Article @ the Canadian Healthcare Network

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By Tim Wilson
Toronto’s University Health Network (UHN) has signed up Haldor Advanced Technologies’ ORLocate System for RFID-enabled surgical instruments and sponges. The UHN operates four major hospitals, and is one of Canada’s largest healthcare providers; the new system promises to improve operational efficiency while, ideally, also lowering costs and upping patient safety.
"This is a modular system,” says Pete Koste, VP Strategic Accounts at Haldor. "It can be deployed in an OR, a sterile processing department, or both, depending on the needs of the customer.”
It is perhaps no surprise that the UHN choose Haldor, which is headquartered in Hod Hasharon, Israel, and has offices in Europe, the Middle East, and North America. Haldor’s ORLocate is at present the only commercially available solution that can monitor and track individual surgical instruments and sponges.
"Haldor doesn’t manufacture RFID-tagged sponges, but rather we partner with those who do,” says Koste. "The company has developed a series of proprietary readers optimized for the relevant intraoperative use-cases.”
Because Haldor is the one vendor that is FDA approved for RFID tracking of both sponges and instruments, the company is in a uniquely competitive position in the market. That said, any customer looking to adopt the technology is still going to go through a rigorous review.
"UHN issued an RFP and undertook a vigorous due diligence process,” says Koste. "As part of that, references were provided.”
Clearly, the reference accounts were solid enough for the UHN. Part of the appeal was likely ORLocate’s integration capabilities: via the HL7 message format the technology can integrate with HIS, EMR, and ERP systems, as well as SPD equipment for decontamination and sterilization, and real-time location systems (RTLS). This all supports life-cycle management for tracking before, during, and after a surgical procedure. There is some flexibility to how the solution is applied in real-life conditions, with clinician input critical to making sure it all runs smoothly.
"Obtaining surgeon preference on tag location is part of our routine process,” says Koste. "But we also have a library of surgical instruments and provide guidance during the site selection process. The attachment of the passive RFID tag is a proprietary process and requires very little surface area on the surgical instrument. Options for locating the tag are therefore numerous.”
The modular offering allows customers to start in a lower risk area, such as the sterile processing department, and then to expand to the operating room.
"The UHN deployment will occur in phases,” says Koste, "but ultimately the plan is to use the complete ORLocate system.”
Additional aspects of the overall solution are ORLocate View, a business analytic module for on-demand data mining and reporting, and ORLocate Management, which covers the entire surgical instrument lifecycle, offering data for analyses while also providing a workflow management tool for defining a wide range of policies and procedures.
With this kind of solution, the UHN’s Medical Device Reprocessing Centres will be in a better position to support continuous improvement cycles. But how does it all get sold and installed?
"The software is typically licensed by site, but is capable of integrating multiple facilities,” says Koste. "Typically, the hardware and software are purchased as a capital expense but per-use or leasing models can be arranged. This integration is a professional service provided by Haldor in partnership with third party software vendors and/or the hospital.”
The benefits of a system like this are hard to argue against. The UHN will now have access to instrument level traceability and user accountability. The solution assists with regulatory compliance and reduces risk, with built-in alerts and recommendations for sterilization methods. Controls can be put in place in a variety of areas, including for when a surgical instrument is either worn out or broken. And the RFID tags themselves are both powerful and durable.
"Our proprietary scanners are capable of sensing these tags even within a cavity of a patient,” says Koste. "The tags have been validated to be washed, disinfected and sterilized for an extended life expectancy of surgical instruments, and it typically far outlasts the actual life expectancy of the instrument.”
This is a solution that takes accountability to a whole new level. Given the patient safety and liability issues—the single most common object left behind during surgery is a sponge—the uptake for systems like this could be considerable, particularly if the UHN can prove long-term ROI and improved patient safety.

This article first appeared in the Canadian Healthcare Manager and is reprinted with permission.