Guidelines for the Use of RFID Technology in Transfusion Medicine

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2 GuidelineFig. 2 Different tag and reader designs: (a) Radio Frequency IDentification (RFID)-labels in different sizes, (b) tags integrated in plastic chips, keys, wristbands,glass bottles and laboratory tubes, (c) handheld with barcode and RFID reader, (d) PDA with RFID reader module, (e) gate reader.Read ⁄ write: includes a chip with designated memoryblocks that can save and update user-defined data at differentstages. Some read ⁄ write tags have permanently lockableor password-protected memory that preventsaccidental alteration of key data.Kill command: an RFID special command designed forpermanently erasing the memory and disabling the tag sothat it cannot be read by any reader.2.1.2 ReadersReaders have an antenna that sends and receives electromagneticwaves to exchange data with the tag. Power foroperation comes from a main or battery power supplydepending on the reader type. Some readers are designed toread and show tag information only; others include a processorto run software on the reader. The received informationcan be sent to servers directly through dockingstations, or via wireless networks. There are many types ofreader designs and functionalities that are optimized foruse as handheld readers, stationary readers, reader gates,tunnels, and equipment-integrated readers (Fig. 2). Somehandheld readers are available with barcode reading capabilityin addition to mixed data carrier usage. Gates andtunnels often allow the identification of individual tags in agroup. Very fast reading of all UID in a group is called‘‘inventorying’’ or ‘‘bulk reading.’’2.1.3 FrequenciesRFID systems can work on different frequency bands(Fig. 3):Low Frequency (LF); unlicensed use is allowed in mostcountries but there are, however, differences in practice.Typically, frequencies at 125 or 134 KHz are used.High Frequency (HF) at 13.56 MHz is available for unlicenseduse in nearly every country, because of theLF300 MHz2·45 GHz13·56 MHz 868-956 MHz 5·8 GHz0·1 1 10 100 1000 10,000Fig. 3 Allocated radio frequencies used for Radio Frequency IDentification(RFID) technology (LF, low frequency; HF, high frequency; UHF, ultrahigh frequency).MHzdevelopment and wide deployment of ISO-standardizedcontactless financial smart cards and an increasing numberof passports using RFID technology.Ultra High Frequency (UHF) covers the widest range offrequencies. Because of conflicts with assigned cellulartelephone frequency bands, UHF tags use different frequenciesin Asia, Europe and the Americas. Most major countriesapproving unlicensed use have some spectrumallocated between 860 and 960 MHz. These tags have thelongest range because of the power levels allowed. Allowedpower levels in radio regulations for unlicensed use of2455 MHz vary dramatically, largely because of health andsafety concerns in different countries (Note: this frequencyband is shared with other types of devices including wirelessLANs and microwave cooking ovens).The physical and operational properties of RFID systemsand how these are influenced by biological materials isdependent on the frequency and power levels used(Table 1). The read range is influenced by the form of thetag, type of reader, frequency used, and environment.Because the readers (and active or beacon tags) employactive radio transmitters, the use of RFID tags is subject togovernmental radio broadcasting regulations.Ó 2010 The Author(s)Journal compilation Ó 2010 International Society of Blood Transfusion, Vox Sanguinis (2010) 98 (Suppl. 2), 1–24
Guideline 3Table 1 Characteristics of frequencies used and some usual applicationsFrequencyReadrangeCoupling method;Biological influenceApplicationsLow frequency 0.1–0.3 m Magnetic field coupled; low impact bywater and cellsHigh frequency 0.1–1.0 m Magnetic field coupled; weak impact bywater and cellsUltra high frequency 0.1–10.0 m Electromagnetic field coupled; rangestrongly affected by water and cellsPersonnel access control, storageadministration, animal identificationTransfusion medicine; medical andpharmaceutical items; ‘‘smart cards’’for identification and financialtransactions; transit passes; logisticsand asset management; anti-theftelectronic article surveillanceCase and pallet level supply chainlogistics; auto and sea containertracking; automatic toll collection2.2 Automatic-Identification and Data CaptureMethodologiesAutomatic Identification (Auto-ID) encompasses a host oftechnologies that help machines identify objects or persons.It is often coupled with automated data capture and so theterm Automatic Identification and Data Capture (AIDC) iscommonly used as a technology umbrella. AIDC systemsmay include barcodes, RFID, magnetic stripe cards, smartcards, optical character recognition (OCR) and biometricsamong others. Linear barcodes are ubiquitous in transfusionmedicine today. There are defined standards for severalBarcode formats (see 10.3.1).Linear Barcode symbologies use parallel black lines andwhite spaces of varying widths. A number of standardizedsymbologies are used such as Codabar, Code 128, Code 39,etc. The current standard linear barcode for use withintransfusion medicine is Code 128, referred to in this contextas ISBT 128 [1].Multi-Row Barcodes exploit the principle of linear barcodesymbols but feature multiple rows capable of containingup to over a thousand characters and in some cases canbe further expanded for data capture functionality. Examplesof symbologies used are Codablock and DataBar.Two-Dimensional Barcodes (2D) are complex printedforms with a high capacity of characters that support errordetection and correction so that even damaged symbols canbe read. These codes require image scanners to read them.A single 2D barcode can hold all the information currentlyheld in multiple linear barcodes. Symbologies used are DataMatrix, PDF 417 and MaxiCode. The current standard 2-Dsymbology for use within transfusion medicine is DataMatrix.RFID and barcode technologies have different characteristics(Tables 2, 3). The strengths and weaknesses of eachtechnology must be evaluated together with the context ofthe application and the implementation environment.3. Advantages of RFID Solutions3.1 RFID Solutions in GeneralAlthough RFID technology has existed since World War IIthere has only been a surge in development of commercialapplications within the last 10–20 years. The primary reasonfor this is that the development of integrated circuittechnology has resulted in higher storage capacities,quicker data processing and lower tag costs leading to newopportunities. Another reason is the increase in throughputof materials and goods because of improvements and innovationsin the manufacturing process.Printed barcodes remain the most widely used AIDC systemto identify materials in processing systems. They arecheap and reliable, but with demand for increased speedand higher throughput the reading of these codes canbecome a limiting factor and therefore new solutions maybe required. RFID provides a more rapid reading technologythat does not require line-of-sight and can operate overlonger distances. In some industries, the benefits havealready been realized and commercial applications are inroutine use (Fig. 4).3.2 RFID Solutions in HealthcareIn health care environments, the potential for improvingsafety through better process surveillance and reducinghuman error, together with the possibility of more efficienttreatment processes, has led to a number of trials of RFIDapplications.However, despite a recognized potential for improvementin patient safety, RFID technology deployment inhealth care is limited beyond generic supply chain applications.It is only recently that significant specialized healthcare applications have emerged. It is likely that this isbecause of a number of factors, including:Ó 2010 The Author(s)Journal compilation Ó 2010 International Society of Blood Transfusion, Vox Sanguinis (2010) 98 (Suppl. 2), 1–24
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