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Columbia's Dental College Finds RFID Instrumental

The school's clinic is using passive UHF tags to manage the dental tool kits it loans to students, and to track the instruments during subsequent sterilization.
By Claire Swedberg
Jan 12, 2016

When students attend the Columbia University College of Dental Medicine (CDM), they traditionally purchase their own dental instruments for use on patients at the school's dental clinic, and are responsible for ensuring that those tools are not lost. Instruments commonly used include mirrors, probes and explorers, each of which is approximately 6 inches in length, cylindrical and composed mostly of steel. Tracking such items has been a difficult task for students, however, as well as for the clinic, which cleans and sterilizes them. Lost tools must be replaced, something that is costly for both the facility and the students.

The solution adopted by CDM is a radio frequency identification system that tracks every instrument and the cassette in which it is packed, through clinical use, sterilization and storage. The technology, provided by dental instruments manufacturer LM-Dental, was taken live in June 2015. The majority of LM-Dental's instruments come pre-tagged with autoclavable versions of Xerafy RFID tags attached to them, and have steel cores and silicone exteriors. CDM's staff attach a Xerafy tag to any instruments used by the school that are not sold by LM-Dental. CDM has tagged 10,000 instruments to date, and expects to have all 20,000 items tagged by the end of this year.

When cassettes loaded with dental instruments are placed on the LM-Dental reader, the device reads the Xerafy tag attached to each tool and the system confirms that all items are present.
The main driver for an RFID system, says Steven Erde, CDM's chief information officer and an assistant professor of oral health informatics, was to identify a better method of documenting each tool's use and sterilization for improved patient safety, and of meeting regulatory requirements. The management of dental instruments, however, is more complicated at a school with hundreds of students than in a small dental office.

The challenge for the 150-chair clinic, as well as for dental students (approximately 80 new students arrive each year), is to track tools not only when they are in students' custody, but also when they are in the hands of the clinic's own personnel, for sterilization by means of an autoclave. Before the RFID system was deployed, each student had to purchase a large set of instruments for all potential procedures he or she might encounter during training, loaded into 14 cassettes to form kits. These cassettes are composed of a mixture of plastic and stainless steel, and vary in size from 14 inches by 6 inches by 1 inch to 6 inches by 2 inches by 2 inches. The students kept cassettes packed with tools in a central storage area until using them, then turned them over to the clinic for sterilization and picked them up again when needed. At the time of cleaning and sterilization, employees at the clinic did not check each cassette to ensure that it contained all expected instruments. As such, students were responsible for tracking that information themselves, by visually identifying what was in every cassette.

The solution consists of an RFID tag on each instrument, linked to data about that asset in LM-Dental's Dental Tracking System software, residing on CDM's server. By using RFID, CDM has been able to eliminate the system of providing cassettes to students that they must then be responsible for throughout their time in the program. Instead, kits remain in CDM's ownership and are checked out when required, then are returned to the clinic for sterilization and are stored there until requested by another student.

To enable this process, CDM installed LM-Dental's tabletop RFID readers at several key locations, says Steven Connor, CDM's clinic associate director: at the point at which cassettes are checked out, as well as on two sides of the autoclave unit—where tools are placed prior to sterilization, and where the sterilized instruments are removed from the autoclave unit. In the future, he notes, readers will also be installed in storage areas to help the staff track any cassettes not in use.

LM-Dental chose autoclavable versions of Xerafy's Dot XS and Dash XS ceramic RFID tags because no other manufacturers make similar tags that are small enough for the company's purpose, according to Stephen van Heerden, the firm's system sales manager. In addition, says Moses Chang, Xerafy's sales and marketing manager, there are no other tags currently on the market that have been as thoroughly tested and validated, and that are as widely in use, as Xerafy's autoclavable tags. "With the lack of real estate on the majority of surgical instruments today," Chang says, "the challenge, from a technical standpoint, is to create a tag small enough as to not interfere with the use, but still provide enough performance to create real value for the customer." Xerafy's family of autoclavable tags, he adds, were specifically built with all of these challenges in mind.

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