Healthcare professionals have long been facing a common pressure known as the “triple squeeze.” The rising incidence of chronic diseases, an aging population, and a shortage of healthcare workers mean that medical staff are being asked to do more with fewer resources. Everyone hopes for solutions that can save time and resources for these frontline workers, allowing them to focus on what they do best—spending time with patients.
According to data from the BMA, in the UK alone, 7.22 million people were waiting for treatment in February 2023, with 3 million patients waiting more than 18 weeks. Among them, approximately 362,500 patients had been waiting for treatment for over a year, a figure 169 times higher than before the COVID-19 pandemic began.
There are many types of surgeries, such as cataract surgery and cesarean sections, and each operating room has a corresponding sterile surgical kit. Once a surgery is completed, the used instruments need to be packed and sent to a sterile services department, often located at a separate site. Typically, these kits are wrapped in plastic to protect them from airborne bacteria, then coded and stored for future use.
While this sterilization process is theoretically excellent—it is prone to errors. Imagine if a surgeon had to perform multiple surgeries using the same limited set of equipment. How can we ensure that the trays are used within their shelf life after re-sterilization and in an efficient order? How can trays be traced back to patients to check if any equipment was left inside the body or to alleviate concerns about related complications?
If items are lost, the initial strategy is to search for them. However, this search can take up a significant amount of clinicians’ time each day. In one study, eight clinicians spent nearly four hours searching for relevant items.
If items are not easily found or are difficult to locate, the preferred method might be to purchase additional inventory to avoid the need for a second search. However, surgical equipment is expensive, making this approach costly. Consider the unnecessary tray cleaning due to poor inventory management, which also increases additional energy costs and carbon emissions. Then think about the inability to pinpoint the location of instruments, which, in the worst-case scenario, could lead to additional procedures like X-rays and a great deal of extra anxiety.
Speaking of X-rays, there is another type of invisible wave called Radio Frequency Identification (RFID) technology. RFID readers can be part of a broader tracking solution for items. In other vertical industries, such as retail and warehousing, RFID technology is used in stockrooms to provide instant visibility of inventory.
To eliminate “extra tasks for clinicians” through automation, RFID technology infrastructure can be strategically deployed throughout healthcare facilities. RFID antennas and readers placed around operating rooms, storage room entrances and exits, or other locations (such as processing tables or autoclaves) can report item locations. Each time an item leaves or returns, its unique identification code is automatically recorded via an RFID tag, which is carefully designed to withstand the durability requirements of medical devices, surgical instruments, or kits.
These RFID devices are connected to a database that contains data on each tracked asset, linked to the hospital’s workflow. For surgical trays, this includes the last recorded location, the time of the last cleaning, and which patients they were used with, among other details.
In fact, a hospital in the UK recently completed an RFID project for sterile services as part of a broader location solution. As a result, they can now search for surgical trays on a computer and use RFID technology to understand their approximate location in the storage room. Even if a surgical tray ends up in the wrong place, it can be found. This has significant benefits for patients, as their surgeries are not canceled due to missing sterile trays and instruments.
Risk reduction is also crucial. For example, if a cardiac surgery instrument tray is dropped, another tray can be located within seconds, ensuring minimal delays to critical surgeries. The hospital’s clinical team reported improvements in patient care, time savings, and reduced procurement costs. With RFID technology, the time spent searching for items is reduced, and sterilization becomes more efficient. Moreover, all the time and resources saved can be redirected to patient care.
U.S. regulations require that a Unique Device Identification (UDI) be placed on each surgical tool after 2020, and Europe has followed suit, planning to complete this by 2027. This is because surgical instruments have a limited lifespan and must be avoided from being lost, necessitating strict management rules for the safe use and storage of all medical devices, with comprehensive product identification rules. Additionally, even skilled and experienced operators can find setting up surgical tools time-consuming.
While the global trend is to mandate ID numbers on each surgical tool, manual recording is difficult and cannot accurately manage usage time. Assembling and checking entire sets of tools requires significant time and manpower. Laser marking can cause rust and staining, and using QR codes to read IDs one by one is very time-consuming, posing significant challenges to the management of surgical tools.
The black dot is the RFID tag, size about 6.0*2.0mm, thickness 2.3mm.
1. How RFID Tracking Prevents Surgical Instrument Errors
Managing surgical instruments through RFID technology offers significant advantages, enhancing both safety and efficiency during surgical procedures. RFID tags not only serve as unique identifiers but can also record the usage time and lifespan of surgical tools, making management easier. Using RFID handheld terminals allows for rapid batch reading, enabling operators to efficiently assemble and inspect entire sets of tools. Additionally, RFID tags can record the number of times each tool is used, reducing excessive inventory, and can track the order of use, optimizing preoperative tool preparation.
This RFID solution utilizes the Impinj Monza R6P chip, compliant with ISO 18000-63 and EPC Global Gen2v2 standards, operating at a frequency of 865-928 MHz. The ultra-high frequency (UHF) characteristics enable a read range of up to 2 meters (4W EIRP) on metal surfaces, and it can still be read even if the surface is stained with blood. It also supports simultaneous reading of a large number of instruments. In contrast, low-frequency (LF) or high-frequency (HF) RFID can only be read at very close distances and is susceptible to interference from metal and liquids.
The introduction of RFID enables full-process management of surgical instruments. Accurate reading allows for tracking the usage of each instrument, managing its lifecycle, and improving hospital inventory. Batch reading optimizes preoperative instrument preparation, and readers can be tuned to avoid unnecessary tag reads. Most importantly, it eliminates the risk of leaving surgical scissors, gauze, or other items inside a patient’s body.
2. Classification of RFID by Frequency Band
At one time, RFID, as a representative object identification technology, was synonymous with the Internet of Things (IoT) because it was the first step in realizing IoT. IoT primarily consists of three key technologies: connectivity, identification, and data manipulation. Although RFID is mainly used for identifying and tracking objects for management purposes, it inherently possesses wireless communication capabilities. This is achieved through a bidirectional wireless transceiver (also known as a reader/interrogator), which uses electromagnetic waves to send signals to tags and read their responses.
While there are numerous technologies for implementing IoT, RFID remains highly important due to its wide range of applications. According to Murata’s official website, RFID primarily uses four frequency bands: LF, HF, UHF, and microwave.
- LF Band (Low Frequency)
The LF band uses electromagnetic induction and has been in use for a long time compared to other communication bands. It is used in applications such as car keyless entry systems. Although the communication distance is short, only a few tens of centimeters, it is difficult to achieve thin and compact designs due to the need for large antennas. - HF Band (High Frequency)
The HF band also uses electromagnetic induction for data exchange but requires fewer antenna windings than the LF band, allowing for thinner and more compact designs. Operating at 13.56 MHz, it is suitable for short-range, one-to-one identification and authentication of people and objects. NFC (Near Field Communication), used in electronic money (e.g., Osaifu-Keitai) and transit cards, is a type of HF RFID. - UHF Band (Ultra-High Frequency)
The UHF band uses radio wave communication and operates at 860-960 MHz. It is suitable for applications requiring a range of several meters, such as batch reading for inventory management and automated product inspection. - Microwave Band
The microwave band falls within the UHF range and operates at 2.45 GHz. Since it uses the ISM band, which is also used in microwave ovens and Wi-Fi, it faces interference issues that require countermeasures. Additionally, its communication range is 2-3 meters, which is shorter than the 860-960 MHz band.
| Frequency Band | Characteristics | Applications | Communication Range | Challenges |
|---|---|---|---|---|
| LF (Low Frequency) | Uses electromagnetic induction. Long-standing technology compared to other communication bands. | Wireless communication systems like car keyless entry. | Short (a few tens of cm) | Difficult to achieve thin and compact designs due to the need for large antennas. |
| HF (High Frequency) | Also uses electromagnetic induction. Fewer antenna windings than LF, enabling thinner and more compact designs. | Short-range, one-to-one identification (e.g., NFC in electronic money like Osaifu-Keitai, transit cards). | Short (proximity range) | Limited to short-distance communication. |
| UHF (Ultra-High Frequency) | Uses radio wave communication. Operates at 860–960 MHz. | Batch reading for inventory management, automated product inspection. | Several meters | Less effective in environments with metal or liquid interference. |
| Microwave Band | Falls within the UHF range, operating at 2.45 GHz. Uses the ISM band (shared with microwaves and Wi-Fi). | Limited applications due to interference issues. | 2–3 meters | Susceptible to radio interference; shorter range compared to 860–960 MHz band. |
3. RFID Communication Principles
RFID can also be classified into active and passive types. Passive RFID typically refers to tags without batteries, relying entirely on received electromagnetic waves to power the circuit. The identification distance of passive tags remains constant. In contrast, the identification distance of active RFID systems decreases as the power supply diminishes.
In general, RFID uses passive tags that do not require batteries and communicate by reflecting the carrier wave transmitted by the reader.
The communication process typically involves:
- The reader emits radio waves.
- The antenna in the IC tag receives the radio waves from the reader.
- Current flows within the IC tag, converting the chip’s information into signals.
- The signal is transmitted from the antenna printed on the IC tag’s electrode.
- The reader’s antenna receives the feedback signal.
- The reader’s controller processes the data for use in PCs or other systems.
4. RFID Application Case Studies
The RFID application on surgical instruments mentioned above can be classified as passive RFID. The greatest advantage of passive RFID solutions lies in their low deployment costs. By introducing RFID to improve internal manufacturing and logistics processes with minimal cost impact, the additional anti-counterfeiting functionality can also enhance brand protection. Below is an application case study for data center cable management.
The red circle in the picture is the RFID tag, the left side of the size of 3.2 * 3.2mm, 0.7mm thick; the right side of only 1.25 * 1.25mm, 0.55mm thick, not the engineer pointed out that I did not see.
If you’ve ever seen thousands of network cables in a server room, you’d think it would be a headache to identify information about each one, but with RFID tags, it’s possible to achieve simple fiber optic identification that eliminates connection errors while reducing costs as well as saving time.
On-site demonstration, when inserted into the No. 2 fiber optic, the reader located below the interface directly read out the interface on the label data, and displayed in the terminal, so that IT engineers can confirm in a timely manner!
Wearable devices have limited space inside, RFID tags can be affixed to the outside of the body, the small yellow stickers are
RFID is also a strong point in the traceability of small items. Whether integrated within the product, or in the form of tags affixed to the product, can achieve the purpose, and not only in the electronics and luxury goods and other RFID commonly used industries, now many high-end ingredients, fruits on the stickers are equipped with the traceability of the source function.
In addition to passive and active, RFID there is a “variant” type of technology – real-time localization system (RTLS), which relies on Wi-Fi and other wireless network system support, to provide high-precision positioning. However, this positioning technology requires the deployment of edge nodes (Edge Gateway), the fusion of location, time and sensor data and other multiple information for real-time vector positioning (measuring the location, direction and speed of the target), so generally only for professional areas, such as factories, hospitals and so on.
Applications in Smart Agriculture. In addition to being able to detect and regulate CO2 concentration in botanical gardens and greenhouses with conventional carbon dioxide (CO2) sensors to promote photosynthesis, the following 13cm soil water environment sensor actually includes three types of sensors for soluble salt concentration (EC), temperature, and moisture. Among them, the high-precision EC sensor eliminates various uncertainties through multi-mode measurement with nine motors, and is capable of measuring the ion concentration of pore water.
This white body is normally buried in the soil, with a cable at the end sticking out of the soil to connect to a transceiver, which transmits to the cloud via an antenna. Generally speaking this kind of wireless transmission system for smart agriculture program requires low power consumption and long distance, such a unit uses 3 No.5 batteries, which can last for more than a year.
5. Conclusion
RFID technology has emerged as a transformative solution for surgical instrument tracking, addressing critical challenges in healthcare such as efficiency, safety, and inventory management. By enabling real-time tracking, lifecycle management, and automated workflows, RFID not only reduces operational costs but also minimizes risks associated with misplaced or improperly sterilized instruments. Seiko Tags’ innovative RFID solutions empower healthcare facilities to streamline surgical processes, enhance patient safety, and improve overall operational efficiency. As the healthcare industry continues to evolve, RFID technology stands as a vital tool in driving smarter, safer, and more sustainable surgical practices.
6. Frequently Asked Questions
6.1 What is RFID technology, and how does it work in surgical instrument tracking?
RFID (Radio Frequency Identification) technology uses electromagnetic fields to automatically identify and track objects equipped with RFID tags. In surgical instrument tracking, RFID tags are attached to or embedded in instruments. These tags store unique identification data, which can be read by RFID readers to track the instruments’ location, usage history, and sterilization status in real time.
6.2 Why is RFID better than manual tracking for surgical instruments?
RFID is faster, more accurate, and less prone to human error compared to manual tracking. It allows for real-time monitoring, reduces the time spent searching for instruments, and ensures proper sterilization and usage. Manual tracking, on the other hand, is time-consuming, inefficient, and can lead to errors such as misplaced or improperly sterilized instruments.
6.3 Can RFID tags withstand the sterilization process?
Yes, RFID tags designed for surgical instruments are built to withstand harsh sterilization processes, including autoclaving and chemical cleaning. They are made from durable materials that can endure high temperatures and repeated sterilization cycles without losing functionality.
6.4 How does RFID improve patient safety during surgeries?
RFID improves patient safety by ensuring that surgical instruments are properly sterilized, tracked, and accounted for. It reduces the risk of errors such as leaving instruments inside patients and provides traceability, enabling quick resolution of any post-surgical concerns.
6.5 What are the cost benefits of using RFID for surgical instrument tracking?
RFID reduces costs by optimizing inventory management, minimizing instrument loss, and reducing the need for unnecessary purchases. It also saves time for healthcare staff, allowing them to focus on patient care rather than searching for or managing instruments manually.
6.6 Can RFID track multiple instruments at the same time?
Yes, one of the key advantages of RFID is its ability to read multiple tags simultaneously. This allows for quick and efficient tracking of entire sets of surgical instruments, significantly speeding up preoperative and postoperative processes.
6.7 How does RFID help with compliance and record-keeping?
RFID systems automatically record detailed data about each instrument, including its usage history, sterilization cycles, and maintenance records. This data can be easily accessed for compliance audits, ensuring that healthcare facilities meet regulatory standards.
6.8 What happens if an RFID tag is damaged or stops working?
While RFID tags are highly durable, if a tag is damaged or fails, it can be replaced. Most RFID systems are designed to flag non-functional tags, ensuring that no instrument goes untracked. Regular maintenance and quality checks can also prevent such issues.
6.9 Is RFID technology compatible with existing hospital systems?
Yes, RFID systems can be integrated with existing hospital management software and workflows. They are designed to be scalable and adaptable, making it easy for healthcare facilities to implement RFID without disrupting their current operations.
6.10 What is the future of RFID in healthcare beyond surgical instrument tracking?
The future of RFID in healthcare is expansive. Beyond surgical instruments, RFID can be used for patient tracking, medication management, asset tracking, and even monitoring medical equipment. As the technology evolves, it will play an increasingly critical role in improving efficiency, safety, and patient outcomes across the healthcare industry.