The Future of Specimen Tracking & Management


Vol. 21 • Issue 11 • Page 24

Bar Code / RFID

Specimen positive identification and “real-time” location will be key attributes of future tracking and management systems. Beginning at the point of collection through post-testing storage, laboratories will need to assure that the sample is unambiguously identified as to patient, date/time of collection, point of collection, collector’s ID and type of specimen.

The collection and access to such data is clearly important for patient safety. Further, to enhance laboratory productivity and service levels, the whereabouts of any particular sample at anytime and anyplace, whether at collection source, in-transit, in testing or in storage, will be an important characteristic of any specimen tracking and management system.

History of Barcoding

For many years, barcoded labels – one or two-dimensional – have been used for specimen identification and tracking. The history of barcoding goes back to the late 1940s when Bernard Silver and Joseph Woodland filed their patent application for the “Classifying Apparatus and Method,” with patent granted in 1952.

However, it wasn’t until the late 1950s when the invention of the laser opened the opportunity for commercial applications of bar coding. When industry standards were established in 1967, the first true commercial uses of barcoding began with a barcode scanning system install at a Kroger store in Cincinnati. The first product, a 10-pack of Wrigley’s Juicy Fruit chewing gum, was scanned at a checkout counter.

Barcode applications expanded through the ’80s, particularly for ðgrocery and warehousing applications. The 1980s also brought ðone-dimensional barcode applications to laboratories for specimen labeling.

RFID Enters the Scene

Evolving over a similar time period was a different identification technology, radio frequency identification (RFID). The ðacronym refers to small electronic devices that consist of a chip and an antenna. The chip typically is capable of carrying 2,000 bytes of data or less. The RFID device serves the same purpose as a bar code or a magnetic strip on the back of a credit card or ATM card; it provides a unique identifier for that object. Just as a bar code or magnetic strip must be scanned to get the information, the RFID device must be scanned to retrieve the identifying information.

Interestingly, the first prototype RFID device was invented by the Soviets in 1945 as an espionage device. However, it wasn’t until the late 1990s that RFID applications made inroads for toll booth “tags” and similar real-time applications.

A significant advantage of RFID devices is that the RFID device does not need to be positioned precisely relative to the scanner. We’re all familiar with the difficulty that users sometimes have in making sure that a ð
barcode can be read (e.g., label positioning and curvature, close proximity to reader). In contrast, RFID devices will work within a few feet to a ðhundred feet or more of the scanner.

For example, you could put all of your specimens in a container and place the bag in proximity to the scanner. It would be able to query all of the RFID devices and log-in all the specimens in the container without need for their removal.

Why has it taken so long for RFID to come into common use? There are two reasons: 1) a lack of standards in the industry and 2) unit cost of RFID labels. As well, the use of barcodes is so widespread, time-tested and relatively inexpensive that hospitals are reluctant to make the transition. Today, the application of RFID technologies in hospitals is modest, primarily due to cost issues. Like most electronic technologies, RFID unit costs have fallen dramatically within the past few years, but have not yet achieved the “tipping point” of economic rationality for cash-conscious healthcare organizations. RFID in healthcare has been limited primarily to asset management and supply chain applications.

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Recently, however, RFID has been used by laboratories to track and manage high value, highly critical pathology specimens. RFID labels placed on surgical specimens uniquely identify the sample and maintain a record of each instance the specimen is handled. New information can be written to the label and/or readers to note the label’s changing location.

Tradeoffs

RFID labels and barcodes both carry information about specimens. Important differences exist between these two technologies: Barcode readers require a direct line of sight to the printed barcode whereas RFID readers do not require a direct line of sight to RFID labels. Large numbers of labels can be read at once rather than item by item, and RFID labels can be read at much greater distances. As noted above, an RFID reader can pull information from a label at distances over 100 feet.

RFID readers also can interrogate, or read, RFID labels at rates of 40 or more per second. Reading barcodes is more time-consuming since a direct line of sight is required; if the items are not properly oriented to the reader, it may take seconds to read an
individual label.

Bar codes have the advantage in that they are already very widely used and, at present, are considerably less expensive than RFID. Bar codes, after all, cost just half a cent each or less, while the electronic labels used in RFID can cost more than 5 cents each.

Worth the Investment?

To justify the return on investment of RFID versus barcode labels for laboratory specimens, a cost/benefits comparison should be made considering equipment and label costs compared to the relative personnel time it takes to perform a task (e.g., how long to scan, track and locate specimens individually using bar codes compared to bulk scanning with RFID). Also consider:

• Logging “in transit” specimens in bulk

• Locating specimens at checkpoints

• Logging specimens received in bulk

• Locating specimens in storage

The Table presents a comparison between RFID and bar codes. Will RFID ultimately surpass bar coding as the primary auto-ID and point-of-care patient safety technology in healthcare? It is more likely that bar coding and RFID will complement each other, based on relative functionality, cost and ease of use.

Hospitals will be reluctant to abandon their investments in bar coding simply to introduce a newer replacement technology – particularly if there is no substantial gain in utility and certainly not if the ROI equation doesn’t add up. Implementing multiple RFID applications will improve ROI.

RFID will continue to make inroads into healthcare via track-and-trace solutions, as asset and inventory management tools, then toward tracking specimens, patients and clinical monitoring devices. RFID may be most applicable in specimen tracking for high value, highly critical specimens and/or when there are multiple collection and processing sites.

Dennis Winsten is president of Dennis Winsten & Associates Inc. (DWA), a healthcare systems consulting firm specializing in laboratory information systems with headquarters in Tucson, Ariz. An ADVANCE editorial advisory board member, he has more than 30 years’ computer experience, including over 25 years in healthcare systems.

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