563.9.1 RFIDs in Health Care

1. 563.9.1 RFIDs in Health Care Ayesha Yasmeen University of Illinois

2. Outline • RFID • What is it? • Why can it be of help? • Where can it help? • Can it help in the medical sector? • How can it help? • Is it a feasible solution? • What problems can arise if RFID is used?

3. Radio Frequency Identification • Three main parts to an RFID implementation: • Tag • a chip with memory • so data can be stored and retrieved • an antenna • can respond to queries • Reader • Database & software RFID - wikipedia

4. Why RFID? • Tag holds unique identification data • a unique serial number and • other attributes of the item • Reader does not require line of sight or contact • Reader can scan tags in motion • Reader can scan in milliseconds • Reader can simultaneously scan multiple items

5. RFID uses • Retail & Distribution • Health care • Contact less Payment • Keyless Entry • Livestock Tagging • Pharmaceuticals • Logistics Assets (containers, trailers) • Pet Identification

6. RFID in Healthcare

7. Motivation • An average of 195,000 people died in US hospitals in each of the years of 2000, 2001, 2002 as a result of potentially preventable, in-hospital medical errors. • Patient went through wrong operation • Patient received unsuitable medication, blood • Equipment got lost • These point to errors in • Patient identification • Medication management • Equipment tracking Fuhrer 07

8. Currently available RFID wristband and readers • RFID wristbands for patients developed by Brenmoor has • 13.56 MHz technology • total memory of 1024 bits and • user memory 768 bits.

9. How RFID can be used in hospitals Patient arrives at hospital & gets RFID tag Take reading Operating room Give correct amount of medication

10. Medication application • All admitted patients are given an RFID-based wristband containing • patient’s ID • blood type, allergy etc. • Nurses have PDA/hand held devices • scans patient’s wristband • scans the medication to be given • The timestamp, patient ID, medication information (and possibly nurse’s ID) is then transmitted via wireless to the central database and verified • Server either sends an alert about wrong medication/wrong time to administer medication or records the administration of the dose at that time

11. Use in operating rooms • Once a patient arrives at an OR verify that it is the right patient • scan patient’s ID and automatically display info about the patient scheduled for operation • Before starting the operation ensure all required equipment is present • Once the operation starts can keep scanning drugs, accessories being used • After the operation ends bulk scan all equipment to ensure everything is in correct place

12. Current example • Chang-Gung Memorial Hospital (CGMH), part of a seven-facility, 8,800 bed health system in Taiwan RFID-based Hospital Real-time Patient Management System • The integration of RFID using • PDC Smart Band® RFID wristbands, • HP RFID PDA readers, • handheld readers

13. RFID based ID in OR in CMGH

14. Medical Billing • Even today, a lot of data has to be entered manually to generate the bill once a patient is ready to leave the hospital • RFID based system will keep records of each billable element/procedure used for the patient • Billing will be more accurate and easier

15. RFID based Asset Tracking • Requirement/procedure: • each equipment gets a RFID tag embedded • the tag should be embedded at production point or • hospitals should be able to attach a tag to equipment in a manner so that the tag is tough to remove radio signal Wifi network intranet asset locator web interface

16. Advantages and Issues • If each medical equipment has an RFID tag it will allow • locating dynamically • stopping theft • reducing time to find assets • increased utilization • Issues: • RFID readers have to be placed all around the hospital • shielding of RFID tags can make it impossible to detect an equipment being stolen

17. RFID synergy at a Netherlands Hospital Patient with RFID wristband RFID readers Clinician ID with RFID tag Blood bag with RFID tag RFID Journal, Aug 07

18. Challenges for deployment in patient identification • Usability • High frequency devices might drown out the RFID tags : MRI devices • Impact of environment on tags • washing with water, boiling for sterilization • Reliability • Medical sector is a safety critical system • False positives/False Negatives can lead to severe consequences • Safety • RF electromagnetic radiation vs Pacemakers • Cost, DOS attacks Nahas 07

19. Security and privacy concerns • Security concerns: • Eavesdropping can lead to tracking of patients • Patient’s medical data can be recorded without knowledge or permission • Privacy concerns: • Doctors, nurses and all other medical personnel will need smart badges containing RFID tags • How the clinicians will feel towards being tracked all the time is unclear.

20. RFID security mechanisms • Lots of suggestions • They are costly computation wise • CGMH uses password based mechanism • Pseudonym: • Each tag has a set of pseudonyms • Choose a different pseudonym from the set every time • Prevent an eavesdropper from being able to associate a tag ID with an object • Not really computation heavy • No password needs to be memorized • Cryptography • Key management can be a problem Juels 06

21. Summary • RFID based identification and locator systems can • reduce time and labor needed to input and manage data manually, • improve operations and data accuracy • improve patient safety (identification and medication administration), • aid in business flow management, and • improve asset/equipment management • However clear laws and recommendations are needed about security and privacy issues in tracking of human beings

22. References • General • Wikipedia entry for RFID • RFID security: • RFID Security and Privacy: A Research Survey, Ari Juels, 2006 • RFID and smart hospitals: • Radio Frequency Identification Applications in Smart Hospitals, Huzifa Al Nahas, Jitender Deogun, CBMS 2007. • Building a Smart Hospital using RFID technologies, Patrik Fuhrer, Dominique Guinard, CBMS 2007.