RFID (Radio Frequency Identification) Tags American Committee For Shaare Zedek Medical Center
The American Committee for Shaare Zedek Medical Center in Jerusalem provides financial support for services, capital projects, research and the purchase of equipment for Shaare Zedek Medical Center in Jerusalem. Shaare Zedek, known as the “hospital with a heart,” provides industry-leading, cutting-edge medical care in a nurturing environment.
Israel is under continuous terrorist threats- both small and large scale. Due to the large numbers of people that have been injured during such attacks the hospital must treat and admit many casualties on short notice.
Shaare Zedek Medical Center, Jerusalem’s largest centrally located hospital in the city, has taken care of approximately 75% of all the casualties from attacks during this past year. To save lives it is crucial for the hospital to be methodical, systematic, and expeditious in preparing for these unexpected situations.
During a mass casualty event, the injured are brought to the entrance of the hospital’s Trauma Center and are rapidly admitted to the various treatment areas, according to the decisions of the medical team. In a mass casualty incident where a large number of victims arrive on short notice, it is critical to keep track of each patient and their immediate medical needs.
We have therefore developed a unique hands-free online system to register and track patients electronically using Radio Frequency Identification (RFID) tags. With tag readers set up in locations designated by the hospital’s mass casualty safety specialist, this hands-free, online, RFID system will fulfill our goal of monitoring the whereabouts of each patient as they transfer from the trauma unit to the appropriate treatments areas.
The RFID system provides key details to the Emergency management center including the number of patients, nature and extent of their injuries as well as their exact location during the treatment process. This system allows us to prevent bottle necking, and to allocate human and medical resources more effectively while improving all aspects of care during the mass casualty event. Using this system we have been able to improve our overall event management protocols.
Immediately upon arrival, the patients are given a tag with an identifying number which is used throughout the initial treatment phase. Personal details are not taken at this stage in order to expedite treatment. It is very important that the information provided will not require manual tracking of the patients, and that this information will be received in a hands-off manner, since there are many changes in patient location. Until now all attempts to manually track the patients have failed.
Typically at this stage with many major casualties, chaos can ensue as attempts are made to verify the identity and track the location of each patient. Patients may be located in various places getting treatment or tests and the medical team must have a clear and immediate picture of the patient load and medical needs at all times.
This efficient monitoring system can provide, at any given time, the exact locations of the injured as well as an accurate map of the number of casualties at each site. This patient tracking system provides the medical team with a clear, logistic overview so they are able to direct and treat the patients more competently while tracking the location of any particular patient.
Although these patients are expected to be in the emergency room at any given time, in practice they may actually be in other locations e.g. the x-ray or the CT unit, ambulatory triage, the operating rooms, the trauma unit etc., and therefore tracking each patient is crucial.
Patients may move between locations independently, with the aid of a porter, or with the assistance of a family member. The ability to know where each patient is, from the range of possibilities noted above, enables regulation and control and is especially important for facilities with a large number of patients, such as Shaare Zedek.
Two main systems were evaluated
- A passive UHF system – A system which operates using passive tags that transmit to readers.
- An active RTLS system – A system which operates using active tags; the tag is battery-operated.
Stage One – Evaluation of the tag types, without patient participation
Passive and active tags were worn, and the reliability of the reports transmitted was evaluated.
The Active Tags displayed 100% reliability and we were able to track movements between the various sites but the tag costs were much more expensive than the passive tags.
The Passive Tags – these tags displayed limited transmission, even when 3 antennas were used, when walking and when being transported lying down covered by a blanket. No results at all were displayed when the tag was attached to and bent around the patient ID bracelet. These tags however, are more cost effective.
The passive system does not enable reliable monitoring as contact with the human body or proximity to it (which is unavoidable) disrupts the frequencies; it was therefore necessary to switch and use only active tags.
Stage Two – Evaluation of an active tag specially designed for the Shaare Zedek Medical Center
Following the results of the pilot study the decision was made to use the active tag system. Tags with a short-term battery were therefore specially designed for the Shaare Zedek Medical Center. This decision was made based on the assumption that the need to monitor patients admitted to the Department of Emergency Medicine would be limited to only several days, until their discharge or transfer to an inpatient ward. These tags are designed to uniquely serve the emergency system for this project.
An active tag was developed at a reasonable price – we evaluated the tag at an initial stage by setting up tag readers at several locations and obtained good monitoring results.
Stage Three – Positioning of readers at numerous locations and evaluation of the system, with patient participation
The system was incorporated into the patient admissions process – upon arrival at the Department of Emergency Medicine, the system assigned the patient a code corresponding to the tag number, and the tag was attached to the patient ID bracelet, which was placed on the patient’s wrist.
At this stage the tag was activated to enable the start of monitoring.
Approximately 30 – 40 patients were tested each day: the location of these patients was monitored, and the ability to examine the history of the locations they visited, and when, was evaluated.
- The system fulfills the requirements and reports the whereabouts of the inpatients in a satisfactory manner.
- It was decided to purchase the system, to be used in every mass casualty incident; the system will be activated and tested every month in order to ensure that the staff is trained in the use of the tags and patient tracking in emergency situations.
How to prepare in the event of a mass casualty, and tasks to be completed:
- 1,500 tags will be purchased for purposes of routine testing and staff training, and for mass casualty events
- The second floor ER/Trauma Area will be equipped with readers in all of the specific areas defined for mass casualty event handling.
- The tags will be encoded with the first 300 sequential numbers – suggest to the supplier to replace the battery with a long lasting battery for this purpose.
- The tags will be prepared and connected to patient ID bracelets so that in the case of an event they can be placed on the patients wrists immediately.
- Complete the interface between the RFID software and the hospital’s patient tracking AZMA system.
- Examine the possibility of the battery dying.
- Reduction of the system coding time from 30 seconds / 1 minute to several seconds only.
- Evaluation of the system for additional advantages, such as timetable to hospitalization.
In a mass casualty incident where a large number of victims arrive at the hospital in a short amount of time, it is critical that the hospital have a comprehensive picture of the incident and the immediate medical needs. This RFID system provides key details including the number of patients, nature and extent of their injuries and their exact location in the treatment process. This system will allow the medical team to better allocate human and medical resources to save more lives during mass casualty events.