Pharmacies and RFID

RFID technology is intriguing in many ways. It offers some advantages over bar code scanning technology, but then again it tends to be more costly and labor intensive. I’ve always thought RFID technology would find significant use in pharmacy practice, but that hasn’t happened. It has found some niche areas in healthcare, but not to the extent that I thought it would.

I read two RFID articles over the weekend, and on the surface they appear to be in stark contrast. But after giving it some thought I’m not so sure that’s entirely true.

Article #1: RxTrace.com – The Case Against RFID In Pharma

“It is pretty clear that there is not much interest in the use of Radio Frequency IDentification (RFID) in the pharmaceutical supply chain because every time I publish an essay in RxTrace about some aspect of it, there is a drop in readership.”

The author goes on to make a pretty compelling case as to why interest in RFID has declined in the pharmaceutical industry. But then later in the same article the author demonstrates where RFID technology might make sense, i.e. for use in inventory management.

“Take a look at what has been done in the apparel industry with RFID to see what I mean.  (Make sure you read that linked article and find the quote by Bill Hardgrave, dean of Auburn University’s College of Business “..when we look back, it almost seems silly that we started it as a supply chain tool.”). RFID is increasingly being used in the apparel retail industry to monitor and continually adjust store floor inventory.  This brings on benefits that go way beyond the cost of the tags and it all runs in parallel with barcodes and outside of the supply chain, and so some chain stores have even decided to tag everything themselves.”

This makes sense, but it’s not entirely without risk. Any time you introduce a human element into something, i.e. placing RFID tags on products, you create opportunity for error. And we all know that making a mistake in the pharmacy has the potential to make its way downstream to the patient. As pointed out by the author “for RFID to be used in pharma, the tags would need to be applied by the manufacturers.” Agreed.

The other problem with applying RFID tags to all medications is cost. Do you really need to tag every acetaminophen tablet that comes through the pharmacy? Hard to imagine a case where that would make sense. However, there are instances where the extra cost might be justified. I’ve always thought that high-cost drugs (EPO, factor, etc), high-risk drugs (chemotherapy), and controlled substances (morphine, fentanyl, and so on) would make a good target for RFID technology. I’m not alone in my thoughts. Ray Vrabel, PharmD left the following commented at the site: “It may be difficult to justify the use of RFID in the supply chain for all types of pharmaceuticals, but there is at least one category of drugs that would benefit ALL three segments of the pharmaceutical supply chain: Controlled Substances, as regulated by the Drug Enforcement Administration (DEA). Each of the three pharmaceutical supply chain segments spent a lot of effort keeping a precise count of every controlled substance manufactured, distributed, and dispensed. The use of RFID would allow this accountability aspect to be done using automation, not humans.” Agreed.

Article #2: HealthcareITNews.com – Hospitals are finding ROI from RFID

The article covers one of the niche cases for RFID technology that I mentioned above. In this case it’s all about inventory management.

“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. By utilizing RFID [technology] from … Kit Check, pharmacy technicians inventory dozens of medications in seconds that are in pharmacy kits including crash carts and anesthesia trays. 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.”

I’ve written about KitCheck before (Cool Pharmacy Technology – KitCheck). They’ve done a good job of finding a useful niche for RFID technology, i.e. management of medication trays, e-kits, etc. The Intelliguard system by MEPS Real-Time, Inc. is similar in their approach to managing trays with RFID technology. On the flip side is Carts by MedKeeper. Carts uses a bar code scanning approach to tray management.

My thoughts on the two approaches for tray management:

RFID
Pros
speed of reading the information without the need for humans scanning each item in the tray
amount of “real-time” information you can get.

Cons
cost associated with RFID tags
cost associated with hardware
lack of mobility with KitCheck and Intelliguard, i.e. you have to bring the tray back to the reader
labor to apply the RFID tags,

Bar code (basically flip the pros and cons of RFID)
Pros
labels are significantly less expensive
less expensive hardware
mobile, i.e. you can scan items anywhere as long as you have bar code imager
familiar technology, i.e. a majority of pharmacies are already using bar code scanning technology

Cons
must visually inspect trays and scan items

Ultimately it depends on your situation and your needs. I can see a pharmacy director making a case for either technology for med tray management.