The University Clinic of Jena is one of the most modern hospitals in Germany. It relies on a foundation of a uniform IT landscape based on SAP software for comprehensive modeling and linking of all patient administration processes, including diagnostics and therapy, along with human resources, purchasing, materials management, and accounting.
Better treatment quality with innovative solutions
The hospital uses SAP R/3 Enterprise (the functionality is now available in mySAP ERP) as its core solution, along with the hospital information system of the SAP for Healthcare solution portfolio and the SAP NetWeaver platform. From this core set of software, the clinic develops new, innovative solutions for continuous improvement of the quality of treatment as part of comprehensive quality management.
To improve patient safety, the clinic early on converted to individual doses, called unit dose forms, to administer medication. US studies have shown that the medication given to about 20 percent of patients in hospitals is incorrect in some way. In addition to potentially major damage to a patient’s health, incorrect medications can also raise healthcare costs. According to a Spanish study, the costs for offsetting treatments can run to €3,000 per patient. And according to a study undertaken by the U.S. National Institutes of Health, the costs can run as high as US $8,000.
Medications broadcast the correct dosage
“We must aim at electronically and seamlessly monitoring and documenting the transportation of a medication from the clinic’s pharmacy to its distribution to a patient,” says PD Dr. Michael Hartmann, director of the pharmacy at the University Clinic of Jena and a member of the European Council on Pharmaceutical Issues. The clinic thought that it could best handle this task with an RFID solution based on the SAP Auto-ID Infrastructure component of the SAP NetWeaver platform. Intel Solution Services was selected for the corresponding hardware infrastructure of RFID tags, along with the reading and receiving units.
With the solution, the clinic can seamlessly integrate all the data read from the RFID tags into its back-end enterprise resource planning (ERP) software and the hospital information system. The application is also scalable, which allowed the University Clinic of Jena to start a manageable and economical project for 89 beds in intensive care. The clinic plans to develop the use of RFID over the long term and implement it in stages.
RFID data linked to business processes
When it began implementing RFID technology, the clinic identified three core processes for supplying medications and combined them into a single, comprehensive process with the help of the RFID solution from SAP. The core process covers medication safety, the tracing of containers and medication packaging for the intensive care unit, and digital allocation of medications to each patient.
Here’s how it works. The SAP Auto-ID Infrastructure component receives, processes, and stores the electronic data captured by the handheld devices. The data is then translated into an SAP-supported data format and transferred to the SAP NetWeaver Exchange Infrastructure (SAP NetWeaver XI) component. SAP NetWeaver XI serves as a central data turntable. It controls the direct exchange of information between the RFID tags, the ERP solution, and the hospital information system, linking the data that has been read directly into business systems.
In the real world, a compressive process mediated by software covers everything from prescribing a medication to having a patient take it – including automatic documentation, consultation, and ordering. If a physician uses the electronic patient chart to prescribe a medication for a patient, the pharmacy order is generated automatically. An in-house pharmacist checks and verifies the order. The clinic pharmacy then individually picks the medications for each patient. All medications are given an RFID tag and then delivered to the appropriate nursing station.
The patients wear RFID bracelets with an identification code. When medications are dispensed, hospital personnel read the code with a handheld scanner to check if the patient is receiving the correct medication in the correct dosage and at the correct time. Exact data on the type of medication, the dosage, and the time of dosage are automatically called from the hospital’s electronic patient chart and displayed on the reader. Once the patient has received the medication, the procedure is documented in the patient’s chart.
“In this manner, we drastically minimize the risks of incorrect medication and improve the quality of care,” says Hartmann. Today, the clinic pharmacy can also forecast and control the replenishment of medications with greater accuracy. Medications are ordered from vendors in the exact amount needed by the nursing stations, so the hospital can order smaller quantities and reduce costs.
Exact calculation of contribution margins
The RFID solution also posts the medications used by patients during their hospital stay directly into the accounting system and determines the costs of medication for each case. This procedure ensures reliable and detailed cost accounting and enables the exact calculation of contribution margins. “Since the implementation of a uniform compensation system based on diagnosis-related groups, the ability to capture key performance indicators for the business is an important competitive factor for hospitals,” says Dr. Peter Langkafel, project director and senior business consultant at SAP.
“RFID technology offers hospitals a clear business benefit,” says Langkafel. They can immediately and exactly record the effective costs for materials used in operations or the time that devices were in use during all operations, be they appendectomies, hip replacements, or the breakup of kidney stones. RFID tags attached to medical apparatuses like defibrillators or to hospital property like beds and gurneys limit the risk of theft, reducing replacement costs.
That’s another reason why market researchers like Idtechex, a research and consulting firm, forecast a significant increase in RFID investments in the healthcare industry next year. By 2016, investments should increase from the current $90 million to $2.1 billion.
Developing medical expertise
Langkafel believes a greater focus on business parameters like improved quality management has accelerated the use of RFID in the healthcare industry. The University Clinic of Jena is a good example of this trend. In the future, the clinic plans to use RFID technology to develop its medical expertise further. Electronic documentation of dispensed medications enables the hospital to discover anonymously any not yet known incompatibilities of specific mediations, so it can identify alternate medications quickly.