Terso Solutions, a provider of RFID-enabled cabinets and coolers designed to allow health-care facilities to automatically track which medical supplies are removed and returned, has developed n RFID-enabled trunk stock kit that medical device field representatives can use to track the implantable items and surgical tools stored within it.
After 18 months of development, Terso has built a beta version of the carrying case, and is now in discussions with several medical device manufacturers to schedule two or three pilots to take place during the fourth quarter of this year. During the pilots, the participants use the cases in the same manner they have used similar non-RFID cases, exposing Terso’s versions to typical rigors that such cases must sustain, including shipping and handling, as well as travelling with field reps throughout various hospitals. The pilots will also be used to understand a field rep’s workflow, and how RFID can assist with speeding up invoicing and diminishing waste due to lost, expired or recalled products. Terso and the participating manufacturers will then assess how well the RFID read data is captured and transmitted to cloud-based Jetstream software.
Terso’s hardware product manager, John Kuehl, says the system was designed to solve common problems related to managing expensive equipment that is distributed to field reps. “Tracking field inventory of medical device supplies has presented a lot of problems,” he states. “Product waste and loss are inevitable. Invoices can lag for weeks or months after a sale. Costs could mount for unnecessarily shipping kits across country.”
Typically, medical device manufacturers use trunk stock kits to ensure that hospitals have the necessary product on hand. These kits contain products that are considered on consignment or on loan until they are consumed during a procedure. It is not unusual for medical device manufacturers to lose track of current trunk stock or kits of goods while those items are on their way to or from those hospitals, resulting in high levels of lost or wasted inventory.
Terso’s RFID Mobile Case is designed to hold 25 to 100 tools and implants, each with an EPC ultrahigh-frequency (UHF) RFID label. The case comes with a built-in discrete Impinj RS500 reader module, a 4G LTE cellular module, antennas and a microprocessor to identify when items are removed or returned from the case, store that information and send it to the cloud-based software via the 4G connection.
Terso expects to make the RFID-enabled case commercially available sometime in 2016, after analyzing the pilots’ results. Terso will lease the case—along with access to its cloud-based platform where RFID read data is stored and managed via Terso’s Jetstream RFID cloud-based platform—to customers for a monthly fee, says Joe Pleshek, Terso’s CEO.
The RFID Mobile Case is similar to a typical hard-sided case that medical device field reps carry with them, or that the companies ship, containing the high-value equipment required for cardiac or orthopedic surgeries. These cases can also be sent via carrier, such as FedEx, to a field rep’s home, or be delivered directly to a hospital. In either situation, the field rep is responsible for the case and its contents, and provides those devices and implants to surgeons as needed for patient procedures. Often, the field rep accompanies the surgeon in the surgical room, and then consults him or her regarding the proper placement of an implant or use of a tool.
That same field rep is then responsible for forwarding information to his or her company’s home office indicating which item was used, at which hospital, and for which patient, for the purposes of billing and inventory replenishment.
The problem, manufacturers have told Terso, is that the manual process of tracking goods doesn’t always work as quickly or accurately as needed. According to Pleshek, medical device manufacturers have told him that of the thousands of cases they may have in the field, 10 to 20 percent are unaccounted for at any given time. They could end up at a hospital, delayed for weeks, or a field rep may have a case but has not yet reported what was used in it. As a result, the companies often overstock the quantity of cases and their contents, in order to ensure that nothing runs out.
“Our customers have come to us and said, ‘Could you integrate RFID into these mobile cases?'” Pleshek states.
In response, Terso designed a solution that includes the Impinj reader module mounted on a circuit board containing a processor to store and manage the collected read data, Kuehl says. The company incorporated its own custom reader antenna into the bottom of the case, and added a 4G LTE module to forward the read data to the server via a cellular connection. A rechargeable battery to power the technology is also mounted on the inside of the case, and requires a recharge approximately every two to four weeks, which is the typical maximum time that a case remains in the field with a rep. The battery can be swapped out by the rep in the field, or at the manufacturer’s distribution center.
A medical device maker would then apply RFID tags to all of the items they place in the case, and use the cloud-based Jetstream software to link the ID number, encoded and printed on the tag, to the case based on its own unique identifier. The case is configured to read all tag IDs, and to transmit that data each time it is opened and closed, as detected by a built-in magnetic switch. The case’s shell also comes with a lightweight RF shield to prevent stray reads of tagged items that are near the case but no longer within it.
The Jetstream software would already have a record of which tags should be in the case, and can thus determine which items have been removed, as well as where the case is located, based on the cellular mobile location services. In that way, if an item is removed at a particular medical facility and is not returned, the manufacturer knows where that product was used for a medical procedure. That information can then be used to begin the billing process, as well as any inventory re-ordering.
The cases are also designed to receive a daily signal from the cloud-based software and to then respond to that signal, indicating that it is still online. “At midnight, every case can receive a heartbeat signal,” Kuehl says, and the software will then record each case’s response.
Pleshek envisions the cases being used for more than medical device management once they are commercially released. “If you think about all the high-value items that are stored in cases,” he states, “this is really transformational.” For instance, jewelry, automotive parts and other items, packed and transported in a case, could be tracked wherever they are, as long as there is a cellular connection.
For medical device manufacturers, the system is expected to reduce the cost of replacing lost items, as well as the amount of inventory that companies need to have on hand in the event that a case or a product in that case goes missing. In addition, Pleshek notes, field reps for medical device manufacturers are usually highly trained, highly paid individuals who assist in the process of patient care, and counting items in cases, as well as making phone calls to the office about what has or hasn’t been used, is a waste of their time. Terso’s RFID-enabled solution automates these tasks, he says, adding, “There’s a huge labor savings.”
The technology offers another return on investment based on the expiration or recall of products, Kuehl says. If a manufacturer recalls a product, Terso’s solution can tell it where each item is located in the field, and can identify anything that has been used at a specific hospital. For expiration dates, the system can pinpoint the locations of items that are due to expire soon and, therefore, need to be used, discarded or returned to the distribution center.
Most standard hard cases weigh 14 to 18 pounds with goods packed inside, Pleshek reports. The Terso RFID Mobile Case filled with medical devices will weigh 20 to 22 pounds, he says.