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Bar Coding


Improving medical device connectivity


Both bar coding and RFID technologies can be applied to improve workfl ow. By Brian McAlpine


T


he application and use of auto-ID technology at the point of care in hospitals is not new. Auto-ID technologies can be implemented in various ways, and bar codes are by far the most common. Other ways include magnetic stripes, optical character recognition (OCR), smart cards, voice recognition, biometrics and various forms of radio fre- quency identifi cation (RFID). Most auto-ID applications have inherent limitations, such as the need for line of sight (bar-code scanning), low data-storage capacity (bar codes) and the need for human intervention (voice recognition, biometrics).


RFID was developed to overcome these limitations and is gaining traction in hospitals. RFID is promising because it does not require line of sight, has a longer read range, can store large amounts of user data using integrated technology and can be implemented in many forms. But make no mistake, RFID is not about to replace the general use of bar codes in hospitals any time soon. Rather, RFID should be viewed as a complementary technology that can enhance and improve safety and clinical workfl ow. From a historical perspective, medical device con- nectivity used to be much simpler and did not typically require the use of either bar coding or RFID. However, partly driven by the American Recovery and Reinvest- ment Act (ARRA) of 2009 and meaningful use, there is currently much more focus on ensuring medical devices are connected and able to send data to the electronic medical record (EMR). Solutions for device connectivity are evolving to adapt to a new set of requirements, and workfl ow is becoming a key factor. We are now entering a stage where both bar coding and RFID technologies can be applied to improve workfl ow. Medical device con- nectivity and related device-setup workfl ows – whereby clinicians are required to set up devices at the bedside to enable integration – is becoming much more challeng- ing because of changing requirements for connectivity. The following trends are contributing to the increasing complexity of device connectivity.


18 May 2011


The scope of devices that require EMR integration is increasing, and the types of devices are changing at the same time. For example, in the past there may have been a requirement to integrate data from patient-monitoring devices in only the ICU. Now all devices at the bedside are candidates for integration, including ventilators, infusion pumps, pulse oximeters and wireless smart beds. The challenge here is mainly how to optimize the clinical workfl ow.


The issue here for clinicians is how the patient-to-device association will get established to ensure the data gets to the right patient record.


• The scope of clinical care areas that have devices requiring integration with EMRs is increasing. It used to be critical-care areas that were the main targets for device connectivity projects. Today, many projects are enterprise in scope and include specialty care areas and all medical surgical beds. Today’s solutions must address requirements for both continuous and periodic data collection and clinician validation of data.


• The use of wireless and mobile devices is expanding rapidly, and lack of patient context limits the ability to integrate the data. The issue here for clinicians is how the patient-to-device association will get established to ensure the data gets to the right patient record.


• The industry is shifting to a patient-centric integration model that requires positive patient identifi cation (PPID). Many hospitals are requiring device con- nectivity vendors to move away from location-based integration models because of concerns for potential wrong patient data mismatches and because of the Joint Commission National Patient Safety Guidelines that address proper patient identifi cation.1


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