How can devices used to track marathon runners save the healthcare industry billinios? Sally Whittle reports

Runners in last year's New York marathon were issued with a small patch, along with their numbered vest. The patch, which was tied to the runner's shoe, transmitted a signal to devices placed along the route, allowing anyone with web access to track the split-times of individual runners.

The technology underlying such a service is radio frequency identification. RFID is not new, it has been used in the shipping industry and the military for many years. It works by attaching small tags to anything from a crate of food to a missile. Each time a tagged item passes a reader, on a doorway for example, the event is recorded and appears in a database (see box). This means managers can tell exactly where a particular shipment is at any given time.Moreover, it is possible to analyse the tags themselves and get a history of exactly where they have been and when.

Increasingly, however, RFID manufacturers are turning their attention to healthcare.Having the ability to track and identify supplies throughout the healthcare supply chain could potentially save billions of pounds, while improving patient safety.

If manufacturers tagged drugs with RFID tags, it would be possible to reduce counterfeiting, which accounts for about 6 per cent of the total drug market in the EU, according to the World Health Organisation. It would also be possible to monitor the temperature and condition of drugs in transit, and it could be possible to reduce medication errors.

Internally, too, tagging technology could improve healthcare efficiency: a system like that used for the New York marathon could track patients in a hospital and allow beds to be turned over more quickly. Or it could monitor when operating theatres have been cleaned.

Accenture Technology Labs has been working with RFID technology for the last decade, and believes the healthcare sector could be one of the biggest users. 'The technology is still embryonic, but It is absolutely proven and viable today, ' says Jamie Hintlian, lead partner in Accenture's health practice.

Traditionally, the healthcare sector has relied on barcode scanners to perform tracking tasks. For example, Morriston Hospital in Swansea uses Symbol handheld barcode readers to scan blood supplies to ensure they match the patient's blood type. According to the Serious Hazards of Transfusion report issued by the Department of Health, 213 incorrect blood transfusions are made each year. At Morriston, mismatched blood supplies can be identified before any harm is done.

New bar-coding technology (sometimes called 2D barcodes) offers the ability to embed information into barcodes themselves. The National Blood Authority is currently trialling 2D barcode systems from Symbol which can embed up to 2,000 characters into a postage stamp-sized sticker.

Previously, deliveries from one centre to another were counted using a scanner - but all other checks were done manually and the information entered into a central database.

Delivery labels can now be embedded with information about the outgoing centre's ID, the blood group and product type of each unit. On receipt at the destination centre, the labels can be scanned and all the data automatically checked against the central database.

The system has a 90 per cent success rate and has significantly improved efficiency, says Dr Marlene Fisher, deputy director of Oxford blood transfusion centre.

The key selling point of 2D barcodes over RFID is cost: at present a barcode system costs around 20 cents per label, while a single 20cm RFID tag still costs around $1, says Mr Hintlian. 'While tags are costing $1 each, they will still be seen as expensive when compared to bar coding.'

However, RFID can justify its higher price tag because it offers more value than 2D bar coding, argues Dirk Morgenroth, segment marketing manager with Philips Semiconductor. Barcodes cannot be updated, which limits their application.

RFID tags can be updated indefinitely.

RFID tags can be used for applications such as authorisation or monitoring. For example, it is possible to put a tag onto a machine and another tag into a doctor's ID badge so that only the doctor can use the machine.

And RFID tags can usually hold more information than a barcode - most bar-coding systems are limited to 128-bits of data, while RFID tags with 20 times this capacity are widely available.

In addition, because RFID uses radio waves to communicate, it is not a line-of-sight technology.

In other words, scanning RFID tags is generally far simpler than scanning a barcode because the scanner does not have to be placed directly next to a tagged label - it needs to come within a few feet of it.

Eventually, hospitals will replace bar-coding systems with RFID, says James Urie, business development manager with Innovations R&T, a specialist in tagging systems. 'The healthcare sector has the potential to cut so much time from routine tasks that are diverting resources from patient care, 'he says.

However, there are still limitations to the technology. For example, most tags and readers can only share data over short distances, meaning that large hospitals or factories would need hundreds of tags, perhaps several on single crates or machines.

'There can be issues around physical orientation of tags, 'Mr Hintlian adds. In other words, if a tag is placed on one side of a box and the reader is on the other side, it is possible for the two devices to miss each other entirely.This is particularly true where cases contain blister packs of medication - tin foil blocks radio waves.

In addition, there are no industry-wide standards on how data is stored and retrieved. If a drug manufacturer tags products to track them through the supply chain, there is no guarantee that the doctor at the other end of the line will be able to read that tag.

There is some progress in this respect: the AutoID Centre is a non-profit organisation developing standards for RFID. It is a partnership between some of the world's largest companies (including Tesco, Gillette and Unilever) and leading research institutions such as Massachusetts Institute of Technology and Cambridge University.

Ultimately, the healthcare sector is likely to rely on a combination of bar coding and RFID technology to manage goods and processes.According to Tom Harwick, a research director with technology analyst Giga Information Group, most organisations will use RFID to monitor high-value goods and bar coding for less valuable supplies.

'RFID is becoming a mainstream technology, and should be considered as an alternative to bar coding in some areas, ' he says. 'But It is about being sensible - that means not tracking shipments of office supplies with tags at $1 a time.' l