Posted by Steve W, 9/23/2008 5:57:39 AM

Don't forget to checkout ECRI's web-conference on this topic tomorrow.

This issue is much larger than RFID as there needs to be a comprehensive evaluation of all the wireless technologies that are invading the healthcare environment.  

Also, medical equipment manufacturers need to be more open about the electromagnetic compatibility of their products.

Posted by Larry Clayton, 9/23/2008 12:29:41 PM

This is a good example of someone trying to push an idea by quoting tests that do not use realistic parameters.

Posted by Dara McLain, 9/23/2008 8:32:02 PM

As a member of Maintenance Team 23, an international committee whose task it is to update IEC EMC Medical test standards to current environments, I can assure you that manufacturers are VERY concerned about EMC.

What some don't seem to understand is that the use of everything (medical and non-medical) in the healthcare environment must be managed, as all environments are unique, no matter how current standards are. It is impossible to predict what non-medical devices a user will install or use, which are not governed by medical standards.

The assumption that manufacturers must manage that for you is asking for problems. The first step to understanding what this involves is to learn about the products you have and use, and take the steps necessary to assure they don't interfere with each other. Technology is not perfect, and never will be.

And the second step is getting all the facts. As the first blog here states, the initial testing of the RFID published by AMA was done unrealistically. I remember similar testing of cell phones 10 years ago that created the same widespread panic.

Posted by VSarmiento, 9/26/2008 7:57:17 AM

EMI is an unwanted electrical phenomena that will require special attention to effectively minimize.  It is a varying and a site specific problem that is unique to a particular site or installation, and therefore will require specific solution tailored to that institution. Some published preventive guidelines can be adopted and maybe helpful in minimizing its harmful effects.

Since every piece of electrical equipment installed produces EMI, it is also up a certain degree susceptible and vulnerable to other EMI emissions.  

EMIs can be additive or subtractive in nature. Beside knowing the equipment specifications and EMI characteristics, it is advisable to know how the particular make and model will behave in your particular environment before finalizing installations.

It is therefore recommended to have an initial RFI survey be conducted before and after any equipment installations.  This will not only serve as a reference footprints, it will be a helpful tool in identifying potential "EMI Hot Spots" of a particular site.

Remember to include all facilities, housekeeping, EMS', etc. handheld as well as stationary radios  operating at full power when conducting the initial RF footprint surveys. Since communication equipment are effectively affected by the atmosphere's ionization levels, it is suggested that several RF surveys be conducted in varying times and days.

Posted by Jim Hughes, 9/26/2008 9:40:12 AM

I disagree that we are asking for problems expecting manufacturers to develop equipment that is immune to EMI.  It should be our job to choose equipment from reputable vendors and to verify that they are following mandates and protocols regarding EMI.  It seems ridicules to assume that Biomed departments have the resources to take on the responsibility of testing a design as this is something that manufacturers should be doing.  Now older equipment that was not designed under the newer standards will be the exception.  Each facility should make an effort to identify these devices, specifically life support devices, and perform appropriate testing.  It has been my experience that it is not the equipment that is operating within it normal parameters, but rather equipment that is malfunctioning that can cause the most trouble.  I have witnessed several examples of an RF emitting device that appeared to be operating normally, yet was causing interference with another device, one of which was a cell phone.  It was later determined that the devices were spewing RF outside the expected frequency.  In nearly all of these incidences the device affected was non-medical and proximity was, as expected, key.  I have also experienced one instance where the affected device was a medical device.  This involved a jet ventilator and a handheld radio.  When the radio was keyed within 1 meter, the ventilator shut down with no audible or visual indication that anything was wrong.  The radio was tested and no problems found.  The ventilator manufacture later developed and installed an upgrade for EMI shielding.  

I don't know what the final answer should be, but we do need to expect that manufactures are performing their due diligence regarding this matter and protecting their equipment from EMI.

Posted by Dara McLain, 9/27/2008 9:53:38 AM

Kudos to V Sarmiento. That's what I LOVE to see!

Posted by j scot mackeil cbet, 9/27/2008 10:44:08 AM

regarding dara mclain from philips article about UPS systems and power quality.  her advice is commendable but not well practiced in the feild by philips engineers.  when they installed our new cathlab, they went out of thier way NOT TO provide UPS protected circuits from the cathlab power distribution unit to the physiologic monitoring, displays and computers simply because they were provided by mckesson and not philips.  the first time a power event happened to the new room, the C-arm stayed up but all the monitors and computers went down and the surgical team was blind unitl everything rebooted and and came back up on emergency power.

i hope philips might learn that having a "they cant play in our sandbox" attitude when it comes to a multivendor collaborative project is not in the best interest of customer service and patient safety.

i would be interested to know if they might willing to rectify this oversite after the fact?

Posted by Dara McLain, 9/29/2008 11:36:40 AM

Scott,

That is an issue you would have to take up with the local team you did business with. Hospital power and emergency power is ultimately the responsibility of its owner, and the power company who supplies it. Every hospital should be aware of its power distribution, and power quality, as well as the capabilities of emergency back-up power.

My goal is to help Healthcare facilities understand how to manage their own environments, and not depend on others to do it for them.

Posted by VSarmiento, 10/2/2008 3:38:54 PM

Since almost all medical instrumentation are electrically operated, all power outlets used in patient areas should be checked not only for correct phasing, polarities, etc., emergency back up power should also need to be ascertained and tested on a regular basis.

UPS' are an essential back up component on all computerized based systems where proper operating conditions mainly depends on its internal batteries. Battery conditions should need to be established and tested regularly. A proper operating UPS' will ensure and enable the proper sequence of powering down of the system, thereby avoiding catastrophic data losses as well as damaging system configuration.

The testing functions is internal to the hospital, jointly coordinated and collaborated between Biomed, IT, and Facilities or Engineering Departments.

Posted by Tim Burke, 10/5/2008 1:32:20 AM

I participated in the ECRI RFID web conference with our IT department, who is leading the project to install 802.11 RFID in our hospitals.  It was a very good webinar, and Barbara Christe and Rick Hampton were very knowledgeable, even eloquent presenters.  The presentation was helpful to support my concerns to both our IT department and our major RFID vendor, who are both quick to minimize any underlying technical concerns with RFID interference.  

We are now doing our own testing, which is challenging considering the lack of resources available to a typical community hospital biomed department.  But at least we ARE testing, and our Quality executives will evaluate and approve our test methods and results before we implement RFID.

I know RFID vendors are in a tough position to offer any type of technical assurance of risk free use of their system, but they have much more engineering resources than most hospitals.  Our vendor's CEO issued a statement that their system should be safe, but it's up to the end user to validate for certain.  Then they reference ANSI C63.18, which I ordered and read.  

This document, written in 1997, describes ad-hoc testing methods for higher power devices such as cell phones and 2 way radios, not low power active RFID tags.  Furthermore, the general theme was how to keep the RF fields AWAY from medical devices, where with RFID we are intentionally attaching an RF transmitter directly to an electronic medical device, with the transmitter perhaps one inch from electronic components.  I felt it was a desperate move by our vendor to absolve themselves of liability.  

I don't mean to be negative, but I feel like there is little support for the end user.  Overall, I am enthusiastic about RFID's benefit, once we eventually get by these start up issues.

Side comment - I hope this 24x7 blog is successful and gets a lot of use.

Posted by V Sarmiento, 10/7/2008 5:32:27 AM

Thank you Dara McLain, glad to be of assistance by sharing some of my previous experiences..

Posted by Bill R., 7/6/2009 9:08:57 AM

Hello,

I just stumbled across your blog. I hope to see more posts on medical devices, since that is my area of expertise.

Thanks