Oct 04, 2013Riviera Hospital, a new oncology center in Switzerland, provides radiotherapy treatments to 30 to 42 patients daily. To ensure that every patient receives the proper therapy specific to his condition, the center opened for business with an RFID-based solution already in place. The solution enables the facility to treat patients at a rate of 10 to 15 minutes each—a decrease from the more typical 15 to 20 minutes per patient required without RFID technology, the center's management estimates. But more importantly, says Marc Pachoud, Riviera Hospital's medical physicist and radiotherapy group leader, linking an ID number on a patient's ID card with the IDs of any treatment devices used on that individual provides assurance that no patient receives inappropriate therapy.
The medical center employs radiotherapy technology vendor Elekta's Versa HD, a high-dose radiotherapy device, to deliver radiation beams to the particular part of a patient's body requiring treatment. Additionally, Elekta supplied an RFID solution known as Identify, to ensure that the correct patient has been matched with the proper treatment. The system consists of an ultrahigh-frequency (UHF) RFID reader installed on the Versa HD device, as well as RFID tags embedded in cards carried or worn by patients. Tags are also attached to the radiotherapy treatment accessories to be used on patients, enabling the software to issue an alert in the event that the wrong treatment is being applied.
The solution can be integrated with Elekta's MOSAIQ Oncology Information System software, residing on Riviera Hospital's server, which tracks each patient and the treatment he has received, according to Uli Lutz, the business line manager of Elekta's patient-positioning portfolio. With the read data, the center collects an automatic record of each treatment, along with the accessories used at that time.
Each patient, depending on the type of cancer being treated, as well as that person's weight, gender and health variables, receives a very specific treatment that includes accessories designed to position and immobilize the patient while the radiotherapy beam is received. Treatment for a man with prostate cancer would be very different, for example, than another patient suffering from a different kind of cancer. Mistakes rarely occur, Pachoud reports, though there is always a risk that an error could be made, with the potential for significant adverse effects. With the RFID solution in place, Pachoud says, "The idea is for security, to try to minimize any risk."
When a patient first arrives, his medical record and therapy plan are entered into the system, and an RFID-embedded plastic card is handed to that individual. The unique ID number encoded to that card's passive EPC Gen 2 UHF tag is linked to the patient and his record. The patient will then bring that card for every visit. When a patient comes for a regular visit, however, the staff does not utilize the RFID system to log him in. Instead, an employee uses a keyboard to manually input the patient's name into the system, along with the time of his treatment, and personnel then prepare the accessories specific for that individual.
When the patient is called into the treatment room, he brings the RFID card with him. A UHF reader is mounted on the Versa HD's linear accelerator, located approximately 1.5 meters (4.9 feet) above the couch—the treatment table on which the patient lies during the procedure. As he climbs onto the couch, an RFID reader (developed by Elekta for this solution) interrogates his RFID card, and forwards that card's unique ID number to the software. The treatment accessories are placed on the couch as well, and the tags on those items are read simultaneously. Each accessory's unique ID is linked to data regarding that item, and the software then determines whether it matches the patient's treatment plan. A monitor on the wall displays the patient's name, along with photograph of his face and real-time images of him lying on the treatment table. The monitor displays a green icon if the accessories are correct, or a red alert if there is a mistake—such as the wrong or missing items.
The solution also comes with a standard camera to provide live conventional video of the patient and the treatment he receives. What's more, the system includes a stereoscopic infrared (IR) camera that detects the positions of IR markers placed on the radiotherapy positioning devices. The software not only instructs the user about where the devices should be placed, but also indicates when the devices are correctly positioned. As soon as the software ascertains that all of the proper components are set up correctly for that patient, a lock in the radiotherapy device is released, and the treatment can then be delivered.
Thanks to the RFID technology, Pachoud says, the center has been able to safely treat patients at a rate of one every 10 minutes, since technicians are now informed automatically about whether the correct equipment is present before a patient's radiation treatment begins. Without the technology, the staff must visually inspect each item and compare it against the electronic record in order to prevent any errors from occurring.
Once a patient has completed his series of treatments, Pachoud says, the hospital discards that tag so that it cannot be used with another patient. At present, he adds, about 80 badges are being used by the center's patients.
One challenge related to the RFID technology involved the presence of carbon fiber in the treatment table. This fiber tended to reduce RF transmission reliability, Lutz says, so Elekta had to adjust reader configuration in order to ensure a clear transmission between tag and reader.
According to Lutz, a variety of UHF RFID tags are being used from multiple tag vendors. In addition, she says, the reader hardware chosen depends on the specific country in which the technology is being used, based on local regulation.
"The key benefit for the user is an independent verification and double-check of patients and treatment accessories prior to treatment," Lutz states, "and thus a key contribution to enhanced patient safety."
