RFID Manages COVID-19 Vaccine Administration at Pennsylvania Hospital

By Claire Swedberg

Reading Hospital is capturing the status of the vaccines it stores and injects into patients' arms, expanding its use of the UHF RFID solution from Kit Check with which it already managed pharmaceuticals.

Facing the challenge of a fast-paced and complex rollout of COVID-19 vaccines, Pennsylvania's  Reading Hospital has deployed radio frequency identification technology to track the status of every vial that is removed from an ultra-freezer—a unit that stores goods at temperatures of -40 degrees to -86 degrees Celsius (-40 degrees to -123 degrees Fahrenheit)—then is placed in refrigeration, transported to the vaccination clinic to be administered, and sometimes returned to refrigeration, all while ensuring no vial expires before reaching a patient's arm. The UHF RFID solution was provided by  Kit Check.

The hospital's management envisioned the solution early this year, after several weeks of providing  Pfizer COVID-19 vaccines to the local population. "Our vaccine inventory counts were incongruous at the end of some days" before the system was introduced, according to Alan Portnoy, the hospital's pharmacy operations manager, "and missing even one vial of vaccine is of dire importance right now, especially considering that the Pfizer vaccine accounts for up to seven doses." Therefore, the hospital sought a way to make the process more seamless, and to maintain an automated digital record.

The Kit Check Blue Box

Reading Hospital already leveraged RFID technology to manage pharmaceuticals received at its pharmacy and administered to patients. The system, deployed in 2019, provides two clinical applications: the tracking and management of goods on crash cart trays and in emergency kits, as well as kit and crash cart tray inventory management using the Shelved Inventory System feature. Goods are tagged upon receipt and the hospital can identify when drugs need to be replenished, since they have been distributed via crash carts and used for patient treatment. The hospital is also evaluating the solution's use in its operating rooms and procedural areas, Portnoy says.

With the distribution of vaccines for COVID-19 prevention, Portnoy recalls, the hospital faced a new challenge. When the Pfizer vaccine first became available, he says, "Overnight, our department had to pivot to supply 600-plus doses a day of a highly temperamental vaccine presentation." The hospital's pharmacy created an on-campus vaccine clinic in which the inoculations could be administered. It had to ensure personnel were on hand to staff the clinic, and it also had to be sure every vaccine dose would find its way to a patient and not be wasted.

Once vaccines were administered, Portnoy says, "We also needed exact use counts to report back to the Pennsylvania Health Department." The vaccines must be stored at -80 degrees Celsius (-112 degrees Fahrenheit). "None of these things are easy to accomplish, let alone in the face of intense public demand for the vaccine and limited quantities." Portnoy drew up a few ideas for how the technology could be used to digitize vaccine management. The hospital then worked with Kit Check as it prepared a satellite vaccination storage area, complete with the requisite ultra-freezer and an RFID scanning station.

Alan Portnoy

For each box of Pfizer vaccines, which contains 195 vials, Reading Hospital employees encode, print and then scan every RFID label. Each tag is encoded with the product's lot number, expiration date and unique ID number, according to Doug Zurawski, Kit Check's VP of clinical strategy. The tags are then entered into the dedicated Shelved Inventory System as the vaccines are placed inside the ultra-freezer.

When vaccines are removed from the freezer, they must sit out for a few minutes to warm up, after which a technician wipes each vial dry and applies the pre-printed, lot-specific RFID labels, one on each vial, and scans them into a scanning station to start the five-day beyond-use-dating (BUD) countdown. "When these tagged vials are scanned," Portnoy explains, "the BUD expiration clock is set 'ticking' to show how many days the vials can be left out of the freezer before they expire." The vials are then moved to the pharmacy refrigerator to maintain a PAR of 120 vials.

The pharmacy created a vaccine kit with an anesthesia drawer liner with the set PAR of 120 vials that remains in the refrigerator and is refilled at the end of each day. When vaccines leave the central pharmacy from the refrigerator, they are scanned at the reader station to ensure every vial is still viable, and that it hasn't passed the five-day BUD expiration time. The scanning station, known as the Blue Box, captures the tag reads of vials stored on trays.

The base of the station has an RFID reader incorporated into it. As a user opens and then closes the door, the station scans the RFID tags, and the trays are read as they leave for the clinic. At the end of the day, the vaccine transport box is returned to the central pharmacy and the box of vaccines is placed in the RFID reader station compartment to be scanned again. The RFID tags on all remaining vaccine vials are interrogated, the remaining time before expiration is displayed, and they are returned to the refrigerator.

With the technology, the hospital can assure a proper count of vials in the refrigerator, as well as monitor expiration dates. The collected data is stored in Kit Check's cloud-based software, and Reading Hospital can view and analyze this information, as well as share it with the Pennsylvania Health Department. The system identifies any vial that has reached its BUD cutoff each time a tag is read, thereby ensuring it won't be mistakenly administered to a patient. By capturing all data in the cloud, the hospital is spared from having to employ paper-based records or use a marker to manually update data on the freezer door, which could be erased.

Doug Zurawski

To date, Portnoy reports, using the RFID-based management system has made the process faster and reduced risks. The system also makes reordering vaccines with the Pennsylvania Health Department easier, he adds, "because we have usage counts all in one place in the Kit Check software."

The workflow for  Moderna's vaccines is less labor-intensive than for the Pfizer vaccines, Portnoy notes, though the receipt, storage and administration of Moderna drugs will also be tracked via the RFID technology. "The pharmacy is a fast-paced place during the pandemic," he states, "and getting every vial to patients is of the utmost importance to our communities. RFID is poised to be a real solution to vaccine-tracking problems, because it provides item-level visibility of every vial." The bottom line for vaccine administration, Zurawski adds, is that RFID makes counts more accurate and, ultimately, more people can be vaccinated.

Since Reading Hospital already used Kit Check's technology, the vaccine-management system only required a single dedicated scanning station, located where it could read vaccine tags. The station is customized to read tags, connect to a PC or laptop to display read data, and plug into a power supply. The hospital created its own vaccine kits and trays in which the vaccines are stored in refrigeration and transported to the clinic. With the software, Zurawski says, "You can track every one of the doses so they can run reports regarding each of them."

The company reports that hundreds of hospitals are using the RFID functionality for pharmaceutical management, and the company has been in discussions with some customers for vaccine management. With regard to pharmaceutical management, Zurawski says, "The system helps users reduce excess inventory. We're able to show them what usage patterns they have," and thereby reduce their inventory. The solution for Reading Hospital may be a temporary one, he adds, but while the vaccines are distributed, it also offers critical benefits. "We are extremely pleased to assist our customers with this application for however long its needed."