An Automated System for Tracking, Recording, and Reminding for Medical Implants (TRACER)-a Pilot Study with Ureteral Stents.

Abstract

Background: There is an urgent need for a seamless clinical system for tracking implants deployed transiently in patients, to reduce the morbidity related to omission of timely removal. Using a ubiquitous implant of ureteral stents as a pilot project, we developed a novel system (Automated System for Tracking, Recording, and Reminding of Implants [TRACER]) that allows seamless tracking and deployment of reminders to clinicians, without the need for excessive infrastructural overhaul of existing hospital processes. Patients and Methods: Briefly, TRACER comprises the following: (1) a two-pronged trigger during implant (stent) insertion to associate implant, patient, and physician details; (2) data field verification by an automated algorithm; (3) automated delivery of reminders to clinicians at a predefined time period if needed; and (4) cessation of reminders upon stent removal. To evaluate the efficacy of TRACER, the records of all stents placed between January 2022 and December 2023 were reviewed and compared between manual stent log entries, electronic operative records, and the TRACER dataset. Results: A total of 1056 ureteral stents were placed through 927 procedures in 713 patients. Fifteen stents could have been omitted from tracking owing to an incomplete trigger during stent insertion (logged by one party rather than two) but were detected by the TRACER system during data validation. Sixty-one (5.9%) stents were identified by TRACER as not removed past the predefined time period; 41 patients (3.9%) were contacted and successfully returned for stent removal. Aside from eight patients transferred to other hospitals for care, the demise of seven patients, and five tumor stents not due for change within the study period, all stents were removed on time. Conclusions: TRACER is effective, safe, and viable and provides significant savings on manpower. It demonstrates high potential to be scaled and expanded to all implantable devices.