A Review of Automatic Patient Identification Options for Public

A Review of Automatic Patient
Identification Options for Public Health
Care Centers with Restricted Budgets
• A comparative review is presented of suitable
automatic identification systems based on
graphic codes, both one-(1D) and twodimensional (2D), printed on labels, as well as
those based on radio frequency identification
(RFID) tags.
• The results suggest that affordable automatic
patient identification systems can be easily and
inexpensively implemented using 2D code printed
on low cost bracelet labels, which can then be
read and automatically decoded by ordinary
mobile smart phones.
Automated patient identification system
• Avoid the error of manual identification
• A speedy access to clinical information
• Remote instant access and management of
patient medical history (EHR: "Electronic
Health Record")
• Security and confidentiality of the medical
data to be handled
Assessment of available technology
• The assessment of available technologies was
undertaken in the context of its possible
deployment by a municipal public health
agency that operates a network of local clinics
in restricted budget
• A very effective alternative to the dedicated ID
tag reader for scarcely budgeted public health
care centers is offered by the ubiquitous
mobile smart phone.
One-Dimensional Graphic Codes
• Graphical encoding uses a combination of
black and white parallel and adjacent areas of
different thickness
• Automatically decoded by a special reading
• Codes are not descriptive, but store a
reference code associated with a database
containing relevant information
Structure of 1D codes
the code begins with a "start character"
ends with an "end character,"
Two "quiet zones," at least ¼ inch long
a control digit, or "checksum,"
Types of 1D code
• UPC (Universal Product
• EAN (European Article
• Code 39
• Code 128
• Interleaved 2 of 5
Characteristics of 1D Code
• Advantage:
– Fast data capture.
– Reliability due to the very low
level of errors in the capture
and decoding of data.
– Immediate integration of the
decoded data into the system
or database.
– Low cost of printing the
• Disadvantage:
– low storage capacity of
approximately 20 to 30 digits
Current application of 1D Code
• Inventory control.
• Tracking of moving objects such as cars,
baggage, mail, packages, medicines,
laboratory test samples, etc.
• Access control to transportation, open-air
events, buildings, offices, theaters, etc.
• PPI in Hospitals.
Use in health care
• To control the hospitalized patient’s medication
process, blood transfusions, and in laboratory
tests (blood, urine, etc.) to identify the
test/patient pair.
• Houston’s "Methodist Hospital System," one of
the largest in the state of Texas (USA), uses a
patient data electronic verification system,
designated KBMA, based on the reading of bar
codes. It is connected online to the medical
documentation system "MethOD" (medical
records database)
Two-Dimensional Graphic Codes
• Two-dimensional codes are in general capable of
storing alphanumeric characters including letters,
numbers and punctuation & Non- alphanumeric
characters, such as Kanji.
• The way to store information is to represent it
two-dimensionally by means of planar distributed
graphic patterns (dots, squares, circles, triangles,
hexagons, etc.).
• The two-dimensionality of these codes allows a
greater data storage density than is possible with
traditional 1-D bar codes.
Historic evolution of graphic code
Comparison of relevant characteristics
of three 2D code types
Illustrative examples of 2D code use in
health care
• Health care centers in Japan, Singapore and Hong
Kong, have implemented a system known as UPI
(Unique Patient Identification)
• Addenbrooke's Hospital in Cambridge uses 2D
codes as part of its patient safety policy. A
bracelet on which a 2D code is printed, in
addition to other basic personal data, is attached
on each patients’ wrist.
• An update of Houston’s Methodist Hospital KBMA
1D code-based ID system has been proposed,
consisting of migrating its old 1D code-based
patient identification to a 2D code-based system
Some relevant characteristics of 2D code
• Special programs to read and decode, that run
in camera-equipped mobile smart phones
• 2D codes can be very easily generated and
printed on a variety of paper or plastic labels,
or on any other surface, without the use of
specialized equipment.
• 2D code requires close proximity of the reader
device to the patient’s bracelet to capture the
General applications of 2D code
• Boarding passes in transportation.
• Advertising in newspapers, magazines, posters and
• Inventory management.
• Tickets for public events.
• Personal contact cards.
• Health services. (patients’ bracelets, medical
equipment, laboratory samples and drugs,
administration of medicines, medical procedures, and
tracking of internal and external transfer of patients )
Radio Frequency Identifiers
• Radio Frequency Identification (RFID)
technology can automatically identify people
and objects in the healthcare environment by
placing identifier RFID tags on the subjects
and then remotely reading them using a
specialized reader devices.
Four Elements of RFID
Label (tag)
Reader or coupler
Transmitting antenna
Database or computer system
Some applications of RFID
Access control.
Inventory Management.
Baggage identification and screening.
Industrial production chains.
Library book input and output.
Identification and location of animals.
Illustrative examples of RFID use in
health care
• Taichung Hospital in Taiwan implemented an
RFID-based system, integrated with the Hospital
Information System (HIS), to improve the
efficiency of patient safety during the medication
process of hospitalized patients.
• The Orthopaedic Institute of Palm Beach, Florida,
put into operation a system known as "SurgiChip"
that uses RFID patient identification to help
prevent surgical errors
Types of RFID tags
• Active
• Passive
• Semi passive
Operating Frequencies
• The operating frequency defines
– the speed of data transfer
– the range is also affected
• A large capture range facilitates the unintentional
acquisition of signals originating from nearby
sources other than the subject’s bracelet, leading
to possible failed or incorrect identification.
• Passive tags commonly operate at frequencies
such as 128kHz, 13.6MHz, 915MHz and 2.5GHz
Some relevant characteristics of RFID
• RFID tags can store an amount of information in
general larger than any graphic code
• Does not require the existence of a short line of
sight link between the tag and the reader, as
graphic codes require.
• The single main disadvantage, with respect to
graphic code technology, that persists today for
the use of RFID technology in patient
identification applications is its relatively higher
Near Field communication tags
• An emerging technology closely related to
RFID is Near Field Communication (NFC). NFC
is a wireless connectivity technology that uses
magnetic field induction to establish a
communication link between electronic
devices placed in close proximity to each
other. The use of NFC tags in conjunction with
NFC-enabled mobile phones could be an
attractive technology for unambiguous and
secure automatic patient identification
Comparison of three technologies
1D Codes
2D Codes
Encoding Method:
Printed variablewidth parallel bars.
Printed twoRadio Frequency
geometric patterns.
Type of decoder:
Dedicated optical
Camera- equipped
smart phone or
PDA, dedicated
Stored data:
Reference number.
Descriptive (general Unique
data, web links,
contacts, etc)
number (UIN)
Type of data:
ASCII, control
binary, Kanji.
Data Security /
Error Correction
Although optional
in some types, most coding: adds
use Checksum.
Partially corrupted
code can be read.
Special dedicated
RF reader device.
No inherent error
correction, but
frequently include
error correction
Comparison of three technologies
1D Codes
2D Codes
Up to 30
Numeric: 138 to 7089
Alphanumeric: 93 to 4296
Binary: 1556 to 2953
Kanji: 778 to 1817.
From 512 bits to 512
kBytes. Active tags
have greater capacity
than passive ones.
- High speed data
- Reliability.
- Integration with
- Easily printed
low-cost labels.
- Short range*.
- High storage capacity,
small size.
- Stores diverse kinds of
- Easily printed low-cost
- Inherent error correction.
- Smart phone readable.
- High-storage capacity.
- Read and write
- Can be automatically
- Can act as biosensor.
- Must be manually
- Long range*.
- Complex use and set
-needs special tags and
dedicated readers.
-Security issues.
Disadvantages: - Low-storage
- Limitations on
the types of data
they can store.
QR Code
• QR code-based applications intended for the healthcare sector are
constantly increasing.
• The distinct characteristics of QR code-based technology:
high data storage capacity,
low implementation cost,
technical simplicity,
widespread use, and
the ample availability of free programs for reading and decoding it by
camera-equipped smart phones
low budget applications
printing in smaller areas or sizes
fast reading
An error correction ability to recover up to 30% of the "codeword"
A capacity to be read or tracked in any direction, and to tolerate
bending distortion.
Cost comparison of 2D and RFID
Conclusion of this comparative
The main conclusion of this comparative assessment is
that the use of 2D codes, and QR codes in particular,
presently embodies the best choice for setting up
automatic patient identification capabilities in lowbudget public health care centers. The use of QR codebased tag technology, when combined with mobile
smart phones as code reading and decoding devices,
seems to be the most practical and cost-effective
alternative available today for automatic patient
identification, as well as for quick remote health record
access, by medical personnel in public health care
systems with limited budgets.
Use of QR code in healthcare
Source: http://www.gs1jp.org/2010/barcodes_identification/1_6.html
Use of QR code in healthcare
Source: http://www.gs1jp.org/2010/barcodes_identification/1_6.html
The Patient Safety
Education Program poster
Common patient safety issues:
•Insisting on proper hand hygiene from
your caregiver
•Preventing an infection when you’re
having surgery
•Preventing a blood stream infection
•Preventing medication errors
•Preventing an infection when you have a
urinary catheter
•Preventing errors during medical care
•Preventing patient falls
•Safety when your loved one is on a
•Patient’s Guide to a Clean Healthcare
Source: http://healthnewstexas.com/5715/quick-response-codeenabled-patient-safety-education-program-launched/
QR code generator
Thank You…

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