An exploration of the use of RFID technology to manage contrast inventory in the hospital setting identified potential cost savings, as well as implications for patient safety, inventory management, and billing
Our research aimed to identify and quantify the impact of radiofrequency identification (RFID) technology on inventory management and was conducted in a typical radiology practice of the medical imaging department at a large tertiary-care center in the Southeastern United States from April 2007 to December 2008. The radiology practice had two 1.5T MRI units and served an average of 220 patients per week, 132 (60%) of whom required contrast media. The practice used 100-mL bulk contrast vials, each of which could be used for seven images. There was a loss of an average of one vial per week from storage due to expiration of partially used vials. The department reordered contrast weekly and waited three days for delivery.
The inventory-related work in a radiology practice requires considerable human involvement. For instance, a technologist may check patient records, scan the bar codes of contrast vials before use, and count the stored vials to determine replenishment needs. This much involvement creates operational problems in patient care and safety, missed reimbursement opportunities, expiration-date compliance, and inventory management.
A mismatch can occur when an exam order for one patient is applied to another, possibly leading to adverse reactions to contrast. The need to repeat such exams also decreases overall efficiency. Scanning a vial can be difficult if the bar code is worn or peeling. These problems waste technologists’ time, and scanning problems can create inaccuracies in billing and inventory records that could lead to lower reimbursement for contrast (where it is billable separately), missing or undesignated stock, and excessive inventory. According to one simulation study¹ in a surgical setting, half of participants failed to scan a bar code on at least one occasion, implying that bar-code readings are unreliable.
RFID and Bar-code Technologies
Adoption of RFID technology in medical environments is growing rapidly. Implementation of the technology in interventional cardiology and pharmaceuticals has already increased reimbursement for expensive supplies, reduced inventory, and improved patient safety. 2-8 For this case inquiry, we identified several differences between RFID and bar-code technologies.
Line of sight: A technologist should scan the bar code of each contrast vial, resulting in higher-than-normal labor time and a high error rate.1 RFID does not require a line of sight.
Automatic logging: With RFID, critical data about patients and drugs are automatically logged.
Multiple reading: RFID technology can read multiple vials at the same time, decreasing the time once allocated to bar-code scanning.
Information updates: RFID tags are rewritable, allowing information about partially used vials to be updated. This increases the accuracy of inventory records and eliminates shrinkage resulting from expiration.9 Bar codes have only static entries; once the information is written, it cannot be changed.
Security, tracking, and product recalls: Bar codes can be duplicated easily, whereas RFID tags have encrypted information that is more difficult to imitate. There are state and federal laws requiring that drugs have information about dosage, lot numbers, and complete shipping history. These can be confirmed by RFID tags, which also make product recalls more efficient because they can update product information within the distribution network. This tracking information helps in the identification of product-related problems in particular locations.
Data capacity: RFID has a high data-storage capacity, which permits coding each item uniquely and recording more information about it. More storage means that information on the exact time, date, and production line of manufacturing; the expiration date and complete shipping information; and the dose, assigned staff member, and patient can be captured using only one RFID tag.
Durability: Because RFID tags can be encased in vial caps, they are likely to be more durable and free of reading errors than bar-code labels.
Real-time item tracking: RFID can gather information about vials in storage in real time, allowing a practice to switch from periodic to continuous inventory review.
Automatic reordering: Because RFID increases