RFID: What’s the frequency, healthcare?

Lana Makhanik, COO, VUEMED, points to five factors that have slowed momentum and progress among healthcare providers.

The first involves investment in new technology against the backdrop of limited resources after “massive investments in [electronic medical record] implementations and industry mergers/consolidations, which have required major IT integration efforts across many IT systems,” Makhanik observed.

The second factor closely relates to the first, and that is priorities: “Various functions within hospitals — IT, clinical, supply chain, biomed engineering (for equipment), finance, etc. — each have their own individual priorities that compete with supply chain for attention, and clinical projects typically get prioritized over operational ones, given hospitals’ limited resources,” she continued.

Even so, once a provider establishes priorities for investment, the third factor adds another speedbump to the path.

“Budgeting approval processes are lengthy, complex and contentious, even while many organizations recognize the substantial ROI that can be achieved in making an investment in operational efficiencies with RFID,” Makhanik noted.

Yet, at the same time, communication can complicate matters as indicated by the fourth factor.

“Hospital administrators don’t have a clear understanding of the magnitude of savings, efficiency gains and safety improvements that the implementation of RAIN RFID technology can bring to their supply chain as well as their clinical areas,” she said. (Editor’s Note: RAIN RFID is a global alliance promoting universal adoption of UHF RFID. For more information, visit https://rainrfid.org).

Finally, the bounty of options available for tracking invites confusion, according to Makhanik.

“There continues to be confusion about the differences between the various tracking technologies that are available,” she said, “first, between RFID, for example, and other sensing technologies, such as Bluetooth Low Energy (BLE). There’s also confusion about the different types of RFID technology out there, such as passive (HF versus UHF/RAIN) versus active RFID, and then within UHF/RAIN RFID there are proprietary versus standards-based protocols.

“Hospitals need to make these tough decisions about which technology suits their needs best, and to consider the costs and benefits as well as advantages and drawback,” Makhanik added. “This is where the RFID industry can, and should, do a better job of educating providers interested in taking advantage of RFID.”

Up until the last 12 to 18 months, the biggest obstacle has been higher-priority projects and business opportunities within the healthcare supply chain, according to Joe Pleshek, President and CEO, Terso Solutions.

“Specifically, EHR implementations have been the top priority for healthcare providers over the last 10 years, both in bandwidth and financial resources,” Pleshek told HPN. Terso represents the engine and horsepower that drives a number of popular brands offered by prominent manufacturers and distributors that with providers use Terso’s ISV channel.

“Across all of those stakeholders over the last 18 months, we’ve seen a dramatic increase in the interest in RFID,” Pleshek noted. “That interest is being driven by a business challenge, and that’s inventory visibility. The lack of inventory visibility today is starting to rise on the priority list of both healthcare providers and medical device manufacturers because the amount of inventory within the supply chain is increasing, leading to growing operational costs and product waste. This includes product consumption not being captured at the point of use, write-offs due to expired products and the costs of manually tracking consignment inventory. As cost pressures are driving healthcare providers and product providers to improve their operations, RFID is being looked at as a technology that helps enable real-time inventory visibility across the supply chain.”

Because other markets — retail apparel, in particular — rapidly are adopting RAIN Ultra High Frequency (UHF) RFID, the price points of both RFID tags and infrastructure (as in readers) are coming down, he observed. “Therefore, you have two things happening at the same time: An increased business need from the providers and manufacturers coupled with lower technology costs. Those two pieces are driving what we see as a growing adoption of RFID in healthcare,” he explained.

Finding balance

Or Lomnitz, Marketing Director, LogiTag Medical Solutions, states that hospitals and medical organizations are happy to adopt passive RFID, particularly for medical implants management, and especially when it’s being supported by artificial intelligence and machine learning, which can help hospitals make decisions faster.

“The world of RFID is wide,” Lomnitz insisted. “The range of solutions from this technology is diverse, and application is different for each segment.” She cites the segments as RTLS [real-time location systems], medical implants tracking, and supplies, sponges and surgery tools balanced in the operating room.

The challenge with RTLS, which is based on active RFID, according to Lomnitz, is that as it tries to solve a location issue it also creates other maintenance issues.

“This requires the hospitals to prepare a complex infrastructure and constant maintenance —especially battery life,” she indicated. “High requirements of accuracy made it challenging to implement the systems and maintain a high level of reliability. Hospitals gradually realized that they could not pay the high maintenance costs.”

Lomnitz sees logistical challenges with sponges and surgery tools as facilities affix tags on tools. “When there are tens of thousands of tools that constantly change, this creates a logistical challenge,” she noted, “along with other problems, such as fearing that the tag will fall into the patient’s body and reading problems in the face of the high cost of the system.”

However, she sees RFID for managing medical implants and supplies as a bright spot that is “developing rapidly,” which is why LogiTag focuses on this area. “The market today is much more mature and [more ready] to adopt the technological solutions that RFID has to offer,” she added.

STANLEY Healthcare’s Sagi Geva, Director, Hospital Solutions, indicates that more healthcare providers are “recognizing the benefits and real-time intelligence that an RFID infrastructure provides over alternative tracking solutions for efficient asset management, improved patient tracking and safety, and quality control (e.g., authenticating prescriptions/medications, hand hygiene compliance etc.).”

But he acknowledges that historical barriers exist, “most likely resulting from the initial investment and recurring costs complexity that are associated with building out an RFID infrastructure,” he added.

Healthcare must embrace a mindset shift, he urged. “While total-cost-of-ownership (TCO) is a key consideration for implementing any new technology infrastructure, as RFID tags, hardware and software continues to evolve and improve, associated development and manufacturing costs continue to decrease,” Geva indicated. “This will ultimately reduce the initial investment and TCO making it an attractive and beneficial solution for healthcare providers.”

Still, Geva relays that his company has been “working closely with the network infrastructure providers to further improve and simplify the initial implementation process as well as reduce the level of complexity to get started and manage the platform,” which they believe will drive adoption rates higher.

However, Kapil Asher, Director of Sales, Asset Tracking/Management, CenTrak, Inc., charges that three fundamental hurdles hinder RFID’s adoption rate in healthcare settings.

1. Workflow design gap. “RFID is a workflow-enabling tool,” Asher said. “In order to successfully implement RFID, healthcare organizations must factor in the people using the system and their reactions to events generated by the location sensors. These users must be trained to follow the system’s prompts and properly close the loop when an event is generated. If users fail to abide by the system, it will perform sub-optimally. While companies are stepping up and closing the workflow design gap, many hospitals still lack the confidence that they will meet their end of the bargain in terms of training staff and holding them accountable for their roles.”

2. Misinformation. “The internet is an excellent conduit for information, good or bad,” Asher lamented. “Incorrect information regarding RFID technology, its prerequisites and expected performance has resulted in sub-par deployments in the past. Hospitals are willing to reinvestigate the potential of these technologies, albeit more cautiously, which in turn has slowed rates of adoption.”

3. Limited application of technology. “Healthcare providers have developed a narrowed field of vision when it comes to the use of RFID technologies,” he noted. “Typically, requirements are related to a specific department and its specific use cases, making it difficult to justify the cost of implementation. RFID can solve multiple challenges related to resource availability and staff/patient satisfaction. When implemented in a way that helps multiple departments under an enterprise, implementation can save millions of dollars annually. This leap into a broader scope of implementation is slower than expected.”

Phil Sayles, President, Summate Technologies Inc., believes vendor market dynamics as one of the initial barriers, coupled with provider departmental fiefdoms as another.

“Business process improvement technology by definition must have an IT component,” he said. “However, security risks posed by any outside solutions — perceived or real — and stringent privacy regulations have made it very difficult for smaller companies to penetrate the hospital market, and smaller companies almost always drive innovation. Another challenge is that process solutions typically touch multiple departments within hospitals, and culturally these departments function largely independent of each other. Introducing holistic process changes is a real battle in this type of environment.” 

Usability, usefulness

Continual hurdles — perceived or real — neither have dampened curiosity or doused interest in RFID, nor has it diminished RFID’s usefulness in the areas of durability, longevity and reliability, experts acknowledge.

“I think the biggest case for RFID’s usefulness is its ability to provide visibility of a product to multiple stakeholders across the supply chain,” Terso’s Pleshek insisted. “We’re breaking free from only being able to read at a single location. For example, a medical device manufacturer can track a product from the point of manufacture, through their distribution center, on to their forward-stocking location, and finally by the healthcare provider at the point of use. This visibility can enable improved collaboration between providers and suppliers through integrated software systems, predictive analytics tools and e-commerce platforms that take advantage of the inventory data to make proactive business decisions.”

VUEMED’s Makhanik clearly favors an RFID functionality that limits, if not minimizes, human interaction, as the wave of the future.

“There are several types of RFID technologies, and they all have the advantage of functioning without the need for human-inputted data, but the most versatile is RAIN RFID — a form of passive RFID that uses several industry standards — both for hardware (FCC) and data encoding (GS1),” she recommended. “RAIN RFID has the benefit of not needing a line of sight and of being able to read information from very close to 100 feet away, depending on the hardware and use case scenarios. It’s also excellent at detecting movement, which makes continuous tracking possible throughout a facility or a functional process.

“RAIN RFID is also highly cost-effective, both in terms of the relatively little hardware needed to achieve visibility in any space, and in terms of the multiple different applications or use cases that it is well suited for, including consumables, equipment and people,” Makhanik continued. “Given its versatility, affordability, and standards-based protocols, RAIN RFID is poised to become a ubiquitous part of any hospital infrastructure as a foundational sensing technology able to deliver the full benefits of [Internet of Things].” 

Because the construction, energy, manufacturing, transportation and waste management industries all use both passive and active RFID tags, then why wouldn’t healthcare join that list, STANLEY Healthcare’s Geva urges.

“Since they were intentionally designed to withstand extreme thermal or humid conditions in rugged environments, and remain durable without degradation over time, [this] makes them an ideal mechanism for various use cases within healthcare environments as well,” he said. The healthcare environment includes strict conditions for infection control, cleaning and sterilization without negatively affecting product shape and form factor, he added.

“The efficiency and effectiveness of RFID technology also makes it particularly attractive for tracking and managing assets,” Geva continued. “Unlike alternative tracking technologies [that] require people to manually scan individual items at a close distance, RFID readers can identify and scan hundreds of tagged items simultaneously per second. Active RFID, mainly used for location-based services, helps improve workflow and efficiency in the hospital by completely automating processes, without the need for manual intervention, which is prone to errors. Finally, the amount of reliable information that can be gathered, stored and shared from an integrated RFID infrastructure offers healthcare providers access to critical and accurate real-time data regardless of the use case or application.”

LogiTag’s Lomnitz calls RFID tags a colorful convenience that aligns with the cataloging method and makes it easier for clinicians and supply chain staff alike to scan instead of the numerous bar codes affixed to products and packages. “We see a unified way to maintain uniformity between the hospital and the medical suppliers in a manner that is convenient for everyone,” she added.

RFID usefulness can be traced to automation itself, according to CenTrak’s Asher.

“We rely on automation in almost all aspects of human survival starting with agriculture, manufacturing to service industries like transportation, food, entertainment and healthcare,” he said. “Automation has allowed for efficiencies directly tied to the improvement of patient care, in turn helping organizations reduce operational costs straining the overall cost of healthcare in the United States. RFID feeds intelligent software suites that enable event-based workflows automatically and help users make decisions based on data. This is not possible with the use of manual data entry or the use of bar codes.”