Part 1: From Drug Supply to Staffing, the Benefits of RFID Integrated into Vial Labels

“In recent years a variety of different RFID solutions have come into the healthcare market to track drug products, instruments, and supplies without any industry-wide standards having been established to ensure quality, performance, and interoperability between them," says the consortium. "With industry-wide support of a comprehensive set of RFID standards for healthcare, players along the pharmaceutical supply chain can work together to solve these issues proactively rather than reactively.”

With that explanation in mind, we sat down with Dr. Schaefer to hear about how the end users at heath systems have gained efficiency from RFID solutions adopted by pharmaceutical manufacturers.

Healthcare Packaging (HCP): To start, how are you using automated inventory management for drugs at your facility? I understand companies are transitioning away from flags into seamless systems with embedded tags. 

Eric Schaefer: What we choose to tag is going to depend on where we're utilizing this technology. When you look at how people select automated inventory management, there's one mindset of “I'm going to use it to check this tray or this kit.”

Then there's also the mindset of “I'm going use this to check those items and reduce the time it takes to check or use pharmacy time. However, I also see the other benefits that are available: the analytics, the inventory pieces, the recall pieces, and shortage management options with the tray.”

At my prior facility, I did a major implementation for two systems. We converted part of the facility to Kit Check for crash cart trays and for anesthesia trays where they do a tray drop, in which they take the used tray out, place a new tray into that drawer, and then it's 100% stocked. Those are going to be items that are usually higher value vials—they lend themselves well to this use. 

Most facilities that implement this are probably going to start with a crash cart because turnover in that cart isn't daily, so it's something where if you have an option to know electronically where stock is, and what's expiring, you're able to manage those and rotate those out rather than opening every cart every month.

That was the case here at Allegheny General Hospital, and at the previous facility I worked at. We started with crash cars and then expanded into other areas, but really you're looking at those kitted items for emergency kits, trays, and operating room (OR) based items.

HCP: What is the importance of the ability to scan vials without a direct line of sight?

ES: There’s a big time difference between scanning RFID versus 2D codes. If I needed a line of sight to scan a 2D barcode for a box or a bagged kit of drugs, if the label is on the side, I have to stand all those vials up or twist them so that the barcode is showing.

With Kit Check the nice thing is that I'm confirming that this drug is inside using RFID, without necessarily having the line of sight. I can use it to scan trays and scan boxes, such as radiology reaction boxes, without physically having to look at each item.

With 2D barcoding, I'm still going to have to physically look at every vial in that area. Many places will spend about one day every six months doing outdates and pulling drugs for the next six months. With an RFID system, I can now scan my bins once a week, or it may even be more frequent. I can eliminate scenarios where I have six months of a drug in limbo that I could be using up. 

The 2D barcode is usually going to end up being on the vial cap. What I had found is when they pop that off, it's still attached and the lid will sometimes fall back down, so it looks like it's an unopened vial. Whereas with RFID, the tag is attached to the side and I can tell when that top is off or when it's used.

HCP: Why did you end up selecting the Kit Check as opposed to other competitors?

ES: I am in the camp that the capabilities of Kit Check allow for a broader use of the system.

Speaking from my pharmacy manager experience in my previous facility, I looked at the options available. As I mentioned previously, there are the subset that look at it as a way to scan a tray, then there are the groups that look at it for fuller functionality.

When you're going to implement any technology, you have to pitch the benefits to the people who are going to be providing you the funds. If you're going in and you're saying, “I scan a tray” and you don't explain the benefits, they're probably going to want to lean towards the cheaper route.

However, I saw that as technology advances, there would be opportunities to use RFID to scan the products for inventory. 

In the past, we would make medication kits for the OR nurses with a 2D barcoding system. Their kit functionality was a laptop with a handheld scanner and scanning each vial. That takes more time than me putting a kit into a scanner and reading in seconds compared minutes.

When I used 2D versus Kit Check, the scan times vary greatly because you have a camera trying to assess the location of those barcodes. So it's something where being able to place it into the reader, have it recognized, not having to stand all the vials up to make sure that perfect make it up there in there with kind of that savings. 

And for me, I don't necessarily assume it as a time savings in the aspect of cutting people or hours. It's about what can I now do that's more value-added with that pharmacist hour. How can I elevate a technician's level of involvement to helping with the dispensing portion rather than just filling the tray and waiting for a pharmacist to check.

Even for pharmacists, other than having them check each of the hundred items that are in a tray manually for expiration, I can have a technician dispatch it, and I can now use that pharmacist’s time for providing clinical information, interacting more with the provider, and being more involved in patient care versus them having to check a tray for 10 minutes at 40 trays per day.

HCP: One feature is that information associated with an RFID tag isn’t static. Can you provide an example of additional or updated information being sent to RFID tags?

ES: We have a prime example of syringe shortages. For several years, there’s been an ongoing shortage of emergency syringes and even FDA updates to their expiration dates. The nice thing is I can validate that information on the FDA website, log into the system, and update the expiration on that lot number.

I can see the history of the tracking. I can see that for some of the syringes, I had to update the lot numbers two or three times because they were performing testing and allowing extended dating due to shortage. We can update expiration dates automatically without having to replace the tag.

HCP: So it's both a patient benefit, a cost benefit, and a sustainability benefit because you're not necessarily getting rid of something that's already in short supply? If an expiration date has been updated, then somebody isn’t mistakenly thinking it’s expired and tossing it? 

ES: Right. So a user looking at the vial doesn't see the old expiration printed on the tag (maybe they do on the carton) but we know that when we're releasing that drug, it has had an updated expiration in the system.

This is part 1 of a two-part series. Click here for Part 2 to read about KPIs, COVID-19 effects, and more.