CEO SUMMARY: The current state of the art for radio frequency identification (RFID) tags employs read-only chips. Labs can use these RFID chips today to track specimens at intake. But pathologist William Neeley, M.D., is most enthusiastic about the potential of read-write RFID chips, which could help cut errors, improve patient safety, and boost staff productivity across all areas of laboratory operations.
RADIO FREQUENCY IDENTIFICATION (RFID) holds the promise of simultaneously boosting productivity and eliminating errors in clinical and pathology laboratories.
Along with Mayo Clinic’s RFID project (see pages 9-10), Detroit Medical Center (DMC) University Laboratories in Detroit, Michigan, and ProPath of Dallas, Texas, are taking active steps to introduce RFID into their lab operations. All three laboratories will be at the Executive War College in Miami, Florida, on May 10-11 and will discuss RFID in their presentations.
One pathologist who is enthusiastic about the short-term potential of RFID in clinical laboratories is William Neeley, M.D., Medical Director at the Detroit Medical Center, University Laboratories. While many technologies offer such promise, Neeley believes there’s no doubt about the significant potential for radio frequency identification. But there’s one big hitch, he said. Currently, RFID uses read-only chips. When appropriate read-write chips are available for RFID, the benefits for laboratories will be obvious and dramatic, he said.
“A read-write RFID chip means that information can be added to the chip at different stations and at different times,” noted Neeley. “By using read-write RFID chips, doctors’ offices, hospitals, laboratories, and other providers could track specimens from collection to pathology reports. Not only would these chips help eliminate common data-entry errors, but they would allow providers and labs to locate lost specimens easily and quickly.
“Read-write RFID is a real solution for real problems,” Neeley explained. “It will produce exceptional results. For labs, RFID’s significant potential resides in read-write chips. Current technology has not yet delivered RFID chips that are small, inexpensive, highly reliable, and with adequate read-write memory. RFID is still in its infancy. As the technology advances, RFID will help clinical laboratories solve many problems they tolerate now, but want to eliminate.
“The laboratories here at Detroit Medical Center process 10 million billable tests annually for seven different hospitals,” observed Neeley. “Our outreach program represents 50% of that volume. Because of our extensive in-house capabilities, we send out only 0.8% of our work to outside laboratories. In any hospital with a broad test menu and high volumes of specimens, RFID has great potential. Our plan for RFID is different from what most laboratory administrators envision. We want to introduce RFID into the pre-pre-analytical step—at the point where the specimen is drawn.
“So, for example, when a courier returns from a doctor’s office, our staff wants to know exactly what tubes the courier has collected,” he explained. “We sort through the tubes and match them to the doctors’ orders. What if the courier is supposed to have 200 tubes and yet has only 199? What if our processing staff goes through those tubes and finds an order for a complete blood count but there’s no lavender-top tube? What if we find a lavender-top tube but no order?
“If the doctor had the proper system, his staff could print and affix a bar coded label with an embedded RFID chip to the specimen,” Neeley said. “The bar coded RFID chip would contain all the patient information, the stopper color, and the test order. It also would safeguard the patient’s privacy.
“With one pass of the RFID scanner, the courier could collect and read a complete record of all the information from all the tubes in seconds, without having to handle each tube for a visual laser scan,” he added. “The software would know that a CBC was ordered and match the required CBC test to the appropriate lavender tube.
“If something is missing, the system will tell the courier immediately,” Neeley added. “While at the doctor’s office, the courier could use a portable printer and print a message to the office staff to inform the doctor that a CBC test was ordered, but the tube for that patient’s test was missing. In this way, RFID would allow the lab to identify and solve this problem while the courier was still in the doctor’s office. And it wouldn’t require the courier to have additional training.
“Contrast that with the current system, where the bag comes to the lab in the evening and our people match the tubes to each requisition,” he said. “If a tube is missing or an order is missing, they fill out a problem card. The next morning, someone on our staff calls the doctor’s office. The current process needlessly wastes manpower and frustrates the lab’s clients.
“RFID can also make it easier and faster to store and retrieve specimens,” continued Neeley. “When storing samples in a refrigerator, it’s easy to accidentally put a sample in the wrong bin. By using an RFID antenna, it is possible to find one or more missing samples among 30,000 tubes in just seconds!”
THE DARK REPORT was the first to alert the laboratory industry about the potential of RFID technology to solve long- standing problems in laboratory operations. In 2004, we predicted that labs would need both bar code and RFID systems. (See TDR, December 13, 2004). In 2005, we were first to describe the use of RFID by the blood bank at Georgetown University Medical Center in Washington, DC. (See TDR, February 14, 2005.)
Almost Ready For Lab Use
THE DARK REPORT believes Neeley’s enthusi- asm for RFID is justified. Simply adopting RFID to the uses Neeley foresees will have a significant effect on productivity and on patient safety. RFID has unquestioned potential to help cut errors sharply in the collection, labeling, transport, and processing of specimens when they arrive in the lab. It is the same for tracking specimens through the laboratory and into storage. As Neeley points, out, however, further technology advances are needed before RFID will be ready for prime time in laboratory operations.