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New wireless technologies reduce medical errors

Executive Summary

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This paper starts off with a case study pertaining to a hospital in Milan, Italy called San Raffaele Hospital. After successive faulty handling of data and incorrect blood transfusions, doctors and other staff at the hospital were contacted by engineers. This case study conducted in 2005 by Joseph Dalton, PhD, a senior technologist with the Intel IT Innovation Center and Dr. Silvano Rossini, Department of Transfusional Medicine,

San Raffaele Hospital, Milan, Italy.

This paper is about how technology today can greatly reduce medical errors. It focuses on one kind of technology as an example of a case study involving RFID technology. This involves a program which uses a wireless infrastructure and RFID technology. RFID standing for radio frequency identification helps in automation of tracking of blood, hence reducing errors related to handling of blood. The field of research involves wireless technology and hospital administration/ handling of patients and assets (example: machines).The study involves a very important health care issue as aforementioned, that of blood transfusion. And if this issue would have been left undealt with, it could have caused a lot of damage to many patients’ lives even resulting into death of quite a few.

After discussion of the case study, the paper talks about the alternatives pharmaceutical companies and hospitals have when dealing with medicine dosage and blood samples and correctly doing so. This leads onto the type of problems that are faced and what the best option should be. One thing is evident in the entire text and that is technology today is not just something that engineers develop. Rather, just like medicine experts come up with new formulas to cure diseases, engineers can also work with hospitals and fight any errors on the hospital’s part through the use of wireless technology and other efficient methods.

This paper is about how technology today can greatly reduce medical errors. It focuses on one kind of technology as an example of a case study involving RFID technology. This was a six month long case study at the San Raffele Hospital in Milan.

Intel with its various innovations ha s also entered the medical field. This involves a program which uses a wireless infrastructure and RFID technology. RFID standing for radio frequency identification helps in automation of tracking of blood, hence reducing errors related to handling of blood. (Joseph Dalton  & Dr. Silvano Rossini, 2005)

Not just blood tracking, but bed-side care, baby care, patient tracking are all benefits that have come out of the use of this technology. Errors in blood transfusion and handling babies have been of great concern to everyone worldwide.

Purpose of the Case Study:

The purpose of the case study was to find out how technology can enable doctors and

nurses to avoid errors and help prevent them efficiently. Around 15000 blood transfusions take place in San Raffaele Hospital every year. And the doctors wanted to test how technology can help in handling these blood transfusions.

Field of Research:

The field of research involves wireless technology and hospital administration/ handling of patients and assets (example: machines).The study involves a very important health care issue. This being the mix-ups in blood samples, that is giving the wrong type of blood to the wrong patient. This could lead to grave consequences like major illnesses to even fatal occurrences, in other words death of the patient.

After learning about the number of deaths that occur because of such mishaps, a new system of tracking blood through RFID was invented and put into action here.

Findings of the Case Study:

After the completion of the study, it was found that in America each year 44,000 people die because of medical errors in hospitals. Out of these, 7000 are those patients who die only because of errors due to incorrect dosages, improper bed-side care and faulty medication control.

The problems arising hereafter mix-ups in blood samples etc all involved the human element. It was found out that incorrect labeling either due to rushing through things or because of same/similar patient names, simultaneously handling of samples, and faulty cross-matching.

A solution to this menace was needed to avoid paying a heavy fees later in the form of bad reputation, high mortality rates etc. An invention was needed that could easily trace packets of blood samples and match them against the lists. Something, that would not involve too much paper reading or physical reading by the eye so that human error could be avoided easily altogether.

This is when Cisco in collaboration with Intel and Autentica came up with a solution to these issues at the San Raffaele Hospital.

With the implementation of this new system, efficiency in health care improved owing to obviously a huge reduction in errors in blood transfusion. It was quite obvious to the naked eye that better methodology in patient care comes from not just good inventions pertaining to the medicine field, rather also because of new ideas in the engineering field.

The entire hospital corresponding to the blood transfusion department is now running on this new wireless system that uses Cisco System’s Technology and software developed by Autentica. This wireless makes use of portable technology like laptops, notebooks, personal digital assistants and even cellular phones now.

Patient information and identification is all entered into laptops etc. after this they are given tags and wrist bands to wear which have this wireless technology instilled in them. This corresponds to the laptops that are fitted with the software RFID uses. After complete verification, the donor gives his blood. After this and sequential tagging, the transfusion begins and this process holds till it finishes itself. This way monitoring and recognition becomes easy and quite efficient.  All possibilities of paper-write errors and human errors are minimal as much of the whole process goes digital, in better words still, wireless. These mobile devices have proven to be error free than the old paper-based systems. The hospital smoothly started running this system in all its departments, by being connected to the main Information System (IS), on completion of this case study proving the fact that wireless technology is indeed very helpful in reducing medical errors. (Joseph Dalton  & Dr. Silvano Rossini, 2005)

Issues:

However, there are certain issues that were also found during the course of this case study. And these according to the conductors of the case study are to be highlighted and dealt with next since RFID is now efficiently been implemented. These issues included blood platelet count and verification as well as complete blood traceability, in accordance with blood donor ties etc.

In conclusion of this case study, it is of our knowledge that blood transfusion became better after installation of this system related to radio frequencies and point-of-care systems. Due to reduction in blood handling, the overall possibility of blood errors decreased.

Findings and Discussion:

The above case study was how at one hospital wireless technology was implemented to check whether errors related to blood transfusion could be reduced or not.

However, RFID technology does not just involves reduction in errors related to blood samples and handling of these. Radio frequency identification is now also being used in assets management that includes hospital machinery, scans, patient bed-side care and also baby/ neonatal care. It has also been found that in the case of cardiac patients, urgency is an issue as minimal wastage of time is the key to saving some one’s life who is suffering from a heart attack. At this time of panic, it is truly essential that efficient tracking is there so that lost things are not have to be searched for.

Radio frequency identification (RFID) systems have been installed in various places now. This specifically involves tagging in hospitals of people. Even dead bodies being kept at morgues have started using radio frequency technology and wireless solutions like this to avoid confusion and mix-ups. (Roger Smith, 2004).

There are many others devices that use wireless technologies and software. As compared to cellular phones, the screen size of PDA’s is big, making clinical data to be read and understood easily. Because of this better readability and efficient input and output of data many hospitals throughout the world now deploy this technology.

Problems:

However, like any other technology, RFID has its own set of issues too.

– Hacking:  First and foremost is that of hacking, as hackers can access data from these tags. In the case of active tags, they also have the accessibility to over-write that data.

– Data fusion is another issue as simultaneously handling of data can cause confusion by multi-tasking tools available on the device.

– On the other hand, speed of reading is another issue which needs to be dealt with as sometimes, when tags are being identified quickly, this simultaneous data input can alter data output and produces a faulty result. Range is the biggest issue however.

– RDIF powered systems run on a certain limit and this has to be maintained to have interference-free direct access to the tag or the laptop etc. This range has been specified as that of being two feet and hence, a little more distance can cause disruption and eventually a broken connection. In the field of technology, this disruption could get dangerous also as in the case of dealing with/ treatment of a cardiac patient as time is a vital factor here for him.

– A standard has to be maintained when using this RFID technology. This includes getting high powered systems that are made specific to the needs of the system being deployed in the hospital. This sometimes, is quite cumbersome and even though being a one time task, can still cause lots of legal and technical issues which can take up a lot of time.

– Devices that use RFID typically can have altered functionality and can even stop working when there is interference. This could happen because of these devices signals cannot penetrate metals and some liquids. Hence, it is extremely vital to the usage of these devices that such materials do not come between the device and the tag. — – Bar code readers, other wireless networks, cellular systems/phones, walkie talkies, and even security systems can also pose a threat in terms of interference to the functioning of the device.

– RFID systems’ implementation can also be very expensive costing millions of dollars even. Even though engineers and scientists are working together to alter this by making it all cost as well as time efficient, but this however will need more looking into and hence more time. These costs that bring the total pay check up are readers, tags, infrastructure, training and development costs, licensing costs and other legal fees, labor cost etc. (Roger Smith, 2004).

Discussion of Alternatives:

After having talked about the problems, the benefits and uses of this type of wireless system to aid the medical field, what’s now important is to analyze what alternatives hospitals and doctors have when choosing what system to implement to avoid errors.

One such alternative could be barcode reading. Barcodes do not involve any range issues and possess no such characteristics as to cause problems related to legal and technical guidelines. There are neither power issues nor frequencies that have to be maintained. It is known that barcodes are readily used in majority of companies that do not even pertain to the medical field. The federal government actually encourages use of bar code readers as far as the pharmaceuticals and medical field is concerned. This is because it helps in dealing with theft and security issues. Patient privacy and safety is hence maintained and looked after. This obviously, highlights implementation of barcode readers since, RDIF are very much prone to menaces like theft and hacking.

Bar code readers need a universal reading graphic that is accepted everywhere hence no conflicts resulting from cross-cultures or legal issues are of trouble here. An internationally accepted such standard is the UCC bar coding system as even more than 22000 units as hospitals or pharmaceutical companies make use of this alternative in the medical field alone. It can also be mentioned here that bar code readers are cost effective also in a way that not much is needed to be spent on training and labor costs in general.

Another alternative to RFID could that be of a CPOE system namely, computerized physician order entry. This type of system can reduce medication errors by a great big amount. Approximately by 83 percent and when it comes to reduction and complete erasing of medication errors it can even be up to 54%. CPOE systems also provide improved software integration and assimilation with workflow. This is a plus point for CPOE systems as newer such systems boast this characteristic also. (Susannah Patton, 2005).

Conclusion and Choosing one Best Alternative:

When it comes to choosing or selecting one best in terms of cost and time efficiency, it is advisable that bar code readers are installed and used. Now, engineers in collaboration with scientists and Intel are also coming up with a wireless solution for handling errors that pertains the system of how a barcode reader works. This is to say that a hospital can have barcode readers installed for tracking and avoiding errors in identification and verification through connection of the bar code readers in the entire hospital connected to one main server through the use of wireless or wi-fi technology. This can be very beneficial as in this case both things are being assimilated and being made to work together to give a better efficient usage.

The nurse uses the wand which then scans the code. This gives access to the nurse to the system so that she/he can refer to work and data available online. Each medicine for instance, in the case of medication control is read by the wand and gets “highlighted”. As soon as that happens, the system runs an automatic check and records what medication is being ordered along with what medication is being scanned or read by the reader. Each reading has its own special symbol, in the form of a color code for instance for amount of do safe, time of dosage, patient etc. all this verification and identification is done by the reader. If the reader does not verify something, the computer would immediately show this on the screen before the patient is about to receive his dose. And hence, any chance of harm is eliminated. During this whole process, paper work is eliminated. There are no problems of interference when coming into contact with some liquid etc and the process takes much less complex steps, also by shortening the amount of time spent on each patient. (Patsy Sublett, 2002)

Recommendation and Implementation:

As far as costs such as financial are concerned, these are much less than what a hospital would be spending on RFID systems. There is no such amount in millions of dollars, unlike RFID. Today, there are however, still, many leasing companies that offer financial break-up of costs to easy getting of these systems and proper implementation. Such schemes involve financing and leasing both. Leasing requires very little payment in terms of advance and there are no such long procedures as per credit lines. The user can even start using the entire system while still paying for it in monthly installments. Hence, profits can be reaped back into the cycle, thus helping to finance the entire project efficiently. There are also lower taxes in America when there is a case of lease of barcode reader equipment. Taxes are big amounts to the operating costs of any hospitals and hence these can be altogether avoided when leasing is undertaken.

Works Cited

1.      Joseph Dalton  & Dr. Silvano Rossini. (2005). RFID Technology helps in reducing medical errors. Retrieved from techrepublic forum. Web site: http://whitepapers.techrepublic.com.com/thankyou.aspx?&promo=110000&docid=164109&view=164109

2.      Roger Smith. (20004). RFID: A Brief Technology Analysis. Retrieved from CTOnet.org © Copyright 2004, Roger Smith. Web site: www.ctonet.org

3.      Susannah Patton. (2005). Medication systems need treatment. Retrieved June, 1rst, 2005 from CIO News Feature.  Web site: http://www.cio.com/article/6745/Medication_Systems_Need_Treatment

4.      Patsy Sublett. (2002). Technology’s Impact on Reducing Medication Errors. Retrieved 2002 from Nelson Publishing, Inc. Patsy Sublett, M.S.N., R.N.-C., senior clinical analyst at Danville Regional Health System, Danville, VA. Web site: http://archive.healthmgttech.com/archives/h1102errors.htm

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