How RFID offers patients direct benefits in healthcare.
RFID Connections spoke with Steve Fleck, chief technology officer for ClearCount Medical Solutions about ways RFID can improve the patient experience in a healthcare setting and how RFID can help ensure successful for patients in the operating room.
RFID Connections: We often hear about the uses of RFID for supply chain and benefits for businesses but we don’t hear as much about clear direct benefits for consumers. It seems to me that health care would be one of those areas where the consumer — that is, the patient — could directly benefit from the use of RFID.
Steve, in health care, where do you see RFID being used to provide direct, tangible benefits to patients?
Steve Fleck: That’s a great question and you’re absolutely right that a lot of attention is paid to inventory control and other applications where RFID is really focused on helping the bottom line of the business — in this case the hospital. So it’s easy to forget that, at the end of the day, the hospital’s job is to provide a good quality product to the end-user, in this case being the patient.
What I like to do is sort of back up a step and look at, from the perspective of the patient, what kinds of things matter to them when they go to the hospital. You can ask questions like “How long does the patient need to wait to see the doctor?” “Will the patient’s bill be correct at the end of the stay?” And those are things that RFID on inventory items like wheelchairs and medications and different pieces of equipment, while they directly benefit the business, being the hospital, at the end of the day it’s really all about creating a better experience for the patient.
That sometimes gets lost in the discussion. And there’s a whole other category of issues where there’s even less visibility by the patient and the stakes are even higher for making a mistake and those are things like “Will the right implant be used?” and “Will anything be left inside of my body?”
And those things really matter because the patient isn’t even awake. And that’s a unique proposition for RFID. RFID can really be an advocate for the patient while the patient isn’t even conscious — while the patient is under anesthetic.
That’s where ClearCount comes into play. We try to provide a safe environment for the patient even though the patient really never gets to fully appreciate our product.
RFID Connections: Steve, you mentioned things being left inside the patient — what sorts of things are you talking about specifically?
Steve Fleck: Well, when the patient is open on the operating room table, various items are being used and placed inside the body cavities — things like surgical sponges and surgical instruments and sometimes even surgical towels. That’s really what ClearCount is focused on: preventing the retention of those items [in the patient] after the surgery.
RFID Connections: Surgical sponges, surgical towels — could you describe that they are? I’m assuming there’s not the same sorts of things you would find on your kitchen sink.
Steve Fleck: Well, they’re actually closer to a kitchen dish towel than the typical kitchen sponge you might be thinking of. Another common item we compare it to a lot of times is a cloth baby diaper — if you’re old enough to remember what those look like.
They’re typically white cotton and eight or ten plies thick and the larger ones are about 18-by-18 inches (46-by-46 cm) so they’re quite large.
RFID Connections: Is likely that a surgical sponge or surgical towel could be left inside a patient?
Steve Fleck: Actually, yes. In fact, sponges are the majority of items left inside a patient — over two-thirds of retained items are sponges. When the surgical sponges get soaked with blood and other body tissue they tend to condense and look just like a ball of tissue or blood. Because they’re white they just take on the color of the surrounding tissue and it’s actually quite hard to find them.
RFID Connections: Cotton’s a natural fiber so it sounds as if they’re fairly benign. What would be the consequences if they were left behind?
Steve Fleck: A lot of people think it might not be a big deal to leave the sponge inside of somebody — it seems benign — but actually sponges, because of their porous nature actually foster infections much better than, say, a needle or a piece of metal. Typically, if a sponge is left inside of a patient it almost always results in a pretty serious infection.
RFID Connections: How do operating room personnel typically keep track of these sponges and towels? Is there a standard procedure?
Steve Fleck: The vast majority of operating rooms still use a manual process that’s been in use for decades now which is simply counting the sponges at the beginning of the surgery and then counting them at various points during the surgery and then doing a final count at the end of the surgery.
There’s an industry group called the Association of Perioperative Nurses the prescribes a recommended practice for surgical counts and, if you follow their practice, there’s up to six or seven times during a typical surgery where sponges could be counted.
RFID Connections: That sounds very time-consuming and it certainly takes the nurse’s attention away from the surgeon, the patient and the surgery itself. And it sounds as if we’re relegating a highly-trained medical professional to perform simple clerical duties.
Steve Fleck: Absolutely. And the Association for Perioperative Registered Nurses, or AORN, is actually revising their counts policies this year to, for the first time, recommend that nurses look at technologies to enhance the count.
We’ve sort of acknowledged the fact that we’ve reached what’s called the “human barrier”. There’s always going to be a percentage of cases where humans just can’t reliably count because of distractions or factors in the operating room.
So, the industry is sort of recognizing this and now they’re recommending looking at technologies, such as RFID, for the prevention of retained surgical sponges.
RFID Connections: How does RFID work for tracking surgical sponges?
Steve Fleck: It’s a pretty simple concept. What we do is securely embed an RFID tag inside of each sponge during the manufacturing process. Those sponges are then folded and packed and sterilized the way a typical sponge would be and supplied to the hospital through their normal supply chain.
ClearCount also provides a piece of hardware which is a small reader that sits inside the operating room that’s custom-made for the operating room workflow. That reader checks things in and checks things out sort of like a mini-inventory and it also provides a wand to wave over the patient at the end as an extra safety precaution.
RFID Connections: Does that mean that the nurse has to manually wand every sponge as it comes out or is there some sort of automated device here?
Steve Fleck: Our device what is called an “in counter” and an “out counter”.
The “in” counter is sort of a little swipe RFID reader that you swipe the package of sponges across and, right through the packaging, it can validate that that pack is a correct pack, that all the sponges are there and even identify what type and what quantity they are.
As they’re used, they’re thrown into what we call the “smart bucket” which is a waste disposal bin that has RFID antennas embedded into the sides so that it’s a seamless process to the nurse. She uses the sponge, throws it away into our bucket and it automatically gets counted.
RFID Connections: So, as you said earlier, it’s designed to integrate with the workflow and not require extra effort.
Steve Fleck: Absolutely.
RFID Connections: As long as we’re on the topic of RFID in healthcare, are there any other thoughts you’d like to pass along to our listeners?
Steve Fleck: Actually, I read an article recently that says, of all the industry sectors that this author analyzed, including retail and aerospace, that healthcare actually is furthest up the curve for RFID adoption and implementations.
And that’s really encouraging for me. When we first started this company about six years ago, healthcare was seen as lagging in terms of technology. A lot of people said, “Hospitals haven’t even adopted bar code solutions yet. How do you expect them to embrace RFID?”
And that’s really not been the case so it’s really been an exciting time for us.
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About Steve Fleck
Steve is CTO and co-founder of ClearCount Medical Solutions Inc. ClearCount has developed and deployed the world’s first FDA-approved RFID-based platform for patient safety inside the surgical operating room. Since inception, ClearCount has launched multiple product lines and built a robust patent portfolio, securing its place as a leader at the intersection of RFID technology and patient safety. ClearCount was recently featured in Time Magazine, named one of Wired Magazine’s 10 Best Uses for RFID, and selected a 2009 winner of “Best of What’s New” by Popular Science.
Prior to founding ClearCount, Steve worked for several privately held and venture-backed medical device manufacturers. He held a strategic marketing position at CardiacAssist, a Pittsburgh-based developer of the TandemHeart ventricular assist device. Prior to this position, Steve worked as an engineer for Boehringer Laboratories, where he was involved in the development of several new autologous blood transfusion products.
Steve launched ClearCount while earning his MBA at Carnegie Mellon’s Tepper School of Business.
About ClearCount Medical Solutions
ClearCount Medical Solutions is committed to patient safety solutions that are relevant to the realities and challenges of surgical services teams. The ClearCount extendable RFID-based platform drives efficiencies while preventing medical errors. The reduction of patient safety risks such as retained surgical sponges will greatly improve the quality of care in the OR, while improved efficiency associated with use of the sponge management system will reduce costs associated with reconciling miscounts.
ClearCount Medical Solutions is the only provider of a sponge management system that combines the benefits of counting and detection. Counts can be quickly reconciled and in the event of a non-reconciliation, a missing sponge can be located using the SmartWand™. ClearCount’s innovations bring to market a comprehensive sponge reconciliation and detection solution that improves patient safety and operational efficiency.
More information: www.clearcount.com
