RFID in Transfusion Medicine

Radio Frequency Identification (RFID), or as it is also known as, Dedicated Short Range Communication (DSRC), is a technology that helps track an animal, person, or object. It does this by using a radio signal to locate what it is searching for. Unlike a barcode, it does not require direct contact or light-of-sign scanning.
There are three components in a RFID system; an antenna, transceiver and a transponder. The antenna sends out a radio frequency wave that is picked up by the transponder which sends back a signal. An example could a warehouse that wants to keep track of how boxes are in it. Each box will have a tag on it that has a transponder on it. An antenna will send out a radio wave that will activate the transponder on the tag to send a signal back. The transceiver will then receive this signal, and then a computer will not only count how many boxes respond, but where each box is in the warehouse.
This technology is being used in Transfusion Medicine. Of all the disciplines in Medical Laboratory Science, Transfusion Medicine is the only one where the end result (a blood product) will be given to the patient. Sometimes a transfusion reaction can occur from the blood product can cause a reaction to the patient, some of the most serious as a result of improper collection, processing or administration.
In any laboratory procedure, it is broken up into three main stages, pre-analytical, analytical, and post analytical.
In the pre-analytical stage, it is the proper collection of the specimen. This stage relies on properly identifying the patient and collecting the right specimens. If a three unit crossmatch is ordered for Mr. John Smith in Room 309, collecting a specimen from Mr. Jon Smythe of Room 903 will cause more harm then good. If Mr. Smythe in Room 903 needs a CBC, collecting a throat swab would be useless.
How RFID helps in the pre-analytical stage is that the person collecting the specimen receives a Transfusion Request Form (TRF) which then produces a label with a tag on it. At the patient’s bedside, the phlebotomist uses an RFID reader that confirms their ID from a tag on their ID bracelet. After the sample is collected and the label is put on it, it will then be scanned generating an electronic signature and updating the status of the specimen collection. The specimen will then be brought to the lab for testing.
At the analytical stage, the specimens will be processed, and RFID will signal whether or not the blood products are compatible with the patient.
In the post analytical stage, when the RN transports the blood product, one of two things can happen once it is transported to the ward. One, it can be transfused immediately, or something occurs that postpone transfusion. What happens to that blood product, for example a unit of blood? Packed red cells cannot stay out of a fridge longer than 30 minutes before transfusion. If the RN can document that the unit is put in a suitable fridge on the ward within 30 minutes, the unit does not have to be returned to the lab, and it can be used later. RFID allows the RN this option. While RFID cannot measure temperature, it can measure that the unit is put in the fridge, and for how long.
If there is no delay, RFID can be used to confirm that the blood product is the correct one the patient is to receive. This is done by using the RFID reader to read the tag on the patient’s armband and the tag on the unit. A mismatch will sound an alarm and prevent a mistake.
RFID has potential cost savings, especially those associated with Risk Management. Each hospital will have to determine if their organization would benefit from this technology. Currently, this system is not being used by the Canadian Blood Services, although some hospitals in the U.S. are. There is the argument that common sense and following standard operating procedures negate any reason for using RFID.
But then again that was what they said about computers and barcodes 15 years ago.