Prior to 2019, the pharmacy department at Pennsylvania's Reading Hospital regularly faced issues related to medication management.

THE PROBLEM

Crash cart trays had to be manually stocked by a technician and then checked by a pharmacist. This was a time-consuming activity that took 20-30 minutes per tray. It also was error prone. Additionally, the hospital never had the ability to track specific lot numbers in crash cart trays and kits, which made it very difficult to locate manufacturer-recalled medications.

Then came the COVID-19 vaccine rollout. Reading Hospital experienced incorrect vaccine counts at the end of the workday, and this was the impetus to use an RFID solution from vendor Kit Check for vaccines that it had begun using for medications.

PROPOSAL

The RFID solution provides a safeguard against expired medications reaching a patient, as RFID can be encoded with a Beyond Use Dating (BUD) when the vaccines leave the ultra-freezer and are scanned in the Kit Check scanning station. 

That is a major differentiator of RFID compared with other serialization technologies – an RFID scan can both read and write data points on the RFID tag, said Alan Portnoy, PharmD, pharmacy operations manager at Reading Hospital.

"Overnight our department had to pivot to supply more than 600 doses of a highly temperamental vaccine presentation per day," he explained. "Not only did we have to set up vaccine clinics and staff them, but we had to figure out how to make sure every dose of vaccine was administered to a patient and was not wasted."

Portnoy and his team also needed exact-use counts to report back to the Pennsylvania Health Department for tracking purposes. With a presentation that needs to be stored at -80 degrees, none of these things are easy to accomplish, especially when the organization is facing intense public demand for the vaccine and dealing with limited quantities.

"Prior to leveraging RFID, we were unfortunately experiencing incorrect inventory counts at the end of some days, as the vaccines needed to be counted by hand three separate times en route to the patient, leaving too much room for human error."

Alan Portnoy, PharmD, Reading Hospital

"RFID technology allows for item-level visibility at the unit dose," he said. "The information that can be encoded using RFID – lot number, expiration, etc. – can be tracked with a scan in a scanning station that only takes a few seconds. As a result, shortaged medications, expired medications and recalled medications are kept from reaching a patient – so there is a huge patient safety component.

"Additionally, as seen in our use of Kit Check RFID for the COVID-19 vaccine, inventory management –understanding exactly what you have on hand and using data to make the best possible decisions for your pharmacy – is automated with RFID," he continued. "With RFID, we are able to make data-backed decisions to optimize inventory, as well as restock kits and trays in a fraction of the time that manual restocking takes."

MEETING THE CHALLENGE

Because Reading Hospital was faced with completing more than 600 vaccine administrations a day, it quickly collaborated with the Kit Check team and was able to come up with a solution that allowed for a cloud-based inventory record of every vial of vaccine, so counts were accurate and more people could be vaccinated.

"RFID is uniquely poised to help in complicated hospital supply chain management use-cases like this, as tags can be encoded with pertinent dose-level information, like lot number or expiration, and edited with new information with each scan – like setting the BUD clock ticking when the vial is removed from the ultra-freezer and scanned in the scanning station," Portnoy said.

Pharmacy technicians print the RFID tags and scan the vaccine vials, as well as other tagged medications, in scanning stations. Then, as the operations manager, Portnoy can look at the inventory reports captured by the RFID scans and confidently report accurate data back to the Pennsylvania Health Department to re-order more vaccines.

The RFID workflow, he explained, allows the hospital to:

• Assure proper count of vials in the ultra-freezer and refrigerator.
• Keep a cloud-based inventory count of vaccine vials that can be accessed from any Internet connection, so the staff always has correct counts to report to the Pennsylvania Health Department.
• Ensure no vial is used on a patient after its BUD expiration.
• Keep all inventory management in one central place, as opposed to paper records or ones done by marker on a freezer door that can be easily erased.

RESULTS

"Since we started using RFID to automate our COVID-vaccination workflow, we have had accurate item-level counts to report back to the Pennsylvania Health Department, which ensures we vaccinate as many members of our health system community – and the larger community, as possible," Portnoy reported. 

"Prior to leveraging RFID, we were unfortunately experiencing incorrect inventory counts at the end of some days, as the vaccines needed to be counted by hand three separate times en route to the patient, leaving too much room for human error."

As for the crash cart trays that previously had to be manually stocked: Time to stock and check went from 20-30 minutes per tray to 2-3 minutes, with almost no errors, he added.

ADVICE FOR OTHERS

"I'm excited about the potential applications of RFID technology for inventory management," Portnoy said. "It's quick, accurate and efficient. It provides the ability to scan and track large numbers of medications without the need to physically handle the products."

He said he always is looking for opportunities to incorporate this technology into a new workflow that can add value to the pharmacy department.

"My hope is that by lowering costs, RFID technology will gain greater acceptance in the industry, so that it's as common as a bar code," he concluded.

Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
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