Cool Pharmacy Technology – Intelliguard RFID Solutions from MEPS Real-Time

By | February 24, 2015

Last week I spent some time down south in San Diego visiting a couple of hospitals and speaking with the good folks at MEPS Real-Time. My objective for the visit was twofold: 1) see MEPS RFID Solutions in a live environment, and 2) speak with the people at MEPS and get an inside look at their technology. I was able to accomplish both goals.

MEPS Real-Time is a company that specializes in providing RFID solutions for healthcare specifically targeted at acute care pharmacies. Their Intelliguard® RFID Solutions product line currently includes a Kit and Tray Management System, Controlled Temperature Cabinets, and a Vendor Management Inventory (VMI) System.

MEPS_RFID_TAG

Products

Intelliguard® Kit and Tray Management System
This is a standalone system for managing medication trays, i.e. code boxes, transport boxes, intubation kits, anesthesia trays, C-section trays, and so on ad infinitum. The system consists of software with a nice UI, a “box”, and RFID tags. The software has a nice, user friendly UI and is designed to be used on a touchscreen, i.e. large buttons, proper spacing, etc. The “box” reminds me of a small pizza oven. It contains all the magic that makes the system work. The box contains the transceiver that generates the radio signal and the antenna that capture all the information.(1) The RFID tags themselves are little bigger than an average bar code label that you might see in a pharmacy. The image above shows one of the tags attached to a 1 mL hydrALAZINE vial. As you can see, the labels are really quite small.

I visited two hospitals using the Kit and Tray Management System.

Intelliguard® Inventory Management System
The Inventory Management System includes a set of Controlled Temperature Cabinets (CTCs). The cabinets come in four sizes – 2.3 Cu. Ft., 5.0 Cu. Ft., 12 Cu. Ft., and 26 Cu. Ft. – and two temperature ranges – Room Temperature 20 to 25°C and Cold Temperature 2 to 8°C. (2) The CTCs provide real time inventory numbers by reading the inventory inside the cabinets each time there’s an “event”, i.e. each time the door is opened. If you know the inventory before the door was opened, and you know the inventory after the door was closed, then you know when and what was removed. The cabinets are monitored remotely for temperature changes. Temperature ranges outside the accepted range will alert those monitoring the system and result in a series of events as defined by the facility.

I visited one hospital using Controlled Temperature Cabinets.

Intelliguard® Vendor Managed Inventory (VMI) Systems
The VMI system is part of the Verified Inventory Program-Consignment (VIPc) offered by FFF Enterprises. VIPc is a “product consignment program that utilizes RFID technology to continuously monitor critical-care products”. In my mind the VMI system is more of a service than it is a product. The service is a combination of pharmaceutical inventory provided by FFF and CTSs provided by MEPS Real-Time, Inc. The video below explains things from FFF’s perspective.

In their own right, each of these products could be covered alone in great detail. Each has a unique feature set that creates value in a given area. The benefits of these products however, really start to crystallize in my mind when they are used together. (3)

Information, pros, and cons

As with all technologies there are perceived pros and cons. The pros are easy to imagine: safety, ease of use, real-time monitoring, etc. The major advantage over bar code scanning technology is that bar code scanning is a manual process. Someone has to tell the system what they’re doing. RFID, on the other hand tells the user what’s happening. It may sound like a subtle difference, but it’s actually night and day. Because RFID doesn’t lend itself to the same manual process as bar code scanning, I believe RFID holds a safety edge over a manual scanning process.

Of course RFID isn’t perfect. No system is, and bar code labels hold their own advantages over RFID. Most detractors of RFID technology are concerned with speed and cost, i.e. it’s too slow and the tags cost too much.

There’s no doubt that it feels like a long time when you’re sitting there watching the Kit and Tray Management System read the contents of a medication tray; watched pot never boils. In reality it’s only about 15 seconds. It actually doesn’t take the entire 15 seconds to read all the tags in a given tray. In fact, reading the contents of a tray typically takes only a few seconds; less than five seconds in many of the readings I observed. But MEPS has determined that 15 seconds is a safe time to ensure as close to 100% read accuracy as possible. When asked about the time required to read a tray, the staff I spoke with at the two hospitals didn’t seems to have an issue with it.

Cost of tags, when viewed in a vacuum, can also be a concern for many. It’s true, RFID tags are much more expensive than bar code labels. There’s simply no denying the fact. When looking at the cost of the tags it’s important to look at the system as a whole and evaluate for yourself what you hope to gain. The cost of the tags may not be as costly as you think when viewed as part of the entire cost of ownership for the system – think ROI. Healthcare systems should decide for themselves what problem they’re trying to solve and how best to approach it.

One negative that I’ve noticed for RFID systems like these is the inability to identify the location of an item within a given tray, tackle box, etc. The readers can identify that objects are within a defined area, i.e. the enclosure, regardless of how tightly packed the contents are. However, the system cannot tell you that an item is in the correct pocket within the tray. The vendors in the RFID pharmacy space are painfully aware of the problem, and I can ensure you that they’re all looking for a solution.

Thoughts and impressions

I’ve had an interest in the use of Radio Frequency (RF) technology in pharmacy for quite some time. I believe the technology can provide value, especially in certain niche areas. The industry as a whole has been slow to respond, but interest seems to be picking up, particularly in refrigerated inventory management, anesthesia, and medication trays/carts.(4)

I was impressed with the entire line of Intelliguard products as well as the people I spoke with inside the company. I was given full access to everyone, including the CEO, the engineers, the sales and marketing team, and the quality control people, among others. It is clear to me that everyone inside the company has a genuine passion for what they’re doing. And let me just say that some of the things they’re doing – that I’m not allowed to speak of – are very cool. The company personality goes much deeper than the persona you see from the outside.

In regards to the products, I thought the Kit and Tray Management System was well thought out and designed. You could see the attention to detail in not only the product design, but the usability and best practices encouraged by the team at MEPS. The Controlled Temperature Cabinets are a great concept for certain niche areas of pharmacy, especially when combined with consignment services like those provided by FFF.

Overall I’d say it’s definitely cool pharmacy technology.

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  1. RFID technology has two components – (1) reader and (2) tag. The reader consist of a transceiver and an antenna. The transceiver generates the radio signal. The signal activates the tag and information is transmitted through the antenna. The signal itself powers the tag.
  2. As defined by General notices and requirements. In: The United States pharmacopeia, 37th rev., and The national formulary, 32nd ed. Rockville, MD: The United States Pharmacopeial Convention; 2014:66.
  3. Integration is becoming more important inside pharmacy. (Are we seeing the final days of standalone systems in pharmacy?)
  4. Following ASHP Midyear 2014 I felt that RFID technology was gaining ground, particularly in certain specific areas within pharmacy and the medication use process. (#ASHP Midyear final thoughts)

5 thoughts on “Cool Pharmacy Technology – Intelliguard RFID Solutions from MEPS Real-Time

  1. Glenn Tamir

    Hi there. Storemed is the NY Area Representative for MEPS, Realtime. Thank you for taking the time to visit the company and our users. As someone who has worked within the acute care pharmacy World for over 25 years, I can honestly tell you that this technology is a big help for the work-flow and safety of all hospital pharmacies.

    One point you made that I would like to address is not know the exact location in the tray. Most trays are divided into separate spaces so locating the meds is quite easy for the tech or pharmacist. MEPS’ use of a unique identification number for every tag makes it simple to locate a specific vial among several when a recall or expiry issue occurs.

    Finally, I think it’s important to note that unlike our competition, Intelliguard does NOT re-label meds which eliminates the possibility of a medication administration error due to a mis-labeled med. The doctor is FORCED to look at the manufacturer’s label – a much safer practice.

    Thanks again for your time and interest!

    Glenn Tamir
    President, Storemed
    glenn@storemed.com
    914.262.4848

  2. Ray Vrabel

    Great review. I especially enjoyed your Freudian slip. In your article you stated the following: “The Controlled Substance Cabinets are a great concept for certain niche areas of pharmacy, especially when combined with consignment services like those provided by FFF.”

    Based upon the earlier discussion in the article, I think you really meant to say Controlled “Temperature” Cabinets, not Controlled “Substance” Cabinets. The truth is that I believe using an RFID cabinets for the management of controlled substances throughout the medication supply chain would be an excellent use of RFID. Currently a lot of effort (and expense) is spent by vendors, wholesalers, and pharmacies manually controlling the inventory of controlled substances as they move from the vendor to the pharmacy end user. The use of RFID would be able to take a lot of these costs out and add additional value. This would only work if a major supplier of health-system controlled substances utilized RFID tags on the unit-of-sale packages (not necessarily down to the individual dose).

    Your comment about knowing “where in a tray” a given medication item is located is also very important. If the end user (e.g., the nurse or anesthesia provider) is looking to obtain a particular medication in a particular location of a tray and it is not there this could be a clinical problem. The existing tray and kit management systems on the market only verify that a given drug is or is not in a tray. These products currently have no way of indicating if the “correct medication” has been placed in the “correct location” within the tray being verified with the RFID box.

    In your article, you also mentioned that you visited a couple of the sites using the MEPS technology. Do you plan to share these findings in a subsequent article? That would be very helpful.

    Thanks…

  3. Jerry Fahrni Post author

    That’s a good catch, Ray. Yes I was thinking about controlled substances, but clearly meant to type ‘controlled temperature’. The post has been corrected. Don’t want to give anyone any ideas.

    Your point about location within the tray is spot on. When I mentioned it to the company they knew exactly what I was talking about. I get the feeling we’re not the only ones to have mentioned it to them.

    I don’t know that I will publicly post about my experience at the two hospitals. People tend to get a little nervous about that stuff. Definitely willing to talk about it face to face. Let me give that some thought.

    As always, appreciate the comments, Ray.

  4. Matthew Farley

    Seems like a very cool technology. I feel a bit confused about whether the label goes on bulk containers or individual vials. Both?

    1. Does pharmacy plug the data for what each label represents? I.E.-does one label always represent warfarin or can they be repurposed for whatever drug product?

    2. From a diversion perspective, can’t the end user remove the tag? Does the end cabinet require an ID card to gain access to the cabinet?

  5. Jerry Fahrni Post author

    I don’t know you background, but it seems that you may have a limited working knowledge of acute care pharmacies. It might help to better understand the use of the technology if you spent some time at the MEPS Real-Time site. They have some good information.

    To your questions:

    The labels can be applied to anything you want, whether that’s a bulk bottle or individual vials. The choice is up to the customer, although in the case of medication trays, code boxes, etc it would most likely be applied to individual vials, syringes, and the like.

    Labels are serialized and used only once in their life cycle. They could be reused, but that would be bad practice. Each label is encoded by the pharmacy to match the item it’s attached to. In the case of the Intelliguard system, the users attach a “blank RFID tag” to the item, select the drug information from a database and encode the tag with that information.

    Yes, of course the user can remove a tag. It’s important to understand that this system is not designed for diversion, per se. It’s an inventory management system designed to account for items stored in a specific location. However, the system could be used in locked cabinets with secure access, such as bio-ID, passwords, security care access, etc. This is how some companies handle consignment storage within pharmacies. An example would be Cardinal Health that utilizes a secure access RFID-enabled refrigerator to monitor refrigerated stock.

    I hope that answers your questions.

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