Just a few years ago, discussion of the use of radio-frequency identification in healthcare was usually limited to drug manufacturers and wholesalers, who use RFID as a way to track drug products through the supply chain or to combat counterfeit drugs.
[See also: RFID & RTLS can save lives]
Nowadays, RFID technology is being used by more and more hospitals to improve safety and efficiency.
At University of Michigan Hospitals and Health Centers in Ann Arbor, hospital pharmacists are using RFID to help them manage drug kits through the use of an automated pharmacy stocking system.
[See also: RFID adoption poised for ‘huge’ growth]
By utilizing cloud-based software and an RFID scanning station from Washington, DC-based Kit Check, pharmacy technicians inventory dozens of medications in seconds that are in pharmacy kits including crash carts and anesthesia trays. Previously technicians and pharmacists would inspect each kit vial individually, a process that can take up to ten times longer.
When medication trays are returned to the pharmacy from the operating room or emergency room, all the RFID-tagged meds in the drug kit – there can be as many as 198 – are scanned and a few seconds later the system tells the pharmacy technician which drugs were used and which ones are going to expire. With this information at their fingertips, the tech knows what to replenish and if the tray has been replenished correctly while at the same time generating all the regulatory paper work.
John Clark, director of pharmacy services at the University of Michigan Hospitals and Health Centers said that the technology not only allows the hospital to refill a kit that much faster, it also basically eliminate the errors that can happen related to incorrect or expired drugs that are in the kits.
"Kit Check helps to simplify the ability to manage drug boxes that are used for emergencies in the hospital," said Clark, who noted that prior to Kit Check, a time-consuming manual process was used. The process is made more efficient, said Clark, by not having to constantly count everything and making sure that everything is where it's supposed to be.
Mark Neuenschwander, a Bellevue, Wash.-based expert and consultant on bar code enabled medication dispensing, preparation, and administration, said that RFID readers are significant because they can quickly reveal what remains in the kit and what has been removed.
"The time savings justify the cost of the chips and the chip reading storage devices," he said.
In just three months since its implementation, Clark said that the hospital is already seen a return on investment that has been measured by a reduction of waste.
The demand for this type of technology appears to be growing. At the end of 2012, Kit Check had two hospital customers; that number grew to 43 at the end of 2013, and now exceeds 100.
"Over time I think we're going to have more and more medications RFID tagged by manufacturers," said Kevin MacDonald, co-founder and CEO of Kit Check.
"We can help hospitals decrease the amount of medications that they need to have on hand and reduce waste in terms of expiration," he added. "That decreases inventory cost. Users also can also increase charge capture and decrease both overtime labor and general labor that's required to process kits manually."
Niche market for RIFD
At the University of California San Diego Medical Center, RFID is helping to monitor plasma and specialty products more efficiently.
Using the Cubixx consignment service from Frisco, Texas-based ASD Healthcare, a division of Amerisource Bergen, healthcare professionals are able to provide life-saving products such as the antihemophilic blood factor products and rattlesnake anti-venom.
Products have RFID tags that allow Cubixx to monitor inventory 24/7 and replenish stock to bring it back to an established par level. "The system is set up so that you will always have products in stock to service critical patient needs at any time," said purchasing manager Danielle Kulischak.
According to ASD, placing RFID tags on all products allows Cubixx to invoice customers only when they use the product and customers determine their own quantities that ASD Healthcare remotely tracks. In addition, Cubixx automatically verifies expiration dates and other pertinent information on each product unit.
Specialty products are often problematic. They're expensive hard to track and respective customers don't like holding the inventory.
In addition, said Chris Flori, vice president of business innovation at ASD Healthcare, there is no reverse distribution on biologics so if it expires you can't send it back like you can a wholesale drug product like a prescription drug or and over-the-counter medication.
"If you buy it, you own it," said Flori. "You can't make any mistakes. We settled on RFID as a means by which to give us confidence around maintaining a consignment inventory in these hospitals."
RIFD technology, according to Kulischak, has benefited the medical center in in terms of cost savings, efficiency, and patient safety.
"We had a one time inventory reduction when we switched to consignment service," she said. "The products are invoiced when it is used. The inventory is tracked remotely by RFID technology."
As far as Cubixx's impact on patient care, Kulischak said that the hospital is able to respond to any unanticipated admission or emergency needs safely and cost-effectively.
Prior to introducing Cubixx, the medical center had a large inventory of plasma and specialty products on hand. "There was waste associated with expired unused products. It was difficult and costly to maintain a large inventory of these expensive and critical medications," said Kulischak.
ASD Healthcare's Flori said the company's hospital customers using Cubixx have seen a windfall due to elimination of expired goods, access to a broader range of products not restricted by manufacturer's inventory, access to restricted distribution products, and the elimination of capital deployment in inventory.
This type of inventory, he noted, can be very difficult to track due to its product identifiers and presence in both the commercial and 340B space.
"Because hospitals do not buy inventory unless they use it, Cubixx essentially frees up dollars previously 'trapped in inventory' specifically for items that are historically slow moving or episodic in utilization," said Flori. "The guess work is eliminated with regard to how to hold and of what products."
In addition to providing the consignment inventory, ASD also manages it around-the-clock, according to Flori. Using Cubixx technology directly reduces staff time that was previously needed to manage such an expensive, delicate and complex inventory.
"As the excursions take place from the respective refrigerators or ambient boxes we replenish in an automated fashion. We have found a nice sweet spot between the amount of product we keep there the number of orders they get, because they really don't do anything but go to the refrigerator and pull the product out."
Flori pointed out that Cubixx gives hospitals the ability to maintain a very expensive, very rare drug stock with no expense.
In September, ASD announced that it had exceeded 400 billion scans on Cubixx. According to the company, that translates to almost 150 million scans read and reported every day.
Proponents of RFID contend that its application in the hospitals will continue its growth spurt.
"We feel fundamentally that you improve safety in hospitals not only in error reduction but because things are at the right place at the right time, said Aldo Zini, president and CEO of Aethon Inc., based in Pittsburgh.
Aethon produces MedEx, a real-time medication delivery tracking software system that controls the medication delivery process and provides real-time status information to pharmacy and nursing. Zini said that this technology is important to hospitals because it addresses the issues related to late, missing or divergent medication deliveries in both centralized and decentralized pharmacies and can be used with pneumatic tubes, manual courier and TUG, Aethon's autonomous mobile robot.
The RFID reader in the TUG detects the presence of passive RFID tags. Tags are associated with a specific order and are typically affixed to high-value medications or IV mixtures. To load the product into the TUG, pharmacy technicians identify themselves at the security pad of the TUG robot.
The correct drawer opens and they place a RFID labeled item inside which registers the presence of the inventory. The user confirms this action using the keypad on the TUG as well. At the receiving end, when the appropriate nurse logs in, a receipt transaction is registered when the item is removed from the drawer.
"The value proposition is centered on reducing costs, that's paramount today in hospitals. We replace the menial task of labor that clinicians don't want to do or shouldn't do," said Zini.
"You don't want nurses and other clinicians having to push carts and run errands and move things around," he added. "Picking up infectious waste or moving large carts of linens, those are things that robots should be doing."
