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 patient 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' 'asuits, 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: Patient sa*et) identi*ication Trac0in. sur.ica' equipment 1ana.in. inventor)

Table of contents
+B)TR+,T 222222222222222222222222222 I"TR-D.,TI-" 222222222222222222222222, 1 /dvanta.es o* RF+D over barcodes 222222222222222,, 1 ,-MP-"/T) -F RFID T/,H"-0-G1 )1)T/M 2222222222 1 RF+D Ta. 2222222222222222222222222,, RF+D Reader 222222222222222222222222 RF+D database 22222222222222222222222,, TH/ B/"/FIT) -F .)I"G RFID 22222222222222222,,, TH/ PR-P-)/ P0+")2)-0.TI-") 222222222222222,,, 3 Patient sa*et) identi*ication 222222222222222222,, 3 Trac0in. sur.ica' equipment 222222222222222222, 4 1ana.in. inventor) 222222222222222222222,, 4 ,-)T -F IMP0/M/"T+TI-"2222222222222222222 5 PRI3+,1 ,-",/R" 22222222222222222222222 5 ,-",0.)I-"2R/,-MM/"D+TI-" 222222222222222,,, 6 4-R5) ,IT/D,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, "

# Introduction Risin. hea'th care cost and patient sa*et) are a ma$or concern *or hospita', Contro''in. these issues -i'' be essentia' to 0eep our competitive advanta.es and improve the qua'it) o* patient care, 7overnment 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 81urph) 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 si.ni*icant') reduce cost, -hi'e improvin. patient sa*et), RF+D can he'p prevent potentia' mista0es that can occur in sur.ica' procedures, -hich contribute to the risin. hea'th care cost and he'p c'ose 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 $ob, =ua'it) care promotes patient satis*action, and that is ver) important, especia'') since no- more patients than ever are choosin. their hospita', + propose that to promote the over a'' qua'it) o* patient care, -e imp'ement RF+D techno'o.) to enhance our sur.ica' department, /dvanta.es o* RF+D over barcodes RF+D 8termino'o.): a -ire'ess automatic identi*ication and data capturin. communication techno'o.) uses to trac0 or identi*) peop'e or ob$ects,: is rea'') an up.raded barcode, 87enera' RF+D in*ormation:: >n'i0e traditiona' %ar Code, it doesn&t require a 'ine o* si.ht to visua'') read or scan ta.s, #o there*ore, RF+D data can be read throu.h patient c'othin., non;meta''ic materia's, and even the human bod), RF+D scanner can read at 'on.er distances than bar code, and read mu'tip'e ta.s at once, +t a'so )ie'ds 'ar.er memor) capacities and *aster processin., %ar code scannin. has dra-bac0s 'i0e not bein. ab'e to read barcode, i* the paper is ripped o** or becomes unreadab'e, RF+D -i'' continue to .ro- in its estab'ished ro'es -here barcode or other optica' techno'o.ies are not as e**ective because o* the unique identi*ication at the product 'eve', ,omponents of RFID tec!nolo*y system / RF+D s)stem consists o* three 0e) components a RF+D ta., RF+D reader, and RF+D database, +nside o* each ta. are inte.rated circuits, The reader decr)pt the data encode in the inte.rated circuit o* the ta. and the data is passed to the host computer processin.,

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, The in*ormation is re'a)ed usin. radio -aves to an RF+D reader, -hich then transmits the data to business so*t-are s)stems -here it can be put to use, 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, are po-ered b) an e'ectronic reader, have a ran.e about 3 *eet, and react -hen a si.na' is received, #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 either be portab'e handhe'd termina's or *ixed device, @*ten antenna is pac0a.ed -ith the transceiver and decoder to become a readerAinterro.ator, /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), Bo-; *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 database 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, 1idd'e-are p'a)s a 0e) 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: +mproved inventor) e**icienc) and mana.ement Fe-er errors Cost reduction 3 Reduce administrative burdens on care .ivers #horten patient -ait times +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., To achieve these

bene*its at 1inistries (ospita', + propose that -e imp'ement RF+D techno'o.) to identi*) patient, trac0 sur.ica' equipment, and mana.e inventor), T!e propose plans2solutions To achieve these bene*its at 7race 1inistries (ospita', + propose that -e imp'ement RF+D techno'o.) to identi*) patient, trac0 sur.ica' equipment, and mana.e 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:, 7overnment estimates indicate that *ive to ei.ht -ron.;site sur.eries occur each month 8FD/:, Due to the *act that paper-or0 is time consumin. and bus) sta**s $u..'in. mu'tip'e responsibi'ities do not a'-a)s communicate -e'' -ith each other or -ith the patient and their *ami'), These ine**iciencies can create opportunities *or medica' errors and sa*et) .aps, potentia'') harmin. the patient, >sin. RF+D to identi*) patient can he'p enhance our standard operatin. procedure b) ma0in. the process more accurate, e**icient, and 'ess time consumin., 1arc) hospita' imp'emented RF+D to patient -ristband and reported, CNurses appreciate the time savin.s and convenience that can be app'ied to their -or0*'o-D 8Eoun. 435:, The RF+D -ristband a'so reduces misidenti*ication o* patients, %e*ore sur.er) be.ins, sur.ica' sta** can read RF+D ta.s embedded in -ristband -ith handhe'd readers to con*irm the ri.ht patient and ri.ht procedure, The memor) o* the ta. can store in*ormation 'i0e doctor&s name, patient&s name, a.e, .ender procedure, operative site, and medica';record number 8%ache'dor 5:, The unique +D number o* the ta. is then associated -ith the record o* the patient in the hospita'&s bac0 end in*ormation s)stem, +t a'so 'ists critica' in*ormation such as a''er.ies, precaution, and specia' needs 8%ache'dor 5:, The device a'so disp'a)s a chec0'ist o* procedures that must be carried out be*ore that speci*ic patient can pro.ress throu.h to the next sta.e o* the sur.ica' process 8%ache'dor 5:, @ur nurses -i'' be a-are o* the status o* their patients and can avoid de'a)s in patient *'o- caused b) a 'ac0 o* in*ormation, The RF+D s)stem -i'' reduce the time nurses spend enterin. data about their patient, 'eavin. them more time to provide care, RF+D cou'd provide a use*u' means *or our hospita' to avoid sur.ica' errors and a''eviate patient concerns, Trac0in. sur.ica' equipment 4 @ur nurses spend 15 to 3! minutes countin. sur.ica' spon.es be*ore, durin., and a*ter each sur.er) to ensure that a'' spon.es used are removed, This manua' process is time consumin., and sub$ect to human error, even -ith our most conscientious sur.ica' sta** count can be unre'iab'e in a bus) sur.ica' unit, /ccordin. to c'ear count, an estimated 1,5!! 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 1edica' #o'ution 35:, 1an) o* them are not discovered unti' )ears 'ater, -hich required an additiona' operation, Embeddin. our

sur.ica' equipment, too's and assets such as, 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. 34:, /'ex macario, 1,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 8schuerenber. 34:, Durin. the stud), 9 RF+D spon.es -ere 'e*t in ei.ht patients, sur.eons pu''ed to.ether the patient&s incisions and used scannin. device to scan *or spon.es and a'' spon.es -ere detected 8schuerenber. 34:, %) 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: in the *orm o* a -and a*ter sur.er) to ma0e sure no spon.es are mista0en') 'e*t inside patients, RF+D techno'o.) cou'd supp'ant time;consumin. manua' counts done b) nurses severa' times durin. the course o* a sur.er), or cost') and time;consumin. F; ra)s that can detect threads se-n into the spon.es -hich reduces sta** time not dedicated to patient care, 1ana.in. inventor) /sset mana.ement is critica' *or patient sa*et), @ur 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** can 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 81urph) 31:, @ur 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, 1ana.in. inventories -ith RF+D #)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 3! minutes per shi*t because the) donGt have to search *or equipment 81urph) 3!:, /n RF+D s)stem can save 'abor cost, improve operatin. e**icienc) and reduce costs, / stud) o* trac0in. in operatin. room 5 sho-ed an improvement in the uti'iHation o* sur.ica' department *rom 5"I to "!I, -hich in turn paid *or the RF+D s)stem throu.h a reduction in need *or overtime pa) 8Na.) 63:, ,ost of Implementation The cost o* imp'ementin. RF+D depends on the app'ication, the siHe 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, Each 0e) component -i'' have up;*ront costs and some unexpected costs, RF+D passive ta.s are priced an)-here *rom 9 cents to J1 each, #emi;passive ta.s ran.e bet-een J6 and J5! a ta., dependin. on the capabi'ities, /ctive ta.s are priced bet-een J15 and J1!! each, based on the options and memor), RF+D readers price ran.e *rom J5!! to J3,!!!, dependin. on their *unctiona'it), RF+D midd'e-are can be purchased *or as 'itt'e as J5,!!! to J !,!!! based on the number o* 'ocations -here it -i'' be insta''ed, the comp'exit) o* the app'ication, @ur Compan) -i'' need to invest in trainin. *or emp'o)ees and pa) *or the insta''ation o* the readers, Ke ma) a'so need to hire a s)stems inte.rator, up.rade enterprise app'ications and net-or0s -ithin our *aci'ities, +tGs 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 J !!,!!! to J6!!,!!! or more to insta'' a *aci'it) -ide RF+D trac0in. s)stem in a medium;siHed hospita', but vendors are quic0 to sa) that the ne- e**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. J !!,!!! a )ear over the cost o* insta''ation and maintenance o* RF+D, not inc'udin. productivit) .ains 81urph) 3!:, For these ear') adopters, the savin.s and improved patient care *ar out-ei.hed the cost o* RF+D insta''ation and maintenance 81urph) 3!:,

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 a 'ot o* thin.s to ma0e sure patients privac) are protected and that -e meet (+P// comp'ianceA requirements, Ke 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 8Lue's 15:, %) carr)in. a b'oc0er, our patients can be ensured a.ainst scannin. o* their persona' possessions 8Lue's 16:, Ke can a'so purchase RF+D ta.s that inc'ude a bui't;in G0i''G 6 *unction and -ith the correct pass;code, the ta. can be either repro.rammed or to'd to Gse'* destructG, renderin. it use'ess 8Lue'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.) 66:, 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 8Kic0s 6:, ,onclusion2Recommendation >pon m) research + *ound, RF+D techno'o.) that can be app'ied across man) hea'th;care app'ications, 1an) hospita's are imp'ementin. one;o** s)stems to achieve a speci*ic aim, such as identi*)in. patients or trac0in. one t)pe o* assets 8Roberti 4:, Khi'e these

s)stems can achieve some potentia' bene*its, 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 4:, + recommend that to .et the *u'' potentia' bene*its o* RF+D -e imp'ement it to identi*) patient, trac0 sur.ica' equipment and inventor) in our sur.ica' department, +t is a'so -here the potentia' return on investment -i'' be the .reatest, +mp'ementin. RF+D can he'p enhance patient sa*et), 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), RF+D has been imp'emented in severa' ma$or hospita's around the countr)< their experience sho-s ho- RF+D can decrease inventor) 'oss, increase time devoted to patients and improve the accurac) o* instruments required *or sur.eries 81urph) 3!:, There is a c'ear advanta.e to usin. RF+D ta.s in department -here trac0in. supp'ies, equipment, and thousands o* other items remains a ma$or cha''en.e *or hospita', +* this proposa' is adopted, + am 'oo0in. *or-ard to *indin. 'eadin. RF+D vendors to he'p us -ith process chan.es 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 R@+ investment are seen, RF+D s)stems are reported to return their investment in 'ess than 3 )ears 8Na.) 63:,

" 4or6s ,ited %ache'dor, %eth, 8 !!":, Ta.s Trac0 #ur.ica' Patients at %irmin.ham (eart'ands (ospita', RFID Journal, 1-2, Mhttp:AA---,r*id$ourna',comAartic'eAartic'evie-A3 A1A1AN C'ear Count 1edica' #o'ution, CTrac0in. do-n -a)-ard spon.es,D Nursing 36,1! @ct !!6: 35;35, (ea'th source: Nursin.A/cademic Edition, 9 Nov, !!", 7/B+BE@, FD/ Consumer, CTechno'o.) *or sa*er sur.er),D FDA Consumer 39,1 LanAFeb !!5: ; , /'t (ea'thKatch, 9 Nov, !!", 7/B+BE@, Lue's, /ri, 8 !!5:, / %it o* privac): %'oc0in., RFID journal, 1, Mhttp:AA---,r*id$ourna',comAartic'eAartic'evie-A1536A1A9 AN 1urph), Debbie, C+s RF+D ri.ht *or )our or.aniHationOD Materials Management in Health Care 15:6 8 !!6:: 9;33, 1ed'ine Kith Fu'' Text, 9 Nov, !!", 7/B+BE@, Na.) P, 7eor.e +, %ernstein K, Caban L, ?'ein R, 1eHrich R, Par0 /, CRadio *requenc) +denti*ication s)stems techno'o.) in the sur.ica' settin.,D Surgical Inno ation 13,1 1ar !!6: 61;6",1ed'ine -ith *u'' text, 9 Nov, !!", 7/B+BE@, Roberti, 1ar0, 8 !! :, RF+DGs Ro'e in +mprovin. (ospita' @perations, Ed, RFID Journal, 1; , Mhttp:AA---,r*id$oura'evnents,comAhea'thcareAN Roberti, 1ar0, 8 !! :, 7'ossar) o* RF+D Terms, Ed, RFID Journal! Mhttp:AA---,r*id$ourna',comAartic'eA.'ossar)AN Roberti, 1ar0, 8 !! :, 7enera' RF+D in*ormation, Ed, RFID Journal! Mhttp:AA---,r*id$ourna',comA*aqA16A5!N #chuerenber., %?, C%ar codes vs, RF+D: a batt'e $ust be.innin.,D Health Data Management 14,1! @ct, !!6: 3 ;4, 36, 39, 1EDB+NE Kith Fu'' Text, 9 Nov, !!", 7/B+BE@, Kic0s /1, Pisich L?, Bi #, CRadio *requenc) identi*ication app'ications in hospita' environments,D Hos"ital #o"ics 94,3 #ummer !!6: 3;9, 1EDB+NE -ith Fu'' Text, 9 Nov, !!", 7/B+BE@,