How RFID Technology Improves Hospital Care

When redesigning the new and expanded emergency room at the Mayo Clinic’s Saint Marys Hospital in Rochester, Minnesota, Mayo leaders didn’t just want to add more rooms and square feet. They saw it as an opportunity to completely transform the operation to improve care and the patient experience and to lower costs. To that end, they decided to have a team study how care is delivered, identify the barriers to smooth operations, and fix the barriers. In other words, they created a living lab of the Clinic’s largest emergency department.

The successful experience illustrates the role that relatively simple technology (e.g., an RFID system) and a multidiscipline team of clinicians and people from other fields can play in improving the quality and cost of care delivery processes and the steps that can ease the way to applying such an approach. The project was launched in 2013, and the RFID system was rolled out in stages starting in the summer of 2015. It was fully integrated into emergency room operations at St. Marys during the fourth quarter of 2015.

The system is reducing the time that staff members spend finding equipment and each other, and it informs them when a colleague is attending a patient and shouldn’t be interrupted. Similarly, family members are now directed more quickly to patients. And misplaced equipment can now be easily located and returned to its correct place. All this is allowing the clinical staff to spend more of their time on activities that benefit patients. Mayo is now evaluating the use of RFID systems in other areas of patient care.

Here is some advice for carrying out such a program:

Create a multidiscipline team. The team that implemented the initiative was led by a physician and a scientist-engineer, and its members were drawn from Mayo’s Emergency Department (ED) and the Clinic’s Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery. This Emergency Department-Clinical Engineering Learning Laboratory (ED-CELL) team comprises physicians, nurses, other health professionals, systems engineers, scientists, informaticians, IT personnel, and project managers.

Use technology to identify and address barriers. The new infrastructure was a real-time-location (RTL) system with state-of-the-art location sensors and devices that use radio frequency identification (RFID) technology to track the movement of and locate patients, staff, and equipment. High-density RFID readers were installed in the ceilings. All patients receive RFID wristbands when they register. Staff members have RFID chips in their badges. And equipment is tagged with discrete RFID stickers. All of the RFID tags are “passive technology,” meaning that the individual tags don’t need power. The ED-CELL team developed software to provide the stream of RFID data to frontline staff in a usable manner.

Address potential obstacles early. One obvious issue was whether the RFID technology would interfere with the ECG machine, monitoring equipment, and the overhead communication and paging systems. The team conducted systematic testing and ensured that it did not adversely affect the functioning of other ED equipment and devices.

Another issue was potential staff and patient concerns about wearables and privacy. The ED-CELL team sought out the insights and perspectives of all stakeholders before the launch of the RTL system. It held a series of town hall meetings with the St. Marys ED clinical staff to explain the scope and benefits of the project, answer questions, and obtain feedback.

Frontline caregivers often react to new data-collecting technologies with caution and resistance. So the team was not surprised when members of the ED staff were concerned that their every move would be monitored. Some were worried that the data collected would be used for their performance reviews. In particular, the staff members were anxious that they might be tracked during breaks and time off the unit.

In subsequent meetings and one-on-one discussions, the team reassured the staff that the system was intended to be a “clinical tool” and would not track them in the restrooms or during breaks. When staff members are outside the clinical area, they are displayed as “out of department.”

Patients were less concerned. When the ED-CELL team asked members of patient and family advisory councils of Emergency Medicine and the Kern Center how they would feel about having an RFID chip in their wristbands, their immediate response was: “Don’t you do it already?” From them, the team learned that patients often worry about being lost in the maze of hallways, being forgotten after registering, and missing their announcement in ED waiting rooms. So they embraced the idea of location devices.

The team also sought the input of various departments, including human resources, legal and compliance, and ethics consultants, and the approvals of key internal committees including clinical practice, location services, and information technology.

Integrate the system into the workflow. From a technical standpoint, several steps need to be taken to seamlessly integrate RFID into the existing workflow. For instance, when a patient is registered at the ED’s front desk, a wristband with a unique ID is wrapped on his or her wrist and the RTL system is notified that this unique ID belongs to such patient through a “commissioning process.”

The RTL system was integrated with existing information technology systems to provide a visual display of the locations of patients, key staff members (e.g., the physician and supervisory “charge” nurse), and equipment, and how long each has been at the current location. The location and duration information for all patients, staff members and equipment can also be obtained using an RTL system search tool.

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In addition to the benefits described above, the RTL system has the potential to generate others. During the first half of 2016, ED-CELL will use it to automate the reporting to government agencies and regulatory bodies of key quality metrics (e.g., the time it takes after a patient has arrived and registered at the ED for him or her to be put in a bed and to be seen by a care provider). Separately, the team is now expanding the system’s capabilities to issue alerts when patients have been waiting too long without being seen or there has been an unanticipated delay in delivering pain medication. In addition, the ED-CELL team is developing the capability to track which patients and staff members might have come into the proximity of a patient with a contagious disease.

An important lesson of this initiative is that you cannot rely on technology alone to bring about innovation and change in a fast-paced environment. Creating an environment that nurtures collaboration across disciplines, ongoing engagement, and continuous learning is just as crucial. Employing a scientific approach to improvement and having a team of scientists, clinicians, and engineers work with the local clinical staff at the patient’s bedside is a powerful way to bring about change.