with handheld readers to confirm the patient and procedure 6This is one more way for us to be super)sure6 that the correct patient is about to undergo the right surgery, says Dr Fran" /oo", an orthopedic surgeon at The .alm 1each 0rthopedic Institution During the first year use of #urgichip, the cost of the system comes to about HB to H; per surgery, including the costs of software installation, says #tewart @owe!er, by the second year, the cost drops to about HC per procedure @unts!ille @ospital decided on an RFID)enabled system mainly because it wanted to impro!e efficiencies and communications that would directly impro!e surgical start times, /athcart says 6The surgery department had identified se!eral components to the patient throughput and staff wor"flow that often creates a bottlenec" throughout the continuum of care,6 she says The hospital specifically wanted to impro!e communication among staff !ia real)time updates of patients? status, pro!ide caregi!ers with !isual cues !ia an D/D monitor of scheduled procedures and their status, as well as pro!ide a mechanism that would correctly identify patients being prepped for surgery

6F/'@0 Ithe Foint /ommittee on 'ccreditation of @ealthcare 0rgani(ationsJ is reporting fi!e to si& wrong site surgeries per month,6 said Debbie *urphy, a life sciences e&pert at Kebra Technologies, the company that pro!ides the RFID printer5encoders and labels for the product The product could pro!ide a useful means for health care organi(ations to a!oid surgical errors and assuage patient concerns, she said 'ccording to #tanchfield, end)to)end setup of the standalone #urgi/hip system will cost health care organi(ations anywhere from HA<,>>> to about HL<,>>>, including software, hardware, installation, labels and staff training A>>LM' Taiwanese hospital is using passi!e RFID to help correctly identify surgical patients and trac" their operations to ensure they get the correct procedures and the proper medications at the right time 1y automating the storage, trac"ing, utili(ation, and billing of clinical resources through RFID, healthcare pro!iders reali(e enhanced care quality, increased producti!ity, accurate billing, and significant in!entory cost sa!ings