Dec 13, 2011When staff members at Maryland's Office of Chief Medical Examiner (OCME) require paperwork pertaining to a human body being stored at the Baltimore facility, it could be located at a variety of places. During the 72-hour period in which a decedent remains at the office, the folder containing these paper documents moves to at least three or four locations onsite. The paperwork is used by a variety of individuals, including office employees and visitors.
To better manage those files—of which the office currently has approximately 30,000—OCME's managers had sought a real-time locating system (RTLS) for about four years. They considered several solutions before selecting FileTrail's solution, which employs ultrahigh-frequency (UHF) EPC Gen 2 RFID technology, and provides a software platform known as FileTrail Professional that manages data from 11 different readers. Because the system is working so well, says Michael Eagle, OCME's director of information technology, the office plans to begin utilizing it to track the bodies themselves, starting in 2012. With data regarding a corpse's location, the office will know if that body has been kept out of refrigeration, and for how long—an important piece of information, since many of the bodies provide organs for transplant procedures, and must thus be kept refrigerated in order for those organs to remain viable.
When a decedent arrives at the medical examiner's office, a worker assembles a folder that includes paper records about that individual's identity, then time of arrival and any expected procedures (such as examination by a physician to determine the cause of death and, when appropriate, the harvesting of organs), as well the results of those procedures. Access to the folder is granted to numerous individuals, including OCME's staff, physicians, forensic pathologists, and attorneys or other visitors. Although a body remains on site for only about 72 hours, its file circulates from one floor to another, and often to a third or fourth floor, and can thus be difficult to find. "We need to track it as it moves," Eagle explains. Without an RTLS solution in place, he says, "We have to guess where the file will be," and then begin walking around, looking for it.
It is critical that the corpses themselves remain at a cool temperature, Eagle says. Employees can ensure that this is the case by monitoring the time at which each decedent arrives at the facility, and when the body was delivered to, for example, a medical examiner for investigation. In the event that there is any question as to how long a particular body has remained unrefrigerated, its organs can not be donated.
According to Eagle, the office looked into a variety of RTLS solutions for managing files, but found that they were typically proprietary—meaning the technology could be used only with other hardware from the same company—whereas he and his colleagues wanted an open system that could potentially be expanded and shared with other government agencies. Therefore, they selected FileTrail's UHF Gen 2 passive RFID system, using fixed and handheld readers provided by Motorola Solutions and tags from Alien Technology. OCME initially considered tracking files only, says Darrell Mervau, the RFID firm's president, but while discussing the solution with FileTrail, the agency realized that the technology could also be used to monitor the bodies themselves. Ultimately, however, it opted to begin with a file-tracking project, and to spend about one year determining how well it worked.
FileTrail installed 11 Motorola FX7400 readers throughout the four-story facility, with up to four of its own antennas wired to each interrogator, creating a total of more than 40 read points. OCME can also utilize the handheld units to conduct inventory searches if a folder ends up missing and has not been interrogated by a fixed reader, or to pinpoint a location within a room in which the system indicates that a file is located. In one case, Eagle notes, a missing file was recovered that had fallen behind a cabinet.
While being carried throughout the offices, Eagle says, files pass reader antennas that capture each tag's unique ID number as the individual holding them walks past. The software then stores that location, based on the antenna that read the tag, linked to that tag ID until the next read indicates a new location.
In addition, the software can display alerts in the event that a file remains unmoving for a long period of time—which could indicate a problem, since the paperwork should be updated with information about each process completed on the body.
There have been periodic problems with reading tags, Eagle says, though these have been minor issues, since the tags in question would then be read by a subsequent interrogator. The software stores only read events occurring at a new location—if a tag fails to leave a specific site, the reader would stop transmitting data until that folder left the antenna's read zone.
With the RFID system in place to track decedents, not only would employees have a more accurate record of how long a particular body remained unrefrigerated, but the system would also provide information to physicians. For example, a doctor would be able to log onto the system in order to view a list of which bodies were in the cooling unit at a given time, indicating the quantity required for examination. The historic data would provide a record for transplant patients receiving organs, verifying that the organs were viable, based on the length of time that the body was located in the refrigeration room.
The agency plans to acquire about 40 UHF wristband tags—since that is the approximate number of bodies that the agency typically has on site on any given day. When a decedent has been examined—and when the organs have been removed, in the case of donors—the wristband would be removed so that it could then be reused. Which vendor's tag will be utilized for this purpose has yet to be determined.
Eagle says he likes the technology, and that he has spoken with the Maryland Institute of Emergency Medical Services Systems (MIEMSS), to suggest that it incorporate the technology for living patients brought in from accident scenes. The tags could then be read within an ambulance, at the hospital and, if a patient did not survive, once more at the medical examiner's officer. However, he says, no decision about this has yet been finalized.