Inside the June/July 2005 print
edition of Canadian Healthcare Technology:
Mount Sinai to
computerize outpatient clinics
Mount Sinai Hospital, in Toronto, announced that
it will implement Electronic Patient Records in more than 100
ambulatory clinics, using an enterprise solution from Nightingale
Informatix Inc., of Markham, Ont.
Safer Healthcare Now! campaign launched in Canada
Last December, the U.S. Institute for Health
Improvement (IHI) launched its 100,000 Lives campaign with the
ambitious goal of enlisting 2,000 hospitals and reducing the number
of preventable deaths by 100,000 over 18 months.
READ THE STORY
UK’s Map of Medicine
British clinicians and researchers have developed
a web-based tool called the ‘Map of Medicine’ that delivers succinct
information about current best practices to doctors and nurses. It
can be used at the point-of-care for quick reference.
Quinte Health Care, headquartered in Belleville,
Ont., is investing $20 million in diagnostic imaging systems that
include a regional PACs, 64-slice CT machines and both Computed
Radiography and Digital Radiography.
READ THE STORY
Supply chain process improves at L’Hôpital Sacré-Coeur de
Managing supplies is big business at L’Hôpital
Sacré-Coeur de Montréal, one of six major university hospital
complexes affiliated with the University of Montreal
READ THE STORY
Virtual clinic for IBD patients
Doctors in Halifax have developed an interactive
web site that allows patients with inflammatory bowel disease to
contact their doctors and care-givers, educate themselves using
online resources, and connect with other IBD sufferers.
SonoSite has miniaturized its ultrasound
technology to the point where a handheld unit offers similar
resolution and capabilities as larger, cart-based systems, the
company says. It makes diagnostic exams easier to perform.
PLUS news stories, analysis, and features and more.
Toronto’s Mount Sinai Hospital to computerize its
By Jerry Zeidenberg
TORONTO – Mount Sinai Hospital, one of Canada’s top teaching hospitals
and a leader in the use of electronic health records for in-patient
care, announced that it will now begin the computerization of more than
100 out-patient clinics. The hospital’s clinics will use secure,
web-based software created by Nightingale Informatix Inc., of Markham,
The Ambulatory Record Management System (ARMS) project is part of Mount
Sinai’s overall strategy of creating an integrated Electronic Patient
Record (EPR) across the organization. As such, it’s among the first
large hospitals in Canada to computerize its out-patient clinics in a
comprehensive fashion and to integrate them with its core hospital
The ARMS implementation is expected to solve a major problem. Because
most hospital-based out-patient clinics are either non-computerized, or
use proprietary systems that don’t mesh with the hospital’s core
systems, physicians have found it difficult to track the status of
patients as they move from one clinic to another, or when they shift
from in-patient services to out-patient clinics for follow-up.
“It’s created an information gap at our hospital, and I’m sure, at most
others,” said Dr. Lynn Nagle, senior vice president, technology and
knowledge management, at Mount Sinai. “We want our clinicians to be able
to see patient data end-to-end.”
Dr. Nagle explained that many of the hospital clinics work hand-in-hand
– for example, the diabetes clinic interacts frequently with other
clinics such as cardiology and opthalmology. Traditionally, this has
meant the sharing of information has been difficult, since each of the
clinics has its own system for patient records. “With ARMS, the benefit
is that clinics will have a consistent approach to the management of
patient records,” said Dr. Nagle. “Right now, they all have their own.”
The ARMS project will computerize the clinical and administrative
operations of the out-patient clinics, which are run by approximately
500 physicians, medical residents, nurses and allied health
professionals. The 100 plus clinics include ambulatory obstetrics,
diabetes, family medicine, cardiology, oncology, pain management,
dentistry, psychiatry and a wide variety of other specialties.
Dr. Nagle observed that the clinics themselves spurred the ARMS project,
led by the diabetes group. The multi-disciplinary team in this clinic
realized that a centralized electronic patient record would save them a
lot of time and improve their collective access to essential clinical
And by striking a license agreement to include all ambulatory entities,
the hospital was able to leverage the investment to the benefit of all –
including a greater range of features than the clinics could have
achieved by negotiating on their own.
After an official request-for-proposal and an assessment of seven
practice management systems, Mount Sinai Hospital chose a solution from
While Mount Sinai Hospital runs Cerner PowerChart software at the core
of its in-patient hospital information system, the end-users at the
clinics opted for the functionality and ‘look-and-feel’ of the
Nightingale offering. “When you want buy-in from the clinicians, you let
the clinicians make the choice,” commented Dr. Nagle.
The Nightingale system will be integrated with the Cerner systems,
providing physicians across the medical centre with access to patient
records, wherever the patients have presented themselves.
Samer Chebib, president and CEO of Nightingale, pointed out several
advantages to the company’s software system. Chebib said the Nightingale
enterprise edition has a patient repository at its core which easily
handles large projects, like the one launched by Mount Sinai Hospital,
with multiple disciplines and physical locations. It also offers the
ability to be customized to suit both GPs and specialists.
The ASP nature of the system means that all applications are hosted
remotely and are accessed using a secure internet connection.
Users don’t have to load upgrades or do their own maintenance –- it’s
all done at secure servers, off-site. The upshot is that doctors can
focus on providing care to their patients rather than fiddling with
The Nightingale system also offers special features that are bound to
benefit both doctors and patients. In particular, a patient-access
component enables patients to see their own health records, view their
lab results, fill out questionnaires, request prescription refills and
schedule appointments for themselves in their care-givers’ calendars.
According to Chebib, Nightingale’s enterprise offering is priced
significantly lower than other enterprise-level Electronic Health Record
systems – a factor that appeals to cash-strapped healthcare providers as
they seek to computerize.
On another front, Mount Sinai is in the midst of a large-scale
Computerized Clinician Order Entry (CCOE) project for its in-patient
Being implemented in a phased approach, by the end of the year
physicians will be electronically entering all orderables, including
lab, diagnostic imaging and medications. That’s expected to boost speed,
accuracy and patient safety, as orders will be much clearer and
re-keying will be eliminated.
What’s more, on the medication side, possible adverse-drug-events (ADEs)
and other alerts have been built right into the system.
Dr. Nagle said in the future, out-patient clinics will be integrated
into this part of the system. They may even be able to order medications
for patients, who could then pick them up at the ground-floor hospital
For its part, Nightingale is building a reputation for itself as a
leading-edge developer of physician practice management systems, with
doctor’s offices across the country using the system.
Of note, the software has been certified by Alberta’s Physician Office
Systems Program, which provides financial incentives for doctors working
outside of hospitals to computerize their practices.
Earlier this year, Nightingale announced a licensing agreement with the
Alberta Orthopedic Society to provide its enterprise software to all 150
orthopedic surgeons in Alberta.
Moreover, the Nightingale system has been certified by Ontario’s
e-Physician program, which is now run by the Ontario Medical
Association’s Ontario.MD division.
And this year, Nova Scotia chose Nightingale as the exclusive supplier
for its own physician computerization program. Nightingale won in
competition with several other bidders, both for its ASP (Application
Service Provider) and local (server-based) solutions.
Safer Healthcare Now! campaign launched in Canada
By Dianne Daniel
Last December, the U.S. Institute for Health Improvement (IHI) launched
its 100,000 Lives campaign with the ambitious goal of enlisting 2,000
hospitals and reducing the number of preventable deaths by 100,000 over
Groups promoting patient safety in Canada also heard the call, and in
April 2005, they responded by launching a similar national effort called
Safer Healthcare Now! (See the web site at:
“When we learned of the 100,000 Lives campaign, we thought it would be
great to have an effort that was Canadian-centric,” said Phil Hassen,
chief executive officer of the Canadian Patient Safety Institute (CPSI),
who is serving as chair of the Safer Healthcare Now! national steering
committee. Although the group is promoting the same six interventions as
the IHI, it is putting a Canadian spin on them wherever possible, he
said, by using appropriate Canadian standards and reference materials.
Safer Healthcare Now! has a 14-member steering committee including Dr.
Ross Baker and Dr. Peter Norton, co-authors of Patient Safety and
Healthcare Error in the Canadian Healthcare Sector, as well as
representatives from IHI, the Canadian Association of Paediatric Health
Centres, the Canadian Institute for Health Information (CIHI), the
Quality Healthcare Network and the Canadian Council on Health Services
Accreditation. A portion of the campaign’s funding is provided through
CPSI, which is mandated “to create a safer Canada for patients,” said
The goal of Safer Healthcare Now! is to encourage hospitals to
“implement changes in care that have been proven to prevent avoidable
deaths.” In particular, it is focusing on the following six strategies
outlined on the IHI website (www.ihi.org):
• deploy rapid response teams at the first sign of patient decline;
• deliver reliable, evidence-based care for acute myocardial infarction
(to prevent deaths from heart attack);
• prevent adverse drug events by implementing medical reconciliation;
• prevent central line infections by implementing the “Central Line
• prevent surgical site infections by reliably delivering the correct
perioperative antibiotics at the proper time;
• and, prevent ventilator-associated pneumonia by implementing the
According to Hassen, the premise is that implementing any one or all of
the interventions will greatly reduce avoidable morbidity and mortality.
Participating organizations – whether individual hospitals or regional
health authorities – are asked to provide two measurements, the first
indicating what processes they’ve actually implemented and the second
providing data to show a reduction in medical error.
“This is not about trying to say who’s better than the other; it’s about
really trying to say we can actually make a difference,” said Hassen.
In its first month, Safer Healthcare Now! enrolled 53 healthcare
organizations and expects to have 200 or more delegates represented at
its first National Learning Series session. To help co-ordinate the
national campaign, three field offices have been established – referred
to as the Western, Ontario and Eastern nodes – and the steering
committee is hoping to add a Quebec presence as well, said Hassen.
Each node aims to enrol a minimum of 30 to 40 participants, said Cynthia
Majewski, executive director of the Quality Healthcare Network and
contact for the Ontario node. As of May 20, 2005, twenty-three Ontario
healthcare organizations had signed up.
“When organizations join Safer Healthcare Now! they’re joining the
campaign, but how they seek to learn and share is entirely up to them,”
said Majewski. “In fact, what we’re working on is a menu of different
educational strategies that will address clinical team needs in both
rural and urban settings.”
A large part of the campaign has to do with collaboration, she adds.
Emphasis has been placed on communication, so that campaign members work
collectively to learn from each other while avoiding replication. For
example, the campaign can serve as a mechanism for sharing expertise,
like that of an ICU collaborative that has been working on three of the
six IHI interventions for the past couple of years
“The reality is improvement is improvement is improvement,” she said.
“People can learn from a variety of different approaches.”
While technology isn’t directly involved in all six interventions
listed, campaign members believe it will be crucial to improving patient
safety over time. As Hassen points out, the first step is to encourage
organizations to change their processes.
For now, campaign participants will learn more about implementing the
six interventions through interactive tools posted on the IHI website,
informational calls and regional meetings, national web casts and
workshops. In addition, Safer Healthcare Now! will be developing a
publication, the first issue of which will be co-sponsored by the
Ontario Hospital Association, said Hassen.
There’s no cost to sign up with Safer Healthcare Now!, but those who do
are expected to be ready to make changes and report on their progress. A
National Measurement working group is currently devising a measurement
method, with the hope that the data collected will provide a good sense
of system level improvements achieved across Canada.
Map of Medicine provides ‘best practices’ support
to clinicians via web
By Jerry Zeidenberg
With medical knowledge expanding at a dizzying rate, how is the harried
physician or nurse expected to keep up with all of the changes?
Staying abreast of ‘best practices” has been a serious concern for
clinicians, and also for patients, who may often wonder if their GPs are
really on top of the latest medical breakthroughs – and if they as
patients will receive the best care possible.
After four years of development, the National Health Service (NHS) in
the United Kingdom has produced what appears to be an effective solution
– one that’s also being made available to clinicians and policy makers
in North America.
Called the Map of Medicine, it’s a web-based tool that presents the
latest information about diseases and medical problems in an easy-to-use
format. The interface is modeled on flow-charts, enabling the physician
or nurse to drill-down through screens to the level of information
“We don’t like to call it a decision support system, because it’s not
replacing the GP or nurse, and the term DSS is sometimes taken the wrong
way,” commented Dr. Michael Stein, medical director for the Map of
Medicine, which was produced by a team of 300 clinicians with an
investment of over 200,000 hours. “It’s an educational and training tool
that provides the diagnostic and treatment information that clinicians
need when they’re caring for patients. We like to call it a change
In a way, it’s like having the input of a team of specialists right when
you need them – with questions answered within seconds.
The Map of Medicine team put a lot of thought into the appearance of the
interface and the ‘ergonomic’ aspects, to ensure that clinicians would
find the system easy to use. There are 208 ‘entry points’, essentially
diseases and medical problems that would be encountered by GPs and
Each of these drills down to further sets of information, so that the
screens are never cluttered or overwhelming. “It’s not ‘roll and
scroll’,” commented Dr. Stein, alluding to traditional databases that
present vast amounts of information in a single view. Instead, the Map
of Medicine allows the clinician to click through flow charts – there
are about 1,200 of them – to find the appropriate data.
The system is continually updated, and each page is dated to show when
the information was last refreshed.
For problems and questions where there doesn’t appear to be a structured
answer, clinicians can call up a query screen that taps into databases
of evidence-based medicine, such as the Cochrane Collaboration or the
British Journal of Medicine.
The Map of Medicine will be useful for a variety of medical
practitioners, including medical students and neophyte physicians and
nurses. It is also expected to be invaluable to experienced GPs
encountering something unusual and who want to quickly check on the
latest diagnosis or therapy.
Moreover, it will equalize regional disparities, enabling GPs in remote
areas of the UK to have access to the same leading-edge knowledge as
their counterparts in urban centers like London, Leeds and Liverpool.
“It ensures that everyone is on the same page,” said Dr. Stein.
Dr. Stein was in Toronto in early May, attending the e-Health 2005
conference, where he conducted presentations about the Map of Medicine.
He noted that the UK is now set to roll out the system to 130 local
healthcare communities, offering access to every physician and nurse.
There are approximately 100,000 physicians and 600,000 nurses in the
A benefit of the system is that it can be customized to particular
regions, so that local treatment or reporting protocols can be
incorporated. “In the western world, the diagnosis of patients will be
same 99 percent of the time,” commented Dr. Stein. “But treatment
options will differ from region to region.”
The system can be used to generate referral letters, so that a GP can
quickly produce the documentation needed for a diagnostic scan, for
example. Moreover, appropriate literature can be printed out to give to
patients for educational purposes.
In a second phase of the British project, the system will be integrated
with electronic patient records, so that notes and referrals can be
integrated into the charts of patients.
The Map of Medicine has built-in security tools, with an audit trail and
permission structure. It can be set up so that clinicians have access to
various types of information, depending on their needs or the policies
of their healthcare organizations.
Dr. Stein noted that the Map of Medicine is being made available to
healthcare organizations in Canada and the United States at relatively
low cost. “It’s not about making money, it’s about getting back some of
the investment that was needed to create the system,” he said. (Further
information about the project can be obtained at
He added that the National Health Service is also interested in
establishing collaborations with clinicians in Canada and the United
States, as a way of constantly improving and updating the product.
Dr. Stein emphasized that the Map of Medicine is a support system for
clinicians, and not a replacement for the skills of physicians. “It
doesn’t patronize the experienced doctor,” he said. “He or she only
pulls out the map when needed.”
Quinte Health Care creates futuristic DI
department – this year
By Jerry Zeidenberg
BELLEVILLE, ONT. – Quinte Health Care, a four-hospital organization
located between Toronto and Kingston, is modernizing its diagnostic
operations by investing $20 million in the latest medical imaging
equipment over the next five years. That includes a 40-slice CT (soon to
be upgraded to 64-slices), a region-wide PACS, and leading-edge computed
radiography (CR) and direct radiography (DR) machines.
But it’s not high-tech for the sake of having the fanciest equipment on
Instead, the investment is part of the hospital’s drive to
simultaneously improve care and lower costs in a mixed urban/rural
QHC serves not only the adjoining cities of Belleville and Trenton, but
also a huge rural region of some 700 square kilometers that’s bustling
with cottages and recreational activities. In terms of volume, Quinte
currently conducts 125,000 diagnostic imaging exams annually.
The major investment in DI is “also a way of ensuring that we can
attract radiologists and technologists in the future,” said Rita
Downhill, director of diagnostic services, emphasizing the importance of
the human resources issue.
She noted that newly trained radiologists are unlikely to locate in
centres without up-to-date technology –- with the 64-slice CT and the
regional PACS, Quinte is putting itself ahead of most communities in
Canada. It’s giving radiologists and technologists the tools that are
considered necessary today to deliver top-notch DI examinations, medical
interpretations and reports.
The Picture Archiving and Communication System (PACS), along with the CT
and radiography machines, are all being supplied by Philips Canada.
Philips won the contract in competition with several other vendors after
Quinte had completed a DI needs assessment, strategic plan, RFP and
Among other factors, Downhill said the organization’s radiologists were
won over by the consistent ‘look-and-feel’ of the tools and interfaces
in all of the new Philips modalities, and by the open architecture of
Quinte Health Care also put a premium on the vendor’s adherence to
Integrating the Healthcare Enterprise (IHE), the standards and
connectivity group that’s gaining ground around the world.
Not only is connectivity a burning issue within the four-site hospital,
where various types of hardware and software systems must be linked
inside and outside the radiology department. Downhill and her colleagues
are thinking ahead, and they’re considering links to Kingston General
Hospital, the area’s major referral centre.
What’s more, with the provincial regionalization strategy spurring the
rise of Local Health Information Networks (LHINs), there are likely to
be connections built to PACS at medical centres throughout the South
Eastern Ontario region as a whole.
For her part, Downhill recently assisted Chatham-Kent Health Alliance
select and implement a PACS while serving as diagnostic services
director for that organization; earlier, she helped Headwaters Health
Care Centre, in Orangeville, Ont., get a PACS up and running. She has
acquired a great deal of expertise in this area, and when she came on
board at Quinte in 2004, she guided the development of strategic
planning in the DI department.
Downhill said the PACS is expected to provide a gamut of well-documented
cost savings -– by computerizing all images, film and chemical costs
will be eliminated, storage space will be freed up, and the time and
expense of filing will be reduced.
What’s more, the PACS is expected to improve workflow and the quality of
care across the region. In particular, it will ensure fast readings of
exams in Bancroft, where there is no radiologist on-site, and Picton or
Trenton, when the radiologist is off-duty. Technologists at these
locations will be able to transmit the images they’ve taken to
Belleville, where radiologists can interpret the exams and quickly
provide results to physicians at the remote sites.
QHC will also be implementing a Voice Recognition
transcription/dictation system as a component of the Philips purchase.
It is the expectation this total integration of HIS/RIS/PACS/VR will
dramatically improve the turnaround times of the radiology reports to
Improved workflow is a major aim for Downhill and her colleagues.
They’re working with Philips to reduce the steps previously required by
radiologists and technologists – steps that have sometimes resulted in
administrative delays. For example, when technologists conduct exams,
the PACS will automatically send data into the hospital’s financial and
statistical systems – previously, this was a separate procedure for
technologists, one that was sometimes neglected in the din and fray of
the hectic work day.
Bruce Pye, director of information technology for Quinte, said the PACS
is being run through the Smart Systems for Health Agency network. The
SSHA network connects all four Quinte sites and currently offers 5
megabit/sec bandwidth. In the future, Pye would like to see a 100 to 300
meg network used, so that offsite storage for disaster recovery becomes
feasible. “You need that kind of bandwidth to do off-site backups of all
your information each day,” he said.
For the time being, the main Belleville site is making do with twin EMC
systems, a main storage system and one for redundancy. In addition,
there is an archiving system for historical data – older information
that’s not frequently accessed.
Patient throughput is expected to be accelerated by the new, multi-slice
CT, DR and CR equipment. And by using the advanced radiography
equipment, the organization will be able to consolidate X-ray and
fluoroscopy services in fewer rooms.
By 2010, the plan is to use DR technology for all X-ray exams.
With PACS, the 64-slice CT scanner will revolutionize diagnostic and
clinical services at Quinte Health Care.
According to Dr. Matt Downey, medical director of radiology, the use of
X-ray for medical diagnosis is significantly shifting from conventional
two-dimensional projection image acquisition to three-dimensional
computed tomographic image acquisition.
Using multislice CT, routine examinations such as in orthopedic imaging,
spinal and maxillofacial trauma, and assessment of the surgical abdomen
are performed in a fraction of the time, with vastly greater accuracy
than conventional radiographs. Moreover, new applications such as
cardiac CT, CT angiography, and CT perfusion are presenting
unprecedented opportunities to diagnose patients non-invasively in their
own community hospital.
The improved speed of image acquisition is expected to reduce waiting
lists and provide more timely diagnosis while containing operational
costs. Indeed, Dr. Downey predicts that, “Any acute care hospital with
emergency, surgical and medical inpatient units will require on-site CT
scanning to achieve equivalent standards of patient care to their peer
hospitals. CT is now available at a range of acceptable capital
investment.” This is the rationale for Quinte Health Care’s decision to
install a second CT scanner at its Trenton site.
For radiologists, Dr. Downey said, “Perhaps the most exciting aspect of
state of the art CT is the ability to finally take full advantage of new
digital technologies in the way we view images. Under the supervision of
radiologists, CT technologists will acquire and process isotropic CT
data for interpretation, just as technologists currently do in
ultrasound. You can take 3D and multi-planar images with equal
resolution in any axis. You can artificially straighten non-linear
structures, flatten curved planes, curve flat planes, color code data,
cut away or render transparent overlapping structures. All of these
tools advance the perception, diagnostic confidence and understanding of
disease processes to the benefit of our patients.”
Dr. Downey cautions that, “While patient benefit justifies the expected
increased use of ionizing radiation for medical diagnosis, the
responsible use of CT becomes all the more imperative.” In this regard,
radiologists through the Canadian Association of Radiologists are
developing guidelines to assist their clinical colleagues in the best
and most appropriate use of the various diagnostic imaging modalities
available to them.
Supply chain process improves at L’Hôpital Sacré-Coeur
By Dianne Daniel
Managing supplies is big business at L’Hôpital Sacré-Coeur de Montréal,
one of six major university hospital complexes affiliated with the
University of Montreal. From a double bin replenishment system and
“warehouse keepers,” to standardized software and electronic commerce,
the hospital has successfully reengineered its supply chain – resulting
in significant savings of both time and money, says director of
materials management Clement Roy.
“Three years ago nurses were doing replenishment,” says Roy. “Now we’re
able to take the nurses’ time and direct it towards the patient.”
According to Roy’s estimates, L’Hôpital Sacré-Coeur will save $1.8
million in nursing hours over five years as well as $1.2 million in
costs following a recent overhaul of its supply chain processes. The
first of several steps, he says, was the implementation of a new
procedure for replenishment that relies on enterprise resource planning
software from SAP Canada, of Toronto.
Whereas nurses used to be responsible for ordering supplies on a
departmental basis, now it is the job of 20 full-time warehouse keepers.
Each nursing unit is equipped with two identical supply bins; when the
first is emptied, the bar-coded product list of its contents is placed
on the wall. A warehouse keeper (on rounds) then swipes the barcodes,
and all of the information is automatically transferred into SAP for
“We are able to handle eight orders for eight different units
simultaneously,” notes Roy. “The warehouse keeper fills the orders and
brings the supplies back to the unit.”
Most medical supplies are stored on-site in the hospital’s warehouse.
When certain minimum inventory thresholds are met, additional supplies
are ordered based on pre-existing contracts and negotiations established
Roughly 80 percent of L’Hôpital Sacré-Coeur’s purchasing volume is
fulfilled through 35 suppliers, half of which are represented on the
Global Healthcare Exchange – a healthcare trading exchange founded in
March 2000. Recognizing the benefit of communicating directly with its
suppliers electronically, the hospital signed up for a $500 yearly
membership fee and is currently live and trading with three of its major
suppliers, including original founding member Baxter Corp. A year ago,
placing orders with Baxter was done by fax and it would take one to two
days to complete an order. Since signing on with GHX in January, says
Roy, orders are now completed on-line in it what amounts to about 10
“By automating our ordering process, we’ve saved one full-time person,”
points out Roy. “And it’s always perfect. Every order passing through
our GHX connection is exactly what I’m receiving,” he adds, noting that
the hospital has freed up the time of one warehouse keeper by replacing
routine inventory inspections with spot checks.
This spring, the hospital intends to begin processing electronic
invoices for payment as well. A key advantage to moving invoices on-line
is timing. “If I receive an invoice by mail, we lose approximately three
days,” explains Roy. “If I receive it electronically we can pay it
immediately … and I can take additional discounts for rapid turnaround.”
Moving to an electronic supply chain or e-supply chain “requires fewer
people, less labour time” and results in “less problems,” he adds. In
fact, operations are so smooth, the hospital is entertaining the notion
of moving to Radio Frequency Identification (RFID) tags in the future.
Right now, the intent is to use a wireless infrastructure developed by
Hewlett-Packard Co. By placing an RF antenna near the shipping and
receiving area, palettes of products equipped with RFID tags can be
automatically scanned and the information imported into SAP as they are
received, replacing a manual process that currently involves keying
items in one at a time.