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The Case for RFID in Healthcare Supply Chains
Robert M. Sheridan
Director, Interventional Radiology
Massachusetts General Hospital
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Today’s Agenda
• Massachusetts General Hospital (MGH)
• Bringing Lean Management to the Hospital
• Goals When Deploying RFID Technology
• MGH 3 Phase Implementation
• MGH Future Plans for RFID
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Massachusetts General Hospital
• 850-1000 beds
• Primary Teaching Hospital – Harvard
• 650,00 exams in Radiology annually
– Interventional Radiology – 15,500 procedures
• Ranked # 1 – U.S. World News
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Bringing “Lean” Philosophy to Hospitals
Know Your Inventory – Transparent Views
• Predictability and Continuous Improvement
• FIFO: Supply Utilization
• JIT: Supply Reordering
Value Stream Mapping – Eliminate non value added activities
– Push vs. Pull Inventory
Streamline Manual Workflows – No manual inventory counts
– Automated Billing, Reordering and documentation
– Recall and Expiration Surveillance
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Bringing “Lean” Philosophy to Hospitals
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High Value Supply Services Service Focus:
– Perioperative Services – Cardiology – Radiology – Endoscopy/GI Services
Technology Goals:
– Information Driven Solutions
• Through automation, create insight into operational and clinical performance of supply chain
– RFID Enabled Automation
• RFID solutions automate processes for clinical workflow improvements, and auto reorder files
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Typical Hospital Supply Spend
Total Supply Spend OR, Cath Lab, Radiology
Rest of Hospital
55%
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Understanding Cost and Revenue Leakage Patient Registration
Reimbursement
Service Provided
Charge Capture
Intra-Operative Documentation
Billing
Leakage..?
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Leaks...! 10 – 20% Missed Charges
Incomplete, Inaccurate and Scattered Data
Idle Money: Prolonged
Billing Process
Loss of Revenue on Services Rendered
Due to Lack of Documentation
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Workflow Accessible
Data
Increased Data/ Charge Capture
Reduction in on hand inventory, Optimize Pars, Reduce stock
outs
System Integration: Billing, Materials, EHR, Scheduling
Eliminate Expired Product
Reduce Time spent on Inventory Management
Reporting and analytics
Increase Compliance, Manage Device
Recall
What makes an inventory management system successful?
The key to all of the benefits provided by “Supply Automation Systems” lies in the systems
ability to capture and present item level data
Source of Benefits
Source of Error
Simple Workflow = Most Accurate Data Negative effects of incomplete data magnified by downstream
decision making
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Login to Device Console
Access Patient Or Account Name
Remove Product(s)
Press ‘Remove’ or enter Product Code
Enter Serial/Lot Number
Close Cabinet
Cabinet Opens
Login to Device Console
Access Patient Or Account Name
Press ‘Return’ for Needed Products
Enter Serial/Lot Number
Replace Product On Shelf
Cabinet Opens
No
Close Cabinet
Yes
Manual Technology Workflow
Automating Workflows: Device/Supply Utilization
• Challenges with Manual Technologies – Requires manual product
identification
– Requires manual quantity entry
– Requires manual entry of item-level information
– Requires manual selection of patient on returns
• Possible Downstream Effects – Missed charges
– Inaccurate inventory
– Inaccurate implant logging Are Supplies Returned?
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Login to
Device Console
Access Patient
Or Account Name
Remove
Product(s)
Press ‘Remove’ or enter Product Code
Enter Serial/Lot
Number
Close Cabinet
Cabinet
Opens
Are Supplies
Returned?
Login to
Device Console
Access Patient
Or Account Name
Press ‘Return’ for Needed Products
Enter Serial/Lot
Number
Replace Product
On Shelf
Cabinet
Opens
No
Close Cabinet
Yes
Login to
Device Console
Access Patient
Or Account Name
Close Cabinet
Cabinet
Opens
Are Supplies
Returned?
Login to
Device Console
Select
Return Item
Replace Product
On Shelf
Cabinet
Opens
No
Close Cabinet
Yes
!
! !
Potential sources
of manual error
‘Hands Free’ Benefits:
- Eliminates 5 manual steps
- Removes 3 sources of potential error
RFID Workflow Manual Technology Workflow
Manual vs. RFID Workflow Comparison
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Design For Success
• Applying RFID appropriately is key!
• Get the right staff involved
• Run PDCA cycles often
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Value vs. Volume Inventory Management Strategy
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Do I track with RFID? Barcode? Both?
RFID-Based Workflow
Automation
Barcode Scan-Based Workflow
Automation
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Phase 1
Testing the waters Initial Deployment- Clinical Workflow Test Fit • 5 cabinets installed in 1 IR Suite, Fall 2007 • Measurement began
• January 2008
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Phase 2
Expansion and 1st Integration • Milestone 1: Expansion into second IR suite • Milestone 2: Interface with Peoplesoft Benefits: • Comprehensive real time tracking of NIR Inventory • Automatic reorder messages generated
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Phase 3 Above and Beyond Milestone: Integration with RIS – automatic delivery of information for billing and insurance
Benefits: • Accurate capture of information by item, date, patient
and exam type • Reduction in time spent identifying and confirming
chargeable devices • Continued Integration with physician documentation
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ROI Model
• 6 month study
• Against well established existing barcode system
• Time studies of staff activities
• Stock outs
• Recalls
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$-
$50,000.00
$100,000.00
$150,000.00
$200,000.00
$250,000.00
$300,000.00
$350,000.00
$400,000.00
January February March April May June
Mass General ROI
Financial Results • 2.1 M Increase in Charge Capture • Nearly 1 M increase in reimbursement
MGH’s Cumulative Cost for System
Cumulative Return on Investment
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Additional Results
Reduction in Stock Outs
Reduction of Clnician FTE Time
Increase in Charge Capture
Increase in Patient Safety
Largest Impact on Revenue Cycle
20%
23
30%
8%
70%
Reduction of Clinician FTE Time
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Patient Safety and Compliance
• FDA Recall assist
– Device recalls have increased over 400% since 2001
• Joint Commission Tissue Tracking Requirements
• Expired product reports and automated alerts – Proactive alerts to supervisors
before products can expire
– Device Recall – Provides item level location and usage data
*Data from ECRI 2009
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RFID in Lunder
Expansion
• 26 unit expansion into the Lunder Building
• 22 unit expansion in Radiology
• Tissue and bone tracking
• Scope tracking
• Ortho implant tracking
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Inventory Controller with Manual System
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Inventory Controller with an Automated RFID System
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