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Improving medical device management with GS1 standards

Simon Dawkins, head of Medical Equipment Library at Cambridge University Hospitals NHS FT (CUH), explains how the trust is capitalising on the benefits of RFID technology.

By pioneering the use of active and passive RFID technology, and implementing GS1 standards to manage mobile medical equipment, CUH has improved efficiency, increased patient safety and reduced capital expenditure. 

At CUH, Harland Simon’s RFID Discovery system has been automatically tracking the locations of 7,500 mobile medical devices around the main hospital site for a number of years using active RFID technology. The system helps minimise time spent looking for equipment, improves utilisation levels and reduces the requirement to purchase new devices.

In order to enable CUH’s wards, departments and clinical engineering team to track the locations of all of their 40,000 medical assets, including those of lower value, the remaining assets are in the process of being fitted with passive RFID asset tags, which are fully compliant with GS1 standards. 

The Department of Health’s eProcurement strategy mandates the use of GS1 standards in every NHS acute trust in England – to increase efficiencies and significantly improve the quality and safety of care. In preparing for compliance with the new regulations, CUH has embraced the use of passive RFID technology and is already actively capitalising on numerous benefits. 

The implementation 

At CUH the project to roll out GS1-compliant new asset labelling utilising passive RFID technology started in May 2015 and is estimated to be completed by October this year. 

Having been one of the pioneers of implementing active RFID asset tracking, CUH was the first trust in the UK to introduce GS1 standards for the tracking of medical devices. With its 1,000 beds and 61 wards, CUH is one of the largest and best known hospitals in the UK, and the task of tracking £130m worth of equipment around a large hospital campus was made a great deal easier. 

To date, a total of 25,000 units have been tagged with either or both active and passive RFID tags.

The technology 

Passive RFID labels replace the existing asset labels, and are fully compliant with GS1 standards, carrying a Global Individual Asset Identifier (GIAI). They are encoded with a unique ID which is linked to a particular asset in the database on registration. Unlike active tags, which are used to track mobile assets, passive RFID tags have no battery and require an external source, a passive RFID reader, to trigger a signal transmission. 

CUH’s clinical engineering staff use two different types of passive RFID readers, which capture data from the tags and send location information to a central database. A specially designed trolley, fitted with a UHF (Ultra-High Frequency) RFID reader and three antennas, performs equipment searches as the clinical engineering technician travels around the hospital. With a read range of typically up to 11 metres, it records the date, time and location when it detects a passive tag. In addition, a small mobile handheld reader with a read range of typically up to six metres is used to audit wards or locate specific equipment. 

The central RFID Discovery database has been integrated with Integra E-Quip asset management system, which is used as the trust’s equipment management database and records all medical device assets. This integration allows clinical engineering and clinical teams to see the location of any medical device assets fitted with active RFID tags and – as GS1 labelling progresses – the location of those fitted with the new passive asset labels.

Specific challenges 

One of the challenges prior to implementation was to choose the best suitable RFID inlay type to ensure that label sizes were suitable for application to all different types of medical devices. 

Before beginning to fit the new asset labels to medical devices, a number of due diligence tests were carried out to establish the most suitable position for labels to be applied on each type of device. The correct positioning is crucial to ensure that the asset tag does not interfere with the regular use of the device ,but at the same time guarantees a successful signal transmission to allow for the device to be captured by a reader. 

Benefits 

As a result of using active RFID tracking, CUH has already experienced an array of benefits such as reducing capital expenditure for new medical devices by improving utilisation levels for existing equipment. For example, tagging all ECG monitors helped improve the use of existing devices resulting in a lifetime capital cost saving of £175,000. The one-off cost of tagging all ECG monitors was just £16,000. 

It has also enabled the clinical engineering team to focus on core tasks of maintenance, repair and delivery of medical devices to the wards by helping them to locate equipment faster. The tracking has significantly reduced the time it takes to audit the average ward from 1 hour 30 minutes to just eight minutes. This enables more effective use of engineers’ time and allows for more frequent auditing. 

CUH has also seen an improvement in the management of hired devices. For example, a first year saving of £99,441 on rental costs has been achieved by tracking hired low level beds to enable a timely return, as well as avoiding unnecessary replacement costs of hired beds that had been lost. 

Additionally, the target for supplying a device to a ward is 30 minutes, but the average achieved is approximately 12 minutes. This has increased confidence amongst clinical staff which means they no longer hoard equipment for their convenience, an issue which used to exacerbate the problem of device availability. 

Implementing GS1 standards and passive RFID tracking for devices means that the above benefits can be extended to all types of equipment. In addition, it has also enabled the clinical engineering team at CUH to: 

• Improve risk management and ensure patient safety by using the international global system of GS1 of unique identification for medical devices
• Ensure a consistent standard is used to be able to interface with other clinical software and other companies or partners used for patient care
• Understand the issue of devices going missing from the trust 

Plans for the future 

This system of asset tracking is already being used for many other types of asset across the whole trust, such as moving and handling, wheelchairs, tablets and communication aids. Its use will be expanded further to include areas such as IT (computers, laptops, tablets) and estates (TVs, microwaves). 

Passive RFID technology is also used to help prepare individual procedure kits for CUH’s 35 theatres, improving inventory management and freeing up clinical time. A central Kitting Store prepares around 100 to 120 kits for elective procedures plus 50 for emergency and contingency kits every day, collating all equipment that theatre staff require for a particular procedure in a patient specific tote box. This means theatre staff no longer need to leave the theatre area to prepare materials for forthcoming operations and can instead focus on patient care. The service also utilises passive RFID tags to automatically capture the usage of high-cost medical devices, implants and pass through items, improving the accuracy of patient-level costing and reducing inventory by creating a consumption-led replenishment. 

For CUH the next stage in the process of moving towards GS1 compliance is to introduce Global Location Numbers (GLNs) to identify each location within the hospital, and use of the system for other departments and sections within the trust as part of the wider GS1 implementation.

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