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Radio cure

Cancer hospital uses RFID to track chemotherapy meds

By Paul Voosen
Staff Writer, The Prague Post
July 25th, 2007 issue

COURTESY PHOTO
SA technician transfers chemotherapy drugs to a patient's IV bag in the pharmacy of Masaryk Memorial Cancer Institute.
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COURTESY PHOTO
Ring-shaped tags identify technicians.
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When it comes to cancer, sometimes the cure can be nearly as dangerous as the disease.
Chemotherapy drugs, which are used to attack and kill dividing cancerous cells, have serious side effects even when administered properly: nausea, hair loss, ulcers, slowed production of blood cells. But when dosed inaccurately, these side effects can be severe — causing new cancers or misshaping DNA — or even fatal.
The risks and care needed in handling chemotherapy drugs are why the Masaryk Memorial Cancer Institute (MOÚ) in Brno, south Moravia, has teamed up with the Czech branch of IBM to use radio frequency identification (RFID) to control its drugs. The institute is one of the first hospitals in Europe to use RFID this way.
“RFID is making a great difference [for the hospital],” said Dr. Pavel Andres, the institute’s associate director for preventive health care. “[It] enables us to verify the correctness of medication at several checkpoints before the drug is given to a patient.”
Not a new technology — basic implementations of RFID have existed for 50 years — it has taken time for industries to integrate RFID into everyday business. Combined with the Internet, these small chips, which transmit, via radio waves, customized digital information ranging from package IDs to face scans on biometric passports, have revolutionized the shipping and retail businesses over the past 10 years, improving efficiency with a torrent of diagnosable data.
The application of RFID to other fields has remained limited, used primarily to verify identities, open doors or for automated public transit. IBM sees broad potential for the technology, which is why the company approached MOÚ. The hospital treats more than 180,000 outpatients each year and was open to any improvement it could make in patients’ safety.
“[Chemotherapy drugs] can be very dangerous, because they kill everything that grows in your body,” said Matěj Adam, IBM’s healthcare industry leader for Central and Eastern Europe. Because each treatment is tailored to the individual patient and cancer type, “human error could have serious consequences.”
Statistics on accidental deaths caused by medical mistakes are notoriously difficult to come across, except in the United States, said Andres. There, studies have estimated that 100,000 people die each year from mistakes made in administering prescription drugs.
On top of safety concerns, chemotherapy drugs are also highly expensive, another reason for the hospital to keep closer tabs on their circulation.
Isolating incidents
IBM had no existing solution it could use to regulate MOÚ’s drugs, and so the company had to work with the hospital to integrate RFID without disrupting the hospital’s pharmacy. Often, organizations get caught up in RFID’s hype and do little planning before adopting the technology, resulting in added technical complications with little benefit.
“[We had] to plan well and consider how and when to adopt the technology,” said Andres. “Especially important was not only purchasing readers and tags, but using RFID to optimize processes in the hospital.”
Previously, once chemotherapy drugs arrived at the pharmacy and were removed from their shipping boxes, there was a digital black hole until their administration to a patient, with little detail recorded. Now, individual ampoules of cytostatics — as cancer drugs are called — are tagged with RFID chips, as are the workers who handle the drugs and the IV bags that go to patients.
“You can track [drugs] from the point when they’re received from vendors,” said Michael Souček of IBM’s Global Technology Services, who helped implement the system. “We’re tracking every single vial.”
Particularly important to the hospital is tracking medicine as it is prepared in the isolator, a unit resembling a baby incubator that is used to reduce the pharmacists’ exposure to the drugs. Inside the isolator, cytostatics are transferred to a patient’s IV bag; the medication, IV bag and technician are all recorded by RFID.
For now the pilot project, which began last year and is scheduled to run until 2009, is in a monitoring phase, said Adam, gathering as much data as possible about the flow of cytostatics through the hospital.
“The next stage is scheduled for the end of this year,” he said. “Then, the people preparing these infusions will be guided and self-corrected during the process, using this existing information.”
RFID systems are not without criticism, and it’s possible that the increased monitoring could highlight ineffective employees, to their detriment. However, according to Adam, the pharmacists are finding that RFID has already improved their productivity.
“It’s taking away some manual paperwork,” said Adam. “Everything is done by the system, capturing data.”
Both the hospital and IBM seem eager to apply RFID to the other parts of the institute.
“We plan to expand RFID usage in a number of areas — mainly identification of personnel, patients, assets and other logistic support processes,” said Andres.
IBM has received queries from other oncology institutes interested in following MOÚ’s lead; the company will showcase the system at a leading healthcare IT conference in Vienna next month.

Paul Voosen can be reached at pvoosen@praguepost.com


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