Last September I began a review of my MBA Dissertation; four BLOG posts since then have focussed on Chapter 6.1 Discussion. These posts can be found here:
- Revisiting. Why?
- RFID has benefits?
- Applied or Embedded RFID?
- Progress? Baby steps
In this final “MBA Dissertation Revisited” post attention turns to chapters 6.2. Conclusions and 6.3 Recommendations
NOTE: Original text from dissertation shown in italics.
a. Patient Safety is the KEY driver for using RFID with MD (e.g. Ranger & Cousins (NPSA), 2006 (2.3.3); Interviews (5.2.2); Questionnaire (5.3.2), 6.1.1.
b. There have been insufficient pilots and resulting case studies to definitively prove that applying or embedding RFID to MDs will deliver greater patient safety. The theory is largely still based on assumption (Ranger & Cousins (NPSA), 2006, (2.3.3); Vincent (2006), Talon (2006) (5.2.4); Questionnaire (5.3.4); 6.3.1.).
c. Whilst RFID has benefits over other AIDC technologies, they are not universally realisable or applicable to all MDs (Arcarese, 2005 (2.3.3), Interviews (5.2.3), 6.1.3.).
d. There are barriers to be overcome with RFID technology (UsingRFID.Com, Anon, 2005 (188.8.131.52.b); Interviewee, Jensen, R (5.2.4); Questionnaire (184.108.40.206); 6.1.3.).
e. There is potential, in healthcare facilities, to derive benefits through a more tactical, widespread and efficient use of other AIDC technologies that are already used by MD manufacturers (78% of Advamed members are bar coding products (Longe, 2004, (220.127.116.11); 6.1.3.).
The hypothesis has not been proved or disproved, but it can be reworded into a statement based on the research and findings of this dissertation, as follows:
Medical Device Manufacturer applied or embedded RFID should be voluntary. RFID has benefits over existing AIDC technologies, e.g. Bar Codes and has the potential to deliver greater patient safety in the clinical environment. But it should not be seen as a panacea; all
AIDC technologies should be considered and piloted, and the most appropriate selected, when attempting to address reported adverse incidents in the most severe “degree of harm” categories (NPSA).”
Just over 4 years on from publication of the original MBA Dissertation the review undertaken in previous posts shows that some, but little, progress has been made of the utilisation of RFID, in fact any AIDC technologies, in healthcare to improve patient safety. Taking each of the conclusions in turn, I would update them as follows:
a. Patient Safety remains the KEY driver for using AIDC technologies with Medical Products. The priority for adoption has been pharmaceuticals, driven by the increase in counterfeit products in the global supply chain, with medical devices (MDs) lagging behind. Where there has been adoption it has been adoption of barcodes rather than RFID.
b. There has been a growth in the number of pilots and resulting case studies (see previous posts). But very few have been focussed on RFID with MDs, the majority have been focussed on use of barcodes predominantly with pharmaceuticals although increasingly on MDs and predominantly they have been manufacturer pilots rather than provider pilots. Therefore the theory, “…applying or embedding RFID to MDs will deliver greater patient safety…” remains an assumption.
c. It remains true that “…RFID has benefits over other AIDC technologies…” e.g. non-line of sight, multiple reads, but it also remains true that these benefits “…are not universally realisable or applicable to all MDs…” For example, the use of RFID at the unit level with the low risk (in terms of potential to cause harm) MDs, e.g. gloves, swabs, is not seen as applicable due to cost. The trend seems to be the use of RFID at the logistics unit / pallet level rather than unit level.
d. Whilst some progress has been made there still remains “…barriers to be overcome with RFID technology, e.g. issues with readability through liquids and on metal or robustness due to repeated reprocessing. The progress made remain insufficient to warrant widespread deployment.
Therefore, this final conclusion still holds true:
e. There still remains significant potential, in healthcare facilities across the world, to derive benefits through a tactical, widespread and efficient use of barcodes that are already printed by manufacturers on both pharmaceutical and MDs. And numerous regulators have recognised this and have or are planning regulations on identification of medical products.
This was the original, ultimate CONCLUSION
Medical Device Manufacturer applied or embedded RFID should be voluntary.
RFID has benefits over existing AIDC technologies, e.g. Bar Codes and has the potential to deliver greater patient safety in the clinical environment. But it should not be seen as a panacea; all AIDC technologies should be considered and piloted, and the most appropriate selected, when attempting to address reported adverse incidents in the most severe “degree of harm” categories (NPSA).
Apart from replacing “Device” with “Product” to include pharmaceuticals, I would suggest that the tag line of the conclusion remain unchanged:
Medical Product Manufacturer applied or embedded RFID should be voluntary.
However, the subsequent paragraph requires updating to be more pragmatic, as follows:
RFID has limited benefits over existing AIDC technologies, e.g. Bar Codes and has limited potential to deliver greater patient safety in the clinical environment. But it should not be seen as a panacea; all AIDC technologies should be considered and piloted in the clinical environment and the most appropriate should be implemented, i.e. the one that shows improvement to patient safety.
You can download the original MBA Dissertation from my website.
My final comment to conclude this review is based on my experience over the intervening 4+ years working in AIDC in Healthcare:
The majority of global pharmaceutical and medical device manufacturers have adopted AIDC technologies and have realised efficiency improvements in doing so. Therefore, the packaging of their products carry, predominantly, barcodes, a few carry RFID tags.
The supply chain processes of downstream trading partners, e.g. distributors and wholesalers, have also benefitted from incoming product being identified.
But it is still the case that utilisation by healthcare providers (e.g. hospitals) of barcodes on incoming product is limited. Therefore, as a minimum, opportunities to realise internal supply chain benefits are being missed; but more importantly opportunities to improve patient safety are also being missed, e.g. ensuring the 5 patient rights, e.g. drug to the right patient.
Implementation/adoption of AIDC technology by healthcare providers has to be the priority going forward… It won’t be easy, but it shouldn’t take the 30+ years taken by the retail sector as healthcare can build on that vast experience. Potentially we are talking about saving lives, which has to be worth it, doesn’t it?