Way Cool Wristbands
How portable data systems are being used in hospitals

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By Jane Erwin
Illustration by Malcolm Garris
Photo courtesy of Ichor Corporation
August 20, 1998

Imagine being able to find out a patient’s basic information just by checking his or her wristband. If the inventor of WristRecord, a patient wristband that includes a memory chip the size of a watch battery, has his way, the technology will soon be coming to hospitals across the nation.

Several years ago, Frank J. Overdyk, MD, a former engineer and an assistant professor of anesthesiology at Medical University of South Carolina in Charleston (MUSC), recognized the need for a better way to manage patient information and began working on it as a research project. The result: WristRecord.

Today, WristRecord is used at MUSC in surgery, where clinicians use it to document patients’ progress from pre-op tests through recovery. At each step, information is entered into a palmtop or desktop computer that stores the data in the memory chip. At MUSC, the data includes a patient’s name, age, sex, race, birth date, diagnosis, type and date of surgery, physicians’ names, vitals, allergies, lab results, physical exam findings, and anesthesia plan.

The chip, which can store up to 80 pages of information, can be removed from the wristband and transferred to a contact pad on a personal computer, where the patient’s information is downloaded into a database for hospital record keeping or data analysis. The chip can store eight kilobytes of information and can be erased and reused.

WristRecord is manufactured and sold by Ichor, a Philadelphia-based company Overdyk helped found.

Wired hospitals

WristRecord is not a stand-alone system; it must be integrated with a modem, a PC network, and a network server. The initial cost for use in a facility with 10 to 20 operating rooms would be approximately $50,000, said Gary Haynes, MD, PhD, associate professor of anesthesiology at MUSC, as well as Ichor’s chief financial officer and treasurer.

"Most hospitals are not wired extensively among areas, but patient care is done in lots of different locations," Haynes said. "Our method is a decentralized or distributed database. You don’t put in all the medical information, just what’s important. It’s clear, concise, and legible. It’s also a bit more secure than a regular paper medical record."

Part of the whole

While the new technology is exciting, the American Health Information Management Association (AHIMA) cautions that it’s difficult for one computerized system to do everything. "I see something like WristRecord as an adjunct to a longitudinal medical record. It’s a convenience type of record," said Harry Rhodes, AHIMA professional practice manager.

During a recent seminar, Rhodes visited several medical facilities with computerized patient records. "The extent of computerization varies. The biggest use is for lab or X-ray results or for transcripts," he said.

"Some places might use a hand-held wireless thinkpad for writing notes, but the computer won’t take those notes and compare them to, say, a drug database. The device meets one need but not any others, and that’s what most systems and devices are—an answer to one need. I know of no one system anywhere that does everything. Those systems are expensive and require dedication and a lot of work to develop and maintain."

Ensuring privacy

Security is an important part of maintaining patient records, said Carol Bickford, MS, RN, senior policy fellow in the department of nursing practice at the American Nurses Association. "Any technology must ensure patient privacy and keep records confidential, and documentation must reflect all aspects of patient care," Bickford said.

Most computers in hospitals are used for billing, lab work, or admittance, not for actual input by nurses and physicians, although some do use laptops for notes, which is better for record legibility and continuity, Bickford said. Still, "there are really exciting opportunities," she said. "When computers are used, we’re finding that nurses get patients involved, having them look at the screen or even do actual inputting. Some professionals are using digital imaging to track such things as wound improvement or deterioration, using pictures to compare what’s going on, which is especially helpful when nurses change shifts or duties."