Diamonds In The Rough?

The Use of RFID Tags in Global Health

Created by:Angel V. Shannon, RN

Objectives• Define Global Health• Describe the use of RFID tags for disease

surveillance in global health• Describe the hardware used with RFID tag

disease surveillance• Describe the software used with RFID

disease surveillance• Evaluate usability of the software• Describe and evaluate the Information

System used for RFID tags

Objectives• List the advantages and disadvantages of

RFID tags in global health• Describe the current ethical and legal issues

of RFID tags in global health • Discuss the informatics competencies

required of a professional nurse working with RFID tags

• Discuss the functions and responsibilities of an informatics nurse specialist (INS) working with RFID tags

What is Global Health? “Global health is an area for study, research and

practice that places a priority on improving health and achieving equity in health for all people worldwide.” (Koplan, 2009, pg 1994)

Disease Prevention

Global Health focuses on: Health Promotion

A Major Trend to Achieve These Goals

• is the use of Radio Frequency Identification tags (RFID) for disease surveillance

• RFID tags are currently being used in developing countries to identify people with certain communicable diseases

QuickTime™ and aTIFF (Uncompressed) decompressorare needed to see this picture.

How Do RFID tags work?

RFID hardware includes three main components:

• RFID tag

• RFID reader

• Antenna

RFID Building Blocks: RFID tags:

• vary in size, shape, and format depending upon the intended application

• are either active or passive active tags: have embedded battery power passive tags: rely on antenna to collect

power

RFID Building Blocks The RFID reader:

• is known as the “interrogater”

• receives data from the tags and passes it along to the associated software

• captures the tag’s unique identifier

RFID Building Blocks

RFID antenna:

• receives and transmits data to the reader

• collects power for tag functioning (passive tags)

RFID Building Blocks

Once they are placed, RFIDs can be monitored with handheld devices such as:

• Smartphones - iPhone, Blackberry

• Palm PDAs

• Pocket PCs

RFID Building Blocks

The Critical Link

Software

RFID Building Blocks RFID software is used for:

• creating barcodes and readable text codes

• processing unique identifier data

• managing distribution of vaccines and medicines

• remotely monitoring patients via implant usingnano-sensor technology

RFID Building Blocks • Current Operating Systems include:

Windows Server 2003Windows MobileSolaris 9 or 10LinuxMac OSPocket PCPalm OS

Software Solutions: Palm OSA leading application used in RFID disease surveillance

Advantages: Mobility: used on handheld Palm PDAs

Integration: bundled with office suite applications such as Excel, Word,

and Powerpoint

integrates with MS Outlook for email

integrated digital imaging

Software Solutions: Palm OSAdvantages:

• Simplicity: Intuitive interface. Known as the ‘little cousin’ to Windows

Short learning curve due to Windows format

Usability: Equipped with handwriting recognition and on-screen keyboard

Automatic back up with every sync

RFID Information Systems

• To be effective and efficient, RFID systems employ a variety of computer-based information systems (CBISs).

• A CBIS is: “a combination of hardware, software, and telecommunications networks that people build and use to collect, create, and distribute useful data, typically in organizational settings.”

(Jessup and Valacich, 2008, p10)

RFID Information SystemsInformation systems most often used in global health

include:

• Clinical Information Systems (CISs) Example: Vesalius–CIS™

• Resource Management Information Systems Example: MASCAL

RFID Information Systems

MASCAL• developed for the U.S. Navy in 2005

• Is an integrated software-hardware system designed to enhance management of resources during a mass casualty incident (MCI)

• uses active 802.11b asset tags to track patients, equipment and staff during the response to a disaster

RFID Information Systems

• utilizes wireless Internet and geo-positioning technologies

• also uses an Oracle 9i database, a Lightweight Directory Access Protocol (LDAP) server and an Oracle 9i application server

• improves communications between care providers and helps to coordinate overall disaster response and emergency medical care

(Fry and Lenert, 2005, p261)

RFID Information Systems

• includes interfaces for a hospital command center, local area managers (ERs, ORs, radiology, etc.)

Advantages of RFID Tags• Effective: enables reliable collection, storage,

and categorization of large volumes of vital clinical information

• Efficient: minimal hardware and software makes it a cost-efficient means of tracking and containing diseases and outbreaks in developing countries

• Sustainable: uses web-based technology for real-time communication, disease management and outcome evaluation across geographically disparate locations

Disadvantages of RFID Tags

• high risk of tag migration and subsequent adverse tissue reaction when implanted in humans

• can only be read within a specified range and are subject to interference from other radio wave transmissions

• data can be read erroneously if the tag becomes damaged or subjected to harsh environments, metals or liquids

Legal/Ethical Issues of RFID TagsMost significant concerns relate to:

• invasion of privacy: how much data is truly being collected? Could there be any data being collected that is not disclosed to the consumer?

• ownership: who retains the ‘rights’ to the data that is collected from citizens, patients, study-subjects, etc? is data being stored for future use?

• confidentiality: how does HIPAA apply to global health?

Informatics CompetenciesNurses working with RFID tags must:

• understand and identify essential components of computer systems including software and hardware

• have basic data entry, computer technology and

information management skills

• demonstrate ability to access and use the internet for information transmission and retrieval

Role of the Informatics NurseThe Informatics Nurse Specialist working with RFID technology

must:

• demonstrate competence and fluency in clinical nursing, continuous quality improvement, and health information technology

• demonstrate ability to “implement, evaluate, and troubleshoot user-centered design principles and methods for clients and users” (Senseimer, 2010, pg 64)

Diamonds In the Rough?RFID tags:

• have a wide range of applications• use minimal hardware and software• are cost-effective and sustainable

But in humans, are they diamonds in the rough or an invasion of privacy?

While human usage of RFID tags remains controversial, nurses and Informatics Nurse Specialists will play a key role in shaping public opinion by ensuring patient safety and adhering to evidence-based standards of care

ReferencesFry EA and Lenert LA. (2005) MASCAL: RFID tracking of

patients, staff and equipment to enhance hospital response to mass casualty events. AMIA Annual Symposium Proceedings, 261–265.

Jessup, L., and Valacich, J. (2008). Information systems today (3rd ed). Upper Saddle River, NJ: Pearson Prentice Hall.

Koplan, JP., Bond, TC., Merson, MH., & Reddy, KS. (2009). Towards a common definition of global health. The Lancet, 373(9679), 1993-1995.

ReferencesSensmeier, J. (2010). Statement to the Robert

Wood Johnson foundation initiative future of nursing: acute care, focusing on the area of technology, october 19, 2009. Computer Informatics Nursing, 28(1), Retrieved April 15, 2010 from http://journals.lww.com/cinjournal/Citation/2010/01000/Alliance_for_Nursing_Informatics_Statement_to_the.13.aspx doi: 10.1097/NCN.0b013e3181c9017a