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  1. 1. 563.9.1 RFIDs in Health Care Ayesha Yasmeen University of Illinois
  2. 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? 2
  3. 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 Fixed RFID Reader LAN Application Server RFID Tag Pocket PC RFID - wikipedia 3
  4. 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 4
  5. 5. RFID uses • Retail & Distribution • Health care • Contact less Payment • Keyless Entry • Livestock Tagging • Pharmaceuticals • Logistics Assets (containers, trailers) • Pet Identification 5
  6. 6. RFID in Healthcare 6
  7. 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 7
  8. 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. 8
  9. 9. How RFID can be used in hospitals Patient arrives at hospital & Take reading gets RFID tag Operating room Give correct amount of medication 9
  10. 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 10
  11. 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 11
  12. 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 12
  13. 13. RFID based ID in OR in CMGH 13
  14. 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 14
  15. 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 15
  16. 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 16
  17. 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 17
  18. 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 18
  19. 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. 19
  20. 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 20
  21. 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 21
  22. 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. 22