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How tracking technology is redesigning healthcare

Tracking and tracing: that’s one of the main missions of Zebra Technologies, the American company that provides Amazon with tracking services for all its deliveries, and has also been tracking American football players on the field for years to offer the NFL in-depth statistics. They’re involved in today’s industry in so many ways, from automotive manufacturing to the food supply chain, which uses Zebra’s systems to know from which farm does a particular slice of meat come, for example when a consumer picks it from the shelves of a supermarket. “We’re also involved in healthcare, offering tracking services from the pharmaceutical manufacturer right to the patient, which is something of great interest today”, says Wayne Miller, Zebra’s EMEA Healthcare Practice Director “Even before the pandemic, healthcare was already one of the fastest-growing market segments for our company, which is now providing its solutions to the UK NHS for the Covid-19 vaccination program. And that involves tracking the vaccine doses as well as taking care of the traceability of the patients”.

Can you give me a bit of background about Zebra Technologies, which was founded in 1969?
We started with the barcode, but we also have what we call RFID technologies, which can be both passive and active. For example, when you try to leave a store but the pair of jeans you bought still have a tag on them, this sets an alarm off, and usually it’s a passive technology. Then, there are active technologies, which require a battery that emits a signal. This way we can track that signal indoors and outdoors as well as position the location and all the important data around that activity. When it comes to RFID technologies, we have the largest portfolio of the industry, from printers to tags to mobile devices.

The barcode is a technology that’s been around for an extremely long time. Will RFID, radio frequency identification, take its place, sooner or later?
 There’s lots of conversation about these higher-level technologies, and they are being widely adopted. But when we think about a global economy, we’ve got to think about the lowest level of technology. So, if we ship a vaccine from Germany, and we ship that to Central Africa, the humble barcode still has a position to play.

What are its main fields of application, today?
 Manufacturing automotive is very big for us. If you order a custom set of red leather seats for your car, and there’s only one of those in the factory, we can tell that factory exactly where those seats are, and make sure they’re down at the production line to fit your custom made BMW, or Mercedes, or Ferrari, if you’re rich enough.

You also have a technology that’s called MotionWorkProximity, developed to make sure that warehouse operators keep the distance and work safely. In other words, you have the technology to check that social distancing is respected.

Wayne Miller
So, in a hypothetical future, you can check that social distancing is respected, for example, during a music festival or a fair.
Potentially yes. At the moment we’re doing this with manufacturers, inside the four walls, and we tested it into distribution centers, facilities, and plants, but it has not been tested in a music festival yet. But potentially it could work.

Or schools…
My partner is a teacher, she’s currently isolating at home because one of her students tested positive. And without technology, there’s no way of proving or disproving that you came into contact with the virus, so 30 students were sent home, just because there’s no technology to use the evidence.

That’s something we all experienced during the pandemic, I think: we lack the proper information, and so we confide in certain methods that remind us of more pre-scientific times in our history…
Technology provides information that allows you to make evidence-based decisions, rather than opinion-based decisions. I’m sure you’ve all seen social media, where’s everyone’s opinion has the same importance. Well, that’s not real.

 Zebra Technologies plays an important role in the UK vaccination.
Yes, scanning the vaccines and cross-matching them with patients. The UK Government has decided that there will be a hierarchy, so healthcare workers will be the first to be vaccinated,  then it will be the turn of the most vulnerable people, so those over the age of 80, especially those who live in old people’s homes, and then we’ll get to younger people. What they wanted to do was have an accurate record of which vaccine was given to which patient, because there are two doses, you know, that you give 30 or 20 days apart. And you want to record the details of both because if you recall one or both of those vaccines, you need to recall all the patients you’ve given the vaccine to. So that was the importance of this.

You also have technologies to check the temperature, and that’s quite essential for the Covid-19 vaccines.
We have technologies that can support and measure the cold chain. We have what we call “thermochromatic labels”, that change color according to the temperature. We also have Bluetooth data loggers: we put a sensor inside a box of vaccines and we monitor the temperature from the manufacturer through to the delivery point. That’s all part of track and trace, it’s not just what it is, where it is, but what condition it is in as well.

Aside from the mass vaccination, I can imagine that, with the pandemic, managing much more patients than normal in the hospital was far more complicated than usual.
I’ll come to patients in a moment. During the pandemic, the supply chain of PPE, personal protective equipment, became really important. We have been working in the healthcare system for 15 years, but the supply chain has been Zebra’s home ground for 51 years. Then we look at patients, we find out which PPE did we give to which clinicians, and which patient, and where is that patient. If we are tracing a patient through a wristband, and if that patient has COVID or is suspected of having COVID, we want to respect their movements, and maybe send alarms and updates to the clinical team. Hospitals aren’t prisons, so there was a lot of information required around patient traceability. It’s never about where they are, but rather about the context because the amount of time that people spend in one place is suddenly involved. It never was. We were used to sitting in a waiting room for an hour or so with 20 or 30 other people, and we can’t do that now. It’s all about volume, as well as timing. It’s not just about locations, it’s about contacts.

Under many aspects, the pandemic and the lockdown didn’t just change our lives. They brought on a sort of acceleration.
I think there’s technology out there that still has to realize its full potential. And you’ll see amazing developments in solutions over the coming years. They all say that sometimes the military develops the biggest innovations during wartime. I think that Covid is a bad thing, but it’s a very positive thing that countries around the world and especially across Europe are working together.

Which kind of technology can you apply to help the hospitals?
We look at the entire patient journey. We look at it with the patient at the center, but also with the clinician at the center. When we think about the patient, we think about placing a wristband on the patient. We also want to track and trace all the blood samples from that patient. We print it outside and track them to the origin. We also track all lab samples inside a laboratory, so we make sure the identity on that sample is there when you take it out five years later to look how your disease is progressing: are you getting worse, or are you getting better? And then we look at the traceability of all assets around the patient, which heart monitor we attached the patient to, which ventilator, which clinician worked on that patient. We provide a medical-grade smartphone with cleaner plastics, an interchangeable battery, and a hard-to-break Gorilla Glass screen. Placing technology in the hands of a clinician replaces the traditional desk. This is also a window into the electronic medical record. I can scan a drug, scan the patient’s wristband, and record the dose bedside. We’re preventing the clinical teams from walking to the desk and back to the patient, they can just go from patient to patient with this.
Could the intervention of AI improve this workflow?
AI only works if you have data. You can imagine all the doctors and all the nurses in one hospital treating 500 beds or 2500 beds a day. Scanning the barcodes, you can record accurately, who, why, what, where, when, all the patients, all the drugs, all the activity, and place that information into a database. That’s way too much information for any human being to be able to do that. So that’s why you would bring in the AI to look for commonalities in data: how are we buying the most drugs off, what country are they coming from. A government could notice that it’s buying lots of drugs from Hungary or China, and choose to make domestic production, also to cut down on travel time. You know what happens if all the planes are grounded.

And we’re back to the supply chain…
Yes, you can start to use AI not just to look at patient treatment, you can start to look at business supply chains and also economies as well. Economies of scale. So AI is really important for our future, what we’re doing is providing accurate data back into that AI.

Are your data involved in the design of new hospitals? Are you in close contact with architecture firms?
Not enough. There’s a hospital that’s very local for me, it was built five years ago and one of its technology consultants asked if we could tell the routes the doctors and patients take around the hospital, to position coffee shops and vending machines in the right places. And that’s something we don’t think about if a clinician or a patient has to walk 30 or 40 meters to get a bottle of water. The other thing is that they didn’t put any grass down near the car parks until they had seen the lines where people walk to get to entrances, and they paved those routes, and the same principles we’re thinking about indoor, is don’t decide in the infrastructure before you’ve tracked how people behave. So yes, we’d love to talk with architects, because they make the buildings beautiful, but also usable and inhabitable.


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