As a pharmacist, I am privileged to work every day on behalf of clinicians in acute care settings such as hospitals by ensuring medication solutions we provide streamline patient care while easing the demands on doctors, nurses, and other caregivers. One important tool is radio frequency identification (RFID), which can enable hospitals to improve medication safety and accuracy while enhancing workflows to help clinicians deliver efficient patient care.
Day in and day out, clinicians work long hours, caring for others in demanding and complex conditions. Advancements in healthcare technologies can provide new options to enhance the safety and efficiency of patient care, but at times, it can add complexity and, inadvertently, manual steps to workflows if not designed correctly. Clinicians are constantly barraged with pings, dings, alerts, and reminders as well as other interruptions. A 2023 study found that emergency department physicians are interrupted as frequently as seven times per hour, which contributes to medication errors. A 2021 study determined that nurses are interrupted even more often—up to 12.68 times per hour. Add to that a dizzying array of systems that clinicians already must master, and it’s clear that technology can be a lifesaver, but also cause distraction and frustration.
These factors can contribute to the serious problem of clinician burnout. According to a 2023 study by the Journal of General Internal Medicine, the burnout rate for physicians, nurses and clinical staff hovers around 50%. Burnout is also an issue for over 50% for pharmacists.
Clearly, hospitals need to find ways to reduce demands on clinicians and staff, and systems that incorporate RFID can provide a wireless solution that can reduce time-consuming or repetitive tasks that are pervasive in healthcare. RFID is already widely used to accurately track patients and equipment. In addition, there is a growing adoption of RFID to support a more efficient and accurate medication-use process that can enhance patient safety, help prevent drug diversion, and give clinicians more time for patient care.
RFID streamlines medication management in hospitals
RFID can simplify one of the more labor-intensive tasks in hospitals: the monitoring and tracking of medications. That’s why a growing number of hospitals are putting RFID technology to work to track and accurately maintain the medications used in kits, trays, and crash carts. These new systems augment and improve a historically barcode-driven workflow by utilizing the power of RFID to read large numbers of drugs during a single scan – in real time, wirelessly. As a result, it is easier and faster to determine what drugs may need to be restocked or removed due to expiration. This also eliminates manual entry of lot and expiration dates while accelerating the recall process, which saves many hours of often tedious work.
There is even an RFID-enabled anesthesia work station designed for use in the operating room that streamlines anesthesia medication workflows while giving pharmacy real-time, accurate snapshots of current inventory levels. These innovations are on the rise, and according to the American Society of Health-System Pharmacists, 47% of survey respondents are either evaluating RFID or are interested in exploring its use.
Current workflows require manual tagging
To use RFID-enabled medication systems, each and every medication needs to be RFID tagged. This typically requires pharmacy personnel to place a vendor-provided RFID tag onto individual products, associate the drug information to the tag, and then double check the tags to ensure accuracy. Tag placement can also be important as the tags must be affixed in the right location so they do not obscure the medication label and in some cases for the best performance. Many hospitals have job aids to direct pharmacy personnel where and how to affix tags, especially on difficult-to-read products.
The ABCs of RFID
RFID is a familiar technology used in credit cards, key fobs, automated tolling and many other applications. But how does it work?
As the name suggests, Radio Frequency Identification technology works using radio waves. An RFID tag typically contains two items — an antenna for transmitting information and a microchip that holds unique information, such as a serial number, lot number, and/or expiration date.
When within range of an RFID reader, the tag’s antenna picks up the radio signal, powering the chip to transmit data back to the reader. As a result, RFID delivers accurate, efficient data collection, wirelessly supporting the internet of things (IoT).
While it may be a lot of work, for many facilities, the benefits in terms of accuracy and efficiency outweigh this tedious task. For others, however, the labor required to tag the number of products required may dissuade them from adopting RFID.
How RFID-enabled manufacturer-prepared products work
Smart-labeled, manufacturer-prepared RFID products help to eliminate the time-consuming and tedious process of manually applying RFID tags. These products utilize RAIN RFID, an ultra-high frequency passive RFID technology consisting of a computer chip and custom antenna on a clear plastic substrate within the medication label. The combination of chip, antenna, and substrate is referred to as an inlay. The chip is tiny—
no bigger than a flake of pepper—and contains various sizes of memory to house crucial data. Using a wireless connection, an RFID reader can instantly know critical details about a particular medication, which can include the national drug code (NDC), serial number, lot number, and expiration date. Since the FDA has not yet ruled on the RFID encoding standards that should be utilized for pharmaceutical manufacturers like it has with barcodes, many drug makers are naturally turning to GS1 for their RFID EPC Tag Data Standards to facilitate the identification, capturing, and sharing of information in a standardized way.
The RFID inlays location within the label and its inherent design is a very important part of the process. Each RFID inlay is embedded into the pharmaceutical label, making it difficult to remove which can provide tamper evidence contributing to diversion detection. This provides additional safeguards, since manual tags can be easily removed.Additionally, when designing the RFID inlay, it is important to take into consideration the drug formulation. A recent Axia Institute study found that “the composition of different pharmaceutical drug formations can significantly impact RFID tag readability.”
RFID-enabled pharmaceutical products should take the formulation, container size, and container composition into consideration during the inlay design process for superior readability, and not solely rely on “one-size-fits-all” inlay. This is critical because RFID products are used in hospital areas that demand precision, accuracy, reliability, and consistency.
A look ahead at RFID’s potential
The growing adoption of RFID for medication inventory management is exciting, and we hope that it will lead to the introduction of RFID into other hospital medication systems to improve accuracy and efficiency. For example, automated dispensing cabinets (ADCs) are typically configured to require nursing and pharmacy to ensure accurate narcotic counts.RFID could help to eliminate that tedious and time-consuming process where mistakes can be made, reducing errors and rework. Imagine if pharmacy personnel could close the door of a narcotic vault and everything could be accounted for without the manual counting that is currently required. What if during IV compounding verification of products and documentation of lot and expiration date could happen wirelessly. RFID could improve the workflows of current medication technology systems where tracking, documentation, or verification is manual or time-consuming process.
There are many more medication and healthcare technology systems that would benefit from the introduction of RFID to reduce drug diversion, decrease waste, provide validation, automate documention, facilitate location, and support data sharing with the electronic health record. In fact, a 2022 report by the ASHP Foundation predicted that hospitals will expand use of RFID in a variety of ways to:
- Pneumatic tube tracking with RFID leading to decrease in waste
- Reduce time spent finding recalled and expired medications by integrating real-time location systems that are similar to RFID but operate on Bluetooth and/or WiFi capabilities.
- Ensure equipment such as infusion pumps and ventilators are in the right place for patients
- Track patients as they travel through health systems, with this information updating into EMR systems in real time.
- Help prevent drug diversion by embedding RFID into patient-specific labels for specific types of medications.
- Automate communication with the CMS PAR systems to provide accurate, real-time inventories
Revolutionizing medication workflows
RFID has the potential to revolutionize medication workflows in the hospital by providing methods of contactless identification and pinpoint tracking that can streamline documentation, enhance inventory control and improve patient safety. I am encouraged by the healthcare companies that are forging ahead into RFID and am hopeful that others will soon follow to support our caregivers with technology improvements so they can focus on what matters most: patient care.
About the Author
Gwen Volpe, RPh, LSSBB, FASHP is senior director of medication technology, marketing North America, for Fresenius Kabi.
