MBA Dissertation Revisited 4: Hypothesis proved?

In my previous MBA Dissertation revisited post I concluded with the statement: “few healthcare facilities are capable in terms of “…technical infrastructure (1.3), processes and trained resource…” to benefit from other AIDC technologies, e.g. Bar Codes.”  In this post I consider chapter 6.1.3 “…RFID has benefits… over existing AIDC technologies, e.g. Bar Codes.”

NOTE: Original text from dissertation shown in italics.

 “6.1.3 “…RFID has benefits… over existing AIDC technologies, e.g. Bar Codes.”

The author would suggest that RFID has some benefits over existing AIDC technologies, e.g. Bar Codes, but they are limited. The benefits are discussed in the literature review and subsequently summarised in Table 3 (2.3.2.4.) [page 29].

But it is generally believed that these benefits are not universal, i.e. not realisable for all classes of [Medical Devices] or for all products within the classes. In addition to the infrastructure requirements (1.3) and related financial costs (Roark & Miguel (2006), 2.3.2.4.) that could be barriers to adoption

• It may not be economically viable to undertake item-level tagging for “disposables” (bandages, syringes, consumables (Interviews, 5.2.3.)) because the cost of a tag may be the same or more than the cost of the item.

• There are known issues with RFID technology, e.g. read rate of tags (Interviews, 5.2.4.) and, particularly for MDs, physics issues (e.g. metal, liquid, sterilisation (UsingRFID.Com (Anon, 2005), 2.3.2.4.)

• Radio Frequency standards are not global (Wyld, 2005 (2.3.2.4.b.))

The author would also argue that there are unrealised opportunities in healthcare with Bar Codes or other AIDC technologies that may lead to greater patient safety. As previously mentioned Bar Codes are not ubiquitous in healthcare facilities, and in some cases they have their own type of bar code and over-label that of the manufacturer. Flynn’s comment (2.3.2.4) sums up the situation: “What makes healthcare facilities think they can be successful with RFID when they haven’t fully adopted bar coding into their operations?”

Broadly, the above still holds true: RFID does have benefits over exiting AIDC technologies, e.g. Bar Codes and, although the benefits are limited, I think they have increased during the period between publication of my original MBA dissertation and this review. The benefits remain particular to, for example:

• Classes of medical devices, e.g. returnable or reusable assets.  A recent case study example is from ThingMagic: “Greenville Hospital Deploys Integrated RFID Solution for Operating Room Asset Tracking”¹ the reported results included labour savings, loss prevention, physician satisfaction, improved productivity and an expected return on investment within one year. The hospital also expects “…to be able to reduce [their] equipment purchases through a combination of reduced loss and our utilisation history reporting…” and have plans to “…expand the solution, e.g. to track additional critical care devices.
• Levels of packaging, e.g. pallet.  A relevant pharmaceutical case study is the Building Radio-frequency Identification solutions for the Global Environment (BRIDGE)) Work Package 6 (WP6, pharmaceutical traceability pilot).  The WP6 evaluation report (p32) states that “…the use of RFID (as opposed to bar codes) could offer advantages for tracking the cross docking movements of pallets and the auto recognition of the delivery vehicles used for the process…”
• Geographies where frequency standards are harmonised.  The frequency landscape is constantly changing but has become more closely aligned.  Probably the best source for the most up to date information is the EPCglobal Inc website; their latest (August 2010) Regulatory status report is available here.

But, some barriers persist… Although the price of RFID tags has reduced, cost remains a barrier to wider implementation both in terms of the infrastructure requirements and the economic viability for some types of medical products.

In terms of the issues with metals, liquids and sterilisation there has been some progress:

• In September 2008 EPCglobal Inc. (www.epcglobalinc.org) formed the Liquids and Metals Interest Group (L&M IG) “to address this problem head-on” and
• There are examples of RFID tag manufacturers working to address these issues, such as Odin Technologies, in a blog post Hot in here¹ they says they have “run these tags through hundreds of cycles of autoclave simulations at temperatures up to 300° F… to stringent FDA standards for autoclave and chemical bath sterilization processes with no discernable performance degradation.” or the University of Kansas’ Information and Telecommunication Technology Center (ITTC) Tag for Metal, Liquids¹ offers superior performance when applied directly to objects containing metal or liquid.

So, although progress has been made, I would still “…argue that there are unrealised opportunities in healthcare with Bar Codes or other AIDC technologies that may lead to greater patient safety”, in particular in healthcare facilities,  and I’m not the only one who thinks this way:

An eHealth Europe article (July 2009) reports on a RAND research report commissioned by the European Commission “…which focuses on Radio Frequency Identification (RFID) [and] says that despite being a useful tool in logistics and operational management it is so far “less successful in patient care and quality of care improvement.””  And:

In July this year (2010) there was a Mobile Aspects blog post on the “Recently HIMSS² released… results of a survey of healthcare professionals around the use of RFID technology within healthcare…”  Their review of the survey draws similar conclusions to those I’ve outlined above!

Progress has therefore been in baby steps… In my next MBA Revisited post I’ll reviewing chapter 6.2 Conclusions.

 Notes:

1. It should be remembered that these are publications from commercial organisations.
2. HIMSS (Healthcare Information and Management Systems Society): US not-for-profit organization dedicated to promoting a better understanding of health care information and management systems.