Health Care IT Forum

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You have probably heard that the Obama administration is soliciting recommendations for health care reform and health care IT.

Join our discussion on Dec. 30 to share your ideas. Recommendations will be submitted to the incoming administration and will be available for download at www.DynamicRFIDSolutions.com.

Light refreshments provided.

Op-Ed in Modern Healthcare

My OP-ED “RFID would be wise investment of hospital IT budget” was selected in featured on ModernHealthcare.com on Wednesday. You can access the full version via the links below. It was also sent out as a feature in yesterday’s Modern Healthcare’s Health IT Strategist email.

Featured on frontpage of Modernhealthcare.com at http://www.modernhealthcare.com/

Featured in Health IT Strategist section at http://www.modernhealthcare.com/article/20081211/REG/312119989

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Lab & Sample Tracking

(Download PDF) Blood transfusion errors are among the most profuse in the health care industry. According to the Healthcare Cost and Utilization Project (HCUP), blood transfusions occur in one of every ten hospital stays and have been the most frequently performed procedure in recent years1. HCUP reports that it is the most frequent and fastest-growing procedure performed during a hospital stay.

The rate of human error occurring during these procedures is extremely high, at 1 in 10,0002, and has been virtually unchanged for over 40 years3. The results range from blood infections to death in some cases. In almost every instance, these errors could have been prevented at various stages in the process. The most prevalent stage for errors – and thus best stage to focus on error prevention – occurs at the bedside. Human error underlies at least fifty percent of the fatalities related to blood transfusions1.

Any health professional can tell you how easily these errors happen, from dealing with two patients with the same surname, to picking up the wrong chart accidentally. Distractions endemic to the hospital environment make clinicians more likely to make these types of mistakes, and can be very costly.

RFID: An Advanced “Safety Layer”

Despite various improvement measures, little change has resulted until recent advances in technology. Experts recommend the implementation of Radio Frequency Identification (RFID), as a more advanced “safety-layer around the application of blood products” to considerably increase transfusion safety4. RFID verification for blood transfusion processes cuts verification time down significantly, while improving its accuracy and eliminating the opportunity for various types of human error.

RFID for lab & sample tracking directly addresses blood transfusion errors by:

• Performing positive patient identification
  
• Automating cross-checking of information across systems
  
• Verifying transfusion blood type matches patients’ blood type found in the system
  
• Documenting the chain of contact between staff and patients
  
• Monitoring the temperature conditions during the shipping and storing of blood products (on an item level)

And can notify the proper personnel by page, email or other predetermined means when:

• The information on the patient’s wristband, doesn’t match the information in the system
  
• The cross-check of information in the system yields a potential conflict, like differing blood types
  
• The temperature range of blood products fell below or rose higher than the required range for safe transfusion (down to item level) during transport or storage

RFID vs. Bar Coding for Lab & Sample Tracking

Bar coding is a commonly used solution that has reduced blood transfusion and lab errors. There is no question that it works. RFID is to bar codes what ears are to eyes.
Bar codes are like your eyes. You manually scan the bar code and it sees the information. It cannot see through walls (or bed sheets), see around corners, or see more than one item at a time. RFID technologies, on the other hand, are like your ears that allow hearing of data at almost instantaneous rates without voluntary actions. While bar codes (eyes) require that you focus using your line of sight (bar code reader), RFID can hear many things at once, and automatically process the information without deliberate action.

An example of where this makes a big difference is location of specific items. Bar coding requires scanning individual items to locate the correct one, while RFID reads the entire contents of a cart or storage cabinet simultaneously to determine if it contains the item needed. RFID offers all-the-time reads, which documents real time inventory and availability of the types and amounts of blood supply. It automatically checks-in and checks-out the blood from the storage area.

Automatic expiration date notification, restocking notification, temperature monitoring and locating recalled items are all other benefits RFID provides over bar coding. By automating these types of processes, the system can generate notifications to whomever you choose, through whatever electronic methods you pre-set in the system rules.

RFID also has the ability to encompass and interoperate with systems you already have in place, such as bar coding systems, EHRs, paging systems, security, scheduling, maintenance, etc. This enhances the capabilities and effectiveness of each individual component.

In addition to interoperability, the flexibility that RFID offers is also a key feature. It offers the ability to control distances at which the tags can be read, and the intervals at which the reads are recorded and forwarded to the assigned systems. Using the system for various functions in concert with lab tracking offers even more benefits in terms of efficiency, productivity and risk reduction. Inventory Management, Patient & Staff Tracking, Medication Tracking and Asset Tracking & Maintenance management are examples of the common applications that can be included.

Dynamic RFID Solutions offer Scalability and Flexibility

Like adding additional bar code labels into a bar coding system, once the infrastructure is in place, the RFID solution that DCC provides can easily be scaled. You can add additional RFID tags to automatically track additional assets or inventory on a case-level or and item-level basis to further increase the efficiency of processes.

Niche and/or proprietary solutions offer certain benefits for specific requirements, but have several drawbacks as well. DCC evaluates your needs and provides the best solution to meet them rather than endorsing a specific technology or product.
We are technology-neutral in the sense that we have partnered with several RFID hardware and tag manufacturers, as well as software providers to meet the diverse needs of health care customers. We have pre-screened the available devices and software from across the industry for the health care environment, in terms of quality, value and functionality. Our solution can incorporate multiple technologies as necessary to solve your particular problem.

An article published in Integrated Solutions magazine used a restaurant scenario as a comparison to illustrate the benefits of working with a solutions integrator.

“Companies desiring a seat at the RFID table can order from a vast menu of hardware, middleware, and software components. When you have a meal at a restaurant, you don’t place an order with the steak provider, another with the lobster farm, and another with a vineyard. You place an order with the server, and the chef prepares the meal to your specifications. In the RFID world, you can use an integrator much like you would your server and chef in the restaurant scenario. An RFID integrator can listen to your goals and objectives, make recommendations, then design a solution that meets your specifications."

DCC’s solution is not proprietary, and therefore is quite flexible and easily expanded. As the ROI builds, funding becomes available to grow your use of RFID. The RFID infrastructure you will need to scale out your applications, or include other types of tracking applications will be in place, whether or not you choose to work with Dynamic again in the future.

Our 30 year history providing IT solutions and 90%-plus rate of repeat business illustrates that we build valuable relationships with our partners and customers. We strive for 100% customer satisfaction with each client, and operate with forthright business practices. Chances are, after tasting our menu you will again patronize our restaurant and allow us to serve you. (Download PDF)

Contact Ralph Wagner, RFID Solutions Manager, at 866-257-2111 or rwagner@dcc-online.com to receive a projected cost estimate to implement RFID in your facility for a safer transfusion process.

1. Levit K, Stranges E, Ryan K, Elixhauser A. HCUP Facts and Figures, 2006: Statistics on Hospital-based Care in the United States. Rockville, MD: Agency for Healthcare Research and Quality, 2008; 2006: http://www.hcup-us.ahrq.gov/reports.jsp.
2. Miyako S. RFID in Blook Bank Managment. Los Angeles, CA: WINMEC RFID Lab, UCLA;2007.
3. R. R. Sharma SK, S. K. Agnihotri,. Sources of preventable errors related to transfusion. Vox Sanguinis. 2001;81(1):37-41.
4. Ahrens N, Pruss A, Kiesewetter H, Salama A. Failure of bedside ABO testing is still the most common cause of incorrect blood transfusion in the Barcode era. Transfusion and Apheresis Science. 2005;33(1):25-29.

RFID and a Culture of Safety

RFID and a Culture of Safety

My previously posted blog entry was published in Hospitals & Health Networks (H&HN) magazine this month (in abbreviated form). Link to the article.

Tight Budget? Spend Wisely! NAHIT survey reveals more cuts.

Modern Healthcare.com featured an article today entitled: Many hospitals will cut IT budgets, staff in '09: NAHIT. Here is an exerpt discussing what hospital executives reported:

"More than half, 55%, of the executives surveyed said their hospitals were experiencing delays in access to capital, and most, 74%, are delaying or extending the timeline on capital projects. More than half, 57%, said they are deferring IT equipment purchases and 52% said they are extending timelines for implementing health IT initiatives, according to the National Alliance for Health Information Technology. The Chicago-based alliance released a report of the survey results."

This news demonstrates why HIT is so critical. Budgets are already tight and these tough economic times and are expected to “get worse before they get better” according to President-Elect Obama’s recent statements. As resources dwindle in terms of human capital and funding, hospitals need to look to health care IT solutions to improve productivity and to help create more efficient processes.

EHRs and E-Prescriptions are not the whole answer to the problem. A change in the culture of America’s hospitals must happen to improve patient care, reduce costs and reduce risks across the board. Advanced health care IT solutions, like Radio Frequency Identification (RFID), to automate information gathering and distribution to the proper systems on the location of hospital assets, inventory, staff & patients, medications, lab samples and so forth.

This type of automation allows clinicians to be patient-centered, and eliminates human error, among its other benefits. The cost of operating hospitals is significantly reduced when staff are more productive and assets are easily located. Costly legal issues are also avoided with the additional decrease in risks and “never events,” ensuring that hospitals can count on compensation from payers -- who are increasingly refusing to pay for hospital-acquired conditions.

While infrastructure for advanced health care IT solutions requires an initial investment, the case studies have shown rapid ROI and long-term cost savings. Less money for IT should induce wiser spending moving forward.

For more information on RFID solutions for health care, contact Ralph Wagner at 866-257-2111 or rwagner@dcc-online.com.

Learn why you should use an RFID Integrator.

Integrated Solutions magazine published an article this week explaining the value in working with an integrator vs. niche solution provider.

The author likened an integrator to the functions of servers and chefs in the restaurant industry:

"Think of RFID in a restaurant scenario. Companies desiring a seat at the RFID table can order from a vast menu of hardware, middleware, and software components. When you have a meal at a restaurant, you don’t place an order with the steak provider, another with the lobster farm, and another with a vineyard. You place an order with the server, and the chef prepares the meal to your specifications. In the RFID world, you can use an integrator much like you would your server and chef in the restaurant scenario. An RFID integrator can listen to your goals and objectives, make recommendations, then design a solution that meets your specifications."

I think this is a great analogy because it provides a clear picture of the way integrators work within the industry. It is often not immediately clear to organizations who are looking to incorporate RFID into their processes, why they should work through what they view as a "middle-man" to the niche hardware and/or software providers themselves.

Dynamic Computer Corporation provides RFID solutions designed for health care environments. We have specialized knowledge of the processes and challenges endemic to hospitals and health care facilities through our 30 years experience designing IT solutions for health care entities.

We continually evaluate the "menu" of hardware, middleware, software and tags available in the RFID market, carefully selecting and partnering with companies that have components that offer the best QUALITY, VALUE and FUNCTIONALITY for the health care environment. Our neutrality in terms of technology allows us to learn about the needs of the customer and determine what the best combination of "ingredients" will best meet those needs. A mix of technologies is often the best solution, and like the Integrated Solutions piece explains -- it makes much more sense to allow the chef to order and combine the various ingredients for your meal rather than "[placing] an order with the steak provider, another with the lobster farm, and another with a vineyard."

All health care organizations continually strive to improve patient care, reduce costs and reduce risks -- while operating costs and demand increasingly rise and resources are more and more limited across the board. Allowing Dynamic Computer to work with you and its partners to: first, examine your needs carefully and complete a thorough site survey and readiness assessment, and secondly, to design the best RFID solution to address whatever "pains" you are experiencing, will result in a carefully planned, tested and easily scalable RFID foundation.

It is not proprietary, and therefore is quite flexible and easily expanded as the ROI, that you no doubt will rapidly realize, permits. The RFID infrastructure you will need to scale out your applications, or include other types of tracking applications will be in place, whether or not you choose to work with Dynamic again in the future.

As our 30 year history providing IT solutions and our 90-plus rate of repeat business illustrates, the relationships we build with our partners and customers are valuable. We strive for 100% customer satisfaction with each client, and operate with forthright business practices. Chances are, after tasting our menu you will again patronize our restaurant and allow us to serve you.

Learn more about Dynamic Computer Corporation as an RFID Solutions provider for health care. Our RFID Solutions Manager, Ralph Wagner, is available by phone at 866-257-2111 x102, or via email at rwagner@dcc-online.com.

Certification for Health Care IT Should Include RFID

Radio Frequency Identification (RFID) is increasingly being used to automate the transfer of PHI within and between EHRs, EMRs, HIEs, etc. It has been proven to reduce errors and create more efficient processes, as well as improve productivity. This results in Improved Patient Care, Reduced Costs and Minimized Risks.

With the move toward standardizing and certifying electronic health information products and HIEs, it is important to include solutions that facilitate this exchange of information in the certification process. RFID solutions are located together with the security protocols, document routing infrastructure and sending systems used to share electronic health information.

RFID automates the identification of people, objects and events that can be integrated with hospitals’ existing systems, including EHRs, HIEs, security, patient flow systems, bed occupancy, asset utilization and so forth.

By certifying RFID solutions, health organizations can make better decisions about which solutions have met the criteria and received the stamp of approval from certifying authorities for electronic PHI exchanges. This will facilitate better interoperability and accelerate standardization across the industry as RFID solutions providers strive to meet the same standards as the systems with which they must communicate.

It is critical that this happens sooner rather than later, especially in light of the climbing number of adverse medical events and progressively more limited funding across the board.

[A note of clarification: It is the RFID solution's application software, which interacts with the hospital's electronic record systems, that I am suggesting should be eligible for certification. Another level of standardization and perhaps future certification needs to occur at the RFID middleware and edgeware level.]


For more information on RFID in health care, please contact Ralph Wagner, RFID Solutions Manager, at 248-473-2200 or rwagner@dcc-online.com.

Dynamic Computer Corporation has been providing IT solutions for health care entities and other enterprise level companies since 1979.

This comment was submitted for consideration to the Certification Commission for Healthcare Information Technology (CCHIT).