APPLICATION OF INTELLIGENT SYSTEMS USING
KNOWLEDGE HUB AND RFID TECHNOLOGY IN
HEALTHCARE WASTE MANAGEMENT IN THE UK AND
CHINA
Anthony S. Atkins
1
, Lizong Zhang
1
, Hongnian Yu
1
and Weiya Miao
2
1
Faculty of Computing, Engineering and Technology, Staffordshire University
Octagon, Beaconside, Stafford ST16 9DG, U.K.
2
Chengdu University of Traditional Chinese Medicine, Chengdu, China
Keywords: Intelligent systems, Healthcare waste, Knowledge hub, Radio Frequency Identification (RFID), Digital
imagery.
Abstract: The paper describes an intelligence system using a knowledge hub integrated Radio Frequency
Identification (RFID) technology and digital imagery in the management of healthcare waste. This paper
outlines the definition of healthcare waste both in the United Kingdom and China together with recent
changes in the classification of this waste in the last few years with regard to clinical, laboratory testing and
biological waste etc. Statistical information regarding the quantity of healthcare waste is outlined indicating
predicted interpretation of future of waste production and the issues involved in traditional incineration and
land fill operations. The paper describes a knowledge hub to provide monitoring, tracking and verification
systems to assist government agents in providing audited records for anticipated legislation and public
scrutiny. The system using rule-based intelligence systems linked to developed simulation software to
provide logistical support via what- if scenarios.
1 INTRODUCTION
Healthcare waste or medical waste is mainly
produced from clinical treatment, laboratory testing,
biological culture and animal experiments
(SEPA(China), 2003). It usually contains infectious
materials, drugs and sharp objects such as syringes,
which are undoubtedly harmful waste that contains
a large number of viruses, bacteria and harmful
chemical reagents. Healthcare wastes are some of
the most dangerous wastes due to the high pollution
risk that will damage both our health and the
environment (DEFRA, 2006, Zhan and Jiang, 2008).
The disposal and treatment of healthcare waste is
a concern of many countries’ government initiatives
and environmental pressure groups. Simply burning
and then landfilling them as normal waste was
historically the case, however this may spread
harmful components for example from exhaust gas
emissions and toxic metal substances that could
cause serious pollutions (EA, 2008b, SEPA(China),
2003). In addition, uncontrolled and low-technology
treatment of healthcare waste usually results in
public unrest or panic and could cause a risk of
epidemical disasters. Therefore, healthcare waste or
medical waste is usually treated as hazardous waste
in most countries. For example, it is listed on the
“National Hazardous Waste List” of China since
1998 and also listed in the hazardous categories in
UK (DEFRA, 2007, EC, 2000, SEPA(China), 2008).
The UK Department for Environment, Food and
Rural Affairs (DEFRA) estimates that approximately
200,000 tonnes of healthcare waste is produced
annually in the UK with 26,450 tonnes of this
requiring high-temperature processing, and 173,600
tonnes suitable for alternative technology treatment
(DEFRA, 2007). Controlling all the healthcare waste
and sending them to the correct treatment facility is
not an easy procedure for most countries,
particularly in developing countries, such as China.
Healthcare waste is a significant environmental
issue. However, due to the complex situation
concerning the treatment requirements of different
types of healthcare waste and also the large volume,
44
S. Atkins A., Zhang L., Yu H. and Miao W. (2009).
APPLICATION OF INTELLIGENT SYSTEMS USING KNOWLEDGE HUB AND RFID TECHNOLOGY IN HEALTHCARE WASTE MANAGEMENT IN
THE UK AND CHINA.
In Proceedings of the International Conference on e-Business, pages 44-49
DOI: 10.5220/0002207500440049
Copyright
c
SciTePress
there is a lack of a suitable system to track and audit
the healthcare waste. The paper proposes the design
of a system that can provide tracking, verification
and auditing for the disposal of healthcare waste and
can also provide logistic support.
This paper firstly explains the current situation of
healthcare waste in UK and China, and discusses
two cases that concern the knowledge management
system or RFID applications. Finally, the proposed
system is discussed, and its process and application
are outlined.
2 HEALTHCARE WASTE IN UK
AND CHINA
The UK and China have different definitions about
the waste from healthcare services. However, they
have similar concerns about the waste in that it
needs to be treated and controlled circumspectly.
2.1 Current Situation in UK
Currently, ‘Healthcare waste’ is the official name in
UK which replaced the term ‘medical waste’,
‘clinical waste’ and ‘hospital waste’ since the
‘Hazardous Waste Regulations’ came into force in
July 2005 (DEFRA, 2007).
In the UK, not all healthcare waste is hazardous
waste, in fact, about 33% of healthcare waste is
normal waste, which is from hospital offices – most
of them are paper or office supplies etc. The
‘Hazardous Waste Regulation’ describes healthcare
waste as the waste generated in the healthcare
environment, and the ‘European Waste Catalogue’
(EWC) gives a clear definition in C18 (‘EWC 18’)
(EC, 2000). These wastes are divided into two
categories which respectively concern human and
animals, and contain 16 sub-categories. However,
only 7 of them are hazardous, and their hazards are
categorised by ‘Hazardous Waste Regulation’ in H9
(infectious), H6 (toxic), H7 (carcinogenic) and H11
(mutagenic) respectively (DEFRA, 2007).
The UK produces about 200,000 tonnes of
healthcare waste annually. Currently, there is no
detailed statistic to show healthcare waste in the
entire UK (excludes Scotland and Northern Ireland)
and only the hazardous healthcare waste statistics of
England and Wales are available from the
Environment Agency (EA). This indicates that the
amount of waste in 2006 is 142,305 tonnes, and this
accounts for almost 8 times more than in the year
2000 (only 16,456 tonnes) as shown in Figure 1. The
data for 2005 is influenced by the new regulations
on waste management system and new data
gathering introduced in mid-2005 to coincide with
the new Hazardous Waste Regulations (EA, 2008a),
and this effects comparability of the information.
However, Figure 1 does indicate that the waste
tonnage has increased since 2003, and certainly, will
continue to increase in future years with predicated
population growth (Zhang et al., 2008).
Figure 1: Trends of Healthcare Waste in England and
Wales from 2000 to 2006, source: EA.
2.2 Current Situation in China
In China, this type of waste is normally referred to
as ‘medical waste’, as there is no official translation.
According to the Healthcare Waste Management Act
published in June 2003, medical waste which is
produced in healthcare organizations in medical-
related activities were all treated as hazardous waste.
In addition, the latest version of ‘National
Hazardous Waste List’ of China published in June
2008, has categorized them into HW01 (Medical
Waste), HW03(Waste Drug or Pharmaceuticals)
and HW16(Sensitization Material Waste)
(SEPA(China), 2003, SEPA(China), 2008).
Currently, there is no detailed data about medical
waste in China. The only information published is
by the ‘National Development and Reform
Commission of China’ in 2006 which is based on
information relating to the number of clinical beds.
It indicates that China produces about 0.65 Mt
medical waste annually and this will increase by
30,000 tonnes to 0.68 Mt in 2010 (NDRC, 2006).
Although there is no accurate statistics, it is assumed
that the increasing trends of waste will be similar to
the UK.
2.3 Treatment Methods
Normally, the treatment methods for healthcare
waste have two broad categories, high-temperature
0
50.000
100.000
150.000
2000 2001 2002 2003 2004 2005 2006
Tons/year
APPLICATION OF INTELLIGENT SYSTEMS USING KNOWLEDGE HUB AND RFID TECHNOLOGY IN
HEALTHCARE WASTE MANAGEMENT IN THE UK AND CHINA
45
and non-burn/low temperature alternative methods
(DH, 2006). Some typical treatment methods are as
follows:
Incineration – Normally operated at 800-1000
o
C.
It is widely used throughout the world, as is low
cost, easy operation with low technology
requirement. It can completely destroy the
bacteria, viruses and most of chemical
components, in addition, the volume and weight
of treated waste will be reduced to
approximately 20%. However, during the
incineration, harmful gases may be produced
and may give rise to emission into the
atmosphere, particularly for low-technology
incinerators (DH, 2006).
Autoclave – This technology uses saturated
steam in a vessel above atmospheric pressure to
treat the material for disinfecting. It is a
traditional method used in hospitals and is
appropriate for healthcare wastes (Zhao et al.,
2005).
Microwave – The system uses electromagnetic
waves to destroy the microbes by thermal
energy (DH, 2006). Currently, most of the waste
is required to be wet. This method is more
complex than incineration technology (Zhao et
al., 2005).
3 CASE REVIEW
The paper outlines two case studies relating to RFID
application in medical waste and/or knowledge
management technology.
Firstly, a trial of RFID applied to medical waste
management in Japan in 2004. It was launched by
‘Kuregha Environmental Engineering Ltd’, which is
a leading Japanese waste management company, and
IBM who provided the technical support for the trial.
They attached RFID tags to containers which are
made from different materials such as cardboard and
plastic to test them in IBM’s RFID Solution Centre
(IBM, 2004). IBM claimed, that this is the “first
medical waste traceability testing” (IBM, 2004).
This trial was launched in July 2004, and there is no
further evidence as to whether this trial was
successful. Taiwan has also launched a trail by its
environment Protection Administration January
2006, and the latest reports have shown that the
RFID read/write function is in the process of testing.
The second case the ‘iKnow’ system which was
developed by a paediatric research group at British
Columbia's Children's Hospital is a system ‘used by
clinicians at the hospital to develop knowledge rules
for improving patient care in surgical operations’. A
decision support system based on the rules in the
operating room to assist anaesthesiologists in
dealing with adverse events (Dunsmuir, 2007).
Figure 2 shows the system, and also its functions.
This is an expert system which uses rule-based
reasoning mechanism. These rules allow reasoning
from physiological and demographic data sources to
provide clinical explanations and advice (Dunsmuir,
2007), and the knowledge base of the system can
contain some other types of data such as pictures.
This system is more complex than the previous cases
outlined, as it includes reasoning and maintenance
and decision making support functions.
Figure 2: The iKnow System Work Process (Dunsmuir,
2007).
4 PROPOSED TRACKING AND
AUDITING SOLUTION
Healthcare waste management and auditing to
prevent illegal disposal is becoming an urgent
environmental issue, particularly in developing
countries. A proposed solution using a knowledge
technology system (knowledge hub) to audit and
track healthcare waste from its source to treatment
facility and/ or disposal location is discussed.
The design will use RFID technology and digital
imagery to integrate records including location,
volume and weight, container movement, delivery
tracking inventories and scheduling etc (Atkins et
al., 2008). It works with the support of a knowledge
management system which helps management to
make decisions of scheduled logistics of waste to
treatment plants and also provides the instruction to
deal with the hazardous healthcare waste for the
operating staff.
The design of the proposed system can be
viewed from two aspects: firstly, providing the
evidence of healthcare waste being sent to the
ICE-B 2009 - International Conference on E-business
46
Figure 3: Proposed Medical Tracking and Verification System using RFID Technology.
correct treatment facility and preventing fly-tipping
during transportation. This relies on comparison of
the information from destination and the source site,
including RFID records, image or video records,
operators checking and the possible use of built-in
weight systems. The second aspect is the logistic /
instruction support that helps management to choose
the appropriate treatment facility to dispose the
waste and real-time instructions to the operating
staff.
Figure 3 illustrates the system of a ‘Community
Healthcare Facility’ and ‘Hospital/Healthcare
Organization’ which are the two typical healthcare
facilities and healthcare source sites. The healthcare
waste must be classified and bagged in the source
sites and a RFID tag is then attached to the container
(bag, sealed box, or bins etc.) with a unique ID. The
ID relates to information about the waste such as
weight, type, and current location etc. The
information is located in the central server, and can
be checked by a hand-held RFID device. The
operators can update the information as appropriate.
The storage points for temporary holding the
healthcare waste are all equipped with RFID sensors
and digital imagery cameras, which can generate
records of waste movement. Once the waste arrives
at or leaves from these points, the records will be
updated to the central server. The destination sites
are also equipped with similar equipment to monitor
the waste arrivals.
The records include the time and date, container
ID, waste type, weight, which are related to the
RFID tags ID, and the image / video records are
associated with the RFID data to eliminate fraud in
the system and preventing fly-tipping. The status of
the waste in the system is updated in real-time based
on records that are generated each time the container
passes the RFID sensors. In addition, hand-held
devices can also be used to update information
manually by the operators to prevent the system
reading errors and to correct any mistakes.
Figure 3 indicates, that before the waste goes to
be treated (e.g. incineration); an RFID sensor will
record and then upload the information. Then the
RFID tag on the container will be removed and a
new ID will be given for future utilization.
Alternatively, the tags can be discarded if they are
the low-price passive tags. The next step is to re-bag
the treated waste with a new RFID tag to enable
tracing it to the correct destination for disposal such
as landfill sites.
Hand-held devices are used by the operating staff
involved in the system, including vehicle drivers,
cleaners, and management etc. The device is a small
sensor that links to the central server, and can
display information from the system. The instruction
and logistical support information will be
automatically downloaded from the knowledge
management system when it is required. The
information notifies the operators which container
should be transported or moved to the correct
location in a specific time, and also notifies the
procedure of transporting this type of waste and any
particular cautionary instructions.
APPLICATION OF INTELLIGENT SYSTEMS USING KNOWLEDGE HUB AND RFID TECHNOLOGY IN
HEALTHCARE WASTE MANAGEMENT IN THE UK AND CHINA
47
Figure 4: Structure of the Knowledge Base.
The proposed system is designed using a
knowledge system as the back end support, and
includes a knowledge base system and reasoning to
provide the logistical support for the waste
management. The reasoning system is designed
using Rule-based Reasoning and may associate with
Case-based reasoning (CBR) system. The structure
of the knowledge base is illustrated in Figure 4.
There are three proposed databases operating in the
system which are as follows:
RFID database that stores the information
from the RFID equipment;
Image database for auditing and tracking
evidence;
A possible Case database that provides the
data for Case Based Reasoning.
These three databases are integrated and their
information is sent to a central database, referred to
as a ‘knowledge hub’, which offers the integrated
information for the reasoning process.
Figure 5 illustrates the structure of the
knowledge system, and it is designed in four layers.
The lowest layer (layer 4) is the hardware layer,
which is the route for inputting the data and
information from the RFID and imagery equipment
to the knowledge system. Layer 3 is the knowledge
base layer, and there are three databases that store
different data which integrates into the knowledge
hub. The data will be used in the reasoning layer,
but the imagery data will only be used in the top
layer for providing evidence of transportation and
logistics. The second layer is the reasoning layer.
Rule-based reasoning is the main reasoning
mechanism for generating the best solution for
logistical and tracking support and Case-based
reasoning may be adopted as a backup in future
work. The result of the reasoning layer provides a
multiple solution by identifying the optimal solution
after checking from the rule-based reasoning and the
field data is then passed to the highest layer
visualisation to provide the resolutions for decision
support. This visualisation layer is designed using
web application for easy access, and represents the
logistical solution and records of the waste
transportation using appropriate simulation software
developed for the project to provide what-if
scenarios (Zheng et al., 2008). This layer can also be
designed to support the individual software or
application for more detailed security and
verification checking.
Figure 5: Structure of the Knowledge System.
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48
5 CONCLUSIONS
The paper reviews the current urgent situation of
healthcare waste production, treatment and disposal,
and the trend of increasing tonnage in the UK and
China. Currently there is no successful automated
auditing and tracking system available for healthcare
waste management. Healthcare or medical waste is
one of most dangerous hazardous wastes in that it
can contain viruses, bacteria and harmful chemical
reagents. Uncontrolled or just low-technology
treatment of healthcare waste usually results in
public unrest or panic and could produce epidemic
disasters for example SARS. A proposed system
which is based on RFID and knowledge technology
to provide auditing, tracking, verification and
logistical support is outlined in this paper. This
system can ensure that the waste is directed to the
correct destination and provide verifiable evidence
for auditing purposes and for independent scrutiny.
The proposed system can also be used with other
types of waste either for recycling purposes or safe
disposal of for example, plasterboard, tyres, wood
and glass to make the waste disposal more
environmentally friendly and contribute to viable
recycling solutions.
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