Sao Paulo Cancer Hospital Uses RFID to Respond to Heart Attacks

By Claire Swedberg

The technology gets messages to staff members closest to the site of a cardiac incident, and stores data about their responses to help management figure out ways to improve procedures.

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The Instituto do Cancer do Estado de São Paulo (ICESP)—a 28-story cancer clinic said to be the largest public cancer-treatment center in Latin America—is employing a Wi-Fi-based real-time location system (RTLS) to facilitate the way in which its staff responds when a patient goes into cardiac arrest. The solution, provided by RFsense and installed by Synergy Tecnologia, includes Ekahau‘s tags and positioning-engine software known as the Ekahau RTLS Controller (ERC), as well as RFsense’s SIGAME software, custom-built for this application to link location data with ICESP’s existing voice-over-IP (VoIP) PBX system.

The RTLS not only alerts responders in the event of a cardiac arrest, but also tracks response times, thereby providing the clinic with information that it can utilize to improve its response processes. Ekahau’s ERC tracks the location of Wi-Fi-based RFID badges worn by staff members, including those in the room of a patient suffering a heart attack, while the SIGAME software receives that data and integrates it with the VoIP PBX system.

The ICESP facility is newly constructed, and the RTLS went live as the hospital began receiving patients in the summer of 2010. The clinic—which cares for those suffering from cancer, as well as others who, in some cases, are at risk for cardiac arrest—includes more than 500 beds located throughout its 28 floors. There are two levels of cardiac arrest: code blue, requiring a response in three minutes or less, and code yellow, with a maximum acceptable response time of five minutes. Rapid responses can be a challenging task when employees must negotiate a facility with more than 12 elevators and 28 floors the length of a city block.

The hospital sought a solution that could make use of the Wi-Fi nodes already installed throughout the facility, and provide two functions: getting messages to qualified workers closest to the site of a cardiac incident, and storing information about responses in order to help management analyze areas of improvement to the system. “One option was to install emergency call buttons in each room,” says Mauricio Strasburg, Synergy’s president, “but that would require wiring, and the hospital would not know where the personnel were located.”

An Ekahau T301BD badge tag is carried by staff members, who, upon reporting to work, first sign in at a PC connected to the hospital’s back-end software, with a wired connection to a battery charger on which the badges are stored, each in a slot equipped with an LED light. As an employee types in his or her name, ICESP’s software instructs that individual to select the badge with a blinking light, located on its specific charger slot. The system then links the individual with the ID number of that badge.

The staff member wears the badge on a cord worn around the neck. Later, if that worker witnesses a patient undergoing cardiac arrest, he or she can press one of two buttons on the tag—one for code blue, or another for code yellow. The tag will transmit the alert, which is then received by Wi-Fi nodes within its read range. The hospital’s wireless local area network (LAN) forwards that information to the Ekahau RTLS Controller software, which determines the tag’s location based on the ID number of the Wi-Fi node, as well as the signal strength, and then sends that positioning data to the SIGAME software. SIGAME forwards the data—including each badge’s ID and location, along with a room number for a patient in distress—to ICESP’s existing VoIP PBX system, which calculates which badge-wearing employees are closest to the patient in question, and sends messages to those individuals.

The staff members nearest the patient are alerted on their own Ekahau T301BD badge tag, with a text message indicating in which room the incident is occurring. If a worker receiving the alert is unable to respond, he or she can press a button on the tag indicating such. The ICESP PBX software then receives that response, and issues a text message indicating an “escalated alert” to the remaining employees. A screen on the badge displays text messages listing the room number and level of each code, whether blue or yellow.

The data from the alert—including staff responses—is stored in ICESP’s database, along with the length of time it took for an individual to respond from one location to another, and that employee’s identity. With information about the responses, the hospital hopes to improve its response procedures by determining which sections of the hospital may have bottlenecks that cause delays (such as elevators), as well as which workers need further training, or which areas of the facility require greater response times. So far, however, the medical center has yet to undertake those kinds of analyses.

Approximately 20 staff members are currently using the tags, Strasburg says, and their response to the system has been positive. The only problem with the system initially, he notes, was that employees would carry the badges in their pockets and forget to return them to the charger at the end of a shift, and the badges, at times, would end up going through laundry as a result. Thus, all workers now wear the badges on a lanyard.

Planning is already underway to leverage the system for tracking and managing clinical assets, as well as for environmental monitoring of temperature and humidity in patient care areas, and in hospital refrigerators and freezers used to store tissue samples and medications.