Patient tracking

It is becoming commonplace for hospital ID bands to include RFID tags and for readers to be placed near elevators and exits to prevent kidnapping or unauthorized movement within a facility.  While such an event may be unthinkable, these systems have prevented numerous abductions since they’ve been in use.

The tags contain proximity sensors and accelerometers, which allow the software to calculate the exact amount of movement and angle of a person's limbs. Each tag comes with an ultrahigh-frequency (UHF) 900 MHz EPC Gen 2 RFID inlay and a battery to transmit information. By pinpointing the tags’ locations in relationship to each other, as well as noting the changing angles and the number of movements, the doctor can derive a much better picture of the patient’s health because he knows the amount of energy being expended during certain intervals.

For those of us who have had a family member or loved one suffer from Alzheimer's, or some other type of dementia, the experience can be painful for everyone involved.  In addition to assistance form the most patient of healthcare professionals, solutions like the Companion anti-wandering system from RFID solutions provider Vuance can provide a new level of peace of mind.

But in some industries, speed of delivery isn’t the priority – or at least not the only priority. Temperature is important too. Pharmaceutical companies are painfully aware of the need to track temperature because the United States Food and Drug Administration (FDA) requires that they guarantee acceptable temperatures of drugs in transit. Having had to carry Epi-Pen myself, I fully understand that temperatures that are both too high and too low will render them useless. And that’s a scary thought if the only remedy to anaphylactic shock isn’t going to work because of something that is easily within my control. But is it easily within the control of the pharma companies?

At The Roy and Patricia Disney Family Cancer Center, RFID-enabled identification badges worn by patients hold information on his or her favorite colors, music and vacation spots, as well as the items critical to fostering a smooth process like billing, pharmaceutical, scheduling, and doctor information. Once a patient walks through a door, the RFID reader identifies the patient and alerts a concierge who immediately greets them and directs them to their next appointment. That’s the way it should be. Patients in these serious medical situations shouldn’t have to question whether they are in the right room, wait unnecessarily for prescription medications or dispute a billing mistake. 

And in fact, our very own Department for Veterans Affairs is currently using these RFID tags on visually impaired Veteran’s prescriptions. The Talking Prescriptions are available at various Veterans outpatient pharmacies. So how do these innovative prescriptions help? An RFID tag with label information is stored inside that can be read by a battery powered talking prescription reader, these tags are equipped to read out loud the drug name, the patient’s instructions and dosage amount, as well as specific warnings, like if the patient is taking the medication too soon after the last dosage.

Furthermore, the use of RFID tags is currently being evaluated in the use of sperm and ova identification at IVF clinics.

Other RFID tags may be used in the HealthCare world to limit access to patient records. According to new laws and regulations that were enacted under the HEPA law, only certain individuals on staff at hospitals and doctor’s offices are permitted to review or discuss a patient’s records. Ironically, those that are against RFID devices find themselves rallying against them because of the possible privacy infringements that could occur. But in fact, the use of these RFID devices in this particular situation could protect patient’s privacy. There are many privacy issues in the healthcare industry. However, they are managed under national legislation and guidelines of good practice and RFID is not a particularly significant component any more than the barcodes they sometimes replace. Although some privacy advocates have concerns about the tagging of patients and they will also be concerned about the tagging of visitors when that occurs, this is in some contrast to the views of the patients themselves. Surveys have shown that patients realise that tagging reduces the chance of errors and can enhance privacy and dignity. For example, the wrist or ankle tag can be read electronically without burrowing under the bedclothes. The tag on disoriented elderly people automatically sets of an alarm if they are approaching somewhere dangerous, obviating the need for staff to be near them at all times - the often oppressive traditional approach. Personal data stored in an RFID-fed server behind a firewall is far more secure than the clipboard at the end of a bed. When, more rarely, personal medical data is stored in the tag itself as with high risk patients having an RFID implant the size of a grain of rice, it is in scrambled form. It is instantly accessible to an authorised device in an emergency and therefore saves lives. The alternative is often written documents that are easily mislaid and can be read by anyone.

In fact, the Federal Drug Administration recommended that all item level prescribed drugs on the US market be RFID tagged. This type of tagging can save lives, reduce theft and unlawful acts, provide more responsive customer care, and provide the drug companies with faster lanes for recall integrity.

Disallow drugs which have been

• Counterfeit or fake

• Tampered with, adulterated or substituted

• Unacceptable (i.e., expired, discarded, returned, recalled, etc.)

The second largest application of RFID in healthcare by value will be Real Time Locating Systems for staff, patients, visitors and assets. Here the systems and support cost more than the tags, partly because many of the tags are reused. The tags cost from one dollar to 100 dollars depending on sophistication. Some record threatening behaviour, many have an alarm button to fetch help to the exact location. The favoured forms of RTLS in healthcare are

(1) So-called zonal (cell ID) systems where interrogators are fixed throughout a building to ensure the tag is never out of range and

(2) Systems parasitic on the facility's WiFi network, so they do not have to emit their own radio frequencies. This is called radio fingerprinting - the tag senses several emitters and the software computes the location knowing where those emitters are.

Zonal systems mainly operate at 433 MHz or 2.45 GHz and the WiFi is at 2.45 GHz. Open standards are not essential for the systems that provide their own emissions and they can more readily perform other tasks such as secure access, high accuracy location (particularly at Ultra Wide Band UWB) and error prevention. However parasitic WiFi systems can be cheaper over life and there are no worries about electrically interfering with other electronics such as life support systems and this seems to be gaining them market share in the healthcare RTLS business. A new chip from G2 Microsystems in Australia seems to have overcome the cost and power problems of WiFi RTLS tags.