1. Radio-Frequency Identification (RFID) Andrew Bowdle MD, PhD Professor of Anesthesiology and Pharmaceutics Chief of the Division of Cardiothoracic Anesthesiology

2. Anesthesia information system Philips Compurecord –computerized anesthesia record –“black box” recorder for anesthesia Hospital charges for anesthesia disposables Pharmacy charges Professional billing and compliance Preoperative evaluation module (not currently funded) Extensive data mining capability –Quality assurance –Outcomes research –OR management

3. RFID Tags attached to people or objects provide “automatic identification and data capture” (AIDC) such as identification, tracking, security, other functions Think of it as wireless bar-coding Well established in retail supply chain Just starting to be used in healthcare

4. RFID Tags Passive –no battery –receive energy from the reading device (induced in antenna) –short range (inches to a few feet) –small, relatively inexpensive (eg 10 cents) Semipassive –battery powers internal circuitry, communication power comes from reading device –longer range (10-100 feet) Active –battery provides all power –range >100 feet –more expensive

5. Data storage in tag Ready only Write-one-read-many (WORM) Read/write Data storage capacity range from 1 bit to 512 Kb –1 bit simply detected or not detected –EEPROM (electrically erasable programmable read-only memory) chips with 512 Kb store pages of information

6. Tag readers Installed –Mounted in doorways, notes passage of objects or people –Mounted in storerooms, provide continuous inventory –Network throughout building can track and locate people or objects anywhere Handheld –Scan individual RFID tags, eg wristbands, blood bags, drugs

7. RFID v Bar-coding Overlapping functions Bar-coding currently much cheaper Main advantage of RFID is wireless, remote capability, can function passively FDA currently requiring bar-coded drug labels, may require RFID in the future

8. RFID applications Locate and track patients –Identification for site of surgery and blood matching (wireless avoids the need to see the wristband) –Identification for drug matching at point of care –Link to automatic notification system when patient enters holding area, OR etc

9. RFID applications Locate and track staff –eg what portion of the patient in the room time is the surgeon in the room? –eg how long from when the patient enters the room until the surgeon enters the room? –eg how much time are the staff spending in the lounge? –eg how much time are the anesthesia techs in the OR rooms, how much time in the workroom? –eg is the anesthesia attending present for critical events?

10. RFID applications Inventory –Continuous readout of inventory in core, anesthesia workroom, holding area, PACU –Handheld readout of anesthesia carts, machines for completeness of stocking

11. RFID applications Locate and track capital assets –Especially items that leave the OR area –Writable devices could be updated with current maintenance information

12. RFID applications Locate and track high value implantable devices

13. RFID applications Pharmaceuticals –Locate and track high value or very time sensitive drugs –When RFID tag cost approaches that of bar codes, inventory, charge capture, point of care matching to patient –Counterfeit protection

14. What to do RFID technology has great potential for solving problems with positive ROI Application in hospitals is in an early phase Convene working group to follow developments and plan time and place to implement