Challenges and breakthroughs of RTLS application RFID technology in hospitals 2009
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In the “2008 RFID Application Promotion Achievements and Seminars” hosted by the “Ministry of Economic Affairs”, the basic life care services of the Hualien Yuli Hospital of the “Department of Health” attracted attention from the participants. Residents lost, fell, and approached dangerous areas in the hospital area. In practical application services such as movement path recording, active RFID technology is used to capture active RFID tags worn on the wrists of residents in the tested hospital area, and accurately report them to the back-end software management platform, as the hospital’s medical management staff. Analysis and evaluation of residents’ behavior patterns. In 2007, the author had the honor to participate in the development and implementation of this “RFID Personnel Real-time Tracking and Location System”. The valuable experience in the process of overcoming various types of problems presented before and on-site has become a copy of the similar medical system in the future. This is a model; the following is to share with you the process and experience of overcoming important problems discovered during the implementation of the project.
Privacy discussion
The “Department of Health” Hualien Yuli Hospital’s “RFID Personnel Real-time Tracking and Positioning System” was built to explore the appropriate and legal medical and health management mechanism, and it can provide the residents of the hospital with the technology to identify the identity and locate the mobile location. The privacy concerns caused by the wearing of active RFID tags by residents in the middle of the project are suitable for the “Mental Hygiene Law of the Executive Yuan Department of Health” (published in the “Republic of China” on December 7, 1979, and the latest revision on July 4, 1996. Japanese) is the source of law for interpretation.
According to the interpretation of Article 25 of the “Mental Hygiene Law”, prior written consent of patients should be obtained before clinical studies that are not human trials are conducted. If the patient is incapacitated or with limited capacity, he must obtain the written consent of his legal representative, spouse or nearest relative in advance, as well as the written consent of another specialist who considers the research/treatment to be necessary; the patient has no statutory requirements If the agent, spouse, or nearest relatives cannot obtain their consent, they must obtain in advance written documents that the other two specialists consider the research/treatment department to be necessary.
Article 24 of the “Mental Health Law” also stipulates that in the process of clinical research, if it is necessary to collect relevant information, it is necessary to conduct interviews with patients, or when recording and recording patients, special attention should also be paid to the needs of researchers. To get the consent of the patient himself, the consent of the family members must also be obtained at the same time.
During the execution of this project, the “Chunghwa Telecom Research Institute” and the “Department of Health” Hualien Yuli Hospital conducted extensive and detailed discussions and research on legal issues regarding the privacy concerns arising from the above-mentioned medical and health management mechanisms. Traditionally, the management of residents in the hospital area uses wristband text markings. The behavioral ability of the residents in the hospital area can easily cause the handwriting to be blurred or broken and make it impossible to recognize; the dynamic tracking of the residents in the hospital area includes: the physiological information of the residents in the hospital area, emergency messages Communication and management of the scope of activities cannot be accurately grasped; in view of the fact that this problem has not been effectively solved for a long time, it is planned to build an “RFID personnel real-time tracking and positioning system” to integrate the movement dynamics, physiological information, emergency information and other information of the residents in the hospital. Be computerized to facilitate hospital management and improve the quality of medical care for residents in the hospital.
In order to implement the requirements of the Mental Health Law on psychiatric institutions and medical staff in the above content, this project will follow the relevant provisions of the Mental Health Law when wearing active RFID tags on the wrists of residents in the mental illness tested hospitals. , Select suitable residents of the tested hospital area and establish good communication and written consent by the hospital and their families. Begin to carry out the work of active RFID wear of the wrist of the residents in the hospital, which can effectively reduce the suspicion and privacy concerns of the residents of the wrist RFID wearing in the hospital, and can maximize the benefits of the active RFID technology in the medical hospital. Full play.
Real Time Location System (RTLS) established
RTLS (Real Time Locating Systems) uses RFID technology for positioning, and its development background comes from radio frequency positioning technology. RFID uses wireless network architecture to first divide the plane space into many sub-spaces. In the system setup stage, the signals of different RFID readers received at different positions and different directions are measured, and a radio index map (Radio Index Map) is established according to the strength of each signal. Then the system locates the user and compares the intensity of the user signal received from the RFID reader with the radio index map, and quickly completes the user’s positioning mark.
The current applications of the RTLS market are summarized in Table 1 below:
Table 1. Summary table of current RTLS market applications
This project can cross obtain the real-time positioning system of the time difference between two points according to the active RFID readers. It uses 433.92MHz active RFID products conforming to ISO/IEC 18000-7 to track hygiene through active RFID readers. Department of Hualien Yuli Hospital’s time and route of travel of residents in the tested area of the hospital to analyze the basic physical condition of the residents (currently only providing information on walking and stationary), and convert it into useful information through RFID intermediary software, and place it On the database server.
Through the web server of the residents’ real-time dynamic system, the hospital provides the management needs of the hospital’s medical management personnel. By setting the access rights of different personnel, it can understand the residents’ latest tracking personnel’s movement trajectory information and provide real-time alarm messages.
In the future, this project can be converted to a more accurate Time of Arrival (TOA) positioning technology. According to the active RFID readers, the cross-acquired distance and the time difference between two points can be used to calculate the seat of a specific person.标 location.
RTLS simulation verification
The original test environment of the RFID intermediary software of this system uses 10 active RFID readers and 400 active RFID tags. It took three months to test in a harsh test environment full of various interference waves. verify. During the test, after environmental testing and verification, it was found that the active RFID reader under test reads the active RFID tags “sequentially” on the same aisle. This method and the active RFID reader required by this project must be able to ” At the same time, a large number of active RFID tags reading 100~200 per minute do not meet the requirements; after the R&D personnel communicate and coordinate with the original agent, the active RFID readers and active RFID tags are replaced; the difference lies in the active The RFID reader is changed from the “sequential” reading method to the “simultaneous mass” reading method, allowing managers to instantly read the active wrists worn on the wrists of residents in the cluster at the same time and in the same activity area. RFID tag.
After replacing the active RFID related equipment, re-developed the intermediary software and conducted various interference radio wave environmental tests. With 10 active RFID readers, each active RFID reader can sense 200 active RFID readers per minute. The goal is to test and verify the system with RFID tags, and simulate various use environments indoors and outdoors to verify the systems one by one.
RTLS on-site construction
During the on-site construction of the Hualien Yuli Hospital of the “Department of Health” (Figure 1), the active RFID readers at each test point and related management and control computers and networks were built first; mainly for the public use of each ward on the site A wooden material type A ladder and an active RFID reader are erected at the doorway of the toilet in sequence, and installed on the inside of the doorway about 170 cm above the ground, and an adjustable attenuator is used to connect the active RFID reader Set the Power Range to the minimum value, start testing and adjust the sensing distance between the active RFID tag and the active RFID reader at the best effective distance.
Figure 1. Location map of the campus
After discussions between the “Telecommunications Research Institute” and the “Department of Health” Hualien Yuli Hospital, the ward and the toilet door near the ceiling are the places where the hospital can accept active RFID readers. Refer to the best on-site construction test results of each test point, and finally select 7 best construction points, install a shield protection box on the ceiling of each ward and public toilet, and use a fixed attenuator with an active RFID reader The extractor is installed in the shield protection box. And after placing an active RFID tag for detection in the mask protection box, then lock the mask protection box; at this point, the best effective sensing distance between the active RFID tags and the active RFID readers is completed.体装置。 Body device.
After the R&D colleagues of “Chunghwa Telecom Research Institute”, “Chunghwa Telecom” Hualien business and guest colleagues, and hospital medical management personnel conducted a comprehensive inspection on the site of the hospital and confirmed that it was correct, the system was officially launched on December 20, 1996. Operation.
Simulation verification of human-vehicle integration system
This project also considers the case application of personnel integration in medical vehicles. The medical vehicles are equipped with residents and medical personnel in the hospital, and the personnel on the vehicle wear active RFID tags within the effective setting range to verify the identity recognition function. Effectively realize the recognition reliability and stability of the active RFID tag of the personnel on the vehicle when the vehicle is traveling. When planning the RFID identification system for people and vehicles in future medical institutions, Fuli will provide an effective and specific plan for actual construction and system operation requirements on the spot.
At the human-vehicle integration test site (as shown in Figure 2), an active RFID reader is planned to be installed and set up at a fixed point, and the vehicle and its personnel wear active RFID tags. Detects moving vehicles at different speeds, and only considers vehicles without heat-insulating paper windows.
Figure 2. Field test diagram of human-vehicle integration
On-site reading rate test items: vehicle identification reading test, vehicle personnel identification reading test. The test results are as follows:
1 Vehicle recognition reading test
1.1 Speed 10km~60km (active RFID tag fixed on the right rear seat of the vehicle): The correct reading rate is 88%.
1.2 Speed 60km~120km (active RFID tag fixed on the right rear seat of the vehicle): The correct reading rate is 86%.
1.3 Speed 10km~60km (active RFID tag fixed to the windshield of the vehicle): The correct reading rate is 100%.
1.4 Speed 60km~120km (active RFID tag fixed to the windshield of the vehicle): The correct reading rate is 100%.
2 Personnel load reading test
The speed is 10km~120km, the result is that after adjusting the low density (thin) and high density (fat) human body, the average reading rate is 100%.
The test data presented after the above-mentioned on-site verification and system adjustment shows that the correct data displayed by the active RFID tag fixed on the right rear seat of the vehicle cannot reach 100%; the main reason is that the active RFID reading is confirmed after analysis. The installation of the device is mainly based on reading the active RFID tags at the windshield, and due to the metal barrier of the car body, the angle of the active RFID reader cannot be fully covered; in addition, it is also possible to increase the speed of the vehicle under the same hardware test conditions. Due to the metal shielding of the car body and the angle of the active RFID reader, the accuracy of data reading will drop by 2%.
When carrying active RFID tags on the human body, such as those who overcome low-density (thin) and high-density (fat) subjects (inhabitants of the hospital) and at a certain distance; because the active RFID tags are placed on the chest and Riding in the front seat of the vehicle; in this way, the metal blocking rate of the vehicle body is relatively reduced, and the correct reading rate of the data is greatly improved to 100%, and the effect of increasing the speed of the vehicle is minimal.
Future outlook
The “New Plan for Economic Revitalization-Expansion of Public Construction Investment-“Accelerating the Handling of Smart Medical Care Plan”” by the “Executive Yuan Department of Health” was passed at the 1352th committee meeting of the Economic Development Council on February 10, 1998; the Department of Health aims to strengthen hospitals Service safety and improvement of the gap in the quality of medical care in disadvantaged and remote areas, proposed the “Accelerated Smart Medical Care Plan”, including the “Hospital Safety Care RFID Plan”. Because of the four indicators of this plan, the two goals related to this study are:
1. Establish and improve service management processes to improve patient service satisfaction.
2. Correctly and instantly monitor the warning environment, save labor costs, and provide medical safety care.
The “Hospital Safety and Care RFID Program” sub-program is to introduce RFID technology into the hospital information system in order to strengthen the safety of hospital services; and use advanced network communication and information technology to establish a high-quality medical service model and provide safe care for patients Correct and timely process management system; content includes medication safety, medical process management, long-term care, isolation ward and access control management, etc.
The research and development results of the basic life care service system of Hualien Yuli Hospital of the “Health Department” ended in accordance with the cooperation agreement signed between the “Chunghwa Telecom Research Institute” and the Hualien Yuli Hospital of the “Health Department”; however, this model can be expanded and applied in the future. In medical institutions such as nursing homes, dementia elderly, psychiatric wards, operating rooms, respiratory care wards, baby rooms, dangerous control areas, isolation wards, thoracic treatment wards, infectious disease wards, etc. With the advent of an aging society, in addition to the increasing number of residents in the hospital, the types of medical applications will also diversify. With the RFID application of RTLS network communication and information technology in this case, in the future, this model can be used to provide process management services in a real-time manner, and to establish high medical quality of safe, real-time, and correct patient care.
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