In June, a report stated that radio frequency identification (RFID) tags used by hospitals to track devices such as IV pumps and prescription medications can interfere with medical equipment. The study — published in the Journal of the American Medical Association and conducted in a controlled nonclinical setting at Vrije Universiteit in Amsterdam — detected 34 instances where electromagnetic interference (EMI) had occurred; of those, 22 were deemed hazardous. In light of this, the authors cautioned hospitals to conduct onsite testing, and called for updated industry standards.
However, despite the potential ramifications, the study was quickly dismissed by manufacturers of real-time location systems (RTLS) and RFID-based equipment. In the days after the results were made public, dozens of vendors posted open letters on their Web sites and distributed messages either defending their particular brand of technology, discounting the findings, or in some cases, both.
With the RFID market experiencing such rapid growth, it is certainly understandable that companies would want to defend their turf. According to an end-user study by Spyglass Consulting Group (Menlo Park, Calif.), 76 percent of larger healthcare organizations in the United States have adopted RFID solutions, primarily to track assets, patients and staff. These numbers, says Spyglass Founder and Managing Director Gregg Malkary, represent an increase of 204 percent from three years ago.
Clearly there is significant interest in the technology, and with millions of dollars at stake, the desire for vendors to clear their products' names is understandable, says Fran Turisco, a principal in the Waltham, Mass.-based Emerging Practices area of CSC Corporation (Falls Church, Va.). However, she says, the fact remains that the study results are indeed relevant, and even if the data doesn't apply specifically to every RFID user, she still hopes the results will serve as a wake-up call to the wireless industry, acting as a catalyst to improve safety.
“This is real — this is not a fluke,” says Turisco. “I read the study and then I read the responses from some of the clinical engineering folks who claimed that there was no interference, but it happened. It does happen. And there are probably other studies that show it.”
What's most important, she says, is how hospitals and health systems — even those that aren't deploying RFID — react to the findings. One important way is enacting policies and procedures to deal with a potentially hazardous incident. The study, she says, can also prompt important discussions about best practices for conducting assessments, the importance of CIOs being proactive rather than reactive in terms of testing, and the need for improved standards across the industry.
A better plan than ‘plug and pray’
Spectrum Health, a seven-hospital network based in Grand Rapids, Mich., began piloting RTLS this past spring at its Butterworth Hospital. When the JAMA study was published, Senior Vice President and CIO Patrick O'Hare received statements from vendors providing details about the tests they had performed measuring the levels of interference in different care settings. O'Hare and his staff, however, still had their own work to do.
“We conducted our own detailed testing and risk assessment on our high acuity equipment, including ventilators and other equipment in the ICUs based on the technologies that we're piloting,” he says. O'Hare's staff placed RFID tags in close proximity to different medical devices at varying levels of power and frequency and monitored the output of the equipment over a period of time to assess the relative interference and risk. “I don't think it's a perfect science by any stretch, but as long as you have vendors that are willing to stand behind and do the testing on their part, making sure that they're doing their level of diligence, and have a fairly consistent risk management program in place, you're at least putting yourself in a better position,” he says.
At Spectrum, assessments start long before the implementation — or even the pilot, for that matter. According to O'Hare, technologies are meticulously monitored and evaluated prior to the start of any trial period. With RFID, for example, O'Hare and his staff studied the Hype cycle from Stamford, Conn.-based Gartner (see sidebar below), and researched its track record in the industry long before making any moves.
According to Turisco, this kind of planning is critical when it comes to wireless solutions. “A lot of places say they don't do a ‘big bang’ implementation. Instead, they try it in one unit or several units and then roll it out. That's the time you would have to do the testing,” she says, adding that a technology as diverse as RFID comes with a host of different variables.