Auto-ID technologies are loudly touted as potent tools to reduce medication errors and to better track material and personnel in hospitals. In a few months Dr. Martin Specht, vice chair, center of data processing, Jena University Hospital, Thuringia, Germany, expects to get a sense of just how much benefit is possible. Martin is overseeing an RFID-based pilot program to manage medication disbursement in a cardiac intensive care ward that handles 25 patients.

“We started talking about this in 1999,” says Specht, when plans for a new building were being drawn. The early focus then, as now, was on preventing medication errors. The use of auto-ID to help accomplish that was part of a broader set of technology enhancements planned for the new building. For example, a small army of robotic carriers moves pharmacy supplies from the pharmacy to the ward.

“There is strong evidence that RFID systems can reduce medication errors, significantly, say from 5 percent to 2.5 percent,” says Specht, “and I’ve seen a number that a typical adverse event costs around $8000 or $9000 per patient. We wanted to improve care and reduce costs.”

Jena has a clinical information system for the intensive care ward, including a complete electronic health record purchased from a small German company. Both technology and procedural changes were incorporated. “We decided to [adopt] electronic auditing [around] unidoses which you have in the USA. In Germany and Europe it’s not very common, but we have learned it can help reduce errors. This would include electronic prescription of course,” he says.

A longtime SAP customer for traditional enterprise applications (finance and HR), Jena extended its existing deployment of SAP NetWeaver to include SAP’s Auto-ID solution.

Now, using passive RFID tags, medication can be tracked in real-time from the hospital’s pharmacy to intensive care and individual patients. Medication can be matched digitally to the individual patient by checking the reference codes on an RFID bracelet worn by the patient. Using handheld scanners, the nurses read these codes, link them to the patient data on file in the hospital’s IT system and gain instant access to detailed information on the patient, displayed on a screen.

The pilot program has been running for about a month. “I think we will run it for the next one or two years because there are many questions,” says Specht. Roughly ten PDAs are in use by the 50 or so nurses working on the ward where the average length of stay per patient is about 2.5 days.

“We are just focused on antibiotics,” says Specht but adds that they are already investigating next steps such as moving to active RFID devices for tasks such as temperature measurements; Jena is unlikely to move quickly into the active RFID area, he says, because of the cost and also the need to learn more from the existing system.

For example, nurses’ jobs are somewhat more time-consuming now. “They had a very good drug flow before and now every bed has a computer and must be scanned,” Specht says. Disinfecting PDAs, bedside computers, and RFID tags is also a non-trivial task “They weren’t designed for it,” he says.

Adoption issues aside, Specht is confident the pilot program will reduce medication errors and that he and the staff will work out kinks in the workflow. Then the system could be rolled out throughout Jena, which at 1375 beds, is the largest hospital in the German Federal State of Thuringia.

The Jena pilot programs use just a small portion of SAP’s AutoID platform capability which is perhaps best thought of as a blend of middleware, operating system, and even a few applications all designed to suck data from AutoID devices, store the data and its associated meta-data, and feed a variety of analytics engines. SAP leverages its NetWeaver technology to do this.

There are two key components, says Eric Domski, director of AutoID solutions for SAP. There’s the Object Event Repository (OER) which is functionally a specialized database structure to capture events and is designed to facilitate maintenance of chain-of-custody logs. The OER can be implemented on any of the major databases platforms. The second piece is the AutoID Infrastructure (AII) which talks to the various internal and external systems.

It’s probably not the best choice for small facilities. Domski says SAP has deployed the solution in organizations as small as $150 million (annual sales), and insists deployment can be as short as a couple of weeks or take several months. Within the healthcare market, SAP is targeting four applications: patient safety; equipment and asset tracking; consumables outside the hospital environment; and personnel tracking (patients and staff).

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