Case study: The magic of RFID

We all make mistakes – it’s human nature. But in the operating theatre or hospital ward, even the smallest mistakes can kill. The AURA laboratory at AUT is developing technology to prevent such errors.
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Radio frequency identification (RFID) technology dates back to WWII, but today it’s being used to make life easier in countless different ways. RFID enables the auto-identification of objects without the need for a line of sight. It essentially works when the presence of an RFID tag on an object, or a person, is identified by a reader.

While relatively simple, the technology has endless applications: to speed us through passport control; to track goods in the supply chain; for cashless payment systems; to protect livestock against the spread of disease; and even to recognise forged bank notes.

“RFID is unobtrusive and it makes collecting data easy and cheap,” says Dr David Parry, founding director of AURA, the RFID applications laboratory at AUT University’s School of Computing and Mathematical Sciences.

The AURA laboratory has been carrying out RFID research since 2008, consulting on projects with medical, security, supply-chain and data-management applications. 

“The AURA lab looks at applications of RFID tags to understand human activity,” Dr Parry says. “We’re able to record how people move, how they move things and to understand what they’re doing when we see that activity. In some cases we can monitor and support what they’re doing and if there’s a problem, give warnings and prompt them to do something different.”

While many RFID applications relate to tracking products, the AURA lab is more focused on people – particularly on the prevention of clinical errors in hospital environments. In collaboration with the University of Auckland, AURA carried out a $1 million study – the largest of its kind in the world – to track the activities and movements of medical professionals using anaesthetic drugs.

“If you’re an anaesthetist, you’re trying to keep the patient alive,” explains Dr Parry. “But the problem is that a lot of the drug ampoules you use look very similar, and you’re generally doing things very quickly. Giving the wrong drug might kill the patient, and even when you put the right drug into the syringe, you have to remember which syringe it’s in.”

As a result, AURA developed the Smart Tray, extending a commercial system available from SaferSleep that uses barcodes. It’s a simple system that features a reader located in the drug tray used by anaesthetists. RFID tags are added to the name tags on each syringe.

While the syringe is within range of the reader, it recognises the syringe’s presence. Remove it and the reader tells you what drug you’ve picked up and adds it to the patient record.

The aim is eliminate ‘skill errors’, which occur when we know what we’re supposed to be doing and how to do it, but mistakenly do something different.

“It provides feedback, saying: ‘No. You think you’re doing this, but you’re not.’ It’s a double check, a multi-sensory way to remind people of things. Nobody wants to make a clinical error, but there is always going to be human error.

“What we are doing with RFID is trying to identify pinch points where a simple warning or reminder could make all the difference. Once you put the people and detectors together, you can see what they do and understand why, and change their behaviour for the better.”

The AURA study also tracked anaesthetists’ movements, both in a simulation suite and in real-life operating theatres.RFID tags placed on the front and back of the surgeon’s cap, wrist and body, provide information about where exactly they are to within 5cm.

“There’s a lot of work being done on how people make errors in operating theatres, and the key is to know what happened just before the error. What were they doing wrong?

“We now know the direction your head is pointing. Are you standing in the right place? Moving appropriately? In many jobs in healthcare, there’s a choreography going on. You can tell someone’s experienced because they’re standing where they’re supposed to be or where they’re going to be before they get told to do it.”

Dr Parry says the great thing about RFID technology is that it can record useful data cheaply and easily. This information can then be used by the medical profession to develop or establish procedure and adopt new techniques that might be much more effective.

“You just set it up and it runs all the time. It’s not video and it’s not an observer so there aren’t issues with privacy. It’s just anonymous data and it’s impartial. The tags are unobtrusive and cheap, and we can put them everywhere. If you had to scan something or type something in, it would just get annoying and you’d end up not doing it.”

The Smart Tray RFID tag system developed by the AURA lab is also being used to help direct non-standard medication to the right patient once it’s sent up from the hospital pharmacy. The aim is to track exactly where the medication is. Not only does this prevent unnecessary re-orders and double-ups of expensive drugs, but it also helps track batch numbers in case there’s a problem and alert medical staff to potential drug interactions.

“There are even developments now where tags will actually go on the drugs to provide information about things such as a patient’s heart rate,” says Dr Parry.