New technology offers the chance to take the paperwork out of medicine. David Labanyi reports
Shoppers driving the consumer boom may not realise the same technologies being used to provide for their every want may soon revolutionise health services.
The challenge faced by multinational firms such as Walmart, Metro, Unilever and Gillette to meet demand has led to heavy investment in radio frequency identification (RFID).
Experts believe this will shortly replace barcodes as the standard identification technology.
The size of a matchstick head, RFID tags may soon be attached to everything, from clothing to pharmaceutical products. The tags can also be placed over or, in some cases, under the skin.
This technology is in use in the Eazy-Pass system on the M50 and in car zap keys. But what does this have to do with healthcare?
The man with the answer is Dr Joseph Dalton, of Intel's IT innovation centre in Dublin. This department is charged with examining business problems and trying to resolve them using new technologies.
According to Dr Dalton, the healthcare industry faces inefficiencies and bottlenecks typical of any sector still heavily reliant on paper-based administration. He believes RFID could help resolve some of these, using a concept Intel calls the "digital hospital".
"The goal of technology is to take the burden off people and put it onto machines. Looking at the problems in the health service, we found administration taking up huge amounts of time and resources."
Part of the digital hospital concept involves knowing where every patient, doctor, nurse auxiliary staff and piece of equipment is at any one time by using RFID tags.
To test the concept, Intel recently installed the technology in a 35-bed ward in St Vincent's Hospital in Alabama, USA.
The researchers had a clear idea of the problems they were trying to solve: poor bed allocation efficiency, poor resource utilisation, poor inventory management. The researchers also wanted to address the significant problem of data being unavailable in real time.
Each patient was assigned an RFID wristband. Each physician was given a laptop and a scanner which could read the tag, using it to access the patient's electronic medical file. To give an overview of activity in the ward, a number of large plasma screens were installed showing the status of each bed in colour code.
Nurses were also equipped with PDA devices which could read the patient's tag to check patient status. For example, when administering medication, the validity of the prescription could be checked.
The patient's file was also automatically updated with each new consultation, prescription or medical test, reducing paperwork via their wristband.
"This is a living, breathing example of the technology. A doctor can sit down with a patient and download an MRI or an ultrasound. They can see the prescribing history, no rushing around looking for files," said Dr Dalton.
Before the trial sometimes up to eight hours passed in St Vincent's between a bed being vacated and a new patient admitted because staff were not aware the bed was free. During the trial, admission and discharge throughput increased by 40 per cent in the digital ward. The time for which a room was vacant dropped from anything up to eight hours to less than 45 minutes, according to a report on the trial published by Intel.
To date, ten US hospitals have adopted the broad digital hospital concept.
Research from PriceWaterhouseCoopers earlier this year found "digitally advanced hospitals have reduced lengths of stay, increased revenues and are more compliant with processes that lead to higher quality".
There are no examples in Europe at the moment, although Intel is in preliminary discussions with a major London teaching hospital. Dr Dalton says the next step is to link a technologically advanced hospital with GPs and pharmacies.
Intel are also examining ways of using this technology to reduce the chance of medical errors. The high number of erroneous blood transfusions was another problem examined by Intel.
"About one in every 16,000 blood transfusions in the US are erroneously administered. So when we looked at why blood transfusions errors occur, we found that 85 per cent are due to poor labelling and misspelling of names," said Dr Dalton.
To see if these errors could be reduced, Intel installed a technology programme for a blood transfusion unit in the University Hospital in Milan. The system was initially designed for autologous transfusions, or self-transfusions and is now being expanded to include the allogenic service.
"Using RFID, each unit of blood was tagged on donation with information on blood type and the donor and other pertinent medical information. Prior to transfusion, the medic uses a scanner to check that the patient's tag and that on the unit of blood is compatible."
Dr Dalton estimates that if such a system were in place in US hospitals the rate of transfusion errors would drop to one in 500,000.
"What the technology is allowing us to do is identify and resolve bottlenecks. It is all about mobility and real time information."
RFID is also being used to reduce the numbers of baby mix-ups in maternity wards and Intel has demonstrated a system in Korea recently which almost eliminates this. It is not just Intel working on future health service technologies, many other hardware and software firms are involved.
The PwC report noted US hospitals are a $500 billion (€402 billion) industry and most spent 2.5 to 3 per cent of their budget on technology. PwC estimates the level of investment will have to rise to about 5 per cent for the health services to catch up with other industries.
Despite the number of technology companies in the field, Dr Dalton said recent agreements around RFID standards means there will be no repeat of the VHS/Betamax scenario where competing companies produced incompatible systems. This problem has plagued healthcare for many years.
"Interoperatibility within the health system is vital. Everything being worked on at the moment is using a standard computer messaging system, called HL7, which means regardless of who you buy your system from or the type of system, it will be compatible with other systems inside and outside the hospital."
For the medic this means that the physicians and other medical staff and other (GPs, patients) should be able to access all patient information both inside and outside the hospital including from the home with no difficulty.