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Electronic Patient Identification System

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Patient Identification errors can disrupt and harmpatients in virtually every facet of clinical medicine, includingdiagnostic testing, scanning, medication and administration andbilling as well. In the healthcare industry, when it comes topatient safety and security, the most debated and talked aboutsubjects are Patient Identification and Patient Data Integrity. The methods which were previously used to identify the patientsare tedious and time consuming.

The accuracy of these methodsis lesser than average. It is the need of the hour to comeup with solutions that will succour the current situation. It isimportant to recognize the magnitude of this prevailing problem. Fingerprint recognition technology is being employed in hospitalsto recognize the patients electronically. Employing fingerprinttechnology would definitely prove to be a reliable and accuratemethod to identify the patients as the biological pattern found inthe fingerprints of every individual is unique and permanent. Incontrast with the past, researchers are paying increasing attentionto embedding systems. Amelioration in a number of platformswith different boards is due to the cause of cost reduction blended with efficiency better than average. Thus, embedding devices witha suitable software is a goal to be accomplished in order to makecompetitive commercial products. This paper presents a low-costelectronic fingerprint recognition system with the help of GT(511C3).

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Keywords: Embedding, GT (511C3), fingerprint recognitionI.

INTRODUCTION

The risk of failing to associate the right patient witha right action, which is referred to as the wrong-patienterrors is significant and is characterized by increasing patientvolume and frequent handoffs among providers. Incorrectpatient identification can occur during multiple proceduresand processes. It is a common mistake which is prevalentin healthcare setting, from hospitals to nursing homes tophysician offices and pharmacies. Many patient identificationerrors affect at least two people. For example, when a patientA receives medication intended for patient B, both patients-A and B, the one who received the wrong medication andthe one whose medication was omitted can be harmed. Akey take-away is that most of the wrong-patient errors arepreventable. Major problem arises in cases when there are no familymembers around or when the patient is unconscious,incoherent or unable to talk or communicate (languagedifficulties). In such cases, the patient is unable to providepersonal information complicating identification by medicalpersonnel.

Therefore, a system should be designed whichidentifies the patient regardless of their condition. This paperproposes a design to cope with the existing obstacles. This paper consists of the development of a low-cost andcompetitive security environment of fingerprint recognitionbased on a GT (511C3) device. Hospitals which utilize thefingerprint recognition technology mostly use the fingerprintscanners to identify the patients. This process involvesplacing a finger on a kiosk, the enrolled patients will then getregistered quickly. On the other hand, this technology tendsto be more challenging and invasive as it would take a largeamount of time to educate the patients in this regard who hailfrom rural background. Patient identification system includes a database of patientinformation which consists of the following:

  1. Identifying each patient who wishes to register andassociating it with some sort of an identification criteria (suchas fingerprint data).
  2. A fingerprint scanner for reading the fingerprint informationfrom the desired patient.
  3. A control system for matching the fingerprint data read bythe fingerprint scanner with the fingerprint data stored in thedatabase.
  4. A printer for printing labels or identification numbers orother visually perceptible medium, for positively identifyingthe patient and creating a data record. This manuscript can be the basis for other possible designswith respect to accessibility and security combined withlow-cost fingerprint scanners. So, this work along with itsimplementation can become the basis for low-cost systemsbased on fingerprint sensors. The remainder of this write-up is organized as follows. Section 2 gives an insight of the preliminary concepts. Section3 details the related work and the unique problems withunique identifiers. Section 4 presents the proposed solution. The experimentation described in Section 5 evaluates theperformance and efficiency of our proposed solution. Finally,Section 6 outlines the main conclusions and future work.

PRELIMINARY CONCEPT

The on-board JST-SHconnector has four signals: Vcc, GND, Tx, Rx. Downloadsand uploads of fingerprint scans can be done using RS232serial interface. It provides a UART (Universal AsynchronousReceiver/Transmitter) connector with a default baud rate of9600. The fingerprint communicating protocol is based on packethandshaking. There are three kinds of packet which thescanners makes use of. They are:

  • Command Packets: This command is particularly usedto order the device to carry out certain operations suchas checking if the finger is pressed on the scanner.
  • Response Packets: They indicate operationsuccess/failure. There are specific opcodes for specificcommands. The opcode of the command field are ACK(0x30) and NACK (0X31), indicating the success orfailure of the operation respectively. In case of failure,the ERROR code is also activated.
  • Data Packets: The data field has no static length as thispacket is used to send extra information, fingerprintimages etc.

Modelidentification of fingerprints with an on-board optical sensorand can store up to 200 fingerprints in its database. Amongother features, it also allows a single entry or the entiredatabase to be downloaded and uploaded. B. FTDIFigure 2 shows the FT232RL is the basic FTDI boardwhich is used as a USB to serial IC. One of the nicestfeatures of this board is a jumper on the back of the boardthat allows the board to be configured either to 3. 3V or 5Vfor both power out and IO level. The board can also be usedfor general serial applications.

C. Software Development KitA software development kit is the software used. Bydefinition, an SDK is a set of programs used by a computerprogrammer to write application programs. Typically, an SDKincludes an integrated development environment (IDE) whichfurther includes a visual screen builder, an editor, a compiler,a linker. SDKs are the origination sources for almost everyprogram a modern user would interact with. Some SDK’salso include sample graphics which can be incorporated intoapplications.

RELATED WORK AND UNIQUE PROBLEMS WITHUNIQUE IDENTIFIERSA.

Related WorkN. Darcy et al. [1] was the first to propose a successfulperinatal referral system in Sub-Saharan Africa and thus,it became the first step towards developing a completeelectronic medical record system. N. Darcy et al. proposed anelectronic patient referral system named ZEPRS for womenwith complications during pregnancy. This system was to beused through a close network. X. Huang [2] proposed an idea of electronic emergencyreferral document system whose main objective was thetransmission of patient data to doctors of other hospitals in acomplete and timely manner during emergency. C. Turcu et al. [3] proposed a unique method which wasan RFID-based system for emergency healthcare services. This system made use of RFID tags to store all vital healthinformation on personal electronic record identity cards(PICs). This system was utilized in place of the formermethod that made use of paper-based medical records. Itsmain objective was to cater to the needs of the patients whocould not provide information by themselves and solve theneed for an accurate and efficient way to transfer patientinformation between distinct providers.

The design consistedof real-time locating systems (RTLS) to ensure safety. However, the cards still had to be handled carefully by themedical staff. In addition, there were limitations of storagesize and difficulty in updating the information. P. Mercini et al. [4] proposed a hospital healthcare anddata management application using QR codes to provide anumber of facilities. This application facilitates the accessof a medical personnel/staff to patient information, providesconstant progress updates, directly sends referrals, andinstantly notifies them of referrals using mobile devices. QRcode technology can basically encode such data as texts,photos, and videos and store them as fixed or dynamic data. B. Unique Problems with Unique IdentifiersPatient identification or matching techniques have evolvedalong with processor speed and database technologies. Inthe past, healthcare organizations employed a deterministicmatching approach that looked at a few characters in keyfields. However, the method fails to scale, or adapt well asthe volume of data increases over time. All integrated delivery networks (IDNs), regional healthinformation organizations (RHIOs), and other data exchangeorganizations must address the challenges of accuracy andpatient matching early in their formation, before they begin toembark on successful data exchange.

Regardless of whethera group relies on a central data repository or a federatedor hybrid model, its members must establish a strategy foraccurate patient matching. Matching records via a unique identifier such as SocialSecurity number (SSN) or Citizen ID or a new nationalnumber of a patient is not a simple solution to solve theproblem. Adding new data to a record that is already existingdoes not resolve the problem of inconsistent or incorrectinformation that may already be present. Numerous publishedstudies find an average error rate of 5 to 10 percent even insingle-facility healthcare centres. Figure 3. Flowchart for identification process“A far better use of the energy that would go into collectingnew data should instead go to cleaning up existing data,hardest cases first,” says Clay Shirky, chairman for Healthtechnical subcommittee and an adjunct professor at NewYork University, who has directed extensive research in thehealthcare technology issues surrounding interoperability. Doing so will greatly improve match rates without need forany additional data.

PROPOSED SOLUTION

Figure 3 describes the user workflow which shows the wayin which the electronic patient identification system is carriedout with help of fingerprints as a criteria for identifying data. There are four steps for the user workflow. The details aredescribed in sequence as follows:

The first step involves entering the input data.Scan patients fingerprints.

  • Enter the patient’s credentials for seeking the patientsdata when the fingerprint is scanned for the first time. 2. Submit query requests to access information of specificpatients. 3. Get the matched/identified fingerprint results.
  • Case 1: SuccessSystem automatically sends a query for patient data. (Goto step 4)
  • Case 2: FailFingerprint quality is low and needs to be scanned again. (Go to step 2)4. Obtain patient data by reading the data displayed on thePC display. The entire working of the system is in the format mentionedbelow:Communication with the GT(511C3) fingerprint scanner(FPS)is by sending packets from a processing application. AnFTDI board is to used to interface with the FPS to aPC via an USB cable. The FTDI acts as a simple serialcommunication device that receives serial data from theprocessing application running on a PC and sends the serialdata to the GT(511C3) fingerprint scanner. Response datafrom the FPS is relayed back to the processing applicationby the FTDI. The processing code sends hard-coded packetsto the FPS and displays the response packet from the FPS inthe processing IDE text display console panel. The GT(511C3) is powered by 5V, but the pins used forserial communication operate at 3.

This implies that theserial output from the controller must be level-shifted from5V to 3. 3V which is easily done with the help of FTDI. 1) Interprocess Communication: Consider an instancewhere the test sketch sends a command packet containingthe open command and non-zero command parameter. Thiscauses a working GT(511C3) to send back an ACK followedby a data packet containing the static information of thedevice. Bytes from the response packet and data packet aredisplayed in hexadecimal format in the SDK visual builderwindow to confirm that the communication of the fingerprintmodule are working. Basically, the scanner sends an imagewhich implies that it takes the data in hexadecimal formatand transfers it over the serial to the controller. The controllerwill then consume this data and sends it to the server. Theserver is responsible for storing the user credentials and thehexadecimal string as an image in the database. When theuser scans his fingerprint again, the hexadecimal code isagain generated, transferred to the server, checks with theFigure 4. Capture Fingerprintdatabase for any such fingerprint which is already present. Ifa match is found, the server sends a positive response.

The system design utilizes the message passing schemefor interprocess communication. In this case, the memory isdistributed and each processor can access directly only itsown memory. The fingerprint must be loaded into the privatememories of the two processors. The fingerprint scannerGT511C3 forms the sending unit. In other words, it sendsthe data to the processor. With the help of the windowsoperating system, it stores the data in its memory. It thenreads this data and it sends a message containing the data tothe processor that executes the program.

The data is in thehexadecimal format which is passed on to the processor. Thesame operations are repeated for subsequent fingerprints. In the implementation, the TX and RX of the GT(511C3)were connected to TX and RX of the FTDI respectively. Avoltage divider circuit was not necessary as the FTDI itselfhas a jumper which pumps down the voltage from 5V to3. 3V. The code was executed in SDK. The FTDI driver mustbe installed in the laptop and the com port number shouldbe entered in the SDK.

If the value returnedis lesser than 200 then the function checkEnrolled iscalled after changing the ID parameter, until the functiondoes not return any error. If an error pops up, it meansthat the ID passed as a parameter is already stored in thelocal database. Finally, the Enroll function with the IDentry number obtained as a parameter is called. If thefinger is not pressed before 10 seconds, timeout occurs.

  • Identify: The LED is turned on when the Identify. Example scenario of using electronic patient identificationsystem in emergency casecommand is used. The server waits for a finger to beplaced on the scanner. The server is informed whenthe finger is scanned.
  • The server sends a captureFingercommand if the identification is successful. The scannerreturns the ID associated with the scanner and the timetaken to identify the finger. If the identification fails, thescanner will return an error.

  • Delete: The Delete command packet is used to deletethe fingerprints. When this command is sent, the scannerinforms the server to remove the fingerprints in thedatabase. The deleteID and deleteAll function will deleteone or all of the fingerprint ID respectively. The scenario in Figure 7 illustrates how an electronic patientidentification system works in during an emergency case fora patient. While Bill was riding his bicycle around his house,he did not notice a car approaching him from behind. He washit by the car when he stopped suddenly. He had alreadylost consciousness by the time the rescue team arrived andhis health demanded an urgent treatment. He was admittedto the local city hospital which was closest to the area theaccident occurred. The doctor did a preliminary medical checkand determined that the condition of his brain was in anabnormal state immediately ordered an operation. However,since Bill was taken to the hospital without his parents, therewas no way to obtain any information. Fortunately, the hospitalwas employing a new electronic patient identification systemthat can request patient data using fingerprints as identityinformation. The medical staff scanned Bills fingerprints andsubmitted a query request to the system, which sent a requestto database that searched for Bills data. Soon all of Bills healthinformation was displayed on the screen. The doctor analysedthe information, made a diagnosis, and gave him appropriatemedical treatment and medication. Bills life was saved. If thissystem is employed in all the hospitals, imagine the numberTrue Positives False Negatives Total Trials39 11 50True Positives False Negatives Total Trials37 13 50of lives that could be saved

PERFORMANCE EVALUATION

True positive (tp): If a user (patient) who has registeredhis/her fingerprint in the database, places a finger on thescanner and the system recognizes him/her. False positive (fp): If an unregistered user(patient) placeshis/her finger on the scanner and the system recognizeshim/her. True negative (tn): If an unregistered user places a fingeron the scanner and the scanner does not recognize him/her. False negative (fn): A user registered in the database placesa finger on the scanner but the system does not recognizehim/her. Table1: Trials with users already registered in the databaseTable2: Trials with users not registered in the database

CONCLUSION AND FUTURE SCOPE

A. ConclusionIn conclusion to the afore mentioned details, the proposedsystem design is reliable and beneficial. This electronic patientidentification system has two main advantages. They are: thehospitals can provide better healthcare to the referred patientsand it supports faster and very convenient requests frommedical staff for patient data retrieval using only fingerprints. The second advantage is possible if a large database consists offingerprints of patients who visit different hospitals. However,the enrolment and matching performance can be poor espe-cially in real world deployment situations. Newer methodsof acquiring fingerprint data have reduced this problem. Inaddition, usability and acceptance is a problem but spreadingawareness would bring about an enormous change. Further,challenges include reduction of time to identify the patientsand matching a fingerprint by searching a large database whichconsists of millions of fingerprints. In general, electronicpatient identification system is a boon to the society as thissystem would be helpful to patients in all situations.

B. Future ScopeFuture scope involves the implementation and evaluationof the system. A system with lesser response time, betterefficiency to identify individuals from a larger database andto gather data from multiple sources are the key areas to befocussed on. Compatibility of the system on various devicesis another area of development. Further, the system can also be used to integrate with multiplehospitals so that doctors will have access to the medical reportof patients and provide better treatment. A data exchangeframework can be designed to allow various healthcare appli-cations to exchange data regardless of systems with differenttechnology. The data exchange mechanism can be enabled asa system that uses the citizen IDs of patients as a masterpatient index (MPI) to submit requests for patient data throughits platform. This platform can then become responsible forqueries regarding patient data from other hospitals.

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