What is RFID?

‍
So, before we explore the benefits of RFID access systems, it's important to first
understand what these technologies and systems are and how they work.
‍
RFID or Radio-Frequency Identification technology is a technology that utilizes
electromagnetic fields to identify and track "RFID tag" fastened onto materials swiftly
and accurately. These tags include components such as a microchip and an antenna,
which are used to transmit information about the object to which they are attached. The
information that can be transmitted includes information such as unique identifiers,
contact details, or location data, and can be read by specialized RFID readers.
‍
RFID tags can be divided into categories based on their power source, including:
‍
-Passive RFID tags, which are powered via radio waves transmitted by the access
control system and require no battery, make them a cost-effective option for many
businesses.
‍
-Active RFID tags, which have a built-in battery and can continuously transmit data to
the access control system, making them ideal for applications where RF signals might
be interfered with or where a robust reading range is required.
‍
Examples of these RFID tags and chips can be found in credit cards, passports,
business cards, and access control cards – among many more!
‍
What is an RFID access control system?
‍
RFID access control is a type of access control system that uses RFID tags to identify
and track access to physical locations, including buildings, elevators, parking lots, or
even vehicles. An access control RFID system is typically composed of a reader,
antenna, access cards or fobs, and software that can be used to manage access rights
and access logs.
‍
RFID technology can revolutionize access control systems, allowing you to use radio
waves emitted by specially programmed cards or key fobs for automated entry and
identification. For example, an employee's card could be designed to grant them access
to your office building - and certain areas within it - with the help of a secure radio
signal. The same technology will also identify who is entering when they used their
credentials. With RFID incorporated into your access control system, ensuring safe
environments becomes easier than ever before!
‍
The key components of an RFID access control system are:
‍
-RFID access cards or fobs:
‍
which contain the RFID tags and transmit information about the user to the access
control system. These access cards or key fobs are typically made from durable
plastics, and often include security features such as holographic stickers or foil inlays to
prevent tampering.
‍
-RFID readers:
‍
which are installed in access points around a building or property and use radio
frequency signals to receive access card information and transmit it to the access
control system. An RFID reader have the ability to work independently or be integrated
with other access control devices, such as facial recognition access control
terminals and access control keypads, to create a comprehensive security system.
‍
Learn more:
Biometric Devices 101: Definition and Examples
‍
-Access control software:
‍
which is used to manage access rights for users of an access control RFID system and
store access logs within the access control database. This software can also be used to
customize access rights for users, as well as generate access reports that can be used
to identify access trends.
‍
-Control panels:
‍
which are used to connect the RFID reader and access cards or fobs to the access
control system, and can also be used in conjunction with access control software to
provide additional access management features.
‍
-An access control database:
‍
which is used to store access logs and access rights information. This database can
either be hosted on-site or in the cloud, depending on the access control system used.
‍
RFID technology can revolutionize access control systems, allowing you to use radio
waves emitted by specially programmed cards or fobs for automated entry and
identification. For example, an employee's card could be designed to grant them access
to your office building - and certain areas within it - with the help of a secure radio
signal. The same technology will also identify who is entering when they used their
credentials. With RFID incorporated into your access control system, ensuring safe
environments becomes easier than ever before!
‍
10 Benefits of RFID access control
‍
When deciding on an access control system for your business, RFID offers a number of
benefits over traditional access control methods. Some of the key advantages include:
‍
1) Convenience:
‍
The convenience of RFID access control systems is unparalleled due to their
contactless nature, eliminating the need for manual entry or clunky keys and codes. Not
only that, but managing staff members has never been easier; permissions can be
adjusted in no time, and logs are created automatically! With this convenience comes
the ability to quickly monitor and track employee activity.
‍
-Convenient Mobile access
‍
Also, with RFID in combination with mobile access, you can unlock your premises and
review access logs right from the convenience of your phone, tablet, or even watch. All
it takes is tapping on a compatible reader to effortlessly pass through any entryway
while leaving bulky cards or fobs behind. It's amazing how quickly an app can deliver
maximum accessibility as well as make necessary updates remotely!
‍
-Easy visitor management
‍
Additionally, thanks to the RFID access control solution, you can easily provide your
guests and visitors with credentials such as RFID cards or mobile credentials. This
allows them to access the appropriate areas of your facility securely, while also
maintaining strict access controls for your employees. Overall, this helps ensure that
your guests are always able to access your facility conveniently and securely.
‍
2) Cost-effective:
‍
Investing in RFID security systems are a smart move for businesses, as it can save
them money over time. Not only are the key cards and fobs significantly more affordable
than other available options, but they can also be easily reprogrammed and
reconfigured. Moreover, its user-friendly nature prevents costly disruptions that would
otherwise occur due to technical or authorization issues - making it a cost-effective
access control system for companies of all sizes!
‍
3) Easy integration:
‍
With its seamless compatibility with other security and surveillance technologies such
as CCTV, RFID access control systems provide a comprehensive solution for both
internal and external monitoring. This ensures improved access security while
minimizing the potential of unauthorized incidents or breaches. Moreover, these
systems can be used in tandem with time attendance software to track employees'
working hours in real time for enhanced management effectiveness.
‍
4) Increased efficiency:
‍
In comparison to its predecessors, RFID access control systems are not only much
faster and more convenient but also help streamline your overall management
operations. With automated permissions and read access logs you can easily identify
trends in the data that would allow you to make informed decisions about who gets what
kind of privilege when it comes to entering or exiting a building. In short, utilizing an
RFID security system will ease up entry/exit processes while simultaneously increasing
efficiency!
‍
5) Robust and durable:
‍
RFID tags are not only more reliable and resilient than other access control
technologies, but they also maintain their integrity even in the most extreme
environmental conditions. Additionally, RFID tags possess fewer chances of failure or
breakage when compared to conventional access credentials for greater peace of mind
within your facility.
‍
6) Increased access security:
‍
RFID access control systems are renowned for their security benefits and ability to
reduce access-related incidents or breaches. With real-time data on who has access to
a building, as well as enhanced monitoring capabilities, your team is thoroughly guarded
against the potential of uninvited guests or unwanted activity in your facility. This
ensures that you can trust in the protection of your staff, visitors, property, and assets at
all times! By incorporating access management software with other systems such as
time and attendance, video surveillance technology, or any others you may use, your
business will have a heightened sense of security. This is because it can quickly detect
access-related incidents and solve them immediately!
‍
-Multi-factor authentication capabilities
‍
Furthermore, with RFID door access control can enhance multi-factor authentication
capabilities, allowing businesses to guarantee that only those who are allowed in will be
able to gain access; this is accomplished by combining access control credentials such
as biometrics and passwords. This additional layer of security acts as an effective
barrier against potential breaches, providing peace of mind while preventing
unauthorized entry into the premises!
‍
7) Scalability:
‍
An RFID door lock system offer great scalability to expand or restrict user permission as
required. Furthermore, their modular nature makes it possible to add or remove an
access door without causing any disruptions in other users' access rights via a
dedicated access control management platform.
‍
8) Flexibility:
‍
By relying on RFID access control technology, you can take advantage of the same
privileges and permissions regardless of where you are: your workplace, home, or even
while out with a mobile device. This flexibility not only makes it more convenient for
yourself but also for staff members too. An RFID access system is highly adaptable to
suit any purpose - granting keyless entry into diverse areas of properties such as
buildings and elevators with just a few taps!
‍
9) Improved employee productivity:
‍
An RFID access system can drastically reduce the amount of time and disruption
related to managing your employees' workday. With automatic storage of activity logs,
as well as the easy ability to update their privileges, you save essential hours that could
otherwise be spent dealing with mundane tasks; allowing them instead to focus on more
important matters and thus improve productivity across your organization.
‍
Also, RFID access control systems deliver mobile and contactless accessibility that
allows workers to tap and enter their workspace easily, whether it is on a construction
site, warehouse, or any other distant workplace. This cuts down the lengthy
authorization process, allowing your employees to reach work faster with improved
productivity and job satisfaction!
‍
10) Versatility:
‍
Last but not least, RFID systems are incredibly versatile and can be adapted to suit your
specific needs. They are available in a range of access technologies, including keycard
access, biometric access control systems, and mobile access. Furthermore, you can
combine with various other access management tools such as time and attendance
software, video surveillance systems, and more to provide a fully integrated access
management solution.
‍
Amazing! Now that you've read all of the incredible benefits, here's one more surprise
for you:
‍
11) Competitive advantages in the marketplace:
‍
An RFID access control system can provide your company with not only unparalleled
security but also a competitive advantage in the market. You can safeguard critical data,
assets, and confidential materials while also providing convenience to your employees.
This combination of security and efficiency can help you stand out from your industry's
competition, allowing you to attract and retain top talent as well as customers.
‍
Additionally, if you are a system integrator or a security product distributor, RFID-
enabled access control systems can provide you with a valuable offering to offer
potential clients. Access control systems that use RFID technology can be a powerful
solution for businesses of all sizes due to their flexibility, scalability, and customization
options, making you a sought-after partner in the access control market.
‍
Conclusion
‍
Are you looking to improve your access security system? RFID technology is the ideal
solution for you. It provides numerous benefits for businesses of all sizes and types,
ranging from improved protection and security to flexibility and versatility. So, why not
make the switch now and enjoy everything that this cutting-edge technology has to
offer? Contact your local access control provider or our team at Aratek today to learn
more about how you can benefit from making this investment.
‍

Aratek TruFace Biometric Access Control System

The all-in-one biometric access control and attendance tracking solution

Radio Frequency Identification (RFID) in health care:

where are we? A scoping review
Laura Profetto,1 Monica Gherardelli,#1 and Ernesto Iadanza #1,2

Author information Article notes Copyright and License information PMC

Disclaimer

Associated Data
Data Availability Statement

Go to:
Abstract

Purpose

(RFID) is a technology that uses radio waves for data collection and
transfer, so data is captured efficiently, automatically and in real time
without human intervention. This technology, alone or in addition to
other technologies has been considered as a possible solution to reduce
problems that endanger public health or to improve its management.
This scoping review aims to provide readers with an up-to-date picture
of the use of this technology in health care settings.

Methods

This scoping review examines the state of RFID technology in the

healthcare area for the period 2017-2022, specifically addressing RFID
versatility and investigating how this technology can contribute to
radically change the management of public health. The guidelines of the
Preferred Reporting Items for Systematic reviews and Meta-Analyses
(PRISMA) have been followed. Literature reviews or surveys were
excluded. Only articles describing technologies implemented on a real
environment or on prototypes were included.

Results

The search returned 366 results. After screening, based on title and
abstract, 58 articles were considered suitable for this work. 11 articles
were reviewed because they met the qualifying requirements. The study
of the selected articles highlighted six matters that can be profitably
impacted by this technology

Conclusion
The selected papers show that this technology can improve patient
safety by reducing medical errors, that can occur within operating
rooms. It can also be the solution to overcome the problem of the black
market in counterfeiting drugs, or as a prevention tool. Further research
is needed, especially on data management, security, and privacy, given
the sensitive nature of medical information.

Graphical Abstract

Keywords: RFID, Healthcare, Medical devices, Equipment, Management,

Logistics
Go to:

Introduction

Today, the most important challenges for healthcare professionals are

minimizing the impact of adverse events and improving patient safety
[1]. An adverse event is defined as any complication that arises during
the patient’s stay in hospital and is not directly related to the underlying
disease or reason for hospitalization [2]. These events can have serious
consequences for the patient, her / his family and even the health
system. The concept of traceability can provide many benefits to these
processes. Traceability means the identification of all information
relating to a product from origin to delivery and / or consumption [3]. In
the context of health services, this can be translated as the exact
identification of the patient, the drug and the patient / drug relationship
administered, which can significantly reduce the incidence of adverse
events, thus increasing safety. Healthcare is currently facing the
challenges of improving this aspect and reducing operating costs, which
unfortunately are often caused by human and systematic errors. The
American Institute of Medicine (IOM), recently renamed as the National
Academy of Medicine (NAM) [4], estimated that between 44,000 and
98,000 deaths per year are related to medical errors occurring in
hospitals, thus showing the desperate need to improve patient safety and
well-being in hospitals [5]. It is possible to identify common phenomena
that lead to serious healthcare operation failures in addition to medical
mistakes, such as theft loss, and drug counterfeiting [6].

RFID technology is becoming more prevalent across a variety of

industries, with the healthcare sector being a growing area. Indeed, the
maturation of applications such as real-time locating system (RTLS) for
patient tracking, medical personnel, and asset tracking will most
certainly contribute to rapid expansion in the RFID industry in the future
years. This market was worth USD 16.95 billion in 2016 and is expanding
at a 7.7 percent CAGR between 2017 and 2023 [7].

Radio frequency identification (RFID) is one of the 16 fundamental

innovations for the next decade, as stated by the Massachusetts Institute
of Technology (MIT) which ranked it as the 10th most innovative
technology of the last 25 years, for automatic data collection and
traceability of goods [8]. The identification process consists in reading an
RFID tag applied to an asset or a person without any physical contact.
The data collection and transfer are done with the use of radio waves, so
data is captured efficiently, automatically and in real time without
human intervention. The advantage is that an RFID reader can read more
tags simultaneously from a greater distance and therefore without the
need to approach the reader, unlike traditional barcode scanning. It is
therefore possible to attribute an electronic label to assets, healthcare
personnel or patients, who once tagged, can be identified, tracked, and
managed through a centralized database, using pervasive IT devices such
as PDAs (Personal Digital Assistants) or mobile phones [9].

A RFID device can have different electromagnetic transmission

configurations, based on different applications, but typically includes the
following components (Fig. (Fig.11):

 Tag RFID;
 Tag reader equipped with an antenna and a transceiver;
 Host system or connection to a business system.
Fig. 1

RFID system: an RFID reader acquires information from one or some tags and transfers
such information to an host system

The Tag is used to store information; each RFID tag contains an

electronic integrated circuit and an antenna inside a package (capsule),
which are affixed to an object with a unique identification number and a
memory that records additional data relating to the manufacturer, the
product type and other related environmental information [10]. The
reader is used to collect all the information stored in a tag. The RFID
reader consists of a decoder that decodes the information; the antenna is
used to transmit and receive the RF waves that carry information from
the tag to the reader and vice versa. The RFID reader can read or/and
write data in the tags by reading the identifying information (IDs) of the
neighboring tags and mapping them to an object through a database or
an external service. The software is used to manage the received data
and the reader and tag operations, it manages the information in a
database [10]. The latter can also contain the details of the tags and
readers. All information is sent to a host computer or RFID middleware
to ensure communication between the RFID infrastructure and the
various intra- and inter-organizational systems [7]. Tags can be classified
into three classes: active, passive and semi-passive tags [10].

Active tags are powered by batteries and incorporate both a receiver and
a transmitter, have large memories, often rewritable, and can contain
sensors. They can operate at distances that are generally much greater
than those of passive and semi-passive tags (maximum 200 meters) and
have larger memory. The disadvantages are: high price, limited duration
as they depend on the antenna and the energy available in the batteries,
larger weight and dimensions than passive tags.

Passive tags do not have an internal power source, they are activated
when they enter the range of action of an RFID reader, the latter
generates a magnetic field that powers, and therefore activates, the chip
contained in the tag. Passive tags are smaller in size, lighter in weight
and low in cost and with an unlimited lifespan. Unfortunately, they have
limited functionality: they have a low communication range, their
information storage and computing capacity is limited.

The semi-passive tag is provided with a battery that is used only to

power the internal circuit. Unlike the active tag, it communicates via the
electromagnetic field created by the reader. The battery stays dormant
until triggered by a signal from the reader, saving battery power and
extending tag life [7].

The RFID technology can operate at different frequencies, each having its
pros and cons. For the low frequency (LF) band, 125 to 134 kHz, the
main advantage is the possibility of its use worldwide, indeed it is
available in all major countries: Europe, North America, and Japan. The
major applications related to its use are those that require the
transmission of limited amounts of data over short distances. It is also
affected by small interference with liquids and metals [11]. The main
drawback is that ferromagnetic materials have a shielding effect on
electromagnetic waves at these frequencies and therefore can cause
reading problems. Furthermore, the large dimensions of the reader
antennas and the reduced operational distances limit the diffusion of
systems using these frequencies [12].

The high frequency (HF) band has a central frequency of 13.56 MHz, and
is characterized by greater reading range and speed than the LF band.
Near Field Communication (NFC), a wireless data interface between
devices also works at an operating frequency of 13.56 MHz [13].

The ultra-high frequency (UHF) band is between 860MHz and 960MHz.

These tags have better reading range and better data transfer compared
to lower frequency bands. Increasing the frequency allows the use of
smaller antennas, that are therefore suitable for portable devices. On the
other side, costs are higher with this technology. Usually the different
governments, through their legislation, independently manage frequency
assignments. Therefore, there are differences internationally in the
frequencies assigned for RFID applications even if standardization by ISO
and similar organizations is helping to make them more and more
compliant. For example, Europe uses 868MHz for ultra-high frequency
(UHF), while the United States uses 915 MHz [7].

The RFID technology used with other technologies, such as the Wireless
Sensor Network (WSN), allows to expand its functionality and create
hybrid monitoring systems, based on the Internet of Things (IoT) [7].
This hybrid technique depicts a possible progression of Internet use:
objects (“things”) become recognized and intelligent since they can
communicate their own data and receive aggregate information from
others; as a result, all items can play an active role owing to Internet
connectivity [14].

“Things” or “objects” are elements such as, among others: devices,

instruments, plants and systems, materials, products, works, goods,
machines, and equipment. The connected objects, that are the basis of
the IoT, are more properly defined as “smart objects” and are
characterized by some properties or functionality. Identification,
connection, localization, the ability to process data and the ability to
interact with the external environment are paramount [14].

The IoT is a system consisting of three levels [15]:

 Perception layer: also called “physical layer”, which identifies and

collects all types of information from the physical world of the IoT,
through sensors, tags, WSNs, cameras, RFID systems and so on.
 Network layer: also called “transport layer”, in charge of
transparent data trasmission.
 Service layer: also called “application layer”, including a sub-level
for data management and a sub-level for application services.

RFID technology, alone or together with other technologies, has been

considered as a possible solution to reduce problems that endanger
public health or for improving the management of the latter. For
example, the problems related to medical waste recycling, if not
managed in a safe and conscious way can cause the spread of diseases
and environmental pollution, that traditional methods often fail to
prevent. There are some studies aimed at finding a solution to this type
of problems; some of these aim to design methods that apply reverse
logistics based on RFID technology [16].

This work examines the state of RFID technology in the healthcare area
in the last five years, It specifically illustrates RFID versatility and
verifies how this technology can contribute to radically change the
management of public health. The aspects that have an impact on the
qualitative characteristics of health services relating to prevention,
diagnostics and monitoring of patients’ health are considered very
important.

Go to:

Methods

For this work it has been chosen the Scoping Review research design to
assess the current state of RFID employment in healthcare area, to have
an overview of the state of the art relating to the chosen topic and to
identify the problems that limit RFID use. Scoping Review is a type of
research evidence synthesis that aims to detect the literature on a
particular research topic or area and to provide an opportunity to
identify key concepts [17]. The guidelines of the Preferred Reporting
Items for Systematic reviews and Meta-Analyses (PRISMA) have been
followed. PRISMA statement aims to provide a guide for the drafting of
the results of research in the medical field [18].

Eligibility criteria

According to the selected eligibility criteria, only journal articles with a

publication year from 2017 to 2022 were included. The examination of
these articles, in particular, allows us to concentrate on newly created
approaches, and the research confined to the aforementioned time
allows us to comprehend the major elements and associated constraints
of the most current methodology. The search was restricted to
documents in English, which was thought to be the most often used
language for this type of topic. Literature reviews or surveys were
excluded. Only articles describing technologies implemented on a real
environment or on prototypes were included.

Searching for a paper

The searching of articles was carried out through Scopus, a search engine
with a database of peer-reviewed scientific products (journal articles,
books, conference proceedings) and more than 70 million bibliographic
citations, abstracts, and bibliometric data. It was preferred over other
search engines, as it covers wider disciplinary sectors, unlike for
example Pubmed which is a purely biomedical database.

The search string launched on Scopus was as follows:

TITLE-ABS-KEY ( rfid AND ( healthcare OR “health care” OR hospital ) )

AND ( LIMIT-TO ( DOCTYPE , “ar”) OR LIMIT-TO ( DOCTYPE , “ch” ) OR
LIMIT-TO ( DOCTYPE , “re” ) ) AND ( LIMIT-TO ( PUBYEAR , 2022 ) OR
LIMIT-TO ( PUBYEAR , 2021 ) OR LIMIT-TO ( PUBYEAR , 2020 ) OR
LIMIT-TO ( PUBYEAR , 2019 ) OR LIMIT-TO ( PUBYEAR , 2018 ) OR
LIMIT-TO ( PUBYEAR , 2017 ) ) AND ( LIMIT-TO ( LANGUAGE , “English”)
)

With this string we have imposed restrictions on the year of publication

(from 2017 to 2022), and on the language: English.

Selection process

After the literature search, all the recovered documents were examined,
selected first by title, then by abstract and finally by evaluating the entire
text. The articles rejected based on their title were not related to the
health sector but dealt with other issues. In reading the abstract, those
articles relating to literature reviews or surveys were discarded. Articles
with higher numbers of citations were preferred in this phase. All of the
records in the output of the literature search had their titles and
abstracts reviewed separately by two reviewers (L.P. and E.I.). The ones
deemed to be unrelated to the scope of the review have been eliminated.
The two reviewers’ individual results have been compared, and the
publications that they both deemed appropriate for the research have
been added immediately to the list for full-text download. M.G., a third
reviewer, was requested to make a choice about the papers that had
been chosen by just one of the two reviewers. The selection process of
the sources of evidence is illustrated by means of the flowchart in Fig.
Fig.22.
Fig. 2

Selection process of papers

Go to:

Results

The search returned 366 results. One paper was found among the
references of [19] and was manually added to the final list [20]. An
article concerning the cognitive learning of autistic children was also
manually added. This paper deals with the guidelines for preventing
Covid-19 infection and is the updated version of a paper [21] published
in the Proceedings of the 12th Asian Conference on Intelligent
Information and Database Systems [22]. Eleven articles were included in
this review at the end of the selection process.

Characteristics of sources of evidence

Tables Tables11 and and22 provide an overview of the selected articles.

For each study, the reference, the used technology, the objective,
advantages, limitations and the date of publication are indicated.

Table 1
Selected articles
Reference Technology Objective Advantages Limitations Year

Improvement in data
Monitoring of Product identification
security, this scheme
medical by means of the drug
RFID (840 - is intended only for
[14] equipment and packaging, name, 2022
960 MHz) management
drugs based on model, quantity,
following the drug
IoT technology expiration date, etc.
purchase

[23] RFID Infection Cognitive learning, Limited number of 2022

prevention and addressed to autistic participants to the
control children, of evaluation study,
Reference Technology Objective Advantages Limitations Year

precautionary actions
guided by WHO to children under the
avoid the risk or spread age of 4
of COVID-19

Rollover detector for

Passive Tag wheelchairs with Improvements in
Protective
[24] RFID (902 - warning to nearby sensor accuracy are 2021
measures
928 MHz) hospitals and / or needed.
relatives

Passive Tag
Prevention and Possible
RFID (800
[25] control of Nappy moisture sensor improvements in 2020
MHz-1 GHz
Infection sensor accuracy
antenna)

Prevention and Contact tracing for

Passive Tag
[26] control of COVID-19 and other Cost and safety 2020
RFID
Infection infectious diseases

Open in a separate window

Table 2
Selected articles
Reference Technology Objective Advantages Limitations Year

Identification of the
product item through
Monitoring of
batch, serial number, Tested in a
medical
[27] Tag RFID expiration date; a closed confined 2019
equipment and
cabinet (Faraday cage) environment
drugs
protects products from
electronic interactions

The RFID tags are

Reduction of not designed to be
Monitoring of instruments
Tag RFID medical errors applied to small
[28] during the surgical 2018
(13.56 MHz) in the operating instruments and
operation
room require further
tests

[2] Tag NFC Patient Tracing of hospitalizations, High costs and 2018
Reference Technology Objective Advantages Limitations Year

care plans, prescriptions need to be more

(13,56 Mhz) identification
and drug administrations tested

Remote and Bulky sensors with

Warning signal to doctors
real-time limited storage
[20] RFID or family members in an 2018
monitoring of capacity; limited
emergency
vital signs device battery

Infection Blood pH detection to More studies

[29] RFID prevention and monitor the state of a needed to improve 2017
control wound flexibility

Reduction of Further clinical

Passive Tag
medical errors Identification of surgical studies needed to
[30] RFID (13.56 2017
in the operating gauze confirm reliability
MHz)
room and applicability

Open in a separate window

Summary of results

The study of the selected articles highlighted six matters that can be
profitably impacted by this technology.

Reduction of medical errors in the operating room

One of the most frequent adverse events related to the use of devices in
surgery is the retention of surgical instruments, such as gauze (clinical
condition defined in the literature as “Gossypiboma” or “textiloma”)
needles, scalpels, electrosurgical adapters, forceps, or parts thereof. A
wide range of clinical outcomes, including asymptomatic patients, cases
with major consequences such intestinal perforation, sepsis, organ
damage, and even death, can result from the retention of foreign
material. Due to these events, a mortality rate of 11 % to 35 % is
estimated [31]. Despite the refinement of the guidelines for equipment
counting in surgery, the risk of retaining foreign objects is high, and can
increase in some situations, such as during emergency operations with
unplanned procedure or in the case of patients with a high body mass
index (BMI). Therefore, the need to find a solution that can solve this
problem at the root. Indeed, RFID technology has proven to be a reliable
tool for detecting and tracking surgical material. For example, as regards
the gauze, a system has been developed that includes an integrated
antenna, capable of scanning the patient’s body and identifying the
retained gauze. Each gauze is equipped with a passive RFID tag, in bio-
compatible material, that is resistant to water, chemicals and high
temperatures [30]. The count of the used gauze is carried out through a
basket-shaped ‘check-out’ antenna, which consists of an array of six
antennas: four on the side surface, one on the bottom and one at the
intermediate level. The localization of the gauze is carried out through a
multiplexer that acts as a body scanner. All data is displayed in real time
with software supporting the operating room staff. Surgical instruments
(scalpels, probes, hemostatic tissue, forceps, etc.) can also be identified
with an RFID tag (Fig. 3) by using an antenna that is able to detect them
and monitor their usage rate. The usage rate is an important parameter
for understanding wear, thus preventing breakage of the instrument
during surgery. The antenna is positioned on an instrument holder, the
Mayo table, where the instruments are sorted and collected thus
allowing a precise reading of the objects that are positioned above [28].
Fig. 3

Radiofrequency identification-tagged
instruments (source: https://www.delta.tudelft.nl/article/tracking-surgical-instruments-
rfid-chips)
Patient identification

Misidentification of the patient is one of the main causes of medical

error, leading to incorrect administration or incorrect dosage of drugs.
These mistakes can lead to serious consequences. RFID technology has
the potential to prevent such consequences. An example is the use of NFC
tags to identify medical staff on shift, hospital patients and drugs [2].

In the Intensive Care Unit (ICU) of the Virxe da Xunqueira hospital in

Spain, an interesting system has been implemented that computerizes
and keeps track of hospitalizations, care plans, vital monitoring,
prescriptions, and drug administration of patients (Fig. (Fig.44).
Fig. 4

RFID system for tracking in the ICU (doctor (source: https://www.mdpi.com/1424-

8220/18/5/1627/htm#)

The developed system consists of two subsystems: hardware and

software. They have been designed to facilitate the flow of information
between all operators involved in the patient care. The administered
drug, the healthcare staff and the patient are identified by means of a
NFC tag. This tag must be read by the application to obtain the unique
identifier (UID) and manage the pending tasks related to the care
process of the patient. For example, the application can thus confirm
whether a certain drug, prescribed by the doctor, is waiting to be
administered to the patient by hospital staff on shift (Fig. (Fig.55).

Fig. 5

RFID system for tracking in the ICU (source: https://www.mdpi.com/1424-

8220/18/5/1627/htm#)

The identification of healthcare staff is important to ensure that each

professional profile has access to information based on its category. In a
possible scenario, the nursing staff will be able to manage the drugs
administration, while the section for drugs prescription is just for
physicians. An objective of this system is the possibility of rapidly
identifying patients so that it is possible to check which of them have
been administered certain batches of drugs, to manage any
pharmaceutical alarms.

Infection prevention and control

It is also important to prevent possible worsening of wounds or
infections in time. For example, it is important to monitor the progress of
wounds healing to prevent deterioration. It is known that pH is an
important biomarker of the state of a wound, normally in the absence of
lesions the skin has a slightly acid pH, in the range of 4-6, while when it is
damaged this acidic environment is altered. When the wound is acute,
pH follows a relatively simple path through a phase of acidic
inflammation, followed by a more basic granulation phase, subsequently
stabilizing in the 4-6 pH range during re-epithelialization. About the
chronic wounds, the process is much more complex [32] and it is very
important to monitor this process to get an idea of the progress of the
wound, in order to act promptly. To this end it was proposed to fix a pH
meter on wound dressings with a non-contact electronic reading based
on RFID, through a low-cost optoelectronic interface [29]. Optical
measurements are carried out with a wireless sensor framework
specifically designed for optical chemical sensing. This framework allows
quantitative pH data to be self-measured and wirelessly transferred via
RFID to a computer. The system is based on a commercial integrated
circuit, the MLX90129, which provides wireless communication
functions (RFID and NFC). The optoelectronic sensor consists of an LED
light source and a photodiode that measures the light reflected by the
pH-sensitive film. The LED and photodiode are controlled by the wireless
platform during sample acquisition with an adjustable sampling rate
(Fig. (Fig.66).
Fig. 6

Schematic showing operation of the wireless smart

bandage (source: https://www.sciencedirect.com/science/article/abs/pii/
S0925400517303222)

Among the many wireless technologies available, the use of RFID for
wound detection is particularly appealing, owing to inherent
characteristics such as low power consumption, which allows for longer
measurements, or its compatibility with NFC, which allows for data
transfer and analysis directly from a smartphone.
The usage of a humidity sensor for diapers is especially important for
non-self-sufficient persons, children, or people with certain diseases,
who, if not examined often, are vulnerable to skin rashes and bacterial
infections [25]. The low-cost smart diaper features a passive RFID tag
made of SAP (Super Absorbent Polymer), a subclass of hydrogel that is
responsible for the majority of absorption and boosts conductivity when
wet. This characteristic is utilised for detection as well as an antenna
element in the tag’s construction. The plan was to create a bow-tie
antenna made of metal and SAP that expands when wet, increasing the
power given to the RFID tag chip. The RFID reader, when placed within
the tag’s reading range and linked to the internet, allows you to send a
notice to the mobile device associated with it, notifying the healthcare
personnel or caregiver in the event of an emergency. Another essential
protection is that linked to epidemics; there are crucial steps to be done
to avoid catching the virus. So, even when we talk about COVID-19, we
know that the WHO has standards in place to attempt to restrict its
spread. They are basic principles that must be followed in order to
protect ourselves and others; consequently, they must be taught and
mastered even by youngsters, but this may be challenging when dealing
with autism. Indeed, autistic children’s learning processes are hampered
from early childhood due to a diminished inclination to watch and copy
others, as well as trouble interpreting others’ words and activities [33].
Technology and gaming, such as the creation of an IoT-based gaming
platform, can be beneficial [23]. The platform is made up of three games
and comprises of a physical device and a mobile application. To save
data, the mobile application is wirelessly connected to the device and the
server. Children’s interactions and activities with the device are assessed
and saved on the server, allowing past data to be obtained, examined,
and analyzed by the server via this application, allowing them to monitor
their learning progress (Fig. (Fig.77).
Fig. 7

Conceptual design of the proposed gaming

tool (source: https://journals.sagepub.com/doi/abs/10.1177/07356331211067725)

A power supply turns on the hardware. There are three switches that
correlate to the device’s three games. Only two of these focus on learning
Covid-19 infection prevention strategies. The linked gadgets are
powered when the corresponding switch is switched on.

One of these games consists of cards, with each card containing a

multiple-choice question and four potential pictures illustrated below.
Each card has four piezoelectric sensors and an RFID tag that uniquely
identifies it. When a card is placed in the corresponding location of the
game box, the system reads the RFID tag associated to the card, allowing
it to be viewed on the mobile application, which records the replies in
the database. As shown in Fig. Fig.8,8, the card’s job is to educate a
youngster which behaviors are appropriate and which are wrong or to
avoid in order to protect us from COVID-19.
Fig. 8

a Function card game box and b respective app interface

A second game is to teach the kid the proper sequence for proper hand
hygiene, always in relation to viral transmission prevention. The game is
organized by six cards, each of which has a picture and an RFID tag (the
tag is used to uniquely identify the cards), which must be placed in the
correct sequence on the game box by the kid. The latter is made up of
RFID scanners, which will uniquely identify the cards and relay the data
to the mobile application. Unfortunately, given the rapid transmission of
some viruses, such as COVID-19, we know that preventative measures
are sometimes insufficient. Several research have attempted to discover
a feasible answer to contact traceability [26]. In one research, an IoT-
based approach that gathers information from moving objects is offered
[26]. This information is recorded anonymously until bearers test
positive for an infectious illness, such as COVID-19, according to the
model.

The visual architectural model shown in Fig. Fig.99 depicts how data
flows from the RFID tag, to the reader, and finally to the blockchain;
similarly, proximity data collected by the application downloaded on a
mobile device (consider the various applications that were freely
downloaded during the Covid-19 pandemic, which were used to detect
and prevent any infections), from the geolocalizer of contacts
incorporated into it, flow into the blockchain via the Internet. In order to
maintain anonymity, the data obtained in this manner is kept using the
blockchain. Indeed, because to its qualities and the manner in which data
is maintained, it is frequently seen as an alternative to other types of
databases for registers administered by public bodies in terms of
security, dependability, openness, and prices). The contact geolocalizer is
a component of the application (DApp), i.e. the front-end through which
users interact with the program. If a citizen with the mobile device or
RFID tag is diagnosed with COVID-19 or another infectious disease, the
information collected may be utilized to send notifications to contacts.
Fig. 9

RFID device data flow diagram to the

blockchain (source: https://ieeexplore.ieee.org/document/9181512)

The collected data is saved on the applicable Smart Contract (SC). A

smart contract is a specific collection of instructions recorded on the
blockchain that may self-execute activities based on a set of pre-
programmed criteria; all of this in an immutable, transparent, and
entirely secure manner. To prevent the excessive use of data and the
phone battery, information on position changes will be acquired every
10 minutes, as will uploading to the blockchain every twenty minutes.
Because the RFID tag lacks the ability to connect to other devices, its
contact with other similar devices will be determined by the timestamp
information (the timestamp can be defined as a “timestamp,” which is a
sequence of characters representing a date and / or a time to determine
the actual occurrence of a certain event).

Protection measures
The scarcity of health providers is a severe socioeconomic issue in many
nations, especially given the aging of the population [34]. Cutting-edge
medical technology, like as intelligent wheelchairs, can assist the elderly
in living independently, therefore alleviating the shortage of health care.
However, the lack of a caregiver makes wheelchair accidents more
perilous; rollover is one of the most prevalent, and the following fall of
the user is possibly lethal. As a result, an RFID-based rollover monitoring
sensor attached to wheelchairs can be quite useful [24]. The suggested
sensor is made up of two symmetrical, meandering dipole antennas on
the left and right sides, as well as a four-port switch, tilt detector
(RBS100600 ONCQUE) in the middle (Fig. (Fig.1010).

Fig. 10

Geometry and photograph of the proposed

rolloversensor (source: https://onlinelibrary.wiley.com/doi/abs/10.1002/mop.32648)

The rollover sensor is intended to be mounted horizontally beneath the

wheelchair seat. When the latter is flipped over, the two pins of the tilt
switch on the opposite side (right or left) are connected, and the RFID
chip on the same side is activated, generating a voltage, by the energy of
the signal sent by the RFID reader. Thus, the wheelchair’s protective
measures can be activated to minimize injuries by connecting their
circuitry to the RFID chip. When this is activated, a response signal
containing the chip code is delivered to the reader. In this manner, the
RFID-based location algorithm can get the sensor position, and the
emergency signal comprising the sensor location will be transmitted to
local hospitals or rescue stations, as well as family members.

Vital signs monitoring remotely and in real time

This is the case with the development of the Wearable IoT-cloud-based

hEalth (WISE) system [20], which employs a network of indestructible
sensors to monitor the health of people with chronic diseases such as
heart disease, diabetes, and Alzheimer’s disease. It is possible to get a
number of biomedical signals, including arterial blood pressure, heart
beat, blood pressure, and body temperature. WISE was developed on the
basis of the hardware platform Arduino, and is integrated with sensor
nodes such as the non-invasive sensor designed to measure blood
pressure. The connection of an RFID reader to the Arduino platform
makes it easier to identify different users. Furthermore, WISE has a WiFi
module that allows data to be sent to the cloud, allowing authorized
users to access data in real time from any location and at any time. As a
result, the WISE system consists of three key components: the WISE
body area network (W-BAN), the WISE cloud (W-Cloud), and the WISE
users. Connecting the RFID reader to the Arduino platform makes it
easier to identify different users. Furthermore, WISE has a WiFi module
that facilitates data transfer to the cloud, allowing authorized users to
view data in real time from any location and at any time. As a result, the
WISE system is made up of three main components: the WISE body area
network (W-BAN), the WISE cloud (W-Cloud), and the WISE users (Fig.
(Fig.1111).
Fig. 11

WISE system (source: https://jwcn-eurasipjournals.springeropen.com/articles/10.1186/

s13638-018-1308-x)

W-BAN data may be effectively and efficiently saved and processed in the
cloud. To detect and diagnose probable cardiac disease, key
characteristics can be extracted. If an aberrant state is identified, an alert
is sent to a designated interlocutor, including a text message to
physicians or family members, and a warning is presented on the LCD
(Liquid Crystal Display) for the users.

Monitoring of medical instruments and drugs

Another important issue is the continuous monitoring of medical

instruments and drugs that are essential for patient care, for example, to
avoid the stock-out in the inventory. A solution could be the use of an
automated system defined as “StocKey® RFID Smart Cabinet” [27]. The
medical supplies for the patients’ care and those for the surgical
operations are labeled with RFID technology when they are supplied to
the hospital. In this way, it is possible to manage expiration dates and
automatically schedule reorders. The tags, in fact, identify the product
with the lot number, serial number and expiration date. The objects thus
identified are kept in a closed cabinet (“Faraday cage”), which allows an
accurate view of the medical supplies present in the warehouse. All the
inputs and outputs of products, thanks to their RFID tags, are read to be
incorporated into the electronic inventory of the cabinet. This system
was designed primarily for operating rooms, unlike the IoT-based
system [14], which was designed for in-hospital or out-of-hospital
pharmacies and mainly for drugs. This system also uses the RFID tag
above the drug packages, which are read by an RFID reader placed in the
center of the compartment, where they are located. Everything is
connected to an LED that alerts the manager of that department if a
check for missing or expired drugs is necessary. RFID labeling can also
be considered one of the best solutions against drug counterfeiting,
because information, such as raw materials, the manufacturer, and the
pharmaceutical company, is collected and thus identification is
facilitated. This is a very important, because counterfeit drugs pose a
significant threat to patient safety and public health and cause heavy
losses to each State economy. For example, counterfeit drugs to treat
malaria and pneumonia cause an estimated 250,000 infant deaths each
year.

Go to:

Discussion of results

From the analyzed studies, the use of RFID tags seems to be more
promising in two scenarios: the first is in the field of surgical
instrumentation, since RFID technology allows continuous monitoring of
the instruments used during a surgical operation, such as gauze or
instruments: scalpels, electrosurgical adapters, forceps, etc. Therefore,
the use of RFID tags benefits the patient, in terms of safety, and the
medical and nursing staff in carrying out their related duties. The second
scenario is that concerning patients’ identification: a correct
identification of the patient helps to reduce errors related to the
administration of drugs; a quick identification of the patient is very
important in case of emergencies launched by the pharmaceutical
companies on a specific batch of a drug that could present anomalies or
manufacturing errors. Passive RFID tags seem to be the most used, this is
probably due to their lower cost compared to active RFID tags, their
small size which makes them more flexible, despite their reading range
that is much shorter than that of active ones. Although RFID technology
holds great promise for Healthcare, there are several risks or barriers
that prevent its implementation, in particular the implementation cost
and the need to improve data security constitute obstacles to its use
within hospitals or public medical facilities. Indeed, data security is a
critical issue, since the protection of privacy and sensitive data currently
requires careful attention. Another problem is electromagnetic
interference (EMI) which occurs when electromagnetic waves from an
electronic device interfere with the operation of another electronic
device and cause an unwanted response. Many studies from the authors
have assessed these aspects by applying risk analysis techniques as well
as by investigating electromagnetic compatibility in real hospital settings
[35–39]. The use of these technologies still needs to be tested and
experimented on a large scale, as experiments have often been carried
out using prototypes, in a limited number of places or on a few people.

In this work, the reviewed papers are academic articles, so the results
are useful for analyzing the current development state of academic
research but may not be suitable for predicting the actual
implementation of RFID technology within medical and healthcare
facilities.

Go to:

Conclusions

The adoption of RFID technology in Healthcare is growing slowly

compared to other areas, despite it is a very valuable tool. The proposed
papers have been selected by searching the Scopus database. The
presented works show that this type of technology can improve patients’
safety by reducing medical errors, that can occur within operating
rooms, such as, for example, the retention of surgical material. It can also
be the solution to overcome the problem of the black market in
counterfeiting drugs, or as a prevention tool designed for monitoring the
state of a wound using “smart bandages”. In the selected papers, issues
concerning human limitations and relating consequences are addressed.
The consequences are faced and prevented using RFID technology, which
provides a prompt solution and an improvement in management, inside
and outside the hospitals. As previously mentioned, further research is
needed, especially on data management, security, and privacy, given the
sensitive nature of medical information.

Go to:

Funding

Open access funding provided by Università degli Studi di Siena within

the CRUI-CARE Agreement.

Go to:

Availability of data and material

Not applicable.

Go to:

Code availability

Not applicable.

Go to:

Declarations
Ethics approval

Not applicable.

Consent to participate

Not applicable.

Consent for publication

Not applicable.

Conflicts of interest

The authors declare no conflict of interest or competing interests.

Go to:

Footnotes

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in

published maps and institutional affiliations.

Monica Gherardelli and Ernesto Iadanza contributed equally to this

work.

Go to:

Contributor Information

Laura Profetto, Email: [email protected].

Monica Gherardelli, Email: [email protected].

Ernesto Iadanza, Email: [email protected].

Go to:

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Engineering May 26-31, 2012, Beijing, China. Springer; 2013. p. 732–5.

Radio Frequency Identification (RFID) in health care:

where are we? A scoping review
Laura Profetto,1 Monica Gherardelli,#1 and Ernesto Iadanza #1,2

Author information Article notes Copyright and License information PMC

Disclaimer

Associated Data
Data Availability Statement

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Abstract

Purpose

(RFID) is a technology that uses radio waves for data collection and
transfer, so data is captured efficiently, automatically and in real time
without human intervention. This technology, alone or in addition to
other technologies has been considered as a possible solution to reduce
problems that endanger public health or to improve its management.
This scoping review aims to provide readers with an up-to-date picture
of the use of this technology in health care settings.

Methods
This scoping review examines the state of RFID technology in the
healthcare area for the period 2017-2022, specifically addressing RFID
versatility and investigating how this technology can contribute to
radically change the management of public health. The guidelines of the
Preferred Reporting Items for Systematic reviews and Meta-Analyses
(PRISMA) have been followed. Literature reviews or surveys were
excluded. Only articles describing technologies implemented on a real
environment or on prototypes were included.

Results

The search returned 366 results. After screening, based on title and
abstract, 58 articles were considered suitable for this work. 11 articles
were reviewed because they met the qualifying requirements. The study
of the selected articles highlighted six matters that can be profitably
impacted by this technology

Conclusion

The selected papers show that this technology can improve patient
safety by reducing medical errors, that can occur within operating
rooms. It can also be the solution to overcome the problem of the black
market in counterfeiting drugs, or as a prevention tool. Further research
is needed, especially on data management, security, and privacy, given
the sensitive nature of medical information.

Graphical Abstract
Keywords: RFID, Healthcare, Medical devices, Equipment, Management,
Logistics
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Introduction

Today, the most important challenges for healthcare professionals are

minimizing the impact of adverse events and improving patient safety
[1]. An adverse event is defined as any complication that arises during
the patient’s stay in hospital and is not directly related to the underlying
disease or reason for hospitalization [2]. These events can have serious
consequences for the patient, her / his family and even the health
system. The concept of traceability can provide many benefits to these
processes. Traceability means the identification of all information
relating to a product from origin to delivery and / or consumption [3]. In
the context of health services, this can be translated as the exact
identification of the patient, the drug and the patient / drug relationship
administered, which can significantly reduce the incidence of adverse
events, thus increasing safety. Healthcare is currently facing the
challenges of improving this aspect and reducing operating costs, which
unfortunately are often caused by human and systematic errors. The
American Institute of Medicine (IOM), recently renamed as the National
Academy of Medicine (NAM) [4], estimated that between 44,000 and
98,000 deaths per year are related to medical errors occurring in
hospitals, thus showing the desperate need to improve patient safety and
well-being in hospitals [5]. It is possible to identify common phenomena
that lead to serious healthcare operation failures in addition to medical
mistakes, such as theft loss, and drug counterfeiting [6].

RFID technology is becoming more prevalent across a variety of

industries, with the healthcare sector being a growing area. Indeed, the
maturation of applications such as real-time locating system (RTLS) for
patient tracking, medical personnel, and asset tracking will most
certainly contribute to rapid expansion in the RFID industry in the future
years. This market was worth USD 16.95 billion in 2016 and is expanding
at a 7.7 percent CAGR between 2017 and 2023 [7].

Radio frequency identification (RFID) is one of the 16 fundamental

innovations for the next decade, as stated by the Massachusetts Institute
of Technology (MIT) which ranked it as the 10th most innovative
technology of the last 25 years, for automatic data collection and
traceability of goods [8]. The identification process consists in reading an
RFID tag applied to an asset or a person without any physical contact.
The data collection and transfer are done with the use of radio waves, so
data is captured efficiently, automatically and in real time without
human intervention. The advantage is that an RFID reader can read more
tags simultaneously from a greater distance and therefore without the
need to approach the reader, unlike traditional barcode scanning. It is
therefore possible to attribute an electronic label to assets, healthcare
personnel or patients, who once tagged, can be identified, tracked, and
managed through a centralized database, using pervasive IT devices such
as PDAs (Personal Digital Assistants) or mobile phones [9].
A RFID device can have different electromagnetic transmission
configurations, based on different applications, but typically includes the
following components (Fig. (Fig.11):

 Tag RFID;
 Tag reader equipped with an antenna and a transceiver;
 Host system or connection to a business system.

Fig. 1

RFID system: an RFID reader acquires information from one or some tags and transfers
such information to an host system

The Tag is used to store information; each RFID tag contains an

electronic integrated circuit and an antenna inside a package (capsule),
which are affixed to an object with a unique identification number and a
memory that records additional data relating to the manufacturer, the
product type and other related environmental information [10]. The
reader is used to collect all the information stored in a tag. The RFID
reader consists of a decoder that decodes the information; the antenna is
used to transmit and receive the RF waves that carry information from
the tag to the reader and vice versa. The RFID reader can read or/and
write data in the tags by reading the identifying information (IDs) of the
neighboring tags and mapping them to an object through a database or
an external service. The software is used to manage the received data
and the reader and tag operations, it manages the information in a
database [10]. The latter can also contain the details of the tags and
readers. All information is sent to a host computer or RFID middleware
to ensure communication between the RFID infrastructure and the
various intra- and inter-organizational systems [7]. Tags can be classified
into three classes: active, passive and semi-passive tags [10].

Active tags are powered by batteries and incorporate both a receiver and
a transmitter, have large memories, often rewritable, and can contain
sensors. They can operate at distances that are generally much greater
than those of passive and semi-passive tags (maximum 200 meters) and
have larger memory. The disadvantages are: high price, limited duration
as they depend on the antenna and the energy available in the batteries,
larger weight and dimensions than passive tags.

Passive tags do not have an internal power source, they are activated
when they enter the range of action of an RFID reader, the latter
generates a magnetic field that powers, and therefore activates, the chip
contained in the tag. Passive tags are smaller in size, lighter in weight
and low in cost and with an unlimited lifespan. Unfortunately, they have
limited functionality: they have a low communication range, their
information storage and computing capacity is limited.

The semi-passive tag is provided with a battery that is used only to

power the internal circuit. Unlike the active tag, it communicates via the
electromagnetic field created by the reader. The battery stays dormant
until triggered by a signal from the reader, saving battery power and
extending tag life [7].

The RFID technology can operate at different frequencies, each having its
pros and cons. For the low frequency (LF) band, 125 to 134 kHz, the
main advantage is the possibility of its use worldwide, indeed it is
available in all major countries: Europe, North America, and Japan. The
major applications related to its use are those that require the
transmission of limited amounts of data over short distances. It is also
affected by small interference with liquids and metals [11]. The main
drawback is that ferromagnetic materials have a shielding effect on
electromagnetic waves at these frequencies and therefore can cause
reading problems. Furthermore, the large dimensions of the reader
antennas and the reduced operational distances limit the diffusion of
systems using these frequencies [12].

The high frequency (HF) band has a central frequency of 13.56 MHz, and
is characterized by greater reading range and speed than the LF band.
Near Field Communication (NFC), a wireless data interface between
devices also works at an operating frequency of 13.56 MHz [13].

The ultra-high frequency (UHF) band is between 860MHz and 960MHz.

These tags have better reading range and better data transfer compared
to lower frequency bands. Increasing the frequency allows the use of
smaller antennas, that are therefore suitable for portable devices. On the
other side, costs are higher with this technology. Usually the different
governments, through their legislation, independently manage frequency
assignments. Therefore, there are differences internationally in the
frequencies assigned for RFID applications even if standardization by ISO
and similar organizations is helping to make them more and more
compliant. For example, Europe uses 868MHz for ultra-high frequency
(UHF), while the United States uses 915 MHz [7].

The RFID technology used with other technologies, such as the Wireless
Sensor Network (WSN), allows to expand its functionality and create
hybrid monitoring systems, based on the Internet of Things (IoT) [7].
This hybrid technique depicts a possible progression of Internet use:
objects (“things”) become recognized and intelligent since they can
communicate their own data and receive aggregate information from
others; as a result, all items can play an active role owing to Internet
connectivity [14].

“Things” or “objects” are elements such as, among others: devices,

instruments, plants and systems, materials, products, works, goods,
machines, and equipment. The connected objects, that are the basis of
the IoT, are more properly defined as “smart objects” and are
characterized by some properties or functionality. Identification,
connection, localization, the ability to process data and the ability to
interact with the external environment are paramount [14].

The IoT is a system consisting of three levels [15]:

 Perception layer: also called “physical layer”, which identifies and

collects all types of information from the physical world of the IoT,
through sensors, tags, WSNs, cameras, RFID systems and so on.
 Network layer: also called “transport layer”, in charge of
transparent data trasmission.
 Service layer: also called “application layer”, including a sub-level
for data management and a sub-level for application services.

RFID technology, alone or together with other technologies, has been

considered as a possible solution to reduce problems that endanger
public health or for improving the management of the latter. For
example, the problems related to medical waste recycling, if not
managed in a safe and conscious way can cause the spread of diseases
and environmental pollution, that traditional methods often fail to
prevent. There are some studies aimed at finding a solution to this type
of problems; some of these aim to design methods that apply reverse
logistics based on RFID technology [16].

This work examines the state of RFID technology in the healthcare area
in the last five years, It specifically illustrates RFID versatility and
verifies how this technology can contribute to radically change the
management of public health. The aspects that have an impact on the
qualitative characteristics of health services relating to prevention,
diagnostics and monitoring of patients’ health are considered very
important.

Go to:

Methods

For this work it has been chosen the Scoping Review research design to
assess the current state of RFID employment in healthcare area, to have
an overview of the state of the art relating to the chosen topic and to
identify the problems that limit RFID use. Scoping Review is a type of
research evidence synthesis that aims to detect the literature on a
particular research topic or area and to provide an opportunity to
identify key concepts [17]. The guidelines of the Preferred Reporting
Items for Systematic reviews and Meta-Analyses (PRISMA) have been
followed. PRISMA statement aims to provide a guide for the drafting of
the results of research in the medical field [18].

Eligibility criteria

According to the selected eligibility criteria, only journal articles with a

publication year from 2017 to 2022 were included. The examination of
these articles, in particular, allows us to concentrate on newly created
approaches, and the research confined to the aforementioned time
allows us to comprehend the major elements and associated constraints
of the most current methodology. The search was restricted to
documents in English, which was thought to be the most often used
language for this type of topic. Literature reviews or surveys were
excluded. Only articles describing technologies implemented on a real
environment or on prototypes were included.

Searching for a paper

The searching of articles was carried out through Scopus, a search engine
with a database of peer-reviewed scientific products (journal articles,
books, conference proceedings) and more than 70 million bibliographic
citations, abstracts, and bibliometric data. It was preferred over other
search engines, as it covers wider disciplinary sectors, unlike for
example Pubmed which is a purely biomedical database.

The search string launched on Scopus was as follows:

TITLE-ABS-KEY ( rfid AND ( healthcare OR “health care” OR hospital ) )

AND ( LIMIT-TO ( DOCTYPE , “ar”) OR LIMIT-TO ( DOCTYPE , “ch” ) OR
LIMIT-TO ( DOCTYPE , “re” ) ) AND ( LIMIT-TO ( PUBYEAR , 2022 ) OR
LIMIT-TO ( PUBYEAR , 2021 ) OR LIMIT-TO ( PUBYEAR , 2020 ) OR
LIMIT-TO ( PUBYEAR , 2019 ) OR LIMIT-TO ( PUBYEAR , 2018 ) OR
LIMIT-TO ( PUBYEAR , 2017 ) ) AND ( LIMIT-TO ( LANGUAGE , “English”)
)

With this string we have imposed restrictions on the year of publication

(from 2017 to 2022), and on the language: English.

Selection process

After the literature search, all the recovered documents were examined,
selected first by title, then by abstract and finally by evaluating the entire
text. The articles rejected based on their title were not related to the
health sector but dealt with other issues. In reading the abstract, those
articles relating to literature reviews or surveys were discarded. Articles
with higher numbers of citations were preferred in this phase. All of the
records in the output of the literature search had their titles and
abstracts reviewed separately by two reviewers (L.P. and E.I.). The ones
deemed to be unrelated to the scope of the review have been eliminated.
The two reviewers’ individual results have been compared, and the
publications that they both deemed appropriate for the research have
been added immediately to the list for full-text download. M.G., a third
reviewer, was requested to make a choice about the papers that had
been chosen by just one of the two reviewers. The selection process of
the sources of evidence is illustrated by means of the flowchart in Fig.
Fig.22.
Fig. 2

Selection process of papers

Go to:

Results

The search returned 366 results. One paper was found among the
references of [19] and was manually added to the final list [20]. An
article concerning the cognitive learning of autistic children was also
manually added. This paper deals with the guidelines for preventing
Covid-19 infection and is the updated version of a paper [21] published
in the Proceedings of the 12th Asian Conference on Intelligent
Information and Database Systems [22]. Eleven articles were included in
this review at the end of the selection process.

Characteristics of sources of evidence

Tables Tables11 and and22 provide an overview of the selected articles.

For each study, the reference, the used technology, the objective,
advantages, limitations and the date of publication are indicated.

Table 1
Selected articles
Reference Technology Objective Advantages Limitations Year

Improvement in data
Monitoring of Product identification
security, this scheme
medical by means of the drug
RFID (840 - is intended only for
[14] equipment and packaging, name, 2022
960 MHz) management
drugs based on model, quantity,
following the drug
IoT technology expiration date, etc.
purchase

[23] RFID Infection Cognitive learning, Limited number of 2022

prevention and addressed to autistic participants to the
control children, of evaluation study,
Reference Technology Objective Advantages Limitations Year

precautionary actions
guided by WHO to children under the
avoid the risk or spread age of 4
of COVID-19

Rollover detector for

Passive Tag wheelchairs with Improvements in
Protective
[24] RFID (902 - warning to nearby sensor accuracy are 2021
measures
928 MHz) hospitals and / or needed.
relatives

Passive Tag
Prevention and Possible
RFID (800
[25] control of Nappy moisture sensor improvements in 2020
MHz-1 GHz
Infection sensor accuracy
antenna)

Prevention and Contact tracing for

Passive Tag
[26] control of COVID-19 and other Cost and safety 2020
RFID
Infection infectious diseases

Open in a separate window

Table 2
Selected articles
Reference Technology Objective Advantages Limitations Year

Identification of the
product item through
Monitoring of
batch, serial number, Tested in a
medical
[27] Tag RFID expiration date; a closed confined 2019
equipment and
cabinet (Faraday cage) environment
drugs
protects products from
electronic interactions

The RFID tags are

Reduction of not designed to be
Monitoring of instruments
Tag RFID medical errors applied to small
[28] during the surgical 2018
(13.56 MHz) in the operating instruments and
operation
room require further
tests

[2] Tag NFC Patient Tracing of hospitalizations, High costs and 2018
Reference Technology Objective Advantages Limitations Year

care plans, prescriptions need to be more

(13,56 Mhz) identification
and drug administrations tested

Remote and Bulky sensors with

Warning signal to doctors
real-time limited storage
[20] RFID or family members in an 2018
monitoring of capacity; limited
emergency
vital signs device battery

Infection Blood pH detection to More studies

[29] RFID prevention and monitor the state of a needed to improve 2017
control wound flexibility

Reduction of Further clinical

Passive Tag
medical errors Identification of surgical studies needed to
[30] RFID (13.56 2017
in the operating gauze confirm reliability
MHz)
room and applicability

Open in a separate window

Summary of results

The study of the selected articles highlighted six matters that can be
profitably impacted by this technology.

Reduction of medical errors in the operating room

One of the most frequent adverse events related to the use of devices in
surgery is the retention of surgical instruments, such as gauze (clinical
condition defined in the literature as “Gossypiboma” or “textiloma”)
needles, scalpels, electrosurgical adapters, forceps, or parts thereof. A
wide range of clinical outcomes, including asymptomatic patients, cases
with major consequences such intestinal perforation, sepsis, organ
damage, and even death, can result from the retention of foreign
material. Due to these events, a mortality rate of 11 % to 35 % is
estimated [31]. Despite the refinement of the guidelines for equipment
counting in surgery, the risk of retaining foreign objects is high, and can
increase in some situations, such as during emergency operations with
unplanned procedure or in the case of patients with a high body mass
index (BMI). Therefore, the need to find a solution that can solve this
problem at the root. Indeed, RFID technology has proven to be a reliable
tool for detecting and tracking surgical material. For example, as regards
the gauze, a system has been developed that includes an integrated
antenna, capable of scanning the patient’s body and identifying the
retained gauze. Each gauze is equipped with a passive RFID tag, in bio-
compatible material, that is resistant to water, chemicals and high
temperatures [30]. The count of the used gauze is carried out through a
basket-shaped ‘check-out’ antenna, which consists of an array of six
antennas: four on the side surface, one on the bottom and one at the
intermediate level. The localization of the gauze is carried out through a
multiplexer that acts as a body scanner. All data is displayed in real time
with software supporting the operating room staff. Surgical instruments
(scalpels, probes, hemostatic tissue, forceps, etc.) can also be identified
with an RFID tag (Fig. 3) by using an antenna that is able to detect them
and monitor their usage rate. The usage rate is an important parameter
for understanding wear, thus preventing breakage of the instrument
during surgery. The antenna is positioned on an instrument holder, the
Mayo table, where the instruments are sorted and collected thus
allowing a precise reading of the objects that are positioned above [28].
Fig. 3

Radiofrequency identification-tagged
instruments (source: https://www.delta.tudelft.nl/article/tracking-surgical-instruments-
rfid-chips)
Patient identification

Misidentification of the patient is one of the main causes of medical

error, leading to incorrect administration or incorrect dosage of drugs.
These mistakes can lead to serious consequences. RFID technology has
the potential to prevent such consequences. An example is the use of NFC
tags to identify medical staff on shift, hospital patients and drugs [2].

In the Intensive Care Unit (ICU) of the Virxe da Xunqueira hospital in

Spain, an interesting system has been implemented that computerizes
and keeps track of hospitalizations, care plans, vital monitoring,
prescriptions, and drug administration of patients (Fig. (Fig.44).
Fig. 4

RFID system for tracking in the ICU (doctor (source: https://www.mdpi.com/1424-

8220/18/5/1627/htm#)

The developed system consists of two subsystems: hardware and

software. They have been designed to facilitate the flow of information
between all operators involved in the patient care. The administered
drug, the healthcare staff and the patient are identified by means of a
NFC tag. This tag must be read by the application to obtain the unique
identifier (UID) and manage the pending tasks related to the care
process of the patient. For example, the application can thus confirm
whether a certain drug, prescribed by the doctor, is waiting to be
administered to the patient by hospital staff on shift (Fig. (Fig.55).

Fig. 5

RFID system for tracking in the ICU (source: https://www.mdpi.com/1424-

8220/18/5/1627/htm#)

The identification of healthcare staff is important to ensure that each

professional profile has access to information based on its category. In a
possible scenario, the nursing staff will be able to manage the drugs
administration, while the section for drugs prescription is just for
physicians. An objective of this system is the possibility of rapidly
identifying patients so that it is possible to check which of them have
been administered certain batches of drugs, to manage any
pharmaceutical alarms.

Infection prevention and control

It is also important to prevent possible worsening of wounds or
infections in time. For example, it is important to monitor the progress of
wounds healing to prevent deterioration. It is known that pH is an
important biomarker of the state of a wound, normally in the absence of
lesions the skin has a slightly acid pH, in the range of 4-6, while when it is
damaged this acidic environment is altered. When the wound is acute,
pH follows a relatively simple path through a phase of acidic
inflammation, followed by a more basic granulation phase, subsequently
stabilizing in the 4-6 pH range during re-epithelialization. About the
chronic wounds, the process is much more complex [32] and it is very
important to monitor this process to get an idea of the progress of the
wound, in order to act promptly. To this end it was proposed to fix a pH
meter on wound dressings with a non-contact electronic reading based
on RFID, through a low-cost optoelectronic interface [29]. Optical
measurements are carried out with a wireless sensor framework
specifically designed for optical chemical sensing. This framework allows
quantitative pH data to be self-measured and wirelessly transferred via
RFID to a computer. The system is based on a commercial integrated
circuit, the MLX90129, which provides wireless communication
functions (RFID and NFC). The optoelectronic sensor consists of an LED
light source and a photodiode that measures the light reflected by the
pH-sensitive film. The LED and photodiode are controlled by the wireless
platform during sample acquisition with an adjustable sampling rate
(Fig. (Fig.66).
Fig. 6

Schematic showing operation of the wireless smart

bandage (source: https://www.sciencedirect.com/science/article/abs/pii/
S0925400517303222)

Among the many wireless technologies available, the use of RFID for
wound detection is particularly appealing, owing to inherent
characteristics such as low power consumption, which allows for longer
measurements, or its compatibility with NFC, which allows for data
transfer and analysis directly from a smartphone.
The usage of a humidity sensor for diapers is especially important for
non-self-sufficient persons, children, or people with certain diseases,
who, if not examined often, are vulnerable to skin rashes and bacterial
infections [25]. The low-cost smart diaper features a passive RFID tag
made of SAP (Super Absorbent Polymer), a subclass of hydrogel that is
responsible for the majority of absorption and boosts conductivity when
wet. This characteristic is utilised for detection as well as an antenna
element in the tag’s construction. The plan was to create a bow-tie
antenna made of metal and SAP that expands when wet, increasing the
power given to the RFID tag chip. The RFID reader, when placed within
the tag’s reading range and linked to the internet, allows you to send a
notice to the mobile device associated with it, notifying the healthcare
personnel or caregiver in the event of an emergency. Another essential
protection is that linked to epidemics; there are crucial steps to be done
to avoid catching the virus. So, even when we talk about COVID-19, we
know that the WHO has standards in place to attempt to restrict its
spread. They are basic principles that must be followed in order to
protect ourselves and others; consequently, they must be taught and
mastered even by youngsters, but this may be challenging when dealing
with autism. Indeed, autistic children’s learning processes are hampered
from early childhood due to a diminished inclination to watch and copy
others, as well as trouble interpreting others’ words and activities [33].
Technology and gaming, such as the creation of an IoT-based gaming
platform, can be beneficial [23]. The platform is made up of three games
and comprises of a physical device and a mobile application. To save
data, the mobile application is wirelessly connected to the device and the
server. Children’s interactions and activities with the device are assessed
and saved on the server, allowing past data to be obtained, examined,
and analyzed by the server via this application, allowing them to monitor
their learning progress (Fig. (Fig.77).
Fig. 7

Conceptual design of the proposed gaming

tool (source: https://journals.sagepub.com/doi/abs/10.1177/07356331211067725)

A power supply turns on the hardware. There are three switches that
correlate to the device’s three games. Only two of these focus on learning
Covid-19 infection prevention strategies. The linked gadgets are
powered when the corresponding switch is switched on.

One of these games consists of cards, with each card containing a

multiple-choice question and four potential pictures illustrated below.
Each card has four piezoelectric sensors and an RFID tag that uniquely
identifies it. When a card is placed in the corresponding location of the
game box, the system reads the RFID tag associated to the card, allowing
it to be viewed on the mobile application, which records the replies in
the database. As shown in Fig. Fig.8,8, the card’s job is to educate a
youngster which behaviors are appropriate and which are wrong or to
avoid in order to protect us from COVID-19.
Fig. 8

a Function card game box and b respective app interface

A second game is to teach the kid the proper sequence for proper hand
hygiene, always in relation to viral transmission prevention. The game is
organized by six cards, each of which has a picture and an RFID tag (the
tag is used to uniquely identify the cards), which must be placed in the
correct sequence on the game box by the kid. The latter is made up of
RFID scanners, which will uniquely identify the cards and relay the data
to the mobile application. Unfortunately, given the rapid transmission of
some viruses, such as COVID-19, we know that preventative measures
are sometimes insufficient. Several research have attempted to discover
a feasible answer to contact traceability [26]. In one research, an IoT-
based approach that gathers information from moving objects is offered
[26]. This information is recorded anonymously until bearers test
positive for an infectious illness, such as COVID-19, according to the
model.

The visual architectural model shown in Fig. Fig.99 depicts how data
flows from the RFID tag, to the reader, and finally to the blockchain;
similarly, proximity data collected by the application downloaded on a
mobile device (consider the various applications that were freely
downloaded during the Covid-19 pandemic, which were used to detect
and prevent any infections), from the geolocalizer of contacts
incorporated into it, flow into the blockchain via the Internet. In order to
maintain anonymity, the data obtained in this manner is kept using the
blockchain. Indeed, because to its qualities and the manner in which data
is maintained, it is frequently seen as an alternative to other types of
databases for registers administered by public bodies in terms of
security, dependability, openness, and prices). The contact geolocalizer is
a component of the application (DApp), i.e. the front-end through which
users interact with the program. If a citizen with the mobile device or
RFID tag is diagnosed with COVID-19 or another infectious disease, the
information collected may be utilized to send notifications to contacts.
Fig. 9

RFID device data flow diagram to the

blockchain (source: https://ieeexplore.ieee.org/document/9181512)

The collected data is saved on the applicable Smart Contract (SC). A

smart contract is a specific collection of instructions recorded on the
blockchain that may self-execute activities based on a set of pre-
programmed criteria; all of this in an immutable, transparent, and
entirely secure manner. To prevent the excessive use of data and the
phone battery, information on position changes will be acquired every
10 minutes, as will uploading to the blockchain every twenty minutes.
Because the RFID tag lacks the ability to connect to other devices, its
contact with other similar devices will be determined by the timestamp
information (the timestamp can be defined as a “timestamp,” which is a
sequence of characters representing a date and / or a time to determine
the actual occurrence of a certain event).

Protection measures
The scarcity of health providers is a severe socioeconomic issue in many
nations, especially given the aging of the population [34]. Cutting-edge
medical technology, like as intelligent wheelchairs, can assist the elderly
in living independently, therefore alleviating the shortage of health care.
However, the lack of a caregiver makes wheelchair accidents more
perilous; rollover is one of the most prevalent, and the following fall of
the user is possibly lethal. As a result, an RFID-based rollover monitoring
sensor attached to wheelchairs can be quite useful [24]. The suggested
sensor is made up of two symmetrical, meandering dipole antennas on
the left and right sides, as well as a four-port switch, tilt detector
(RBS100600 ONCQUE) in the middle (Fig. (Fig.1010).

Fig. 10

Geometry and photograph of the proposed

rolloversensor (source: https://onlinelibrary.wiley.com/doi/abs/10.1002/mop.32648)

The rollover sensor is intended to be mounted horizontally beneath the

wheelchair seat. When the latter is flipped over, the two pins of the tilt
switch on the opposite side (right or left) are connected, and the RFID
chip on the same side is activated, generating a voltage, by the energy of
the signal sent by the RFID reader. Thus, the wheelchair’s protective
measures can be activated to minimize injuries by connecting their
circuitry to the RFID chip. When this is activated, a response signal
containing the chip code is delivered to the reader. In this manner, the
RFID-based location algorithm can get the sensor position, and the
emergency signal comprising the sensor location will be transmitted to
local hospitals or rescue stations, as well as family members.

Vital signs monitoring remotely and in real time

This is the case with the development of the Wearable IoT-cloud-based

hEalth (WISE) system [20], which employs a network of indestructible
sensors to monitor the health of people with chronic diseases such as
heart disease, diabetes, and Alzheimer’s disease. It is possible to get a
number of biomedical signals, including arterial blood pressure, heart
beat, blood pressure, and body temperature. WISE was developed on the
basis of the hardware platform Arduino, and is integrated with sensor
nodes such as the non-invasive sensor designed to measure blood
pressure. The connection of an RFID reader to the Arduino platform
makes it easier to identify different users. Furthermore, WISE has a WiFi
module that allows data to be sent to the cloud, allowing authorized
users to access data in real time from any location and at any time. As a
result, the WISE system consists of three key components: the WISE
body area network (W-BAN), the WISE cloud (W-Cloud), and the WISE
users. Connecting the RFID reader to the Arduino platform makes it
easier to identify different users. Furthermore, WISE has a WiFi module
that facilitates data transfer to the cloud, allowing authorized users to
view data in real time from any location and at any time. As a result, the
WISE system is made up of three main components: the WISE body area
network (W-BAN), the WISE cloud (W-Cloud), and the WISE users (Fig.
(Fig.1111).
Fig. 11

WISE system (source: https://jwcn-eurasipjournals.springeropen.com/articles/10.1186/

s13638-018-1308-x)

W-BAN data may be effectively and efficiently saved and processed in the
cloud. To detect and diagnose probable cardiac disease, key
characteristics can be extracted. If an aberrant state is identified, an alert
is sent to a designated interlocutor, including a text message to
physicians or family members, and a warning is presented on the LCD
(Liquid Crystal Display) for the users.

Monitoring of medical instruments and drugs

Another important issue is the continuous monitoring of medical

instruments and drugs that are essential for patient care, for example, to
avoid the stock-out in the inventory. A solution could be the use of an
automated system defined as “StocKey® RFID Smart Cabinet” [27]. The
medical supplies for the patients’ care and those for the surgical
operations are labeled with RFID technology when they are supplied to
the hospital. In this way, it is possible to manage expiration dates and
automatically schedule reorders. The tags, in fact, identify the product
with the lot number, serial number and expiration date. The objects thus
identified are kept in a closed cabinet (“Faraday cage”), which allows an
accurate view of the medical supplies present in the warehouse. All the
inputs and outputs of products, thanks to their RFID tags, are read to be
incorporated into the electronic inventory of the cabinet. This system
was designed primarily for operating rooms, unlike the IoT-based
system [14], which was designed for in-hospital or out-of-hospital
pharmacies and mainly for drugs. This system also uses the RFID tag
above the drug packages, which are read by an RFID reader placed in the
center of the compartment, where they are located. Everything is
connected to an LED that alerts the manager of that department if a
check for missing or expired drugs is necessary. RFID labeling can also
be considered one of the best solutions against drug counterfeiting,
because information, such as raw materials, the manufacturer, and the
pharmaceutical company, is collected and thus identification is
facilitated. This is a very important, because counterfeit drugs pose a
significant threat to patient safety and public health and cause heavy
losses to each State economy. For example, counterfeit drugs to treat
malaria and pneumonia cause an estimated 250,000 infant deaths each
year.

Go to:

Discussion of results

From the analyzed studies, the use of RFID tags seems to be more
promising in two scenarios: the first is in the field of surgical
instrumentation, since RFID technology allows continuous monitoring of
the instruments used during a surgical operation, such as gauze or
instruments: scalpels, electrosurgical adapters, forceps, etc. Therefore,
the use of RFID tags benefits the patient, in terms of safety, and the
medical and nursing staff in carrying out their related duties. The second
scenario is that concerning patients’ identification: a correct
identification of the patient helps to reduce errors related to the
administration of drugs; a quick identification of the patient is very
important in case of emergencies launched by the pharmaceutical
companies on a specific batch of a drug that could present anomalies or
manufacturing errors. Passive RFID tags seem to be the most used, this is
probably due to their lower cost compared to active RFID tags, their
small size which makes them more flexible, despite their reading range
that is much shorter than that of active ones. Although RFID technology
holds great promise for Healthcare, there are several risks or barriers
that prevent its implementation, in particular the implementation cost
and the need to improve data security constitute obstacles to its use
within hospitals or public medical facilities. Indeed, data security is a
critical issue, since the protection of privacy and sensitive data currently
requires careful attention. Another problem is electromagnetic
interference (EMI) which occurs when electromagnetic waves from an
electronic device interfere with the operation of another electronic
device and cause an unwanted response. Many studies from the authors
have assessed these aspects by applying risk analysis techniques as well
as by investigating electromagnetic compatibility in real hospital settings
[35–39]. The use of these technologies still needs to be tested and
experimented on a large scale, as experiments have often been carried
out using prototypes, in a limited number of places or on a few people.

In this work, the reviewed papers are academic articles, so the results
are useful for analyzing the current development state of academic
research but may not be suitable for predicting the actual
implementation of RFID technology within medical and healthcare
facilities.

Go to:

Conclusions

The adoption of RFID technology in Healthcare is growing slowly

compared to other areas, despite it is a very valuable tool. The proposed
papers have been selected by searching the Scopus database. The
presented works show that this type of technology can improve patients’
safety by reducing medical errors, that can occur within operating
rooms, such as, for example, the retention of surgical material. It can also
be the solution to overcome the problem of the black market in
counterfeiting drugs, or as a prevention tool designed for monitoring the
state of a wound using “smart bandages”. In the selected papers, issues
concerning human limitations and relating consequences are addressed.
The consequences are faced and prevented using RFID technology, which
provides a prompt solution and an improvement in management, inside
and outside the hospitals. As previously mentioned, further research is
needed, especially on data management, security, and privacy, given the
sensitive nature of medical information.

Go to:

Funding

Open access funding provided by Università degli Studi di Siena within

the CRUI-CARE Agreement.

Go to:

Availability of data and material

Not applicable.

Go to:

Code availability

Not applicable.

Go to:

Declarations
Ethics approval

Not applicable.

Consent to participate

Not applicable.

Consent for publication

Not applicable.

Conflicts of interest

The authors declare no conflict of interest or competing interests.

Go to:

Footnotes

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in

published maps and institutional affiliations.

Monica Gherardelli and Ernesto Iadanza contributed equally to this

work.

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Contributor Information

Laura Profetto, Email: [email protected].

Monica Gherardelli, Email: [email protected].

Ernesto Iadanza, Email: [email protected].

Go to:

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THE RFID TECHNOLOGY AND ITS APPLICATIONS: A REVIEW 1DAVINDER
PARKASH, 2TWINKLE KUNDU & 3PREET KAUR 1Haryana College of Technology &
Management, Ambala Road, Kaithal 136027, India 2Haryana College of Technology &
Management, Ambala Road, Kaithal 136027, India 3YMCA University of Science And
Technology, Sector-6,Faridabad, India ABSTRACT Radio Frequency Identification (RFID) is
one of most exciting technologies. The purpose of this paper is to review the RFID technology
and its applications. This paper gives a brief introduction to principles of RFID, classification
of RFID tags and reader, frequencies used, current application, as well as advantages and
limitations. This paper aims to review current development and future scope of this technology.
KEYWORDS: Radio Frequency Identification (RFID), RFID Components, RFID Applications
INTRODUCTION Radio Frequency Identification (RFID) is a generic term for technologies that
use radio waves to automatically identify people or objects from a distance of several inches to
hundreds of feet. This is an Automatic identification (Auto-ID) technology [1] by which any
object can be identified automatically. Barcode, Magnetic Strip, IC card, Optic Character
Recognition (OCR), Voice Recognition, Fingerprint and Optical Strip etc are also identification
technologies. RFID technology use automatic data capture system which helps in increasing
system efficiency. Combination of tag and reader is used for identification purpose. A code
is stored in RFID tag and this tag is attached to a physical object. Now object becomes unique
identifiable. Then object transmit code from tag. In this way reader get information about
object.RFID is not actually a new technology, but it is applied in new ways [2]. RFID is rapidly
growing technology. RFID offers much advantage over traditional identification device like
barcode. To read the barcode, the barcode scanner needs to be in line of sight with the label. It
means that the manual movement of the objects or scanner is necessary [3].RFID, on the other
hand can read data from tag without line of sight. Also no alignment is necessary in RFID
technology. Singh et al. [4] provides a brief overview of the RFID technology. RFID has high
reading speed and this can work in presence of barrier. This technology is more effective when
longer read range, fast scanning and flexible data carrying capability is required.RFID system
has received more and more attention in many areas like manufacturing companies, agriculture,
transportation and industries [5] etc. International Journal of Electronics, Communication &
Instrumentation Engineering Research and Development (IJECIERD) ISSN 2249-684X Vol.2,
Issue 3 Sep 2012 109-120 © TJPRC Pvt. Ltd.,
110 Davinder Parkash, Twinkle Kundu & Preet Kaur Several frequencies are
used in RFID applications: 125 KHz, 13.56 MHz and 860-930 MHz for passive RFID; 433MHz
and 2.45GHz for active RFID. The global standardization of RFID system is an important issue.
RFID has been implemented by different manufacturers in different ways. There is no global
standard that can be used everywhere. Various standards or protocols are proposed for different
RFID applications. These standards include hardware physics specification, tag-reader air
interface specification and reader-host command specification. A number of organizations have
set standards for RFID, including the International Organization for Standardization (ISO),
the International Electro technical Commission (IEC) and global. A short list of RFID
standards [2] follows: ISO 10374,ISO 10536,ISO 11784,ISO 14443,ISO 15693,IS0
18000,EPC global. These standards manage the communication between RFID reader and
tag. These standards works on selected frequency bands (e.g. 860 – 915 MHz for UHF or
13.56 MHz for HF).This paper will provide different aspects of RFID technology. Review of
RFID literature is also presented in this paper. CLASSIFICATION METHOD The literature
review of RFID is divided into five categories: (i) RFID components, (ii) Operating frequencies,
(iii) RFID principle,(iv) Advantages and limitations, (v) Application areas. RFID Components A
combination of RFID technology and computing technology is called RFID system as shown in
figure 1. A RFID system consists of following components : 1. Tag/Transponder (electronic
label). 2. Antenna (medium for tag reading). 3. Reader /Interrogator (read tag information). 4.
Communication infrastructure (enable reader/RFID to work through IT infrastructure). 5.
Application software (user database/application/ interface). Figure 1: Basic RFID systems
The RFID Technology and ITS Applications: A Review 111 Transponder (Tags) An
RFID tag is a small electronic device that is also referred to as a transponder. The tag
consists of a simple silicon microchip [6] and antenna. The tag can be attached to an object,
typically an item, box. Information is collected by chip and can be transmitted wirelessly. RFID
tag can be active (with batteries), passive (without batteries) and semi-passive (hybrid).Tag has
an identification code that can be transmitted towards reader. Classification of RFID tags is
presented in table 1 [7]. Table 1: Classification of RFID Tag Classification of RFID tags
Passive  Also called „pure passive‟  Obtains operating power from reader  The reader
sends electromagnetic waves that induce current in the tag‟‟‟‟s antenna, the tag reflects
the RF signal transmitted and adds information by modulating the reflected signal Semi-
passive  Use a battery to maintain memory in the tag  Communicates in the same method,
as the other passive tags Active  Powered by an internal battery  Generally ensures a
longer read range than passive tags  More expensive than passive tags  The batteries
must be replaced periodically
112 Davinder Parkash, Twinkle Kundu & Preet Kaur By the tag’s memory
type Read-only  The memory is factory programmed, cannot be modified after its
manufacture  Its data is static  Limited amount of data can be stored  Cheaper than
read-write tags Read-write  Can be as well read as written into  Data can be dynamically
altered By the method of wireless signal used for communication between tag and reader
Induction  Close proximity electromagnetic or inductive coupling-near field  Use LF and
HF frequency bands Propagation  Propagating electromagnetic waves-far field  Operate
on the UHF and microwave frequency bands RFID Antenna RFID antennas are used to
collect information about any item. There are many types of RFID antenna like patch antennas,
linear polarized antennas, stick antennas and adaptive antennas, gate antenna and Omni
directional antennas. RFID antenna types are shown in figure 2. Figure 2: RFID antenna types
The RFID Technology and ITS Applications: A Review
113 According to the researchers, an RFID antenna should satisfy following requirement [6]: (i)
Its size should be small, (ii) should have omnidirectional or hemispherical coverage, (iii)
must provide maximum possible signal to the microchip, (iv) be robust and (v) be very cheap.
Antenna designer firstly make a known antenna and then change its physical parameters to
obtain optimum bandwidth. In last few years, researchers have looked into the designing of
circular polarized antennas. Dual polarized antenna can be used. This antenna is suitable for
passive 5.8 GHz in RFID applications. Inverted F antenna has been used in many RFID
applications due to its small size and its ability to change its polarization characteristics. For
ultra high frequency (1GHZ), meander line antennas (MLA) are used for reducing size of
antenna Marrocco et al. (2002) first introduced the design of miniaturized meander line antennas
for RFID applications. Micro-strip antennas are used for RFID These has attractive features such
as lightweight, small volume, low profile and low production cost. RFID Reader Third
component of RFID system is RFID reader. The reader sometimes called an interrogator or
scanner sends and receives RF data to and from the tag via antennas. A reader may have
multiple antennas that are responsible for sending and receiving radio waves. Reader informs
data processing system about presence of tagged item. It consists of three main parts: control
section, high frequency interface and antenna. Read range of reader is affected by number of
factors. Antenna gain, frequency used, orientation of antenna will effect read range. Reader
comes in four types: Read, Read/write, fixed and mobile [7] as shown in table 2. First two are
based on design and technology used and last two are based on fixation of device. Table 2:
Classification of RFID reader Classification of readers By design and technology used Read
 Only reads data from tag  Usually a micro-controller-based unit with a wound
output coil, peak detector hardware, comparators, and firmware designed to transmit
energy to a tag and read information back from it by detecting the
backscatter modulation  Different types for different protocols, frequencies and
standards exists
114 Davinder Parkash, Twinkle Kundu & Preet Kaur Read/write 
Reads and write data from/on the tag By fixation of the device Stationary The device is
attached in a fixed way, for example at the entrance gate, respectively at the exit gate
of products Mobile In this case the reader is handy, movable device Operating Frequencies
Different types of RFID systems operate at different radio frequency as given in table 3. Each
radio frequency has its own read distance, power requirements and performance. The
choice of frequency depends on the application. Mostly four types of frequencies are used in
RFID technology: A. Low frequency (120-140 KHz) - Low frequency RFID tags operate in low
frequency range. Low frequency tags are used for depositing and withdraw and controlling
following with the assets. B. High frequency (13.56 MHz) - High frequency RFID tags operate
in high frequency range. HF tags are useful for asset-tracking applications, contact-less credit
cards and ID badges. C. The ultra-high frequency (869 MHz-928 MHz)-UHF RFID tag operate
in 869 MHz - 928MHz.UHF tags are used in supply chain management applications.UHF tags
offers the longer reading range and are cheaper to manufacture in bulk. D. Microwave (2.4
GHz-2.5 GHz) - Microwave system offers higher read rate. Microwave tags are expensive
than UHF tags. Microwave tags are used in electronic toll applications. Table 3: RFID operating
frequency Frequency Frequencies Passive read distance Range Low Frequency 120-140
KHZ 10-20 cm (LF) High Frequency 13.56 MHz 10-20 cm (HF) Ultra High 868-928
MHz 3 meters Frequency (UHF) Microwave 2.45 & 5.8 GHz 3 meters
The RFID Technology and ITS Applications: A Review 115 Operating Principle
Passive tag does not have its own power source. Chip in this tag get power from reader. Reader
antenna transmit RF signal towards tag. Tag gather energy from RF signal by using inductive
coupling in case of LF and HF tag and backscatter coupling in case of UHF tag . These are
shown in figure 4. a) Inductive coupling b) backscattering coupling Figure 4: Operating
principle of passive RFID system Backscattering coupling uses electromagnetic waves and
inductive coupling uses magnetic field to exchange data between tag and reader. Inductive
Coupling An inductively coupled tag consist of an electronic data carrying device, usually
a single microchip and a large area coil that functions as an antenna. These always operate
passively. This means that it gets its power from reader side. For this purpose, the reader's
antenna coil generates a strong electro-magnetic field, which penetrates the cross-section of the
coil area and the area around the coil. A small part of the emitted field penetrates the antenna coil
of the transponder. By induction, a voltage is generated in the transponder's antenna coil. This
voltage is rectified and acts as the power supply for microchip. Inductively coupled systems are
based upon a transformer-type coupling between the primary coil in the reader and the secondary
coil in the transponder. This is true when the distance between the coils does not exceed 0.16 l,
so that the transponder is located in the near field of the transmitter antenna. Backscatter
Coupling We know from the field of RADAR technology that electromagnetic waves are
reflected by objects with dimensions greater than half the wavelength of the wave. The
efficiency with which an object reflects electromagnetic waves is described by its
reflection cross-section. A tuned receiving antenna retransmits a portion of incident RF energy.
This retransmission is known as backscattering if it is in the direction of the original transmitter.
This backscattering can be detected by another antenna. Advantages and Limitations of RFID
System The RFID technology has many advantages [6]. While having advantages this
technology also has some disadvantages. Table 4 presents advantages and disadvantages of
RFID.
116 Davinder Parkash, Twinkle Kundu & Preet Kaur Table 4: Advantages and
disadvantages of RFID Advantage Disadvantage High speed Interference Multipurpose and
many format High cost Reduce man-power Some materials may create signal problem
High accuracy Overhead reading (fail to read) Complex duplication Multiple reading RFID
Applications RFID technology has received more and more attention in many areas like
manufacturing companies, agriculture, hospitality [8], industries, parking management [9]
and transportation [10] sectors. Major applications of RFID are given below: Healthcare
Applications RFID applications in healthcare [6] could save important resources that can further
contribute to better patient care. RFID applications could reduce the number of errors by tagging
medical objects in the healthcare setting such as patients‟ files and medical equipment tracking
in a timely manner. RFID further improves the situation for patients‟ care by integrating medical
objects involved throughout the patients‟ care. RFID based timely information about the location
of objects would increase the efficiency and effectiveness of paramedical staff leading to
improved patients‟ experience [11, 12]. Baggage Applications Airline industries, package and
delivery service lose a lot of money on lost or late delivery of baggage/packages [6]. Handling
large amount of packages from many places to various destinations on different routes can be
very complex. In this scenario RFID application provide best resource management,
effective operation and efficient transfer of packages. RFID helps to identify the packages, and
provide records that can advice the industry on possible areas that may require some
improvements. It also keeps customers informed about their packages. Toll Road Applications
RFID applications make the toll collection/charging better with improved traffic flow, as
cars/vehicles cannot pass through toll stations without stopping for payment. RFID is
used to automatically identify the account holder and make faster transactions [6]. This
application helps to keep
The RFID Technology and ITS Applications: A Review 117 good traffic flow and
to identify traffic patterns using data mining techniques that can inform the administration
or decision support systems. For example, the information can be used to report the traffic
conditions or to extend and develop future policies [13]. Asset Tracking and Locating Objects
RFID can be used to prevent misplacement of items, or to locate items. An asset is tagged with
RFID chip for its physical verification. A database is used to keep track of item movements.
Libraries of RFID Labels RFID can be use in library for management of the books. For this
management RFID use many components like tag, reader, self check-out/in, book drop reader,
middleware etc.With the help of these components it manage the process of borrowing and
return the book. RFID remembers to be already borrowed books while borrowing the book and
already returned book while returning the book. Animal Identification This is one of earliest
RFID application. RFID tag can be injected to remain under skin of animal [1]. This process
is less painful and there is no identification mark with the help of which tag can be removing or
modify. RFID chip inside tag is „Read-only‟ so data cannot be modified. This chip contain
many information like date of birth, last vaccination done, any medical history and
distinguishing features about the animal. Anti-Theft System Any item can be protected by using
RFID anti-theft tag [1] tag is attached by a strong string or a plastic band to the item. If anyone
walks to the exit with this item, RFID door antennas placed near exit will detect the presence of
tag and sound an alarm. Waste Management RFID can be used for waste management [1] also.
RFID tag is attached to each waste bin and every garbage truck has RFID reader attached to it.
When waste bin is emptied into truck then reader read tag and transmits data to truck driver‟s
cabin wirelessly. At end of route data is transmitted to central server. This data include waste
bin number, collected at what time, who was waste collector. National Identification National
identification has been a biggest problem for all the countries. For identification RFID
technology can be used [1]. A user has only a single card with embedded RFID chip. This RFID
tag number then points to an online database which is accessed by multiple agencies. A single ID
card needs to be issued for identification. Researchers [14, 15] have also focused on improving
the traffic control systems using RFID technology.
118 Davinder Parkash, Twinkle Kundu & Preet Kaur The RFID tag can be
attached to animals, plants and in particular human body. The technology is capable of
preventing medical accidents in the health industry. RFID tag system is able to obtain and store
blood pressure and body temperature. RFID sensors have found application in health care.
RFID sensors have been used to monitor the heart-rates of cardiac patients [16], to identify
patients for surgery [17], and to monitor the life of dental retainers [18]. Lin et al. [19] propose a
RFID-based information management system for wirelessly monitoring the missile assembly
process. Torrent et al. [20] use a combination of global positioning systems and RFID-tags
to monitor the components arriving at a construction site. Other applications include an
efficient paper roll management system [21] and improved asset management and
accountability [22]. FUTURE SCOPE RFID technology uses radio waves to automatically
identify people or objects. After sixty years of development RFID is being used in many fields.
There are some problems needed to overcome before RFID technology becomes widespread in
the world. One major problem is the high costs, the other is privacy issue. After avoiding
problems, the RFID technology will be a big help to human. Price of RFID tags are expected to
decrease. RFID tags will only become cheaper and more powerful with improving technology
and design experience .Some standards for RFID system are under development. Also there is
improvement in tag life expectancy and durability in past few years. The RFID technology
brings new opportunities as well as challenges to the AIDC infrastructure. Although RFID
suffers from many limitation but still Demand for RFID systems is increasing day by day.
RFID tags can combine with sensors of different kinds. This would allow the tag to report not
simply the same information over and over, but identifying information along with current
data picked up by sensors. Over times, the proportion of “scan-it-yourself” will increase.
RFID technology does not replace barcode. This technology improves barcode by adding
functions which existing barcode technology fail to achieve. CONCLUSIONS The paper gave an
overview of current state and trends of RFID technology. RFID technology will open new doors
to make organizations, companies more secure, reliable, and accurate. The first part of this paper
has explained and described the RFID technology and its components, and the second part has
discussed the RFID technology in terms of advantages and limitations. The last part explores
RFID technology applications. The paper considers RFID technology as a means to provide
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