RFID still a solid alternative to barcoding

There’s an interesting article in the most recent issue of Patient Safety & Quality Healthcare (PSQH) about the use of RFID technology in healthcare and what advantages it may offer over current barcoding technology.

I’ve been interested in the use of RFID technology in healthcare for quite some time. I think there’s real value in the use of RFID secondary to the ability to encode significant amounts of information in the tag. The information contained in an RFID tag could potentially include a patient’s medication regimen, allergies and medical condition. The value become obvious when you consider the possibilities during medication administration in the acute care setting.

The article has a great list of reasons why RFID should at least be considered a viable alternative to BCMA.

Barcoding presents challenges, however, especially with regard to barcode medication administration (BCMA).

  • Barcoding requires human compliance—in order to perform its function, a barcode must be scanned and that requires a human to pull the trigger. If a human elects to bypass the process and not use the barcode scanner, there is little that can be done about it.
  • Barcodes require line-of-sight scanning. To identify a patient, for example, the care provider must locate and scan the patient’s wristband. If the patient is asleep and resting on that hand, that means disturbing, and possibly waking, the patient.
  • The scanner cannot verify that the barcode scanned is actually physically attached to the item it represents. There are well-documented instances of users producing surrogate copies of barcodes and scanning those surrogates, rather than scanning the barcodes actually affixed to the appropriate items (Koppel, et al., 2008).
  • Barcode scanners cannot tell the difference between scanning 10 different instances of the same barcode (e.g., scanning 10 different medication vials) or scanning the same barcode 10 times (e.g., scanning the same vial 10 times). This means that people can “cheat” the system, and a user who loses track of where they are in a scanning process cannot tell if they have already scanned an item. It should be noted that the FDA has proposed a serialized National Drug Code (NDC) implementation that would improve this issue.
  • When a large number of items must be scanned, users experience fatigue that may result in failure to scan some items, or increase the probability of the user taking shortcuts.
  • Barcodes rely on print quality: a damaged barcode may not scan.
  • Data is fixed at the time the barcode is printed; it cannot be updated.
  • Barcode scanning typically requires a flat surface with high contrast. Barcodes on irregular surfaces (such as on a foil-wrapped suppository) or on surfaces without good printed contrast (such as an IV bag) are difficult to scan.
  • On some packaging (notably IV bags), the container has multiple barcodes, and the provider cannot always tell which one they should scan.
  • Barcode scanning of medications relies heavily on barcodes containing the NDC for which there is not a well-maintained definitive reference list.”

RFID technology in healthcare is in its infancy even though it’s an older technology, but in my opinion now is the perfect time to be exploring its use. Waiting for the technology to mature in healthcare means you’ve already missed the boat. In addition, having your hands in technology during it’s development offers the opportunity to influence future direction.

Here’s a cool video demonstrating some possible uses for RFID technology in healthcare. I especially like the part where the patient’s profile is automatically pulled onto a tablet pc once the patient has been positively identified via an RFID scanner in the tablet.

On a side note, I’ve seen articles popping up all over the internet this week talking about Apple’s use of the iPhone and iPod touch as a RFID transponder, and according to the Patently Apple website “the RFID antenna could be placed in the touch sensor panel, such that the touch sensor panel could now additionally function as an RFID transponder.” Details on the patent from Apple can be found here.

I have a small collection of RFID web clippings and articles that can be found in a shared Evernote Notebook. I haven’t been collecting information for long and the notebook is quite limited, but feel free to browse. If you know of a good article relating RFID to healthcare don’t hesitate to point me in the right direction.