Not all tracking is via RFID

Army's telemedicine center uses bar codes to keep the blood supply in circulation

Supply chain management

CHALLENGE: The Army loses over a $1 million worth of blood a year due to a slow inventory process that requires medical personnel to manually transcribe identifying
information for each blood packet onto paper or a laptop-based spreadsheet. This leads to blood going unused because information was not transcribed correctly.

SOLUTION: The Army's Telemedicine and Advanced Technology Research Center built a prototype system that can be used to quickly and automatically check shipments in. Personnel scan the bar codes on each bag using Hewlett-Packard Pocket PCs fitted with wireless scanners from Socket Communications Inc. When the PocketPC is docked with a workstation, the data is automatically forwarded to the inventory database. The mobile software is built for the Microsoft Windows Mobile platform.

MISSION BENEFIT: In field trials in three combat support hospitals in Korea, the system has successfully kept track of 100 percent of the blood supplies. The system could potentially save millions of dollars worth of lost blood.

LESSONS LEARNED: Wireless inventory scanning can be a real time-saver, though picking the correct scanner is vital.

The choice often comes down to ergonomic issues, said Tommy Morris,
director of mobile computing at TATRC. Most scanners offer about the same
level of performance, and the Army uses an industry standard bar code for labeling bags. Heavier scanners tended to tire personnel, however, and those connected to a laptop with a USB cable are too cumbersome. TATRC also learned the economic benefit of yoking together various commercial software and hardware offerings to provide customized functionality. The prototype cost only $58,000, potentially saving the millions it might have taken to develop a system from scratch.

It really helps us streamline the data capture and reporting.' Tommy Morris, Army Telemedicine and Advanced Technology Research Center

David S. Spence

A plane arrives outside a remote Army field hospital, carrying pallets of blood that must be transferred to refrigerators or freezers as quickly as possible. Field unit personnel quickly scan the bar code of each packet for blood type, expiration date and other pertinent details. The data is compiled on a handheld PC, then added to the field hospital inventory and, later, synchronized with the records of the combat support hospital that sent the supplies. Within minutes, the new supplies of blood are ready for use.

This is how the Army's Telemedicine and Advanced Technology Research Center plans to streamline the process of getting blood to the battlefield. By using off-the-shelf hardware components and standard software development tools, the center built a blood inventory system that could withstand the rigors of field use and keep costs to a minimum.

TATRC has fielded a setup like this at three combat support hospitals in Korea, as well as with selected units in Iraq and Afghanistan. Tommy Morris, director of mobile computing at TATRC, said it cost a mere $58,000 to develop a working prototype.

The field system uses iPAQ hx4700 series Pocket PCs from Hewlett-Packard Co. of Palo Alto, Calif., in conjunction with series 7P Socket Cordless Hand Scanners from Socket Communications Inc. of Newark, Calif. The iPAQs are protected by hardened cases from Otter Products LLC of Fort Collins, Colo., and the tracking applications were developed using the Microsoft .Net framework.

For its current operations in Afghanistan and Iraq, the Army uses about 300,000 units of blood per year. But prior to the new system, it had also lost millions of dollars worth of blood annually, whether by simply losing track of it or keeping the blood beyond its expiration date.

Using a PocketPC and wireless scanner speeds the process of checking new supplies into inventory and reduces errors, Morris said. TATRC is pitching this idea to the Armed Services Blood Program, the Defense Department's cross-service effort to supply blood where it's needed on the battlefield.

Untethered operation

In most cases today, field medical personnel use Excel spreadsheets on notebook PCs, or paper, to inventory incoming blood supplies. Either approach can stretch the time it takes to assimilate information up to five minutes'possibly putting supplies at risk. The approach tethers soldiers to the notebook PC and necessitates manual reentry of data.

'You can see where there are potential errors in transcription,' Morris said.

To streamline this process, TATRC developed the Blood Information Program, a suite of three interconnected software programs that run on the PocketPC and field workstations.

The Army needed a way to connect the combat support hospitals with the field units, so the hospitals could make sure blood deliveries arrived at their intended locations. In BIP, one program keeps track of blood inventories on a workstation.
Another program generates reports, and a third module tracks which blood containers are used and which are discarded.

BIP rides on the Medical Communications for Combat Casualty Care platform, a mobile medical tracking system for personnel deployed overseas developed by the Program Executive Office Enterprise Information Systems at Fort Belvoir, Va.

Morris said MC4 looked at a Java mobile platform as well as Microsoft Corp.'s set of mobile offerings. Microsoft got the edge because its products addressed the office's security concerns better. Most of the programs were developed in C++ or C#.

For the scanner, TATRC chose the Socket model due to its light weight and wireless capability. The units can read bar codes on the blood bags and transmit them to the PocketPC through a 2.45-GHz Bluetooth connection. It has a Class 1 Bluetooth radio, which can communicate up to 100 meters with another Class 1 device in an open environment. (Most devices use Class 2 radios, which are limited to 10 meters.)

Many of the other scanners tested were too large or were tethered to the PocketPC by a cumbersome cable. Because personnel have to scan hundreds of bags in a short period of time, heavy scanners were out of the question. The Socket scanner weighs just under a quarter-pound and can provide up to 8,000 scans on two rechargeable AAA batteries.

The scanner also works easily with the Microsoft Windows mobile platform. Socket offers a software development kit that can link the scanner to individual applications. The SDK supports Windows CE and Windows XP, as well as Nokia Symbian, Palm OS and BlackBerry RIM, according to Peter Phillips, vice president of marketing at Socket.

For Morris, using a wireless scanner facilitates the process immeasurably. 'It really helps us streamline the data capture and reporting.'

About the Author

Joab Jackson is the senior technology editor for Government Computer News.

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