RFID helps prevent wrong-site surgery and other medical mishaps
By Marisa Torrieri
A patient needs a new knee. A nurse marks a big “X” on his right knee.
Think “X” marks the spot?
Sometimes surgeons don’t and they operate on the wrong knee.
At best, wrong-site surgeries like these turn into a multi million-dollar lawsuit. At worst, they are fatal. Thanks to RFID technology, such scenarios are avoidable.
This year, more hospitals and health centers are implementing RFID to eliminate patient identification errors, and in turn, improve patient safety. RFID shows great promise in other medical safety arenas, as well, such as increasing the safety of blood transfusions.
For hospitals that use RFID to prevent surgical errors, there’s an added bonus: better compliance with a new rule recently released by the Joint Commission on Accreditation of Healthcare Organizations, which surveys and accredits hospitals. As of July 1, 2004, all accredited hospitals must comply with its “Universal Protocol For Preventing Wrong Site, Wrong Procedure, Wrong Person Surgery.” The protocol calls for hospitals to put systems in place to ensure patients are identified correctly from the time they arrive to the moment they are cut open.
Without RFID, a host of things can go wrong, says Todd Stewart, vice president of business development for AMTSystems, a technology firm that produces software for the medical community. It just released its first RFID verification product for hospitals. The product, Surgichip, was the brainchild of an orthopedic surgeon who saw a need for multiple safety checks before making the first cut. He collaborated with AMTSystems and RFID printer/encoder company Zebra Technologies to develop it. Surgichip was approved by the FDA in November 2004, and Stewart says it is more reliable than bar code tracking.
With an RFID chip, when changes must be made, the information is input into the patient’s electronic chart and the new data are sent to the chip. Because one can’t write changes to bar codes, another bar-coded wristband must be printed out every time some information changes.
The RFID system, which is being implemented by at least five medical centers, works as a “three-step verification” process, Stewart says. As with most medical RFID products, it runs on a 13.56 MHz frequency. The close range frequency prevents patients on adjacent beds from getting mixed up.
At the time that a patient arranges for the procedure, personal information, such as name, type of operation and the surgeon’s information, is entered into an electronic database. The information is forwarded electronically to a designated Surgichip, which stays with the patient’s medical chart.
When the patient comes in for the procedure, the hospital staff reviews the information on the chip, checks within the hospital’s patient database and reads it out loud to the patient. The patient confirms the correct data. As soon as the patient confirms it, the surgical site is marked with an indelible marker, and the chip is stuck to the site with a biocompatible adhesive. The patient is conscious throughout this entire process.
“That’s where, by far, the majority of errors are going to get caught,” Stewart says.
After the chip is affixed, the patient is wheeled into the operating room, where the surgeon does a final check before the surgery begins.
Because the information is right there, up to the moment the surgery begins, the physician can rest assured, he adds.
According to Stewart, the FDA approved Surgichip after a 10-month beta test. Independent of the FDA’s testing, AMTSystems conducted more than 100 procedures with volunteer hospitals, “and not a single error” occurred. Stewart couldn’t say how the error rate compared with bar code tests.
On average, Surgichip takes only half an hour to learn, Stewart says. Clients include Palm Beach Orthopedic Institute and Jupiter Outpatient Medical Center. While prices are negotiable with AMTSystems, the cost works out to about $7 per case during the first year, Stewart says. So a system for 2,500 surgeries would cost about $17,500 (the price includes software, hardware, training and support). In years two and beyond, the price drops to about $3 per case.
This article originally appeared in the June 2005 issue of RFID Operations.