Although radiofrequency identification (RFID) technology in healthcare was one of the breakaway topical discussion hits in 2005 it didn’t take long for the promotional sizzle to fizzle and the hype to be sideswiped by reality.

While virtually no one questions the value RFID will usher into the areas of patient care, asset management, supply chain management, administrative operations and security, among others many seem reluctant to give the technology its due beyond reading and talking about it. That’s largely because they’re either content with bar coding and see RFID as the wave of the future, they’re not even using bar coding yet so RFID seems beyond their reach or they’re counting on the Internet and the World Wide Web to obviate the need for either technologies.

Whatever the excuse, RFID has been making slow inroads in healthcare with a small but growing number of providers for selected applications and faster penetration among suppliers.

To gain some insights into RFID’s sticking power and longevity among healthcare providers Healthcare Purchasing News Senior Editor Rick Dana Barlow turned to Deborah Murphy, global practice leader, life sciences, and Matt Ream, senior manager of RFID systems at Zebra Technologies Corp. to assess the technology’s progress and prospects for adoption and implementation.

HPN: At least one prominent study found that while companies recognize RFID’s value to the supply chain and the bottom line, they’re really in no hurry to adopt and implement the technology. Why? What are some possible reasons? How can they be resolved?

REAM: What may appear as slowness to adopt is much more likely the affect of healthcare organizations performing due diligence and giving proper consideration to applying RFID where it makes most sense. Existing technologies, such as bar coding, still offer healthcare proven, tangible benefits in areas such as patient safety and privacy, healthcare materials management, laboratory inventory and specimen management, and more. Bar coding may offer the most efficient and cost effective means of data collection in a given application, and there may be no compelling reason to change what already works very well. RFID – in its ability to provide real-time updated data – has potential in areas such as e-pedigrees and track-and-trace that may allow healthcare organizations to provide higher levels of service or more security in serving patients in certain applications.

MURPHY: While these benefits would be considered extremely worthwhile, many organizations realize that successful RFID implementations often require business process changes as well as technology changes. Again, this would reflect organizations taking the time to do it right, rather than any reluctance to adopt RFID.

Companies seem to be confused about conflicting RFID standards. Why haven’t we learned anything from the bar coding industry’s experience with standards setting? Should there be a single standard for RFID or can multiple standards be supported? Why?

REAM: Multiple RFID standards are needed. ‘RFID’ is a blanket term, but it is not a single technology or application. RFID is available at different radio frequencies, which have different performance and cost characteristics. Wristbands to detect and prevent infants from being abducted from maternity wards require different technology and standards than an RFID application to help pharmacists determine if drugs are counterfeit. This is consistent with the bar code experience. People don’t always realize that there are dozens of different bar code formats, called symbologies, and also different numbering systems. The bar codes used on blood bags are different than those to identify surgical products, which in turn are different from UPC symbols.

Standards are important for supply chain applications where manufacturers, logistics providers and distributors use the same tag to identify goods. Most RFID standardization efforts are currently focused on supply chain activity.

Standards aren’t always necessary for closed-loop applications, where the RFID tag will only be read within a facility or health systems. Examples of closed-loops systems include RFID patient wristbands or asset tags for wheelchairs, IV pumps and other equipment.

MURPHY: There are already some RFID standards appropriate for healthcare applications. More need to be developed, and some of these efforts are underway by various industry associations. Problems arise when there are redundant standards. The RFID community understands this lesson and is coordinating standards development to meet the needs of many stakeholders.

REAM: Because there are so many ways to use RFID, there are many potential standards, which can be confusing. However, when an organization has a specific project or application in mind, finding the appropriate RFID technology and standards isn’t usually too challenging.

Some may fret about the vast amount of additional data that RFID will collect, read, sort and analyze on demand – as in what to do with it. Should they be concerned about this? Is it okay not to use everything? Why?

MURPHY: RFID systems can provide significantly more data than organizations are used to having, which is often why organizations want to implement the technology. RFID tags are also rewritable, so users can add data to support specific processes.

Today, many supplies are identified by bar codes or numbering systems that may identify the product, manufacturer and perhaps size or other unit of measure, e.g., ‘MedSupplyCo 2-inch sterile gauze.’

A standardized RFID tag for the same item might provide the following information ‘MedSupplyCo 2-inch sterile gauze, serial number 070767321, lot code ABC12345, use by May 15, 2007.’ The added information could be very useful for stock rotation or in a recall situation. The RFID application could be set up to capture and take advantage of the additional data, or to ignore it and only capture the information the organization is set up to accept.

REAM: Users can take control over the type and amount of data they collect, and the frequency they receive it. These issues should be addressed during system planning, which is why it’s important to work with experienced RFID integrators.

Additional data isn’t necessary to make RFID applications valuable. Tremendous efficiency improvements can result by using RFID to collect the same information that is currently recorded manually or with a bar code. Some companies have implemented RFID systems that can identify and record entire pallets of goods in about the same time it takes to scan the bar code on a single case. Applications like this can be modified and adapted for a variety of healthcare material management operations.

Incorporating RFID into facility’s existing infrastructure seems to be a key concern – or developing the right infrastructure to support RFID. Can RFID technology (including middleware) simply be plugged into a facility’s IT infrastructure or does that facility have to invest in something different, greater or specifically dedicated to RFID? Why?

REAM: RFID shouldn’t be viewed as a proprietary, standalone system. Neither is it a straight replacement for bar coding. The technology is often most valuable when it is integrated with legacy applications. Middleware is one way of making that happen. RFID equipment is networkable and supports common interfaces, so it usually can be added to the legacy infrastructure, including wireless networks. New software applications are usually implemented along with the RFID system. RFID data can also be shared with existing applications, which may need to be modified.

MURPHY: RFID shouldn’t be viewed as a ‘plug-and-play’ technology – which isn’t a drawback. The fact that an organization is considering RFID usually means there is a problem with processes or a limitation to current systems. If current systems efficiently provide the organization all the accurate information it needs, there’s probably no good reason to introduce RFID into operations. But nearly every organization has areas that could improve from more information, or information that is collected more quickly, efficiently and accurately. Whether an organization opts for bar coding or RFID to accomplish this objective, the most effective applications of this technology require process change.

Perceived cost implications aside, how easy is RFID to use, compared to, say bar coding and bar code-enabled wireless handheld computers and mobile/cellular telephones?

REAM: RFID systems may take more effort to set up than those systems, because most IT departments aren’t experienced with the technology and some experimenting is usually required to optimize where tags and readers are placed to get the best performance. After the initial set up, RFID systems can be easier to use because RFID is a hands-free technology while PDAs, cell phones and some bar code applications are not.

RFID tags may be either passive, which requires a close proximity to a reader, or active, which relies on a small battery to enable continuous monitoring. Passive tags are often used to track supplies and active tags are generally used to track equipment. In many applications, no worker intervention (such as scanning a bar code) is required to identify an object. Assets can be monitored constantly and movements recorded and reported automatically. RFID provides more range and much greater reading tolerance than bar codes

However, RFID does pose some challenges that bar coding does not. Because it is a radio technology, RFID can be susceptible to interference from metals, liquids and other radio devices. Systems should be planned and tested with experienced RFID integrators to ensure reliable performance. HPN