Middle Tennessee Medical Center to Install TotGuard

By Claire Swedberg

The system's RFID tags prompt an alert if an infant is brought to a stairway, elevator or exit, and contain light and temperature sensors to protect them against tampering.


When the Middle Tennessee Medical Center opens its new facility next year, it will employ GuardRFID Solutions‘ TotGuard system, which includes 344 MHz active RFID tags and readers, to ensure the security of its newborn babies and pediatric patients.

The new $267 million, 286-bed hospital, scheduled to open in 2010, and is designed to accommodate the hospital’s current delivery rate of 2,500 babies per year. For its new home, the organization wanted a security system that could enhance the existing manually checked, bar-code- and text-based wristbands that patients currently wear, says Janet McIntosh, a registered nurse and the medical center’s director of maternal-infant services.

“We are hoping to be state-of-the-art in each component of this new hospital,” McIntosh says, and that includes infant safety. “We don’t believe it matters how wonderful an infant security system is; we still need nurses to be acutely aware of the surroundings and check wristbands,” she explains. With that in mind, the hospital has selected a system that is intended to be easy for employees to use, and that provides an additional layer of security by sending alerts if a baby approaches an exit, or if someone attempts to remove the child’s security band. “We wanted a system that would blend into the woodwork until you had a problem,” she says.

The medical center discussed the TotGuard system with GuardRFID, and visited other hospitals where the system was already in use. Based on what they witnessed, McIntosh says, the hospital’s management selected the system for the new facility. When a baby is delivered, workers will provide a TotGuard RFID tag attached to a soft fabric band that wraps around the baby’s forearm or calf by means of a Velcro fastener. Information such as the infant’s health record, the date and time of birth and the parents’ names will be entered into the TotGuard system, residing on Middle Tennessee’s server. The staff will then employ an RFID reader to capture the ID number of the tag assigned to that particular child, linking the number to the data stored in the TotGuard software.

The tag, which will transmit its unique ID number at a rate of once every 10 seconds, has two built-in sensors—one for detecting changes in light exposure, the other for discerning temperature changes. If a parent were to briefly move an infant’s tag, says Zahir Abji, GuardRFID’s president and CEO, the light sensor would detect that the tag had been lifted from the child’s skin. However, because this type of brief, inadvertent tag movement is so common, the second sensor—which detects temperature changes—is required to transmit an alarm to the system as well. In that case, if a tag is completely removed from the infant, it will detect a drop in temperature, as well as an increase in light exposure, thus causing the alert to be issued.

“In that way,” Abji says, “we cut down on nuisance alarms.” The alert would be displayed as a pop-up box (indicating the tag’s location) on the computers of staff members throughout the facility. After responding to that alert, the employees must then log into the software to input the reason the alarm was generated.

The hospital may also utilize a TotGuard tag housed within a disposable plastic pod that clips directly onto the clamp attached to the stump of an infant’s umbilical cord. With a newborn baby, the tag is more difficult to remove than a standard TotGuard tag, and is also resistant to water, so the child could be bathed without the tag being removed. The umbilical model can detect if someone attempted to remove the tag; to do so, that person would have to open or cut the pod, at which time the tag’s light sensor would detect light and trigger an alarm.

Sixty GuardRFID readers, connected to the server via Ethernet cable, will be installed throughout the hospital in such a way that they will provide real-time coverage of the entire obstetrics floor, as well as at doorways, elevators and stairs throughout the remainder of the building. What’s more, GuardRFID will install a total of 18 exciters at the facility’s entry and exit points. Each exciter transmits a 125 kHz signal encoded with a unique ID number. When a tag comes within range of an exciter, it will immediately transmit its own ID, rather than wait for the next scheduled beacon. It will also transmit the ID of the exciter, thereby establishing the tag’s location. This transmission of the tag and exciter ID numbers causes the TotGuard software to trigger a pop-up alert on the hospital’s computers.

Tags will be read by at least three readers at any given time they are in the obstetrical department, or near exits. In that way, the system can pinpoint an infant’s location within about 10 to 12 feet, by using a combination of triangulation and tag signal strength.

The system can then be designed to integrate with IP cameras, in order to provide users with a video image of what is happening at a doorway, for example, when an alert alarm is issued. The hospital, however, will not initially utilize the system in that manner. The system is designed to be flexible, according to Beth Bandi, GuardRFID’s sales VP, and the middleware allows the integration of the data from the RFID reads with other information, such as asset management, or other hospital functions, such as admitting or discharge. “Initially,” she states, “they want to keep it simple.” In fact, she adds, the software is designed to be intuitive for first-time users, so that staff members unfamiliar with the system can quickly and easily adjust to it.

In addition to being used to provide security to newborns, the tag can also be attached to older pediatric patients. Middle Tennessee Medical Center will employ the wristband tags for such patients, though the pediatric department will have readers installed only at the exit points, thus affording children greater freedom to move around the facility.