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The right patient, the right drug, the right dose, the right route, the right time."
"Problems cannot be solved by thinking within the framework in which the
problems were created."
Albert Einstein
Introduction
Healthcare has emerged as one of the major activities concerning human beings
in the recent past (changing life styles, awareness, and habits) irrespective of
age, income, region, religion, caste, culture, and so on. The need for effective
health services is the order of the day. As a result, hospitals are absorbing
tremendous amount of resources. Globalization has opened up new opportunities,
and there is cut-throat competition among hospitals in offering services to
patients at reduced rates. The needs, priorities, and expectations of the patients
This paper was earlier presented at the 3rd International Conference on Logistics and Supply Chain Management
(ILSCM), Organized jointly by PSG College of Technology, Coimbatore, India and Central Michigan
University, USA, held during August 2-4, 2006.
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The Icfaian Journal of Management Research, Vol. VI, No. 11, 2007
from time to time have to be captured and the hospital services are to be
redesigned
accordingly
to
enhance
the
efficiency
of
hospital
supply
chain
of
traditional
logistics
procedures
as
tight
integration
between
warehouse, distribution, and retail have smoothed out duplication and improved
time to market. However, further improvements have been constrained by the
technology used to track goods through the supply chain. The use of bar codes
has become prominent in the manufacturing service organizations. But bar codes
have a tendency to get damaged easily and need human intervention to read
and give partial information as they represent only a product number.
To ensure supply chain efficiency, Indian companies are slowly realizing the
importance
of
Radio
Frequency
Identification
(RFID)
tags.
RFID
(wireless
information
and
compel
applications
and
processes
across
the
33
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The Icfaian Journal of Management Research, Vol. VI, No. 11, 2007
RFID can add value to healthcare by identifying and locating a person around
the operating room. This enables a better understanding of the environment in
and around the operating room which can help in organizing logistics optimally.
It is easier to track and trace operating room materials, blood products, implants
and disposables (a high cost price and turnover rate), the use of materials, and
certain machines for effective hospital administration. The tracking and tracing of
blood products is done using temperature-sensitive tags.
Business processes and workflows in the organizations, which involve a
lengthy chain of custody in terms of a product, asset, document or even a person,
have complete visibility from the beginning to the end when RFID tags are used
at each stage. The amount of information immediately available at each stage
provides scope to predict the next step.
Hospitals comprise many peoplemobile assets such as beds, equipment, and
drugs and departments such as admissions, the emergency room, the operating
room, the intensive care unit, and the recovery roomthat associate with many
documents at various points in the total patient care process. It is obvious that
mistakes may happen in the medical process, leading to reasonable delay in care
while looking for information about previous steps to track the root causes.
If RFID tags are updated with the patients history and intended treatments at
every step, the process will be simplified with complete visibility of data thereby,
an efficient delivery of patient care is ensured.
In healthcare, RFID tags may be applied to people, patients, staff, and objects.
The readers can be placed at door frames, wards, and treatment areas to detect
and record interactions. Some application areas where RFID can be most
prominently used are:
Care
Unit
Management,
35
wheel chairs, etc. These must be accounted for, and their availability must be
ensured to treat a patient in time.
The impact of improper management of assets may lead to the following:
Increase in labor costs related to searching for the equipment and items
when needed;
schedulesof
Active RFID tags can be placed on valuable assets, whether due to cost or
operational necessity. The active RFID tags have the ability to detect certain
conditions such as movement, tamper, or certain environmental conditions
through the use of sensors incorporated into the tags. The movement of these
tags can be followed from distances ranging from 20 feet to 1,000 feet based
on the surrounding environment and the characteristics of the asset.
For instance, for assets such as wheelchairs, it may be sufficient to simply know
that they are within the building or perhaps on a particular floor. Other assets
such as IV pumps or certain surgical equipment may require that the location be
determined and narrowed to a particular area within the facility. In both the cases,
the technology selected and the location of the readers should be dictated by
the requirements and not the other way around.
In hospitals, patient records are key documents. Doctors, secretaries,
and medical staff record and retrieve all patient-related information from data
files. As several people access the files, patient records are often lost or
misplaced. Also, unauthorized people must not get access to the files.
RFID technology solves these document-tracking and management problems.
With an RFID label, staff can track the file movements and locate them wherever
they are in the hospital premises. As archiving records is now easy and efficient,
losing or misplacing files is no longer a problem. Hospitals can use RFID technology
to track medication dispensing, laboratory samples, and blood bags much like bar
codes. RFID saves time and improves precision because it automatically records
the movement of all items and does not require human intervention to scan a
bar code or record data on a form.
Patient Tracking
RFID can be used to track people, more specifically patients. Sometimes, a patient
who wanders from his room may find it difficult to locate his room and may be
subjected
to
unnecessary
anxiety.
Situations
like
this
can
be
avoided
by
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The Icfaian Journal of Management Research, Vol. VI, No. 11, 2007
RFID tag. The tag can take on a number of forms, which include wrist straps or
a special badge. The tag contains a tamper-proof mechanism that will prevent
it from being removed or emit a tamper signal if an attempt is made to remove
it. Some uses of RFID in healthcare services are to tag patient wristbands with
ID and care information, manage distribution of medications, combine with
nanosensor
technology
to
remotely
monitor
patients
via
implants,
provide
RFID
application
will
eliminate
opportunities
for
baby-snatching
or
37
Initiative
Patni Computer
Systems Patnis Lab has delivered an RFID pilot that integrates with a
SAP back-end for processing transactions. It has
successfully
It has been associated with the Auto-ID lab at MIT for the last two
years. Wipro Technologies is among the first Indian companies to
become a member of the Electronic Product Code (EPC), a unit of the
Uniform Code Council that oversees the development of standards
behind the development of RFID in retail and consumer product goods.
It is setting up a lab to study RFID and plans to try out the technology
in its Electronic City campus at Bangalore. The company is working on
a pilot project with a UK-based retail company. Three other customers
in the US and Europe are in pipeline.
Infosys Technologies
Intellicon
Intellicon sells retail solutions from Tag Master, Zebra and MIRC in India.
It worked on a pilot project for BEL Bangalore in the RFID space three
years
ago
where
tags
were
installed
on
employee
buses.
Buses inside the BEL campus were tracked with the aim of gauging
employee punctuality.
TCS, Satyam, and HCL companies have also made forays in the field of
developing RFID applications. Oracle-Warehouse Management System (WMS),
SAP, and other ERP systems have been integrated with RFID enabled solutions.
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(JIT)
manufacturing
and
retailing,
enabling
organizations
to
The Icfaian Journal of Management Research, Vol. VI, No. 11, 2007
make
strategic
end-customer
decisions.
Goods
tracking
is
also
important
for
direct
service.
Lack of tracking
Inefficient methods
Error-prone
of data capturing
processes
mechanisms
Disparate,
the items at
various
non-integrated
nodes
Stock-outs
Lost
sales
Delayed
Production
shipments
s lowdowns
systems
Excess
Shrinkage
buffer
and billing
inventory
delays
39
technology. The huge volumes of data, which cover all aspects of the supply
chain, including order entry, manufacturing, maintenance, shipping, receiving,
and inventory, will push the boundaries of data warehousing scalability,
performance and manageability.
The factors which affect the supply chains working at different levels are
presented in Figure 1.
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Improved production planning and smart recalls for effective scheduling, and
The Icfaian Journal of Management Research, Vol. VI, No. 11, 2007
RFID provides a quick, flexible, and reliable electronic means to detect, identify,
track and manage an array of items. RFID can also improve efficiency and reduce
cost in different industries which include shipping and receiving, warehousing,
manufacturing, logistics, pharmaceutical, library, cashless payment, transportation
management, and hospitality.
RFID system is mandated by Wal-Mart as defined by the Electronic product
Code (EPC) specification. This specification describes five major components of
an RFID system that includes the EPC, tags, readers, middleware, and the
information service. The EPC is a globally unique number that identifies a specific
item in the supply chain. The number is stored on an RFID tag, which is a silicon
chip mounted on an antenna.
The biggest benefit is the visibility across the entire supply chain.
RFID technology has the ability to track items in real-time as they move through
the supply chain covering various touch points (Figure 2). Greater visibility to the
supply chain will provide opportunities to lower inventory carrying costs, as well
as reducing the need for storage warehouses, thereby improving cash flow,
boosting productivity, and reducing overheads.
Figure 2: Components of Supply Chain Visibility
Total Visibility
R aw
materials,
Ingredients,
Packaging
Procurement
To stores
Stock
Control
Planning
Stores
Production
Finished
goods
To RDC
and
Consumer
Inventory Management
It is easy to maintain and track a real-time movement of tagged inventory while
it flows through the supply chain with trigger alerts around inventory.
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Benefits to Consumers
RFID can go beyond intangible cost savings in the areas such as food safety,
counterfeit control, and warranty programs. Businesses should stay focused on
how RFID can improve consumer value and address complex business issues.
banks,
and
EMS,
concerted
effort
is
required
to
develop
The Challenges
RFID is the front-runner technology for automatic identification and data collection.
RFID in India is still in its infancy with an untapped potential. Unless and until
more standards are set within the industry, awareness of the benefits is created
and the reduction in the cost of RFID tags is achieved, more implementations
would not be possible.
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The Icfaian Journal of Management Research, Vol. VI, No. 11, 2007
RFID data will have to be managed differently than bar code data,
therefore, a solid middleware solution is crucial for organizing the
information; and
Find a solution provider with the right experience to design low-risk solutions.
Finally, it is important to see through the hype and understand that bar codes
cannot be replaced by RFID overnight. The best choice will be a hybrid solution
that employs a range of multimedia data-capture technologies to deliver greater
visibility and lower costs across the supply chain. Compatibility of incorporating
legacy systems with future RFID requirements in a single hand-held unit is a much
more open, flexible approach to meet the future challenges. RFID will certainly
drive the mass adoption of auto-identification technologies and services in Indian
industries following the successful implementation of the RFID adoption programs
of large retailers such as Tesco in the UK, Wal-Mart in the US and the US
Department of Defense (DoD).
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RFID is being tagged as the next big thing to bring a revolution in the
enterprise software solution market. It promises to help companies to get rid of
problems related to inventory management, material tracking, and supply chain
processes.
RFID Standards
There are two primary organizations that are taking steps to develop the
standards for RFID technology. They are:
EPCglobal, a joint venture between the Uniform Code Council (UCC) and
the European Article Numbering International (EAN)collectively
EAN.UCC; and
Conclusion
Radio frequency-based applications in healthcare are opening up new avenues.
It is the next wave in the evolution of computing. As healthcare in India is a
sunshine industry and growing annually at a rate of about 13 percent,
RFID will continue to make inroads via track-and-trace solutions, first as asset
and inventory management tools, then gravitating toward personnel, patient, and
clinical monitoring devices. High-end asset tracking, location tracking, and
anti-counterfeiting are the futuristic areas for active RFID. As volume of
consumption drives down unit costs, workflow and business process efficiency
will become key drivers of RFID implementation.
Supply chain visibility is the key to increasing supply chain performance, from
both financial and service level perspectives. Greater visibility as well as accurate
and timely information about supply chain execution leads to reduced safety
stocks, thus optimizing cash-to-cash cycles and reducing inventory carrying cost.
RFID helps in identifying the expired drugs, real-time tracking of expensive and
critical instruments, restricting the access of drugs to only authorized medical staff,
accurate matching of test samples to the patients, and reduction in medical errors.
Supply chain efficiencies are being driven by improvements in information
accuracy and availability. Organizations need to take a strategic look at the
development of an information management structure that exploits the availability
of real-time, accurate information to drive business improvements.
Exploiting the power of RFID technology is not simply about replacing bar codes
with tags. The specific benefits that RFID tags offer over bar codes present an
entirely new way of working in the competitive business environment.
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The Icfaian Journal of Management Research, Vol. VI, No. 11, 2007
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2. EPC and Healthcare Distribution: Current State of the Industry, Healthcare
Distribution Management Association White Paper, November 2004.
3. Express
Healthcare
Management,
www.expresshaelthcaremgt.com,
April 2007.
4. Financial Express, August 29, 2005.
5. Handfield Robert B and Earnest L Nichols (Jr.) (1999), Introduction to Supply
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6. Health Care RFID Startup Scores $9 mn in Venture Funding, Dow Jones Reuters.
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Reference # 02J-2007-11-03-01
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