Radio frequency identification-enabled automation for inventory management has only achieved its massive adoption in the retail space over the past 2 decades.
Automation, and in particular radio frequency identification (RFID)-enabled automation, is becoming more prominent in the pharmaceutical industry. As such, it is crucial that the hospital, as both the end user and the advocate for patient safety, plays a central role in developing the standards that are being developed to grow the use of the technology.
Although it was developed in the early 1970s, RFID for inventory management has only achieved its massive adoption in retail in the past 2 decades and even then, it had its ups and downs.
In 2003, Walmart attempted to add supply chain visibility in their warehouses by mandating that its largest suppliers implement RFID tagging of their pallets and cases.1,2 Initially, this was a massive let-down because the RFID tags were expensive, unreliable, and ultimately, the data that they provided were all but useless. This experiment, although unsuccessful, paved the way for the technology to hone in on how to do RFID the right way.
The studies that came out of that experiment led Walmart—along with other retailers such as Dillard’s, Bloomingdale’s, Target, and Macy’s—to realize that their lack of visibility wasn’t in the warehouse, it was in the brick-and-mortar storefronts. RFID-enabled individually packaged products flowing through and across hundreds of storefronts introduces a completely different set of technical requirements than pallets in a tightly controlled warehouse. This is why it's so important for the use-case to define the technology and not vice versa.
It wasn’t until the development of standardized quality metrics, application-specific performance specifications, and the advent of cloud-based data systems that the industry was able to achieve the necessary quality, performance, and cost requirements to get to the 30 billion-plus RFID tags we see used per year today. Walmart, in particular, has turned their past RFID missteps into one of the greatest RFID success stories.
Currently in health care, we face many of the same challenges when implementing RFID in the hospital. Hospital-centered RFID organizations are helping to ensure that we do not repeat the same mistakes that delayed the adoption of RFID in retail.3
The most fundamental standard in RFID tag manufacturing is quality management. The chips and antennas used in RFID tags are so small that even minor variations in manufacturing quality can make the RFID tag unusable by the time it makes it to the end-user.
The gold standard for quality certification in the RFID industry is the ARC RFID Lab at Auburn University.4 ARC is an independent lab and is the certifier of quality and performance for almost every RFID tag made to date.
ARC has also worked with RFID solutions providers, pharmaceutical manufacturers, and RFID tag manufacturers to develop the most widely used performance standard for RFID-enabled medications, Specification S.5 This is important because not every RFID tag works well on every medication in every situation—there is no one size fits all.
Specification S was developed specifically with hospitals in mind and working with RFID solutions providers ensures real-life hospital cases are the focal point of emerging standards. The specification allows RFID tags to work reliably in the harshest of environments (densely populated kits and trays, for example) and achieve the highest possible speeds attainable. These specifications are important for pharmacy end users to ensure reliability of the tags to accurately and efficiently restock kits and trays.
Beyond just quality and performance, there are data standards that must support patient safety and enable the hospital to meaningfully use RFID-enabled medication data. The most commonplace to store the majority of RFID data isn’t actually on the RFID tag itself but rather, in the cloud.
This has several advantages in general because tags can be physically smaller, less expensive, and there are no limits to the amount of data you can store if they are offloaded to the cloud. Systems that don’t offload data to the cloud have to store data on the tag itself. In theory this sounds ok, but in practice, it can cause significant issues, especially when it comes to variable data.
For example, without storing dating information in the cloud, beyond-use and extended-use dating has to be stored in the tag itself. This means the data on the tag must be rewritable, which can have adverse effects on patient safety if the data get lost or errors are introduced in rewriting. Imagine if a vial’s barcode, which is meant to be a static source of truth, was rewritable and any user can change any information about the medication at any time.
Clinically important drug recalls occur approximately once a month in the United States.6 It can be challenging for a pharmacy staff members to identify where recalled medications are located in kits/trays across the health system. Recalls are handled more efficiently through the cloud.
Without a cloud connection, the pharmacy staff member must identify the lot number from the RFID tag and manually look it up in another system, making it no better than barcode. However, with cloud-connected RFID, you can be certain that the medication’s recall information is up-to-date, and its location can be checked, without additional effort from pharmacy staff members.
The use of a cloud registry allows for improved data accuracy and reliability, multi-hospital reporting, enhanced data security, real-time analytics and increased collaborative capabilities across multiple stakeholders down to the unit dose. Cloud-connected databases are opt-in but are free and openly accessible to any technology vendor in the hospital.
RFID automation is part of the future of pharmacy operations. It is critical that end-users understand this technology to advocate for themselves and for their patients.
1. Kaplan, D. A. (2018, August 21). The rise, fall and return of RFID. Supply Chain Dive. Retrieved March 30, 2023, from https://www.supplychaindive.com/news/RFID-rise-fall-and-return-retail/530608/
2. Dan Berthiaume Senior Editor. (2022, March 18). Walmart requiring RFID tagging, partners with Auburn University. Chain Store Age. Retrieved March 30, 2023, from https://chainstoreage.com/walmart-requiring-rfid-tagging-partners-auburn-university
3. UnitVisID Alliance, Inc. (2023, March 28). UNITVISID. UnitVisID. Retrieved March 30, 2023, from https://www.unitvisid.com/
4. Radio Frequency identification Lab. RFID Lab. (n.d.). Retrieved March 30, 2023, from https://rfid.auburn.edu/
5. Auburn University. (n.d.). Tag performance specification S version 1 - Auburn University. Retrieved March 30, 2023, from https://rfid.auburn.edu/wp-content/uploads/2020/12/ARCInlayRequirementSpecificationS_V1_1.pdf
6. Natof T, Pellegrini MV. Food And Drug Administration Recalls. [Updated 2023 Mar 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK570589/