WHY RFID PROJECTS IN HOSPITALS FAILLESSONS FROM COMPARATIVE CASE STUDIES

Falk Zwicker, Torsten EymannUniversity of Bayreuth, Germany

Agenda

Why RFID?

Life Sciences – not an innovation-friendly domain?

Innovating with IT – an adapted process model

Comparative Case Studies

Summary

Why RFID?

?

Great Technology Yet a little greater technology…

RFID couples physical and logical world

[Zwicker 2009, p.23]

Why RFID?

Visible Technology InvisibleTechnology

Ubiquitous Computing

Pervasive Computing

Ambient Intelligence

Augmented Reality

Calm Technology

“In the 21st century the technology revolution will move into the everyday, the small and the invisible…”

“The most profound technologies are those that disappear. They weave themselves into the fabrics of everyday life until they are indistinguishable from it.”

Mark Weiser, Xerox PARC, Palo Alto: “The Computer for the 21st Century”, Scientific American, 1991

Agenda

Why RFID?

Life Sciences – not an innovation-friendly domain?

Innovating with IT – an adapted process model

Comparative Case Studies

Summary

High Reliability Organizations (HRO)

Why should HROs remain skeptic?

• Anticipation:

– Preoccupation with failure

– Reluctance to simplify

– Sensitivity to operations

[Weick/Sutcliffe 2007]

How do HROs react?

• Containment:– Commitment to resilience

• Absorb strain and preserve function despite adversity• Maintain the ability to return to service from untoward

events• Learn and grow from previous episodes.

– Deference to expertise

[Weick/Sutcliffe 2007]

In other words: no bandwagon effect!

≠

A quote from the case studies

• „The clinical system reacts exceptionallyeffective and dynamic to changes and youneed to pay attention, that this dynamic is not enchained by information technology […].“

[Zwicker 2009]

…never change a running system?

How would one then get a hospital toinnovate – ever?

Agenda

Why RFID?

Life Sciences – not an innovation-friendly domain?

Innovating with IT – an adapted process model

Comparative Case Studies

Summary

Steps to convince skeptical users

http://aisel.aisnet.org/icis1995/4

A process model how IT innovationswork

Investments

Conversion Process

Appropriate Use Competitive Dynamics

ImpactsAssets Organizational Performance

Competitive Process

Use Process

Management/Conversion Activities

[Soh/Markus 1995]

Introducing RFID in Hospitals – Results from Literature

[Zwicker 2009]

(RFID) Investments

Adaptation of IT Infrastructure

Strategy

Communication

Planning

Pilot studies / Experiences

Qualification

Management

Conversion

determines(P2)

influences(P13)

supports (P10)

Increases (P9a, b)Pervasiveness

Acceptance

Privacy Valuation

influences(P4)

influences(P5)

determines(P12)

supports (P6)

supports(P7)

supports(P3)

(RFID) Assets

(RFID)Impacts

Use

Staff Competence

IS Risk Management

Committment

Staff Performance

Patient Satisfaction

Efficiency

Effectiveness

Quality

influences(P11a)

Should increase (P1a, b, c, d)

supports(P8)

(P14)

(P15a)

(P15b)

(P16)

Counts to

benefits

influences(P11b)

constitutes

Agenda

Why RFID?

Life Sciences – not an innovation-friendly domain?

Innovating with IT – an adapted process model

Comparative Case Studies

Summary

Case Study 1: Patient ID Safety

[Zwicker 2009]

Case Study 2: Pharmaceutical Safety

Case Study 3: Patient Tracking

[Zwicker 2009]

Quotes on Starting Innovation

• „It is difficult to transfer any technologywhatsoever from industry into a clinicalenvironment. That mostly does not work.“

• „In a larger hospital it is absolutely mandatorythat the external partners have substantiateddomain knowledge.“

[Zwicker 2009]

Quotes on usability

• „Many error messagesresulted from normal user behaviour. You do use medicamentsalloted to somebodyelse, to give higherdoses to patients in caseof an emergency.“

[Zwicker 2009]

Quotes on patient‘s acceptance

• „The patients all said yes and immediatelycomplied. The aspect of increased safety ledthem all to participate.“

• „Every introduction of an identificationtechnology results in discomfort andsuspiciousness for the patients. In a hospital, they never think of being mistaken forsomebody else at all.“

[Zwicker 2009]

Quote on the role of staff

• „The occasional pocketing of a RFID wristbandby hospital staff and the following errormessages when he moved through the ER areawas a problem.“

• „Hospital staff looks very closely to that thescarce resource ‚time‘ is not made any scarcerby introducing new technology.“

[Zwicker 2009]

Agenda

Why RFID?

Life Sciences – not an innovation-friendly domain?

Innovating with IT – an adapted process model

Comparative Case Studies

Summary

RFID in hospitals – beacon projects

• „RFID has not been a breakthrough in thiscase.“

[Lighthouse at Folly Island, Charleston]

[Zwicker 2009]

Summary

• „The benefit of the projects was not sufficient. The project examples have shown thattechnologically they could be implemented, but the final solutions were not convincing in business terms.“

[Zwicker 2009]

Introducing RFID in Hospitals –the resulting framework

[Zwicker 2009]

RFIDInvestments

RFID ImpactsUse Process

Staff Competence

Process Quality

Patient Satisfaction

RFID AssetsConversion Process

Staff Acceptance

Accounts toCounts

to

Usability Error handling culture

Reputation of Project Leader

Information

Expertise of external Partners Qualification

Privacy Issues

Pervasiveness

Work Strain

Patient Acceptance

InnovationCompetence

Counts to

H1

H2(+)

H3(+)

H4

H6(+)

H7(+)

H8(-)

H9(+)

H10(+)

H11

H12

Electromagnetic compatibility

H13

Treatment Risk

H14(-)

H15(+)

H5

References• [Eymann et al. (2008)] Eymann, T.,

Niemann, C., Zwicker, F.: Innovating mindfully in healthcare IT using RFID technology, in: Meckl, R., Rongping, M., Fanchem M. (Hrsg.): Technology and Innovation Management. Oldenbourg, München (2008), p. 121-130

WHY RFID PROJECTS IN HOSPITALS FAILLESSONS FROM COMPARATIVE CASE STUDIES

Falk Zwicker, Torsten EymannUniversity of Bayreuth, Germany