Nagesh P. Shinde

Printers offer positive patient identification

Serving more than 700 hospitals, healthcare group purchasing organization Magnet, Inc. adopts on-demand bar-code and radio-frequency identification printing equipment and label supplies for seven regional member organizations as part of a strategy to reduce the medication dispensing errors in hospitals.


Recent reports indicate that RFID technology for healthcare and patient and asset tracking could rise by 29 percent within two years.

With more requirements imposed on the pharmaceutical industry by the Food and Drug Administration on tracking the supply chain of prescription drug products, more healthcare industry companies are making track-and-trace technology initiatives to improve drug and patient identification. In June, the FDA stated that it considers radio frequency identification (RFID) to be a most promising technology for electronically tracking and documenting the chain of custody for prescription drugs. While not a mandate, the FDA's announcement will probably have positive, long-term effects.

One of the oldest and largest shared-services, healthcare group purchasing organizations (GPO), Magnet, Inc. (for Mid-Atlantic Group of Shared Services), Mechanicsburg, PA, is taking steps toward such improvements.

Magnet serves approximately 12,000 providers, including hospitals, alternate-care facilities and physician practices and clinics. It has a contract portfolio that includes equipment, services, commodities and a newly emerging area of niche/boutique (innovative and cost-reducing) products. Founded during the 1979 Middle Atlantic Health Congress, the company negotiates on the behalf of its hospital and clinic members.

Magnet says it has a user-driven philosophy. To meet the needs of the individual healthcare provider, it employs a partnership approach, in which Magnet and its vendors can respond quickly to a healthcare organization's needs and to regional healthcare trends. Magnet and its member organizations provide vendors with data and firsthand information regarding what is driving the purchase of services, labels, patient identification supplies, capital equipment and more.

Recently, it signed a three-year agreement with Zebra Technologies (www.zebra.com), whereby Zebra will provide thermal printers, including bar-code and RFID printers, supplies and service agreements to Magnet's seven regional member organizations, which include hospitals and clinics. Some of these may use Zebra products to repackage medications within their pharmacies. All of them provide access to Magnet's portfolio of products and services through local groups operating in 20 states and in the District of Columbia. The individual members then purchase and use the printing equipment for the marking of a variety of products.

The agreement became effective on April 1. Explains Steven Duke, vp of Magnet, "Our mission is to provide our member organizations with programs and services that reflect the highest standards of quality, safety, reliability and service. We chose to partner with Zebra because of the broad use of its printing applications."

Printing out labels for hospital dispensaries can save time and eliminate administration errors versus hand-writing label/test data.

Figures tabulated by the Institute of Medicine reveal that, though not widespread, roughly 7,000 deaths occur each year as the result of medication-related errors in hospitals. To combat this, on-demand thermal printers and related supplies can help reduce the adverse effects associated with medication administration errors by offering a compliant, precise, bar-code strategy that ensures positive patient identification and builds security.

"With the right strategies and technology solutions in place, hospitals can dramatically reduce the incidence of medical errors and improve overall safety," notes David Crist, vp of sales for Zebra Technologies. "This agreement allows us to work with Magnet and its members to better meet patient safety goals and to improve the quality of care through proven solutions like bar coding and RFID."

Zebra points out that according to the 17th annual Leadership Survey from the Healthcare Information and Management Systems Society (HIMSS) [www.himss.org] in Chicago, which reports the opinions of information technology (IT) executives from healthcare provider organizations across the U.S. on their use of IT, medical-error reduction and patient safety will remain top business objectives for hospital IT executives in 2006. The most frequently identified technologies respondents plan to implement in the next two years are sign-on/identity management technology, bar-coding technology, speech recognition and personal digital assistants (PDAs). Implementing RFID technology and participating in a regional health information organization (RHIO) could increase over the next several years. The report indicates that at this time, about four percent are implementing RFID technology for patient/asset tracking, but that figure is also expected to rise to 29 percent in about two years.

Magnet's regional member organizations are starting to use bar-code and RFID printers in the repackaging of meds within pharmacies.

The jump may come for many reasons, notes Zebra's Don Gibb, corporate accounts director for healthcare. "The push nationally for an EMR (electronic medical records) initiative requires more information to travel with the patient, the medication or specimen. The potential for RFID is on the upside for now—most healthcare providers will be happy to implement the technology in phases. The cost savings to the healthcare provider can be significant; approximately $2,000 is saved for every medication error eliminated. Bedside point-of-care should increase by more than twenty-five percent in that same time period, and its impact will be equally significant, if not more so."

Zebra's specialty printers used by Magnet's members include wireless, mobile and high-volume label and wristband machines designed to accommodate the healthcare market. The healthcare provider and an authorized healthcare equipment reseller determine the specific printer type most suitable. Models comprise but aren't limited to the Z4M thermal label printer, the H 2824 Z direct-thermal wristband printer, which is said to ensure accurate scanning for improved patient safety and privacy, the QL 220 and the Z4M Plus and S4M tabletop vial- and bottle-label printers, which can be used in high-volume applications such as at the pharmacy level. Desktop models (LP 3844 is one example) are also used. The R 2844, a compact RFID printer, is also used to encode smart labels at the point of use, among others. Gibb adds that members notice that the equipment can help solve process issues and are found to save time versus having to hand-write or key in so much information required for vials or for tests. "At this point, the hospitals are using the 2844-Z [RFID] printer, mainly to imprint patient wristbands with standard bar codes," he adds. Adoption can mean a significant "shot in the arm" for hospitals. Hospital members are early adopters focused on patient safety and improving processes in the hospital, he continues. "Printing as-needed might prevent a sheet of labels from mistakenly being used to label a specimen or medicines incorrectly."

Lauren R. Hartman, Senior Editor

Reading this article I find this a POSITIVE use of RFID. Used on a wristband that patients are already wearing while at the hospital is a wonderful idea to make sure the right medication and health needs are being provided with less error and a big savings not only on dollars but with survival rates of patients. I was happy to hear they were using it only on wristbands.
Looking at the uses of RFID I ran across this new law that was passed in the state of Wisconsin on May 31, 2006. This law makes it a crime to require a person to be IMPLANTED with a microchip.
http://www.spychips.com/press-releases/verichip-wisconsin-ban.html

Even though a person may be carrying an item implanted with RFID on their person at least your own body would not be implanted. The state of Wisconsin passed this law because the government has been thinking of using the implants in the military, replacing the dog tags.

"7,000 deaths occur each year as the result of medication-related errors in hospitals"

Hopefully RFID doesn't help too much, we already have enough people on the sphere. I guess we'll at least be able to know where everyones medication is now.

It sounds like RFID is a constructive way to make sure that patients are receiving the proper medication. My concern would be that people would rely too much on the computer and not double check for accuracy and some medication errors would still occur. If it still saved more lives than the 7,000 we're loosing now, it's worth trying. I certainly wouldn't want to die because of human error.

I found another company, Audio-Tel, is using RFID technology to prevent theft or loss of records for institutional and retail banking customers. Their employees use one of a number of types of RFID tags to enter important areas through sensors mounted on door frames. This way they can keep track of the location of employees as well as controlling their access.

I think the idea of using RFID technology in hospitals is a very interesting idea. I am not sure however if I am completely sold on the idea, but after working in the medical field for a few years and working with numerous patients I can understand the benefits of implementing a system like this.

I think this idea has the potential to do a lot of good for the medical community. One problem in dealing with pharmaceutical drugs I researched was the ever increasing counterfeiting of certain medicines that spoils the integrity of the pharmaceutical industry. A World Health Organization study suggests that counterfeit drugs make up about ten percent (10%) of the global pharmaceutical market. Healthcare RFID could be a major catalyst in changing this trend for the better. Manufacturers can have a transparent view over the transit of drugs even after they leave the confines of the warehouse. The surveillance starts with the manufacturing process and you have full control over the movement of your produced pharmaceutical and healthcare products.

Before implementing such a system, I feel more research must be conducted to insure that this is a fool proof plan and will truly be in the best interest of patients and healthcare providers. Some health care providers have raised concern about implantation of RFID’s in patients because of the potential of MRI incompatibility, adverse tissue reaction, device migration and unknown body electrical risks. (RFID technology is refinement of garage door devices, which raises some odd imagery).
Ultimately, a well-designed, properly implemented RFID-enabled solution will automate and standardize data management to reduce cycle times and provide more current, complete and accurate data for high-value decision-making.

I agree that the RFID technology for healthcare and patient tracking is a great idea, but should be tested thoroughly with lots of feedback and revisions for the elimination or to lessen human error. It also seems like it might be a neat idea to start out, but turn into a fad that will wear off.

Target recently changed the design of their perscription bottles so that grandma doesn't get her medication mixed up with grandpa. I think that's a great idea. I believe the labels are color coded and large type is used to make it clear for everyone. I know on my perscriptions, it would be nice for the expiration date to be bold or large, because I have bottles left over from years ago that I've forgotten to throw away, and don't want to take something that's expired.

Also, I have seen wrist bands for children that indicate when they've been in the sun too long. I believe the band changes color when in the sun too long, so that the childs' parent can put more sun block on so he/she does not get burned. Little inventions like this can go along way!

RFID is an interesting concept. It's innovativeness goes along with the transition of the use technology in just about every aspect of our everyday lives; this transition can be overwhelming though. Like most things, I think it's use is good in moderation and in a controlled way.

Wikipedia (http://en.wikipedia.org/wiki/RFID) has further information on what RFID is and it's uses. An instance mentioned in Barcelona, Spain, Rotterdan, and The Netherlands tells about the technology being implanted in people's hands to identify VIP customers at clubs, who in turn use it to pay for drinks. I can understand having the technology replacing a barcode or helping managing stock at a Wal-Mart, but when the technology invades our personal lives and lessens the need for interaction and communication with other people I think it's possibilities need to be re-eakuated. With that said, using RFID as a tool to better aid in caring for patients at a hospital can only be considered responsible if there is also genuine one-on-one care between the patient and the caregiver and there isn't a complete dependancy formed for the technology.

I read an article a couple years ago about how RFID can help with terrorism in the US. Think of how it could keep terroists out of the country.

Here's a link to an article with kind of the same information as the one I read.

http://www.aimglobal.org/members/news/templates/casestudies.asp?articleid=134&zoneid=12

It's definitely an intersted concept and I'm sure we'll be hearing a huge debate about it in the near future. I think I would be a little scared about privacy issues.

I definitely agree with RFID technology. I believe that everyone does make mistakes and if there is a way to counter act at least a few of those mistakes why not take the chance. I actually have lost someone due to them mixing wrong drugs and the unfortunate part was that they layed in a coma for several years before passing. So I will for sure stand behind the idea.

When people lose privacy and freedom its often because someone argued to protect there safety. People are willing to give up alot when they are afraid. That being said, I think that RFID is a positive technology as long as it is used with a persons full understanding and consent. In addition, any data in the RFID braclet should be properly guarded from unapproved access. According to a recent study by a group of European computer researchers, a software virus can be inserted into the RFID tags. It was previously thought that the chips contained too little memory to add a computer virus. (http://www.privacy.org/archives/001758.html#001758)

I believe as long as RFID's are controlled they can be a good thing. For hospitals for the wristbands and labeling vials and more it could make the job more efficient. I also have heard other uses for RFID's from my roommate who is a packaging major and would like to specialize in this technology.

He mentioned that companies want to put RFID labels on all the products throughout their store so that they can keep accurate stock numbers. Also through this technology there's a possibility to go to a store, pick up everything you need in a cart, and when you walk out the exit doors the technology makes it so you automatically pay and get checked out, just by walking through a door.

I think the technology is a good advance so far as long as it does not affect our personally wellbeing in anyway. To inject someone with this is wrong and could violate your freedom since people could know where you are all the time. There's also no guarantee that the chip won't effect your health or malfunction.

Overall RFID's are morally wrong to inject into people but to use the technology on products should be a good advance.

I read this article awhile back, on over at packaging digest...

http://www.packagingdigest.com/articles/200608/50.php

It's quite interesting.. It just solidified, in my head, the reasons that RFID tags can be used for good. It will be interesting to see how this technology develops in real world use.

As you mentioned in class, in very few places in europe, RFID tags are already in use. These real-life tests are producing all sorts of interesting results. Packaging digest does a pretty good job on its reports on these areas, if your interested in more information...

I certainly beleive that RFID technology will be usefull in the healthcare system, I do agree with a pervious post that one concern would be relieying on it to much and so not double checking things. But how can a person say no to preventing 7,000 deaths?

When looking at RFID technology in stores it also makes sence, though privacy is a concern. I found a source that stated "Privacy is a major concern; people are concerned with companies tracking their buying habits and being unaware of their tags being scanned. However, profits always have a way of overruling any concerns. Wal-Mart is a chief example as it has become the pioneering icon of RFID technology. Wal-Mart is forcing its top 100 suppliers to implement RFID by January at no additional cost so the chain can monitor its inventory and stocked item" I definetly don't agree with wal-mart using their power in this way, but if it's going to happen anyway, why not sooner rather then later.

The potential of RFID is pretty much endless. I agree with Steph in the sense that they are a great technology if it is controlled, but it is a very intimidated thought how powerful monopolizing the technology could become.

I agree with everyone that the RFID's can be very beneficial but a major concern is privacy. This link was a preliminary online consultation to see how people would feel about RFID.
http://www.rfidjournal.com/article/articleview/2736/1/1/

As long as they take into consideration about the privacy concerns I think alot of people will be on board. Europe is working on developing more privacy enhancing technologies so it will be interesting to see what comes of those.

I just finished reading an article taken from PC Magazine. Ewlett-Packard has revealed a memory chip the size of a tomato seed. Dubbed the Memory Spot, it can be attached unobtrusively to any object and carry media or data. Among its many potential uses, it may rival RFID tags in carrying information.
"It has some of the characteristics of RFID, but it's orders of magnitude different in bandwidth," said Howard Taub, VP and associate director of HP Laboratories. Memory Spot has a 10-megabits-per-second data-transfer rate and can store up to 4Mb of data, although the demonstration chip stores only 256Kb. The chip also has an integrated antenna, making it much smaller than RFID chips, which get their size from separately attached antennae.
HP claims that the chip will bridge the digital and physical worlds, something Taub demonstrated using picture albums with the nearly invisible chip attached to the borders. When a reader touched the chip, audio from the picture played. He next waved the reader over the chip on a medicine bottle and the attached computer received the dosage, direction, and all other information from the prescription.
Other proposed applications include sending digital postcards with movies and sounds, like the moving pictures in a Harry Potter movie, The chip can also be used to attach catalogs to merchandise or resumes to business cards. Taub estimates that the chips could cost consumers $1 each, and that commercial applications will not arrive for two to five years.
As we continue on this 21st century footpath, it is becoming more and more clear that technology has become ubiquitous. It has found roots in all the many facets of our lives. Where these new innovations will go from here is yet to be determined, so we will just have to say tuned!

I think the RFID technology could be very useful as far as tracking products and not getting products mixed up.

I read an article about using RFID in DFA cheese processing plants to manage and track cheese shipments.
http://www.rfidjournal.com/article/articleview/2752/

It sounds like Walmart has a huge part in the RFID technology because they require DFA to tag their shipments and I believe they also require it with their pharmacy products. This could be very useful in the upcoming years as long as it is controlled and not taken too far. I think privacy is going to be the biggest issue regarding RFID, but when it comes to packaging this should be a good, new technology.

I believe the use of the RFID technology within the healthcare/medical field is a beneficial way to adapt into a more clear future of the said fields. RFID as a concept is certainly not new, but the application of it is relatively new. There are many areas its use is being allocated to. The article mentioned that so far within the pharmaceutical areas it has showed some success and will continue to be a promising advancement towards medicine. Also mentioned is that these companies providing the services are open to implementing the technology in phases, which, I think would be the smart thing to do. They can monitor and track the progress of successes and flaws of the technology and readily make changes as needed. Like everything being developed and put into place there needs to be room for improvement. They can learn through these trial phases how to efficiently manage the technology. If it's going to save money and decrease error-related deaths, then it is for a good cause.
As many of other responses mentioned, there is a issue with privacy and the technology as a whole, not just in the applications of the medical field. Right now, there isn't a special force in place to govern and regulate the usage of RFID's more intently and firmly; however, the FCC is, at the moment, overseeing the allocation of frequencies in the US(Wikipedia). As the technology grows and evolves, I think we'll start to see more stringent policies being initiated and put in place surrounding the issue of privacy. This won't prevent people from debating the issue, but maybe it will facilitate a more general ease for people to be more accepting.

RFID Technology is interesting in the way that it will change things with many feilds, medical, consumer, product etc. Basically we will just have a faster way to purchase and organize products etc. This is only going to change with time as another 'standardized' technology. For the medical aspect, it is good, but could be bad at some point because the radio frequency, if the signal were interfered or changed it would have extremely negative consequences. Also cost of printing for smaller product base companies may be expensive at first and be a cost issue in the begining.

We'll see how long it takes for this technology to change and become standard for all products.

As far as RFID technology goes, the article's reference to it is a positive notation of what the technology can do. But as what so many other people have noted, t could be a huge invasion of privacy if not regulated. I read an article by Declan McCullough ( http://news.com.com/2010-1069-980325.html ) that in the near future there will be such tags hidden in clothing and food that we put into our bodies. It takes the technology to the extreme negative outcomings of what it could do. Having these tags in your clothes means anyone can track you at any point and find out where you are, what you're doing, and even who you are with. Something about that just seems wrong to me.

As for the use of it in the medical field....it is a good resolution to making sure people get the right medication they need, but you also have to think about how technology has changed our lives from 50 years ago. Technology is basically phasing out we as humans. I mean half the jobs out there are being performed by machines right now. Jobs are being cut back because machines can do the same procedures faster and more precisely. With the medication ID, one also has to make sure the data is entered correctly. today we all depend and rely so much on technology that we forget there are still errors to be made by us trusting that what this machine is telling us is right. Who is to say that it got the right information, or that it is being applied in the correct manor. Yes it is making our lives easier, but is it always the correct route to go?