Several Danish hospitals are conducting tests to determine whether an RFID solution provided by Caretag can improve efficiency in surgical tool management and reduce the incidence of lost instruments at health-care facilities. The test and subsequent evaluation, being conducted with funding from Danish government agency Markeds Modningsfonden (Market Maturation Fund), is expected to last for more than a year. Early results, however, indicate that the system can reduce labor costs and the potential for errors, such as misidentifying a tool or failing to notice a tool missing from a tray.
The goal of the testing is to help the hospitals determine how radio frequency identification technology could improve the tracking of tools before, during and after surgery, as well as identify when they require maintenance, such as sharpening or replacement. The tests will compare the amount of time that employees spend manually tracking tools against the time needed when using Caretag’s surgical solution, which consists of Xerafy EPC Gen 2 passive ultrahigh-frequency (UHF) RFID tags on tools, as well as Caretag’s patented readers used at the surgical and sterilization areas. Data collected from multiple tests conducted to date at the four Danish hospitals show that on average, confirming the presence of the correct tools in a typical tray requires 10 to 30 seconds with the Caretag solution, versus approximately five minutes when done manually, according to Sören Bilsöe, Caretag’s cofounder and CTO.
Employing RFID technology to track surgical tools can be challenging, in part because most tags do not easily fit onto very small items, such as scissors, forceps and scalpels, and because few can sustain the autoclave sterilization process that takes place before the tools are used. Manually tracking tools, however, is a time-consuming and error-prone process—individuals could, for example, fail to notice that an item is missing. A surgical tray for a procedure, such as heart bypass surgery, must include specific tools, and if the set of tools is incomplete, the tray cannot be used for that procedure. What’s more, tools occasionally end up missing at hospitals, resulting in an expense for the facility and a potential safety hazard for patients. Staff members spend considerable time inventorying the tools for each process—before and after surgery, as well as following autoclave sterilization or maintenance.
Caretag developed its solution for tracking surgical tools after testing Xerafy’s XS tag, which can be attached to or embedded in tools and can withstand high temperatures, such as those related to autoclaving. Caretag developed software and readers to enable hospitals to read the tags and interpret the collected data. The system also alerts personnel in the event that a tool requires servicing, is missing from a tray or is placed in the wrong tray.
In 2012, Caretag demonstrated an RFID-based laundry-management solution at Rigshospitalet, located in Copenhagen. The company discussed the potential benefits of the surgical tool-tracking solution with that hospital’s management over the past year, Bilsöe says, adding that management was interested, especially since the facility is currently building a new sanitization department in which an RFID system could prove useful in improving efficiency and reducing errors. Caretag then met with other Danish hospitals, which collaboratively campaigned to obtain funding so that Markeds Modningsfonden could test the solution.
To create its surgical solution, Caretag developed a device with a built-in RFID reader, though Bilsöe declines to provide additional details about the reader or the other components used. The company also developed the software, which resides on a hospital’s server and can integrate data with the hospital’s existing tool-management software.
Earlier this year, Caretag tested the solution at a hospital that has asked to remain unnamed, for tracking tools used in surgical procedures conducted on pigs for research, as well as the training of medical students or physicians. The results of that test, Bilsöe reports, helped refine the testing that is now underway at the four Danish hospitals, including Rigshospitalet, for monitoring tools as they are used in surgery and are then put through autoclave sanitization and placed on a tray for another surgical procedure.
The latest test is designed to simulate a full deployment. First, the tagged tools are placed on a tray, which is also tagged. Each tag ID is linked to the tray or instrument’s own serial number, along with other descriptors in the Caretag software. The software also lists which surgical instruments should be stored on each tray to make up a complete tool kit for a particular procedure. The tags attached to the tray, as well as the instruments on that tray, are read using the Caretag device, thereby linking them together in the software. When the filled tray is brought to the surgical suite, it is placed on the Caretag countertop reading device, which captures the ID numbers and transmits that data to the software, which then confirms that the tray is appropriately loaded and ready for use during surgery.
After surgery, staff members collect all of the tools, place them back on the same tray and put the loaded tray on another Caretag reader. A screen on the reading device indicates if any items are missing. The tray of tools is then moved to the sterilization center, where it is again read, either before or after sterilization, in what is called the “rules station,” where the software links each tag ID with that object’s history, as well as how often it has been used and when it is scheduled for disposal—or for maintenance, such as sharpening. The Caretag software then displays an alert for the staff if an item needs to be removed and sent for servicing or disposal.
The testing is slated to continue for about six more months, Bilsöe reports, after which the four hospitals will review the results for several more months to determine what the gains have been. If the technology proves to increase efficiency, reduce expenses and improve safety, the medical facilities intend to install the technology within their sterilization and surgical areas. Several other hospitals in Sweden and Germany are also interested in testing the technology, he says.