The healthcare sector has come under unprecedented pressure during the COVID-19 pandemic. At this crucial time, it is more important than ever to investigate and invest in new innovations that can deliver tangible benefits to both patients and the service providers.
One area where advances in technology could play a pivotal role is pathology, which is a high-volume, complex and time-critical service where efficiency is key. According to the Royal College of Pathologists (RCP), over 1 billion tests were being carried out each year in England. In the last few months COVID-19 testing has ramped up to around 250,000 per day in the UK (Pillars1&2 swabs only). This rise and the need to provide the results in record time have brought historic inefficiencies back into the spotlight. In this blog post we aim to offer some hope for the future, with more specific details of an exciting trial in the North East of England of a new sample transport and tracking system using novel flexible electronics and RFID that has the potential to revolutionise pathology services and save the NHS millions.
In recent years there have been considerable changes in the pathology sector, including the consolidation in several regions of multiple in-house hospital facilities into larger ‘super’ labs which are designed to be centres of excellence. Whilst this has provided some benefits, there are still inefficiencies that prevent the labs operating effectively. Indeed, Sarah Jane Marsh, Director of Testing for NHS Test and Trace, has claimed it is our laboratory processing that has been “the critical pinch point” during the COVID-19 testing debate.
It doesn’t take long to identify areas where improvements could be made. For example, traditionally the incoming samples are manually unpacked and sorted, plus come with a lot of paperwork to be processed. It is very time-consuming, requires significant numbers of staff and is prone to errors. Additionally, samples can be lost or damaged in transit, paperwork can be mis-placed or mis-matched. All of which must be recorded and reported, and tests re-ordered.
It would also be an advantage if the pathology lab knew in advance exactly when and which samples were due to arrive so staff could define an optimum schedule of work and maximise the use of the equipment, because many of the machines are batch loaded. Without prior knowledge staff can only react once the samples are unpacked. . What is needed is a new system that can process incoming samples quickly without compromising on accuracy or safety.
QHS (Quality Hospital Solutions) have developed a solution known as SamplePod. This new sample transport and tracking system is a collaboration between the NHS, leading pathology experts and technology innovators aimed at improving efficiency, increasing capacity, and reducing costs for pathology services. It consists of a reusable transport pod in which up to 52 samples can be carried, designed to accommodate a wide variety of different sizes of test tubes. A low-cost RFID label encoded with a unique ID is attached to each sample providing item-level digital traceability in real-time from the patient all the way through to the pathology lab. As each individual sample has a unique ID no sensitive patient information is stored anywhere in the SamplePod.
At the point when the sample is taken, each sample tube is associated with a master RFID tag within the SamplePod itself. The clinician generating the samples can then send a notification to the lab of the expected arrival time of the SamplePod and what is required for the associated samples. In this way the appropriate lab staff and equipment can be made ready.
At the lab, the SamplePod is quickly scanned with a reader and the samples verified, identifying any time critical ones, these samples can very swiftly be moved on to testing. This new system reduces the time that was previously spent unpacking lots of plastic bags and there are costs savings not only from the reduction of use of the bags, but also of the costs associated with disposing of packaging deemed clinical waste.
Summarising the areas where efficiencies and cost savings can be achieved using this new system:
- Prompt sample handling process
- Fewer lab staff required
- Reduction in re-tests caused by lost or damaged samples
- Improved utilisation of lab equipment
- Reduction in paper documentation and plastic bags
- Reduction in waste disposal
There are of course infrastructure costs of installing a new system, including hardware and software for the readers, plus the SamplePods and RFID tags (inlays). The readers and pods are re-useable, so their costs are amortised over many uses. The inlays for the samples make up the largest volume and are single use. Conventional RFID tags use silicon chips, or integrated circuits (ICs), and their relatively high cost makes them economically unviable in this scenario. QHS has partnered with PragmatIC, whose unique technology platform delivers ultra-low-cost, thin and robust flexible integrated circuits (FlexICs) that provide the perfect solution. Inlays based on PragmatIC’s RFID FlexICs can be easily applied to the small circumference test tubes and bottles to provide the unique identification required. PragmatIC’s production facility is based at CPI’s National Printable Electronics Centre at NETPark in Sedgefield, County Durham.
The initial NHS trials of SamplePod in the North East have progressed well. Assuming the next steps go well in the region, the vision is to roll this system out across the whole of the UK pathology network, with a projection that it could save the NHS an estimated £250 million a year! It is envisaged that in the future, additional functionality could be added to the process, such as robotics designed to unpack and sort the samples. The SamplePod system could also be used with temperature monitoring tags to ensure the samples are kept in a consistent environment. So, although we don’t know what will happen over the next few months and how the global COVID-19 situation will develop, it is clear that investment in technology and innovation is key to enabling our pathology services to increase the number and speed of tests.
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