This article was originally published by RFID Update.
June 2, 2009—Researchers working with the Finnish Defence Forces tested an RFID-based patient identification system that utilized mobile phones and near field communication (NFC) to track casualties by their triage classification during a mock military exercise.
The test occurred during the Finnish military’s Pyry 2006 exercise. Results were published last year in the International Journal of Electronic Healthcare.
Triage is a method of sorting and classifying large numbers of casualties. Typically, medical personnel use color-coded cards to tag each patient as immediate, delayed, minimal or expectant (dead or dying) using classifications developed by NATO.
Efficiently tagging each patient and then communicating information about the number of casualties in each classification to receiving medical facilities can be a time-consuming and complex process. According to the researchers working on the Finnish project, getting relevant information about casualty location, numbers and categorizations to the command center has taken up to 24 hours in previous exercises.
The study, conducted by the Finnish Defence Forces’ Field Medical Services division, was designed to determine the applicability of RFID and commercial cellular networks to provide an online triage system for handling mass casualty situations. Also participating were representatives from Helsinki University, Helsinki University Hospital, Abo Akadeni University, and the Finnish Defence Forces’ Joint Defence Command and Centre for Military Medicine.
There have been several similar tests and pilot projects in other areas of the world. In 2007, researchers at Kyushu University in Japan tested RFID in another mock mass casualty exercise (see the white paper here). The Seattle Fire Department also tested a triage system using mobile computers and RFID tags from Intermec Technologies, along with Exodus MCI software from Asentrix Systems. Last year, the Anaheim Fire Department in Anaheim, California, purchased several thousand RFID-enabled triage tags from VerdaSee Solutions.
What made the Finnish trial unique was the use of near field communication (NFC) and off-the-shelf cellular phones for the RFID readers/encoders.
The Test
The Pyry field exercise involved 4,000 conscripts and 800 vehicles, and occurred in December 2006 in sub-arctic winter conditions. Eighteen of the 45 field medics in the exercise were given a personal RFID tag and a Nokia 5140i phone with an integrated RFID reader/writer and mTriage software from WM-data, a division of Logica.
Several medical facilities and five evacuation vehicles were equipped with the RFID tags and readers as well. The mock casualties included 130 randomly selected conscripts, each tagged with an injury card (including an RFID tag) that described their injury.
All of the RFID tags were passive 13.56 MHz tags with 1K of RAM, and based on the ISO 14443A proximity card standard.
Field medics used the Nokia phones to read their own tag (which authenticated their identity), and to write the triage category for each casualty to the triage tags. The application then sent information via short message service (SMS) over a wireless GSM connection to the Nokia SM computer server, which communicated with the command center’s Merlot Medi server and emergency medical care software application (another Logica solution). The Merlot Medi system matched patient medical data to the field RFID tag.
All of this information was then available to receiving medical facilities. As casualties moved from the field to the Company Aid Station and then to hospitals, personnel read the RFID tags again to provide advance information to the next facility about how many patients were on their way, and what condition they were in.
According to the report, the system allowed field personnel to distribute destinations among the casualties in order to prevent congestion at receiving medical facilities. The system could “also be adapted without any difficulties by the civilian sector” for similar mass casualty emergencies.
Researchers did identify a number of challenges and system flaws. The Nokia phones, since they aren’t ruggedized, could be easily broken or lost, and the wireless network could be jammed or made unavailable during a military crisis. Researchers also noted that the RFID tags would need some sort of human readable element (similar to the color coding on traditional triage cards) to simplify the work of transport and field personnel who are not equipped with RFID readers.
The Chief Medical Officer involved in the exercise, however, was interviewed afterward and indicated that the “new system provided a timely and true picture of the prevailing situation and greatly improved both the general management and planning of the whole operation.”
The full case study is available for download here.