Technology now used on toll roads and in stores is moving into hospitals
There are only five ventilators spread throughout the football-field-sized emergency department at Beth Israel Deaconess Medical Center -- so sometimes the breathing machines are hard to find.
''But, in a crash situation, with a trauma patient, I really need to find that piece of equipment," said John Halamka, an ER doctor and Beth Israel's chief information officer. The same goes for EKG machines, IV pumps and other expensive medical devices in the emergency department. When they're needed, they're needed now.
It can be just as critical to know exactly where a certain doctor is, or a patient with a life-threatening condition. So, last fall, Beth Israel turned to a technology known as radio frequency identification, or RFID. Partnering with a Framingham company called PanGo Networks, the hospital developed a system of small tags with transmitters that broadcast signals to wall-mounted receivers, telling hospital computers the position of everything including patients, surgeons, and sophisticated medical equipment.
RFID technology has been around for years -- used in everything from office key cards to the Massachusetts Turnpike's E-ZPass transponders.
Now, trial runs at several Boston hospitals are helping to test its potential in the medical arena. In addition to using RFID to track critical equipment, local hospitals -- often teamed with area technology startups -- are creating trial programs to ensure patients aren't made to wait too long between tests, or given the wrong medication or blood.
''We've been testing to be sure [the tags] were accurate, that nobody could intercept the signals and that there was no interference with other medical devices," Halamka said.
Massachusetts General Hospital began using the technology two years ago as part of its ''Operating Room of the Future," created in partnership with a Lawrence-based company called Radianse, which has also partnered with Brigham and Women's Hospital to track hospital equipment with RFID.
This spring, Mass. General will expand the RFID tagging to other departments and also will tag medicine and medical equipment. Rules, written into the hospital's computer system, will issue alerts to staff pagers if, for example, penicillin is brought into the same room with a patient who's allergic or if a patient waits more than a half-hour between medical tests.
''To ensure a zone of safety around a patient, the first thing you have to know is where the patient is at all times," said Dr. Warren Sandberg, a Mass. General anesthesiologist.
In addition to patient tracking, Mass. General this month will begin using RFID in the hospital's blood bank to ensure that transfusion recipients get the proper blood type.
The technology being used for the blood bank is known as ''passive" RFID because the unpowered chips send their radio signals only when special scanners are brought near them.
It's also passive RFID that the US Food and Drug Administration wants on drug packaging by 2007 to help combat counterfeit medicine. Compared to traditional bar codes, RFID tags can contain more product-specific information, need not be lined up within sight of a scanner, and can be read many at a time.
But finding people and medical devices in a hospital requires battery-powered ''active" RFID tags that broadcast their signal to receivers connected to hospital computers, mapping the location of patients, staff, and equipment in real time.
Halamka is such a fan of the technology, he was one of the first people in the country to get a tiny chip implanted in his arm. The company that makes the chip,
Theoretically, if Halamka ever ended up as an unconscious patient in an emergency room, hospital staff could use a special scanner to read the identification number encoded on his chip and use that number to access his medical history.
Privacy advocates worry, however, that medical uses of RFID could threaten the security of medical information and they want patients to have more control over its use. For example, they argue that people should be able to have RFID tags on drug packages deactivated when they pick up their prescriptions.
''It's important that a patient be informed and given the opportunity to opt out," said Emily Stewart, policy analyst for the Health Privacy Project in Washington.
According to Angela Fulcher, Applied Digital's vice president of marketing, patients with an implant would be able to choose what information was stored in the database linked to the chip and which medical centers would have authorized access to that information.
But such precautions don't go far enough for privacy advocates, who are concerned about the vulnerability of such a massive medical records database to hackers and other unauthorized users.
Doctors and administrators at the Boston hospitals using RFID stress that patient privacy is a top concern, and that they're using only temporary, external tags hidden in standard identification bracelets. The tags contain vital information, such as name, hospital identification number and blood type.
Still, the more RFID becomes a standard of patient care, the less likely it is to be optional. ''Basically, now . . . a patient can still say, 'I don't want it,' " said Sandberg, the Mass. General anesthesiologist. ''But as soon as this is critical to patient safety, the procedure will be the same as putting on an ID bracelet. There's no choice because your safety depends on it."
