PPLICATIONS OF AUTOIDENTIfication technologies such as radio frequency identification (RFID) in everyday life include security access cards, electronic toll collection, and antitheft clips in retail clothing. 1,2 RFID applications in health care have received increasing attention because of the potentially positive effect on patient safety and also on tracking and tracing of medical equipment and devices. 2-11 The current expenditure levels on RFID systems within health care in the United States are estimated to be approximately $90 million per year 12 with 10-year growth projections to $2 billion. 13 Possible applications of RFID include drug blister packs, which could be intelligently marked to prevent drug counterfeiting; and the quality of blood products being monitored with temperature-sensitive RFID tags. 2,10 The decreasing size and cost of RFID tags also permits incorporation into surgical sponges, endoscopic capsules, and endotracheal tubes, as well as the development of a syringeimplantable glucose-sensing RFID microchip. 3,8,9,14 However, the array of literature that promotes RFID in health care is not accompanied by research on the safety of RFID technology within the health care environment. 15 The potential for harmful electromagnetic interference (EMI) by electronic antitheft surveillance systems on implantable pacemakers and defibrillators has already been recognized, but EMI reports on critical care devices are lacking. 16,17 The focus of the present study was to assess and classify incidents of EMI by RFID on critical care equipment. For editorial comment see p 2898.

The potential risks that RFID technologies may bring to the healthcare setting should be thoroughly evaluated before they are introduced into a vital environment. The RFID performance assessment framework that we present can act as a reference model to start an RFID development, engineering, implementation and testing plan and more specific, to assess the potential risks of interference and to test the quality of the RFID generated data potentially influenced by physical objects in specific health care environments.

Background A complex process like the blood transfusion chain could benefit from modern technologies such as radio frequency identification (RFID). RFID could, for example, play an important role in generating logistic and temperature data of blood products, which are important in assessing the quality of the logistic process of blood transfusions and the product itself. Objective This study aimed to evaluate whether location, time stamp, and temperature data generated in real time by an active RFID system containing temperature sensors attached to red blood cell (RBC) products can be used to assess the compliance of the management of RBCs to 4 intrahospital European and Dutch guidelines prescribing logistic and temperature constraints in an academic hospital setting. Methods An RFID infrastructure supported the tracking and tracing of 243 tagged RBCs in a clinical setting inside the hospital at the blood transfusion laboratory, the operating room complex, and the intensive care unit within the Academic Medical Center, a large academic hospital in Amsterdam, the Netherlands. The compliance of the management of 182 out of the 243 tagged RBCs could be assessed on their adherence to the following guidelines on intrahospital storage, transport, and distribution: (1) RBCs must be preserved within an environment with a temperature between 2°C and 6°C; (2) RBCs have to be transfused within 1 hour after they have left a validated cooling system; (3) RBCs that have reached a temperature above 10°C must not be restored or must be transfused within 24 hours or else be destroyed; (4) unused RBCs are to be returned to the BTL within 24 hours after they left the transfusion laboratory. Results In total, 4 blood products (4/182 compliant; 2.2%) complied to all applicable guidelines. Moreover, 15 blood products (15/182 not compliant to 1 out of several guidelines; 8.2%) were not compliant to one of the guidelines of either 2 or 3 relevant guidelines. Finally, 148 blood products (148/182 not compliant to 2 guidelines; 81.3%) were not compliant to 2 out of the 3 relevant guidelines. Conclusions The results point out the possibilities of using RFID technology to assess the quality of the blood transfusion chain itself inside a hospital setting in reference to intrahospital guidelines concerning the storage, transport, and distribution conditions of RBCs. This study shows the potentials of RFID in identifying potential bottlenecks in hospital organizations’ processes by use of objective data, which are to be tackled in process redesign efforts. The effect of these efforts can subsequently be evaluated by the use of RFID again. As such, RFID can play a significant role in optimization of the quality of the blood transfusion chain.

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