Aug 04, 2010Meridian Health, which operates five New Jersey hospitals and a home-care service, is conducting a pilot of its patients using an RFID-enabled pain-management product known as Impak Health Journal for Pain, which was developed by Meridian in partnership with silicon chip company Cypak. The journal is being marketed by Meridian's and Cypak's new joint venture company, Impak Health. Approximately 22 patients are currently testing the Health Journal for Pain, an RFID-enabled cardboard foldout printed with several questions for patients to answer regarding their pain management. A patient can input his or her answers to those questions by pressing buttons on the card, which is later placed on an RFID reader to upload those responses into a database accessed by that individual's physician.
Meridian began working with Cypak on this system earlier this year, as a way to provide better accounts of pain management for patients with chronic conditions, thereby affording doctors a view of those patients' daily experiences in their home. The system is the response to what Sandra Elliot, Meridian Health's director of consumer technology and service development, calls a unique challenge. The health-care firm is located in central New Jersey, where the elderly represent a larger percentage of the population than in most areas of the United States—as much as 25 percent, she says, are over age 65. And as the population continues to age, the pressure on hospitals and physicians is likely to grow as well. "That raises the question: What else should we be doing to connect with people, without bringing them necessarily into hospitals or physician offices?" she says.
To address those with chronic disease by improving medication management and offering greater independence and safety when not in a health-care setting, the hospital began seeking technology that would help it track an individual's health and symptoms. Many patients are assigned the task of maintaining a pain journal on paper, which doctors can then use to determine the next course of action, such as changing medication or recommending surgery. But many patients find paper-based journals difficult to fill out, and instead rely on their memories of pain upon visiting their physician.
The new option, which has been piloted by Meridian since June of this year, allows that process to be handled electronically. Pilot participants receive a Health Journal for Pain, consisting of a pocket-sized piece of cardboard folded in three, and printed with a list of questions and rows of response buttons. The journal contains an embedded battery-powered 13.56 MHz RFID inlay that can store data and transmit that information to a reader. The RFID inlay, which supports 13.56 MHz Near Field Communication (NFC) and ISO 14443-A RFID specifications, is developed and provided by Cypak.
A patient answers questions about the severity of his or her pain when taking his or her normal pain-suppression dose, upon taking a higher dosage for breakthrough pain (discomfort that comes on suddenly and is not alleviated by the normal regimen), and one hour after taking the medication. The patient can also rate his or her pain once weekly, on a scale of 0 to 10. The journal emits an audible beep to indicate when a button has been successfully pressed. The data is saved to the RFID tag, which has sufficient memory to store up to two reports daily for 36 days, for a total of 72 reportings.
When that patient then visits one of the two physician offices participating in the pilot—located in New Jersey's Monmouth or Ocean counties—he or she places the journal on a desktop Continua Certified Smart Cable reader, developed by Cypak. The interrogator captures the journal tag's unique ID number, along with all of the pain and medication data reported on it. The device plugs into a computer's USB port, and Impak software running on that PC downloads and displays the results for the physician's office staff, explains Albert Baker, Cypak's strategic alliances VP for North America. The pilot, launched in June, will continue until October, with the goal of including around 200 participants before the trial period ends.
The patient can place the journal directly onto the reader at regular intervals, and—just as occurred at the physician's office—the tag ID number and stored data is then captured by the interrogator and forwarded to the software on the PC. The PC will send that information via the Internet to a server hosted by Meridian Health, where it can be viewed by the appropriate health-care provider. In the event of an unusual result, the software can be instructed to issue an alert, either as a pop-up on the Meridian employee's screen, or as an e-mail or text message to a family member or home-care provider.
Meridian Health intends to continue increasing the number of participants from the initial 22 to about 200, all of whom will be offered the home reader option. In October, the system is expected to be permanently deployed—initially for sufferers of chronic back and cancer-related pain, and then for arthritis and fibromyalgia patients.
In the future, Elliot says, Impak may also offer versions of the journal that test blood for sugar or cholesterol levels, with the card hardware measuring those levels and then transmitting that information to the hospital's server over the NFC reader.
Impak plans to market the solution to other health-care providers, Elliot says, for use in pain management and health screenings. It also intends to offer an RFID-enabled food journal for those attempting to lose weight under a physician's guidance. However, she says, before any of the versions are marketed, Impak wants to study the results of the existing pilot and determine if the presentation of questions and responses is effective and comprehensible for patients. Thus far, Baker says, the pilot participants find the electronic health journal easier to use than manually writing notes via pen and paper, both because it requires only pressing buttons rather than writing, and due to the clear and simple nature of the questions. Most patients involved in the pilot are elderly, in their late-eighties or nineties.
In 2006, Cypak participated in a pilot in which its battery-powered RFID tags were embedded within medication blister packs in order to monitor patients' compliance with drug prescriptions (see Novartis Trial Shows RFID Can Boost Patient Compliance).
