Your Boss Wants to Know Whether You Washed Your Hands

This article is part of Privacy in the Pandemic, a Future Tense series.

In order to stop the spread of the novel coronavirus, experts say we need some form of contact tracing: a way of tracking who has the disease, where they went before diagnosis, and with whom they may have come into contact. To that end, a variety of parties, from tech giants like Apple and Google to governments like those of South Korea and Singapore, are developing systems that use Bluetooth and GPS data to monitor the movements of the broader population.

But as the economy reopens and people return to work, many private employers will need a more intimate, smaller-scale form of location tracking to monitor their employees’ movements within the office. According to the companies that offer these technologies, dozens of factories and hospitals across the country are already considering using badges and wristbands to track whether staff members are practicing social distancing and even whether they’re washing their hands or not. Such location-tracking systems have existed before in hospitals and health care facilities, but they are now poised to expand to other industries as employers try to reopen their offices and factories without causing a renewed outbreak of the virus. They could even help trace the spread of infectious disease in crowded environments like hospitals and academic conferences.

The phone-based contact tracing system proposed by Apple and Google raises clear questions about user privacy, but it will also use anonymized data that many apps already collect, analyze, and sell to advertisers. The smaller-scale systems that will soon enter the workplace, on the other hand, will provide many private employers with new kinds of data about how their employees move around and interact with one another.

Many of these systems use radio-frequency identification, or RFID, technology, which is not exactly new. Retail stores and manufacturers have used it since at least the 1980s to track shipments and prevent shoplifting, and you can also find it in gadgets like contactless toll passes and house-arrest ankle monitors. Far more limited than a satellite-based technology like GPS, an RFID network typically consists of individualized tags attached to pieces of merchandise like T-shirts or socks. If a tag passes within a few feet of a receiver located, for instance, at the exit of the store, the system detects the movement of the item and alerts store management, often by setting off an alarm.

The companies that market this tech to hospitals include CenTrak, SwipeSense, and Proventix. CenTrak alone operates in more than 1,700 locations.* They supply hospitals with one RFID-enabled lanyard for each staff member, and these lanyards then track the employee proximity to readers placed beside door thresholds, soap dispensers, and sinks. The lanyards record when nurses enter and exit patient rooms and whether they washed their hands before and after doing so, as well as whether they used soap and hand sanitizer when they washed their hands (or at least put their lanyards near the sensors). The systems then generate reports on each employee’s performance for management to review.

The idea is that workers will be more likely to follow hygiene guidelines if they know their employers are tracking them. A hospital can’t exactly pay someone to stand in the bathroom all day watching nurses come in and out, but if workers receive regular feedback about their hand-washing habits, they’ll snap into shape rather than risk facing discipline from their supervisors. (Hand hygiene was a critical issue in hospitals even before the coronavirus: According to one estimate, as many as 70 percent of infections contracted in hospitals could be avoided if staff followed basic hygienic protocols.)

“We know the movement of where the staff are, so we can do labor analytics,” said Felicia Boyd, a spokesperson for Proventix, which makes a system called nGage. “We break it down individually so that managers know which individuals are doing well and which ones have low compliance. There’s no good way to change behaviors if we can’t get that individual data and work with managers to identify those who might need some encouragement.”

Though hospitals most often use nGage to monitor hand-washing habits, Boyd said the data it collects could also be used to track whether nurses had visited rooms with patients known to have infectious diseases and whether they had washed their hands after doing so. Management could also use the information well beyond the scope of hygiene, though—for instance, to determine whether certain nurses or orderlies are spending too much or too little time on patient visits.

Boyd said the company is in talks to install nGage at two hospitals once the spread of the virus abates and also said the company is looking at expanding into other facilities including nursing homes and jails. One Barcelona, Spain, hospital is meanwhile testing a system that would require staff to wash their hands before unlocking doors to let them into patient rooms or intensive care units.

Larger RFID companies that provide workplace safety solutions are now retooling their technology to promote social distancing in the wake of the virus. Zebra, the largest RFID and asset-tracking company in the world, said in a phone interview that it was weeks away from releasing a “MotionWorks Proximity Solution” that would provide employers with in-house contact tracing through a Bluetooth-based phone app or Bluetooth “beacons” that could attach to workers’ uniforms. The system would generate up-to-the-minute reports on which employees had come into proximity with one another and for how long, and could even make workers’ phones vibrate if they got too close.

“We’ve had a flurry of activity and incoming inquiries,” said Tom Bianculli, the company’s chief technology officer. Bianculli said he couldn’t share the names of the clients Zebra working with, but the company has developed tracking solutions in the past for Boeing, Jaguar, and the NFL. Another company, RFID Global Solution, said it is working with IBM to develop tracking badges for some factory floors; the badges would alert employees when they got too close to one another or entered a room with too many people in it.

As more and more workplaces return to work in the next few months, these social distancing monitors are likely to become a minor boom industry of their own: Bloomberg News has reported that Ford planned to enforce social distancing by having its workers wear RFID wristbands, developed by Radiant RFID, that would buzz when a worker got too close to a colleague and would also provide supervisors with alerts about employees who were congregating together in larger groups. Another company, Guard RFID, published a blog post detailing how its technology could be used for “infection control in the workplace,” including through the use of wearable RFID tags that would “alarm when tagged individuals come within close proximity to each other.” (Guard RFID and Radiant both declined to comment on their ventures into social distancing solutions.)

There’s still very little research into the social distancing solutions these companies are marketing, but past studies have suggested that RFID badges can produce short-term improvements in hand hygiene. One study of a hospital in Bangalore found a “significant increase” in hand sanitizer usage among a cohort outfitted with RFID trackers. It’s unclear whether these systems can foster long-term changes in employee behavior, though. More in-depth studies have found that the benefits of this increase disappear after the tracing system has been in place for more than a year. Furthermore, it’s not clear that RFID can always be relied on for a true picture of employees’ hygienic habits. One study of Proventix’s nGage found that while the lanyards captured about 90 percent of nurses’ movements and hand-washing actions in a laboratory setting, its accuracy dropped to about 50 percent in a real-life clinical test, meaning it only captured every other instance of a nurse entering a room or washing their hands.

Nevertheless, these RFID technologies are likely to become more and more common in workplaces of all industries as the pandemic continues, and their presence could lead to unforeseen changes in the relationship between bosses and floor workers. These systems are not as data-rich as the Apple-Google program, which will be able to follow infected individuals as they traverse entire cities, but they could still allow employers to monitor and analyze behaviors that were previously almost impossible to track.

In time, employers could use that data as a pretext to discipline or dismiss employees for other reasons, says Alexandra Mateescu, a researcher at the Data & Society Research Institute. Amazon and Walmart, she noted, have already begun measuring employee temperatures using thermometer guns on their employees, sending home those who had high temperatures even though not everyone who has COVID-19 presents with a fever.

“If employers are tracking employees to make sure they’re social distancing properly, it doesn’t really mean much if the environments don’t make social distancing actually easy,” said Mateescu. “It’s a question of where this could possibly be punitively shifting responsibility for safety onto workers themselves.”

There’s no doubt that hand hygiene and social distancing are essential to slowing the spread of the coronavirus and preventing future outbreaks. But interventions like RFID, introduced to protect worker safety and guard against the virus, will still take place within the context of an imbalanced relationship between employers and their employees. Given the murky science about antibodies and the long timeline for developing and distributing a vaccine, it seems possible that hospitals and factories may need to use social distancing technology for years to come. Until the disease is defeated, Mateescu says, there’s no telling what employers may do with the new data they gain under the auspices of worker safety and public health.

“A lot of tracking of workers happens under the rubric of worker safety or ensuring that workers are not injuring or hurting themselves,” she said. “But the boundaries between that and using the data in ways that are punitive or negative are hard to establish.”

Future Tense is a partnership of Slate, New America, and Arizona State University that examines emerging technologies, public policy, and society.