Grace Ministries Hospital

Memo

To: Robert Repetto, Executive Champion From: Tonquita Davis, Product Champion Date: November 19, !!" #ub$ect: %ar Code&s Rep'acement (ere is the proposa' )ou requested *or imp'ementation o* Radio Frequenc) +denti*ication, The proposa' inc'udes secondar) research that sho-s ho- RF+D can enhance the qua'it) o* patient care in our sur.ica' department, /'thou.h bar codin. reap some improvements, RF+D -i'' do a more e**icient $ob, Recommendation *or the *o''o-in. RF+D app'ication inc'udes patient identi*ication, sur.ica' equipment and inventor) trac0in.,

Bar codes replacement: Radio Frequency Identification

Prepared by Tonquita Da is Production c!ampion Report Distributed "o ember #$% &''( Prepared for Grace Ministries Hospital )ur*ical department

+B)TR+,T The purpose o* this proposa' is to sho- ho- RF+D can have a pro*ound impact in our sur.ica' department, Providin. qua'it) care to patients in our sur.ica' units inc'udes the *o''o-in.: Cost reduction, *e-er errors, increased patient sa*et), and reduce patient -ait time, -hich promotes patient satis*action, RF+D is a'so intended to respond to the potentia' prob'em that can occur in our sur.ica' units such as, misidenti*ication, *orei.n retainer, and 'ost or misp'aced inventor), The resu'ts o* this stud) sho- more e**ort is needed to increase patient sa*et) and mana.e inventor), +n this area, RF+D can do a more e**icient $ob than %ar Code because o* it man) advanta.es, The primar) .oa' o* RF+D is to enhance patient care in our sur.ica' unit b) reducin. medica' errors, potentia' 'a- suits, and cost and time not spent on patient, Recommendation inc'udes the *o''o-in. RF+D app'ication to achieve these resu'ts in our sur.ica' department: 1 Patient sa*et) identi*ication 1 Trac0in. sur.ica' equipment 1 2ana.in. inventor)

Table of contents +B)TR+,T 333333333333333333333333333 I"TR-D.,TI-" 333333333333333333333333, 1 /dvanta.es o* RF+D over barcodes 333333333333333,, 1 ,-MP-"/T) -F RFID T/,H"-0-G1 )1)T/M 3333333333 1
RF+D Ta. 3333333333333333333333333,, RF+D Reader 333333333333333333333333 RF+D database 33333333333333333333333,, TH/ B/"/FIT) -F .)I"G RFID 33333333333333333,,, TH/ PR-P-)/ P0+")2)-0.TI-") 333333333333333,,, Patient sa*et) identi*ication 333333333333333333,, Trac0in. sur.ica' equipment 333333333333333333, 2ana.in. inventor) 333333333333333333333,, 4 4 5 5

,-)T -F IMP0/M/"T+TI-"3333333333333333333 6 PRI3+,1 ,-",/R" 33333333333333333333333 6 ,-",0.)I-"2R/,-MM/"D+TI-" 333333333333333,,, 7 4-R5) ,IT/D,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "

1 Introduction
Risin. hea'th care cost and patient sa*et) are a ma$or concern *or our hospita', Contro''in. these issues -i'' be essentia' to 0eep our competitive advanta.es and improve the qua'it) o* patient care, /ccordin. to 2urph), .overnment studies su..est stron. +n*ormation Techno'o.) investment cou'd cut hea'th care costs b) ! percent each )ear, and Radio Frequenc) +denti*ication techno'o.) can de*inite') contribute to hea'th care cost reductions 82urph) 9:, /s our hospita' see0 -a)s to reduce expenses, it is important that patient sa*et) is not the trade;o**< Radio Frequenc) +denti*ication 8RF+D: ho'ds .reat potentia' to reduce cost, -hi'e improvin. patient sa*et), RF+D can he'p prevent potentia' mista0es that can occur in our sur.ica' procedures, -hich contribute to the risin. hea'th care cost and sa*et) .aps -ithin sur.ica' units, /'thou.h %ar Code e'iminates some potentia' prob'ems and provides some sa*et) measure, it has dra-bac0s, RF+D is a more e**icient process *or the $ob, =ua'it) care in our sur.ica' units -i'' promote patient satis*action, and that is ver) important, especia'') since no- more patients than ever are choosin. their hospita', + propose that to promote the over a'' qua'it) o* patient care, -e imp'ement RF+D techno'o.) to enhance our sur.ica' department,

/dvanta.es o* RF+D over barcodes RF+D 8termino'o.): a -ire'ess automatic identi*ication and data capturin. communication techno'o.) uses to trac0 or identi*) peop'e or ob$ects,: is rea'') an up.raded barcode, 8>enera' RF+D in*ormation b) Roberti states the advanta.es RF+D have over %ar codes:: ?n'i0e traditiona' %ar Code, it does not require a 'ine o* si.ht to visua'') read or scan ta.s 8Roberti, 1:, #o there*ore, RF+D data can be read throu.h patient c'othin., non;meta''ic materia's, and even the human bod) 81:, RF+D scanner can read at 'on.er distances than bar code, and read mu'tip'e ta.s at once 81:, +t a'so )ie'ds 'ar.er memor) capacities and *aster processin. 81:, %ar code scannin. has dra-bac0s 'i0e not bein. ab'e to read barcode, i* the paper is ripped o** or becomes unreadab'e 81:, RF+D -i'' continue to .ro- in its estab'ished ro'es -here optica' barcode techno'o.) is not as e**ective because o* the unique identi*ication at the product 'eve' 81:,

,omponents of RFID tec!nolo*y system / RF+D s)stem consists o* three main components a RF+D ta., RF+D reader, and RF+D database 8midd'e-are:,

RF+D Ta. /n RF+D ta. 8termino'o.): /,@,/ transponder is a device attached to or embedded in a ph)sica' ob$ect to be identi*ied or trac0ed, +t contains an embedded microchip, radio receiver and radio transmitter, The chip stores basic in*ormation about a ta..ed ob$ect, t)pica'') a product code and a unique seria' number, RF+D ta.s are avai'ab'e in three di**erent t)pes: passive, semi passive, and active, Passive ta.s store a sma'' amount o* data and are po-ered b) an e'ectronic reader, #emi;passive ta.s are simi'ar to passive ta.s, but contain an interna' po-er source, Due to this po-er source, the semi passive ta. ho'ds more data and has a .reater ran.e, /ctive ta.s o**er the most *eatures, data, .reatest ran.e, and uses batter) po-er source,

RF+D Reader Readers 8termino'o.): can be either portab'e handhe'd termina's or *ixed device, /n RF+D reader, or interro.ator, is a device to communicate -ith the RF+D ta., +t broadcasts a radio si.na', -hich is received b) the ta., The ta. then transmits its in*ormation bac0 to the reader, This enab'es a RF+D reader and RF+D ta. to communicate to each other throu.h a speci*ied radio *requenc), Ao-; *requenc) s)stems have short readin. ran.es, (i.h *requenc) s)stems o**er 'on.er read ran.es and hi.her readin. speed,

RF+D 2idd'e-are RF+D midd'e;-are 8termino'o.): consists o* computer hard-are and data processin. so*t-are that connects readers to computer s)stems and data storehouse, +t converts data *rom ta.s into trac0in. or identi*ication in*ormation, +t ta0es the ra- data *rom the reader *i'ters it and passes on the use*u' event data to bac0;end s)stems, 2idd'e;-are p'a)s an important ro'e in .ettin. the ri.ht in*ormation to the ri.ht app'ication at the ri.ht time,

T!e Benefits of usin* RFID RF+D can have pro*ound impact and bene*its *or our sur.ica' units -hen the ri.ht resources are trac0ed and identi*ied, RF+D -i'' he'p e'iminate potentia' prob'em in our sur.ica' department and provide the *o''o-in. si.ni*icant bene*its: 1 +mproved inventor) e**icienc) and mana.ement 4 1 Fe-er errors 1 Cost reduction 1 Reduce administrative burdens on care .ivers 1 #horten patient -ait times 1 +ncrease patient sa*et) These bene*its -i'' he'p enhance the overa'' qua'it) o* patient care in our sur.ica' centers, The bene*its o* usin. RF+D in our sur.ica' department are compe''in.,

T!e propose plans2solutions

To achieve these bene*its at >race 2inistries (ospita', + propose that -e imp'ement RF+D techno'o.) to identi*) patient, ta. sur.ica' equipment, and trac0 inventor),

Patient sa*et) identi*ication

/s )ou 0no-, the FD/ no- requires hospita' to do a universa' protoco' procedure to e'iminate the 'i0e'ihood o* -ron. site, -ron. procedure, and -ron. patient sur.eries 8FD/ 1:, Due to the *act that paper-or0 is time consumin. and bus) sta**s $u..'in. mu'tip'e responsibi'ities do not a'-a)s communicate -e'' -ith each other or -ith the patient and their *ami'), These ine**iciencies can create opportunities *or medica' errors and sa*et) .aps, potentia'') harmin. the patient, ?sin. RF+D to identi*) patient can he'p enhance our standard operatin. procedure b) ma0in. the process more accurate, e**icient, and 'ess time consumin., The RF+D -ristband -i'' he'p reduce misidenti*ication o* patients in our sur.ica' unit, %e*ore sur.er) be.ins, sur.ica' sta** can read RF+D ta.s embedded in -ristband -ith handhe'd readers to con*irm the ri.ht patient and ri.ht procedure, The memor) o* the ta. can store in*ormation 'i0e doctor&s name, patient&s name, a.e, procedure, operative site, and medica';record number 8%ache'dor 6:, The unique +D number o* the ta. is then associated -ith the record o* the patient in the hospita'&s bac0 end in*ormation s)stem 86:, +t a'so 'ists critica' in*ormation such as a''er.ies, precaution, and specia' needs 86:, The device a'so disp'a)s a chec0'ist o* procedures that must be carried out be*ore that speci*ic patient can pro.ress throu.h to the next sta.e o* the sur.ica' process 86:, This -i'' a''oour nurses to be a-are o* the status o* their patients and -i'' avoid de'a)s in patient *'o- caused b) a 'ac0 o* in*ormation, The RF+D s)stem -i'' a'so reduce the time nurses spend enterin. data about their patient, 'eavin. them more time to provide care, RF+D cou'd provide a use*u' mean *or our hospita' to avoid sur.ica' errors and a''eviate patient concerns,

Trac0in. sur.ica' equipment 5 Bur nurses spend 16 to 4! minutes countin. sur.ica' spon.es be*ore, durin., and a*ter each sur.er) to ensure that a'' spon.es used are removed, This manua' process is time consumin., and sub$ect to human error, even -ith our most conscientious sur.ica' sta** count can be unre'iab'e in our bus) sur.ica' unit, /ccordin. to c'ear count, an estimated 1,6!! ob$ect are 'e*t inside patients durin. sur.er) each )ear, and studies have sho-n t-o;thirds o* them are spon.es 8C'ear Count 2edica' #o'ution 46:, 2an) o* them are not discovered unti' )ears 'ater, -hich required an additiona' operation, Embeddin. our sur.ica' equipment, too's and assets especia''), spon.es -ith RF+D ta.s can save us *rom potentia' 'a-suits, RF+D can prevent spon.es and other

materia's *rom bein. 'e*t inside our patient durin. sur.er) because it does not require a 'ine o* si.ht to read ta.s, There*ore, spon.es and other sur.ica' instruments can be detected inside the human bod) 8#chuerenber. 45:, /'ex 2acario, 2,D, 'ed a stud) at #tan*ord ?niversit) medica' center to determine i* RF+D techno'o.) cou'd be used to he'p reduce such errors 8#chuerenber. 45:, Durin. the stud), 9 RF+D spon.es -ere 'e*t in ei.ht patients, sur.eons pu''ed to.ether the patient&s cuts and used scannin. device to scan *or spon.es and a'' spon.es -ere detected 8#chuerenber. 45:, %) imp'ementin. RF+D to trac0 sur.ica' instrument, our sur.ica' teams -i'' be ab'e to scan the patient -ith an RF+D reader 8interro.ator: a*ter sur.er) to ma0e sure no spon.es are mista0en') 'e*t inside patients, RF+D techno'o.) cou'd a'so supp'ant time; consumin. manua' counts done b) our nurses severa' times durin. the course o* sur.er), or cost') and time;consumin. C;ra)s that can detect threads se-n into the spon.es, -hich reduces sta** time not dedicated to patient care,

2ana.in. inventor) /sset mana.ement is critica' *or patient sa*et), Bur sta** spends vast amounts o* time 'oo0in. *or sur.ica' equipment and shared resources, -hich *requent') de'a) our sur.ica' procedures, (avin. the ri.ht products, *or the ri.ht doctor, at the ri.ht time, is comp'icated and cha''en.in. -hich, potentia'') trade;o** patient sa*et), sta** $ob satis*action and overa'' productivit), %) monitorin. the status and -hereabouts o* critica' medica' equipment used in the sur.ica' units, our sta** -i'' be ab'e to ensure that equipments are read) *or sur.ica' procedures, ?sin. RF+D to mana.e inventor) can 'ead to more precise supp') orders and more accurate de'iver) o* appropriate materia's to ph)sicians and patients 82urph) 41:, Bur hospita' o*ten incur hi.h costs re'ated to 'ost and misp'aced equipment, -hich 'eads to increase cost because o* the need to rent equipment to meet usa.e demands, 2ana.in. inventories -ith RF+D s)stem -i'' 'ead to improved asset use and 'o-er renta' costs because o* the abi'it) to pinpoint the misp'aced items, -hich saves a 'ot o* mone) spent *or rep'acin. items, %on #ecours (ea'th #)stem insta''ed RF+D at three hospita's to trac0 equipment and reported the) no 'on.er had to spend mone) on rep'acin. 'ost equipment and the nursin. sta** saved 4! minutes per shi*t because the) donDt have to search *or equipment 82urph) 4!:, /n RF+D s)stem has potentia' to save 'abor cost, improve operatin. e**icienc) and reduce costs *or our hospita', /ccordin. to Na.), a stud) o* trac0in. in operatin. room sho-ed an improvement in the uti'iEation o* sur.ica' department *rom 6"F to "!F, -hich in turn paid *or the RF+D s)stem throu.h a reduction in need *or overtime pa) 8Na.) 74:,

6 ,ost of Implementation The cost o* imp'ementin. RF+D depends on the app'ication, the siEe o* the insta''ation, the t)pe o* s)stem, maintenance and man) other *actors, so it is not possib'e to .ive an exact *i.ure, 2oreover, each main component -i'' have up;*ront costs, RF+D passive ta.s are priced an)-here *rom 9 cents to G1 each, #emi;passive ta.s ran.e bet-een G7 and G6! a ta., /ctive ta.s are priced bet-een G16 and G1!! each, RF+D readers price ran.e *rom G6!! to G4,!!!,

RF+D midd'e;-are can be purchased *or as 'itt'e as G6,!!! to G !,!!!, Bur Compan) -i'' need to invest in trainin. *or emp'o)ees and pa) *or the insta''ation o* the readers, +t is not possib'e to provide a 'ist o* ever) e'ement that our compan) -i'' need and the cost o* those s)stems, These questions -i'' be discussed and ans-er -ith RF+D vendors, /ccordin. to Pa.e, quotes *rom various vendors indicate that it costs G !!,!!! to G7!!,!!! or more to insta'' a *aci'it) -ide RF+D trac0in. s)stem in a medium;siEed hospita', but vendors are quic0 to sa) that the nee**iciencies RF+D s)stems produce can pa) *or the investment in one to t-o )ears, and man) hospita' c'ients a.ree 8Pa.e 19:, +n tota', the s)stem reports savin. G !!,!!! a )ear over the cost o* insta''ation and maintenance o* RF+D, not inc'udin. productivit) .ains 82urph) 4!:, For these ear') adopters, the savin.s and improved patient care *ar out-ei.hed the cost o* RF+D insta''ation and maintenance 82urph) 4!:,

Pri acy concern / 'ot o* the attention around RF+D is re'ated to privac), -ith concerns bein. raised that ri.hts are bein. compromised, #i.ni*icant privac) issues cou'd resu't -ith RF+D i* it is not care*u'') contro''ed, (o-ever, -e can do man) thin.s to ma0e sure our patients privac) are protected and that -e meet (+P// comp'ianceH requirements, Ie cou'd invest in a techno'o.ica' too' 0no-n as a b'oc0er ta. that emit private;read commands that $ams readers, renderin. the reader incapab'e o* communicatin. -ith other ta.s 8Jue's 16:, Carr)in. a b'oc0er can ensure our patients a.ainst scannin. o* their persona' possessions 8Jue's 17:, Ie can a'so purchase RF+D ta.s that inc'ude a bui't;in D0i''D *unction and -ith the correct pass;code, the ta. can be either repro.rammed or to'd to Dse'* destructD, renderin. it use'ess 8Jue's :, Persona' hea'th in*ormation is not at ris0 i* -e carr) RF+D ta.s that on') have a unique +D that requires an externa' s)stems database to match patient demo.raphics 8Na.) 77:, To consume patient *ear o* third part) snoopin., ta.s can have a random number store in a secure database to identi*) hea'th in*ormation or a securit) code to access the data stored on the chip 8Iic0s 7:,

7 ,onclusion2Recommendation
?pon m) research, + *ound RF+D techno'o.) that can be app'ied across man) hea'th;care app'ications, 2an) hospita's are imp'ementin. RF+D to achieve one speci*ic aim, such as identi*)in. patients or trac0in. one t)pe o* assets 8Roberti 5:, These s)stems can achieve some potentia' bene*its but, imp'ementin. RF+D in*rastructure that can be used to trac0 patients, assets, and sur.ica' instruments can pro*ound') improve the qua'it) o* hospita's bottom 'ine 8Roberti 5:, + recommend that to .et the *u'' potentia' bene*its o* usin. RF+D -e imp'ement it to identi*) patient, trac0 sur.ica' equipment and inventor) in our sur.ica' department, +mp'ementin. RF+D can he'p enhance patient identi*ication, inventor) mana.ement and asset

trac0in. in the sur.ica' department o* our hospita', -hich can he'p reduce cost and increase patient sa*et), 2urph) states RF+D has been imp'emented in severa' ma$or hospita's around the countr), and their experience sho-s ho- RF+D can decrease inventor) 'oss, increase time devoted to patients and improves the accurac) o* instruments required *or sur.eries 82urph) 4!:, There is a c'ear advanta.e to usin. RF+D ta.s in our sur.ica' department -here trac0in. supp'ies, equipment, and thousands o* other items remain a ma$or cha''en.e, +* this proposa' is adopted, + am 'oo0in. *or-ard to *indin. 'eadin. RF+D vendors to he'p us -ith process chan.e and trainin., + am con*ident that -e can ma0e the transition and that the sta** -i'' be happier -ith the -or0*'o-, it is desi.n to ma0e our -or0 process easier, not harder, +mp'ementation phase ta0e about 1 months, The advanta.es o* RF+D s)stems are more than cost and RB+ investment are seen in 'ess than 4 )ears 8Na.) 74:,

" 4or8s ,ited %ache'dor, %eth, 8 !!":, Ta.s Trac0 #ur.ica' Patients at %irmin.ham (eart'ands (ospita', RFID Journal, 1-2, Khttp:HH---,r*id$ourna',comHartic'eHartic'evie-H4 H1H1HL C'ear Count 2edica' #o'ution, MTrac0in. do-n -a)-ard spon.es,N Nursing 47,1! Bct !!7: 46; 46, (ea'th source: Nursin.H/cademic Edition, 9 Nov, !!", >/A+AEB, FD/ Consumer, MTechno'o.) *or sa*er sur.er),N FDA Consumer 49,1 JanHFeb !!6: ; , /'t (ea'thIatch, 9 Nov, !!", >/A+AEB, Jue's, /ri, 8 !!6:, / %it o* privac): %'oc0in., RFID journal, 1, Khttp:HH---,r*id$ourna',comHartic'eHartic'evie-H1647H1H9 HL 2urph), Debbie, M+s RF+D ri.ht *or )our or.aniEationON Materials Management in Health Care 16:7 8 !!7:: 9;44, 2ed'ine Iith Fu'' Text, 9 Nov, !!", >/A+AEB, Na.) P, >eor.e +, %ernstein I, Caban J, @'ein R, 2eErich R, Par0 /, MRadio *requenc) +denti*ication s)stems techno'o.) in the sur.ica' settin.,N Surgical Inno ation 14,1 2ar !!7: 71;7",2ed'ine -ith *u'' text, 9 Nov, !!", >/A+AEB, Pa.e Aei.h, M(ospita's tune in to RF+D,N Material management in Healthcare17,6 2a) !!": 19; !, 2EDA+NE -ith Fu'' Text, Nov, !!", >/A+AEB, Roberti, 2ar0, 8 !! :, RF+DDs Ro'e in +mprovin. (ospita' Bperations, Ed, RFID Journal, 1; , Khttp:HH---,r*id$oura'evnents,comHhea'thcareHL Roberti, 2ar0, 8 !! :, >'ossar) o* RF+D Terms, Ed, RFID Journal! Khttp:HH---,r*id$ourna',comHartic'eH.'ossar)HL Roberti, 2ar0, 8 !! :, >enera' RF+D in*ormation, Ed, RFID Journal! Khttp:HH---,r*id$ourna',comH*aqH17H6!L #chuerenber., %@, M%ar codes vs, RF+D: a batt'e $ust be.innin.,N Health Data Management 15,1! Bct, !!7: 4 ;5, 47, 49, 2EDA+NE Iith Fu'' Text, 9 Nov, !!", >/A+AEB, Iic0s /2, Pisich J@, Ai #, MRadio *requenc) identi*ication app'ications in hospita' environments,N Hos"ital #o"ics 95,4 #ummer !!7: 4;9, 2EDA+NE -ith Fu'' Text, 9 Nov, !!", >/A+AEB,