RFID: Increasing patient safety, reducing healthcare costs
By Dr. Bill Crounse, M.D.
Americans invest a lot in healthcare. We expect a lot in return.
Expenditures for healthcare in the United States will approach $2 trillion in 2005. That is more than $6,500 for every man, woman, and child in our country.
But this commitment of resources is not producing the best possible results. In fact, the average life expectancy in America is shorter than in countries spending less than half as much per capita, including Canada, France, Germany, Greece, Ireland, Italy, Japan, New Zealand, Spain and Sweden. 1
The problem is not with the skills of our healthcare professionals nor with our facilities and equipment. The challenge is efficient service delivery. A recent study by Boston University contends that up to 50 percent of our health-care expenditures are lost to waste, excessive pricing, and fraud.2 For this reason, improving the productivity and efficiency of healthcare must be a critical priority for patients, providers, and payers.
Almost every healthcare worker—doctors, nurses, technicians, administrators—is a knowledge worker, processing information and making life-critical decisions. So it makes sense to look to technology for the same kinds of efficiency and productivity gains in the healthcare industry that have been achieved by knowledge workers in other segments of the economy.
Radio frequency identification (RFID) in particular is one technology that has the potential to introduce dramatic new efficiencies in patient care. And some organizations are already beginning to achieve those efficiencies.
Turning to RFID for better outcomes
RFID chips are tiny radio-frequency transmitters that broadcast data to local, or, in some cases, satellite-based, receivers. Each chip has a unique signal or "tag," so that its location and other data can be captured and processed. Typical components of a system include not only the chips and receivers, but also middleware to capture and process the signals and applications that use the information for business support.
While RFID is already widely used in the business world—for example, to locate packages or track inventory—its applications in healthcare are just emerging. The possibilities are as promising as they are varied, and include:
| • | Tracking pharmaceuticals from the manufacturer, distributor, and pharmacy to the point of administering medication to the patient |
| • | Tracking movable equipment, furniture, medical devices, and other high-value items both to provide ready access when needed and to reduce losses |
| • | Identifying the location of caregivers in hospitals and other institutions to ensure the most efficient assignment in response to emergencies |
| • | Ensuring the proper identification of laboratory specimens, including biopsy samples and containers of blood or urine to reduce medical errors |
| • | Tracking patients—both for the purposes of redundant identification prior to the administration of medications or surgery and for protecting infants, Alzheimer's patients, and others with special vulnerabilities |
| • | Managing controlled substances, pathogens, and other materials that pose a public health risk |
Putting potential into practice
Some forward-looking organizations have already put the potential of RFID into practice—and in turn are realizing the benefits.
For example, a recent report in eWeek details how Purdue Pharma L.P. has begun placing RFID tags on the labels of 100-tablet bottles of OxyContin and Palladone. The intent is to reduce theft and also to ensure that distributors receive genuine products rather than counterfeit copies of these popular drugs.3 Pfizer is said to be planning a similar strategy to track and protect Viagra.
At Jacobi Medical Center in New York, nurses use a Tablet PC to match the RFID tags on patients' wrists with bar-coded information on packets of medication. The match ensures that each patient receives exactly the right dose and only the medication that has been prescribed to him or her. It also automatically creates an electronic record of the nurse's visit, allowing the nurse more time to provide direct patient care. This pilot program is the subject of a recent study by Gartner, Inc.—a leading provider of research about the global information technology industry. That study concludes that "as RFID technology continues to mature, it is almost certain to become an essential tool in helping care delivery organizations to decrease their error rates, increase staff satisfaction and constrain costs."4
Taking the concept one step further, Lucile Packard Children's Hospital in Palo Alto, Calif., now uses RFID tags on the ankles of newborn babies to ensure that they are not removed from the hospital without permission. That's the kind of inventory control that can touch the heart of any new parent!
Building a platform for RFID success
While the potential for RFID to improve the quality and decrease the cost of healthcare is significant, implementing an RFID solution is not a trivial activity. All of the elements of an RFID infrastructure must be in place—not only the tags, but the network, the receivers, and the software to process the data. These components must work together efficiently, tightly, and, with the lives of patients at stake, flawlessly.
For care providers today, making this initial investment can be challenging. Nearly two-thirds of the hospitals in the United States barely break even financially; many are losing money. They simply do not have the deep resources necessary for major technology investments. That's one of the reasons most have been slow even to implement bar-coding.
Michael Dereszynski, a senior consultant for the Microsoft Healthcare and Life Sciences Industry Solutions Group, has identified two factors that may help to speed the adoption of RFID. First, major retail suppliers are beginning to purchase chips in large quantities. As Dereszynski notes, this increase in chip production has the net result of "reducing costs to a reasonable level." Hospitals can take advantage of the benefit of such economy of scale to implement affordable RFID solutions.
Second, more developers are working to bring RFID to the healthcare industry. While the initial focus was on helping to lower costs in manufacturing and inventory management, Microsoft is now working with providers and strategic partners to develop interesting and innovative uses of RFID in healthcare generally. As Dereszynksi says, "Microsoft has jumped in with both feet to make the most of our existing server software—BizTalk and SQL Server—and also Microsoft CE to reduce costs for application developers and technology adopters."
In fact, the Microsoft RFID infrastructure is designed to help hospitals and healthcare stakeholders achieve the benefits of RFID as quickly and painlessly as possible. Microsoft technology can be used to capture and interpret data from sensors and manage business events in an easy-to-deploy, familiar environment. Because it is built on the widely-used Microsoft .NET Framework, the Microsoft platform can also be embedded within third-party applications. Which means software developers can usually rapidly develop and deploy new RFID business solutions without having to invent the underlying technologies. And it can also mean that fiscally-challenged healthcare providers will not have to risk investing in competing or obsolete systems—because a standard platform can help ensure that early investments are scalable and extensible.
"Seamless integration of sensor data with applications and business processes through easy-to-use tools at low cost is a big step forward for companies justifying a strategic investment in RFID technologies," Microsoft Senior Vice President of Server Applications Paul Flessner has observed. "This infrastructure will take full advantage of the .NET Framework as well as advancements across the Windows Server System family of products. The intent is to reduce the complexity and cost of integrating and managing RFID data."
For now and for the future
While RFID solutions provide hospitals and drug companies with real business benefits today, the full potential of the technology is only just beginning to unfold. Continuing advances in nanotechnology and robust wireless infrastructures are now making it possible to envision an environment in which RFID devices ingested or implanted in patients could actually:
| • | Provide real-time information on health indicators and vital signs. |
| • | Regulate the release of medications. |
| • | Monitor and report on the results of surgeries. |
| • | Communicate with other devices in medication labels to alert caregivers to potential allergies, errors in dosage, or drug interactions. |
With RFID technology doing more of the "mechanics" of medicine, a single nurse could more effectively and accurately monitor the status of an entire ward of patients, with care automatically dispatched in response to changes in a patient's condition. And outpatients could be monitored remotely, receiving nearly the same level of attention as those within the walls of the hospital.
Certainly, RFID is not the total solution to the complex challenges of healthcare cost, quality, and equitable distribution. And we have to be mindful that some uses of the technology could raise issues of patient privacy and data security, which we then must carefully consider and address.
But done right, with expert developers building practical, economical solutions on an integrated platform, RFID can play a significant role. As Michael Dereszynski puts it, "It will take a few reference implementations before providers will adopt RFID en masse, but when they do I think they are going to see the greatest value in the increased efficiency and better patient care. Then we all benefit."
So though it may not even be visible, RFID is the tiny chip that is already making a very large difference.
Find out more about how Microsoft helps companies put RFID to work.
Dr. Bill Crounse, M.D., is the global healthcare industry manager for the Microsoft Corporation. Dr. Crounse is responsible for working with industry partners and healthcare organizations to help them benefit from using Microsoft technologies and solutions. Prior to joining Microsoft, Dr. Crounse was vice president and chief medical information officer for Overlake Hospital Medical Center and the Overlake Venture Center in Bellevue, Wash.
1 World health report 2005 statistical annex, World Health Organization
2 Sagar, Alan and Deborah Socolar. “Healthcare Costs Absorb One-Quarter of Economic Growth, 2000-2005.” BostonUniversitySchool of Public Health, 2005
3 Burt, Jeffrey. “RFID Project Safeguards Drug.” eWeek, June 20, 2005
4 Hieb, Barry R., M.D. “Medication Administration Uses RFID and Bar Codes to Save Time and Money.” Gartner Research Paper Number G00127318, June 6, 2005
Was This Information Useful?
