Tune in to radio location

Location and timing technologies are playing an increasingly important role in healthcare provision in hospitals and as an aid for assisted living for the elderly and disabled. Bob Cockshott of the UK Technology Strategy Board’s Location and Timing Knowledge Transfer Network (KTN) takes us through it.

In five months use, the safe sugery system has prevented four potential incidents of mistaken identity

RFID (Radio Frequency Identification) is one example of a location technology that is improving patient care as well as the lives of elderly and disabled people. It uses tiny electronic chips and short-range radio waves to store and remotely retrieve data. There are over 1000 RFID technology suppliers around the world. More than 200 already have healthcare applications. The use of RFID and other location technologies will continue to grow in this sector as we approach the next decade and new applications are being developed all the time.
These systems can improve efficiency in fields as diverse as locating hospital equipment, tracking drugs, and minimising cases of mistaken identity in the operating theatre.

In terms of assisted living, other location technologies such as satellite navigation and mobile phone cell location are helping elderly, blind and disabled people live a safer and more independent existence.
Safe Surgery Systems Ltd, a member of the KTN and a spin out from the UK’s Birmingham Heartlands Hospital Trust, has been using RFID tags with patients to support hospital staff since 2007.

On admission the patient is photographed and given a printed wristband with an embedded RFID tag. The digital photo is then saved in the patient record and used to further verify their identity. Once recorded in the system it is available at all relevant workstations.
The surgeon, anaesthetist and pre-operative nurse have wireless personal digital assistants (PDAs) that allow them to view the operating list and patient records. The system uses a series of ‘traffic lights’ in the patient record which change from red to green as the checks are done. If checks on a patient are outstanding or there is a risk of infection, the surgeon can change the order of the surgery list using the PDA. Only when all the pre-op checks have been verified and the patient’s status is updated to green can the patient be sent to theatre. In theatre, the reader recognises the patient from the tag and retrieves the appropriate record to the screen – making it impossible to operate on the wrong person.

In five months use, the safe surgery system has improved patient safety by preventing four potential incidents of mistaken identity. It also has had a positive effect on theatre efficiency. Results published by the Birmingham Heartlands Hospital Trust show that the average number of patients operated on per theatre session have increased by nearly 12% overall and, in the case of the top five performing consultants, by nearly 24%.

Other applications concern security for babies in maternity units. Tamper proof tags can be used to prevent the abduction of new born babies by unscrupulous intruders. They are attached to the infants and linked to ultra high frequency antennae and door security systems to prevent children being moved from the ward. However it’s not just people that can be tagged with RFID. By 2013 more than one billion drug containers including pharmaceutical bottles and syringes will contain an RFID tag. By 2016 that figure will be 30 billion.

Large companies including Pfizer and Astra Zeneca can now monitor where drugs are sold, lost and stolen. Pfizer tags every bottle of Viagra sold in the US to identify where drugs drop out of the supply chain and since 1996, Astra Zeneca has placed RFID tags in the syringes of its anaesthetic, Diprivan.
Hospital drug dispensers can even recognise and read the tags to ensure patients get their correct dose. The system removes the risk of human error by avoiding incorrect dosages and the mistaken re-use of old syringes. Astra Zeneca has already tagged more than 50 million syringes and is continuing at a rate of about five million every year.

Another important function provided by a combination of RFID and Wi-Fi is ‘asset tracking’. This relates to items such as crash trolleys, infusion pumps, endoscopes and wheelchairs. Applications are in the pilot stage in a number of hospitals where active Wi-Fi tags are attached to equipment. Currently nurses are thought to spend half an hour per day trying to locate equipment meaning that return on investment comes with saving time as well as money. Airetrak, another member of our network is leading the way in this.

Location technologies can also help patients with dementia. This does not mean we are moving towards a big brother society, ‘virtual gates’ can be set up which are triggered only when the sufferer enters a dangerous area. We are moving towards a system where relatives of an Alzheimer’s sufferer may be alerted if they wander out of a certain area. For example if an elderly and confused person leaves the town shopping centre and walks onto an area outside the virtual gate such as railway tracks – the sufferer’s family could be alerted immediately.

Enhanced applications using the Global Positioning System (GPS) are also helping to get blind and elderly pedestrians where they need to be. These devices are GPS enabled PDAs controlled by a touch screen and adapted with a tactile overlay and speech output software. These systems are becoming more prevalent and are helping those able to walk get from A to B. What is important here is that clear mapping information is provided. For instance ‘Turn right in 300 yards’ may be helpful in a car satnav, but perhaps not for a partially sighted pedestrian. It is up to a network organisation like us to make sure the latest research is filtering through to manufacturers to find the best way forward for the whole community.

In many of these technology areas - the problem is that responsibility for funding research and application of these devices can fall between government departments and even between central and local government. For example we could see service centres where operators guide pedestrians with learning difficulties over the telephone, using the GPS location of the caller and an onscreen map. The technology for this is available now – but these facilities do not exist due to confusion over who would fund it.
 It is important to ensure government and manufacturer collaboration on the application of these technologies to ensure the best service possible, and to integrate them with other digital mapping services. It is part of our role to bring people together and ensure that these technologies are beneficial to the whole community and benefit everyone in society.

Bob Cockshott is acting director of the Location and Timing Knowledge Transfer Network, a managed network of more than 500 organisations which research, develop, operate and apply location and timing technologies. The KTN team works with industry and researchers to exploit knowledge and connect companies to emerging technologies and the best international research and practice. The KTN is a forum for its members and an authoritative voice advising government about the impact of location and timing technologies.