Identitovigilance technologies

Transcription

1 Identitovigilance technologies Typologies and future developments Séverine Dewerpe, Healthcare & Barcodes Manager, GS1 Belgilux Tuesday, 10 th of March 2015

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3 million 3

4 30 years 4

5 Agenda The need for global standards What is GS1? Why Identitovigilance Unique Identifiers Available technology Use cases Documentation and References 5

6 Why do we need global standards? 6

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8 Why global standards? Lack of standards in daily life is inefficient and annoying 8

9 Why global standards? in healthcare it is dangerous and inefficient! Multiple bar codes on one package which one to scan? Different types of bar codes inconsistency; incompatibility No bar code need to bar code; re-package; re-label 9

10 Why global standards? Mr. John Smith Mr. John Smith Same name patient 10

11 Why global standards? Speak one language Will reduce complexity in the healthcare supply chain and within a hospital 11

12 What is GS1? An international standard organisation Not-for-profit 111 Member Organisations Over one million user companies (from SME to global companies) Member driven 150 countries served; 20 different domains 2,500 people helping us Over 6 billion transactions a day 12

13 ACT LOCALLY THINK GLOBALLY 13

14 What is GS1? The healthcare supply chain To lead the healthcare sector to the successful development and implementation of global standards by bringing together experts in healthcare to enhance patient safety and supply chain efficiencies. 14

15 Global system of standards 15

16 Why is identitovigilance important in a hospital? 16

17 Identitovigilance What is that? = Monitoring and prevention system linked to misidentification of patients This means that: Patient identification is crucial Patient monitoring Need to link everything and everyone during the patient s journey 17

18 Identitovigilance Patient s Journey = When an individual is entering a clinical care setting and commence a series of steps along a continuum of patient care. STARTS at patient admission and ENDS with his discharge! Admission Health procedures Discharge This means, it is the interaction between patient and the healthcare facility system 18

19 Identitovigilance Actors involved Patients All healthcare providers Administration PARTNERSHIP BETWEEN PATIENTS AND HEALTHCARE PROFESSIONALS There is a need for identification systems that will allow unambigous identification throughout the patient journey! 19

20 Identitovigilance How do we start? Need for unique identification of patients and everything within Need for technology to automatically capture information?? 20

21 Unique Identifiers The need for unique identifiers WHO? PATIENT RECORD WHAT? BY WHOM? WHERE? 21

22 GS1 Identification Keys Global Standard GS1 Identification Keys are: Unique Non-significant International Secure Foundational And most importantly Used by millions of companies and organizations! 22

23 Unique Identifiers Every medication given to a patient must carefully be recorded 23

24 Unique Identifiers GTIN GLOBAL TRADE ITEM NUMBER Used to uniquely identify all trade items Products or services that are priced, ordered or invoiced Provides a common language for all Used worldwide to uniquely identify the item and easily communicate information 24

25 Unique Identifiers GTIN GTIN A Single Unit GTIN D Carton GTIN B Package of 2 SSCC 1 Pallet GTIN C Box of 10 Build a hierachy of products = Uniquely identifies each product 25

26 Unique Identifiers Use of GTIN to identify WHAT a patient is receiving 26

27 Unique Identifiers Every patient movement from one physical location to another must be recorded 27

28 Unique Identifiers GLN GLOBAL LOCATION NUMBER To identify locations, giving flexibility to identify any type or level of location required To identify a company s physical locations, for example: - The hospital - Room - Care unit - Department - Operating theather 28

29 Unique Identifiers GLN GLN A Operating Theather GLN B Room/Unit GLN C Hospital Pharmacy GLN D Private Practicioner Enables a unique identification of all locations visited by the patient 29

30 Unique Identifiers Use a GLN to identify the PATIENT S JOURNEY 30

31 Unique Identifiers Every patient must be uniquely identified in an unambiguous manner 31

32 Unique Identifiers GRSN - Provider GLOBAL SERVICE RELATIONSHIP NUMBER To identify care givers, for example: - Doctors - Nurses - Surgeon - General practitioners - 32

33 Unique Identifiers GSRN - recipient GLOBAL SERVICE RELATIONSHIP NUMBER To identify care recipients, for example: - patient 33

34 Unique Identifers GSRN: Provider - Recipient Each physician/nurse is uniquely identified Each patient get a unique number used across organisations An automatic link is made between the care giver and the care recipient 34

35 Unique Identifiers GSRN Provider and recipient 35

36 Unique Identifiers Use a GSRN to identify the CARE GIVERS and PATIENTS 36

37 Unique Identifiers Every step of the patient s journey must be recorded in the patient s file 37

38 Unique Identifiers GDTI GLOBAL DOCUMENT TYPE IDENTIFIER To identify documents, including the class or type of each document An optional alphanumeric serial number can be included Used for: - Retrieval - Document tracking - Electronic archiving - Related events 38

39 Unique Identifers GDTI Each individual patient record and related document will receive a unique identifier An automatic link is made between the patient record and all of its related events and care givers 39

40 Unique Identifiers Use a GDTI to identify each PATIENT RECORD 40

41 Unique Identifiers GIAI Global Individual Asset Identifier Can apply to any asset to uniquely identify and manage Enables hospitals to record individual assets in asset management and accounting systems across hospital boundaries. 41

42 Unique Identifers GIAI A GIAI is assigned to each type of asset including a unique serial number Every single asset of the hospital can be identified. A link can be made between patients and assets used. 42

43 Unique Identifiers Use a GIAI to identify each individual ASSET 43

44 Unique Identifiers GRAI Global Returnable Asset Identifier Suitable for management of reusable items, equipment, and tools The GRAI with serial number can also be used to manage regular maintenance and record repairs Track and manage valuable returnable assets Provides greater supply chain visibility 44

45 Unique Identifers GRAI A GRAI is assigned to each type of returnable asset in order to track its life cycle Every single asset of the hospital can be identified. A link can be made between patients and assets used. 45

46 Unique Identifiers Use a GRAI to identify each individual RETURNABLE ASSET 46

47 What technology can be used? 47

48 Technology Barcode technology RFID tags Biometric technologies 48

49 To avoid misidentification, the identity of the patient must accompany him throughout its clinical care journey At any time we should know: Who it is What he needs When he needs it Who gave it to him What happened/ What will happen 49

50 Wristbands Advantages Disadvantages Portable Cheap Easy and quick Readable by all parties Widely accepted No automatic identification Errors can occur Missing or incorrect information Information not standardized Identification braclets containing basic information in written text of color-coded. But, basic technology that will not be easily redundant. 50

51 Wristbands 51

52 Barcodes 1D Advantages Disadvantages Simple to use Well known technology Inexpensive Automatic identification Accuracy Error free Limited capacity Line of sight Large amount of space Not readable for human eye Most familiar form of identification coding technology. Information can be accessed through a machine readable format. Data encoded is used as an index to a record. 52

53 Barcodes 1D 53

54 Barcodes 1D GS1-128 Barcode GSRN PATIENT GDTI + serial number GLN room

55 Barcodes - 2D Advantages Disadvantages Simple to use Well known technology Inexpensive Automatic identification Accuracy Error free Several data attributes Line of sight Not readable for human eye Need for image scanners Implementation of identification keys Most familiar form of identification coding technology. Information can be accessed through a machine readable format. Data encoded is used as an index to a record. 55

56 Barcodes - 2D 56

57 Barcodes 2D GTIN Unit Dose Lot Number ABCDEF Expiration Date 31/12/2015 Serial Number ABCDEF 57

58 RFID tag Advantages Disadvantages Tracking Not require line of sight Tags are reusable Available after the clinical care circuit Orientation dependent Expensive technology Requires magnetic induction Infrastructure needs to be adapted Radio frequency transfer of data between a reader and a tag. The tag transmits a signal through an antenna. The receiver reads the signal and transmits it to a server. Different types of tags may apply. 58

59 RFID tag 59

60 Technologies Technology Charachteristics Advantages Disadvantages Patient ID Wristband Alpha and alphanumeric characters Inexpensive Prone to error Name, DOB, colorcoding 1D Barcode Alpha and alphanumeric data characters Inexpensive and machine readable data Line of sight and limited data capacity GSRN 2D Barcode Alpha and alphanumeric data characters Inexpensive and machine readable data. Can hold large amount of data Line of sight GSRN Passive RFID characters Relatively small Short read range and limited data capacity sgsrn Semi active RFID Battery powered tag. Reader activates tag. Long reading range Hight cost and battery issue sgsrn Active RFID Battery powered tag that transmits data Real time data High cost sgsrn 60

61 GS1 in practice 61

62 Five Rights Right patient Right medication Right dose Right time Right route 62

63 Scanning at Point-of-Care Barcode-enable point-ofcare system 1. Electronic patient record - GDTI 2. Electronic prescription - GDTI + serial number 3. Patient identification - GSRN - recipient 4. Healthcare provider identification - GSRN - provider 5. Medication (dose) identification - GTIN 63

64 Scanning at Point-of-Care 64

65 NHS: eprocurement 65

66 Unique Device Identification GS1 accredited as Issuing Agency for Unique Device Identification by the U.S. Food and Drug Administration 66

67 Unique Device Identification AIDC Master Data Management 67

68 New Zealand Medication Safety Project The New Zealand Medication Safety Project is an initiative of the New Zealand Ministry of Health to reduce medication errors by introducing bedside verification of medication using a standardized GS1 barcode point-of-care system in all public hospitals. 68

69 UZ Leuven 69

70 And many more CHU Strasbourg, CHU Dijon, Saudi FDA St-James Hospital Hospitál Aléman 70

71 Lessons learned The introduction of patient identification technologie will not solve misidentification. The solution lies in defining and consistently executing appropriate processes and workflows, supported by relevant technology. It is critical that staff are engaged in the implementation of patient identification technologies. 71

72 Contact Séverine Dewerpe Healthcare & Barcodes Manager GS1 Belgium & Luxembourg E [email protected] T W 72

73 QUESTIONS? 73

74 References García-Betances R.I, Huerta M.K. (2012) A Review of Automatic Patient Identification Options for Public Health Care Centers with Restricted Budgets Online Journalm of Public Health Informatics Vol.45, No.1 Martin D, et al. (2008) Technology Solutions to Patient Misidentification: Report of Review Australian Commission on Safety and Quality in Health Care. Oct 13 McKinsey (2012) Strength in Unity: The promise of global standards in healthcare McKinsey & Company 74