Based on Sheba Medical Center successful and inspirational ROI case study, the article tells the story of the digital transformation that led Sheba to embrace 100% consignment in managing implants in its Heart Center. “Sheba Medical Center is among multiple hospitals using an RFID Total Sense Cabinet system to manage catheter labs and high-value medical supplies, ensuring that no device expires before it can be used and that products are available when needed. Using this technology, the hospital has real-time data about what medical supplies are in stock or have been accessed for procedures. One result of the improved product visibility is that they have now created a consignment program selling supplier products to patients only as they are used”.
In March of this year, Newsweek and Statista’s panel of doctors, medical professionals and administrators across four continents selected Sheba Medical Center as one of the top 10 hospitals in the world. The full top 1000 world-wide list is available here.
“Sheba Medical Center in Israel (also known as Tel HaShomer Hospital), is a leader in medical science and biotechnical innovation, both in the Middle East and worldwide. The center’s collaborations with international parties have advanced innovative medical practices, hospital systems, and biotechnology. More than 25 percent of all Israeli medical clinical research takes place at its state-of-the-art facilities, and as a hospital, it works with nearly every Israeli medical institute to educate students and advance the future of the medical profession.”
One of the variables for choosing the hospital was the level of adoption and openness to innovation in all aspects of the hospital. The transformation of the hospital to manage full consignment through a digital implant management system is part of the implementation of this concept.
“IDENTI’s passive UHF RFID Total Sense cabinet solution, which supports GS1 and unique device identification (UDI) requirements, allows staff members to remove necessary items, such as implants, from a locked cabinet and to automatically create a digital record of which items have been removed, and by whom. The system not only tracks what is in the cabinet in real-time but also detects which items are due to expire first. The data from the system provides hospitals with a way to ensure that nothing expires, goes missing or is over-stocked”.
Sheba Reports Cost Savings With RFID Cabinet Solution Before using the solution provided by IDENTI in its cath lab suite, the hospital managed its inventory manually. That was a time-consuming process that resulted in inventory discrepancies, the hospital reports. “Sometimes, we had a shortage of popular sizes of implants or wires,” says Hani Hag-Yihye, Sheba’s senior nurse for Invasive Cardiology, “or, in other cases, an excess that caused us to waste money.” This caused the healthcare provider the challenge of ensuring surplus products were used before they could expire.
The largest installation, however, has been in the Heart Treatment and Research Center, in which 30 cabinets are now in use to track the location and status of all implants for Sheba’s diagnostic, therapeutic and preventive cardiovascular units. These include intensive and intermediate cardiac care, catheterization, heart failure, electrophysiology, cardiac pacing, noninvasive cardiology, nuclear cardiology, cardiac imaging, cardiothoracic surgery, vascular surgery and cardiac rehabilitation. All implants are provided via consignment.
“In general,” explains Or Lomnitz, IDENTI’s marketing director, “cardiac catheter labs serve as some of the most complex environments in health care when it comes to managing inventory. The products are critical when needed and are high in value, but each comes with an expiration date. Every hospital loses a lot of money each year due to expired items,” Lomnitz explains, “additionally, they tend to overstock products simply because they don’t have an accurate inventory count”.
Each cabinet comes with a built-in UHF RFID reader and eight antennas developed and manufactured by IDENTI. The cabinets also include a 13.56 MHz HF RFID access-control reader compliant with the ISO 15693 standard, for access by authorized staff members with badges. They are designed as modular units that can be built according to a hospital’s particular needs. Each unit measures 38.2 inches in width, 80.7 inches in height and 25.6 inches in depth. The company also offers a tabletop Smart Cabinet for storing dental implants and eye lenses for clinics. In this case, the cabinets’ measurements are 38.2 inches wide by 25.6 inches deep by 27.5 inches high. The cabinets connect to the cloud via TCP\IP, Wi-Fi or a cellular connection. “Most of our installations rely on a cellular connection to the cloud,” Lomnitz says “enabling fast integration to hospital networks without the need to involve the hospital’s IT infrastructure teams in preparing TCP\IP sockets.”
Typically, goods are tagged either by the supplier or at the hospital’s distribution center. When products, such as stents or other implants, are received at the lab, they can simply be placed on a cabinet shelf since the tags have already been applied and encoded. The built-in reader antenna captures each item’s tag ID, then forwards that data to the IDENTI software, which
identifies that object and any details related to it, including its manufacturer and expiration date. Nurses can access the cabinets by tapping their RFID badge near the front door reader. They can then use the touch screen to indicate which product they seek, and for which patient. The software manages that data and provides information regarding when inventory is used. It can also provide inventory optimization to identify when a hospital is ordering too much of a given product or needs to place an order. “Simply identifying excess purchasing can save a hospital thousands of dollars annually,” Lomnitz says, “because the products are so high-value and the cost of having them sitting on a shelf unused is also high.”
In addition, the system is designed to reduce the incidence of lost inventory. For instance, if a healthcare worker accesses the cabinet and removes a particular item, but it is never billed to a patient, an alert can be sent to management. This enables the loss to be addressed quickly, rather than at the end of the month when it might be noticed during a manual inventory count. The system can also notify the supplier and the healthcare staff if inventory is running low. The software will instruct nurses to
use one product before another if the first is the soonest to expire. The software performs cost and usage analyses, inventory optimization, and averaging seasonal usages, and can identify what are known as ‘dead items’—those that are not used frequently and thus create an unnecessary expense. When it comes to replenishment, the software sends consumptions reports to all vendors that utilize the system on a daily basis, thereby giving them the ability to refill quickly. That enables hospitals such as Sheba Medical Center to keep products on-hand via a consignment program, thus reducing the expense of purchasing goods that they might not use.
The IDENTIPlatform cloud-based server software can be integrated with existing enterprise resource planning (ERP) systems, such as Lawson, McKesson, SAP and Meditech. The solution employs standard communications protocols, including HL7, XML files and other interface tools, to simplify communication. For that reason, Lomnitz says, the integration between IDENTIPlatform and the hospital’s ERP and clinical software is accomplished without having to replace it or make dramatic changes. “It is an easy-to-use add-on,” Lomnitz states, “designed to provide a simple solution for managing inventory and report usage consumption in the operating room and clinical care areas.”
Sheba Medical Center has found that the system works autonomously, according to Hag-Yihye, and that it has resolved several manual process-based challenges. “First,” he says, “we moved to full, pay-per-use consignment. Second, we do not need to deal with the inventory levels—each vendor is managing their inventory remotely, by themselves.” The hospital has reduced disputes with vendors regarding item consumption, he notes, adding, “and if we have a problem, we solve it immediately.” Finally, Hag-Yihye reports, the amount of waste related to discarding expiring items has dropped to zero. “In general,” he says, “the system has enabled me to deal more with my team, my patients and my medical work, and not to run after administrative tasks,
logistics and supplier disputes.”
Find out more about the Total Sense Cabinet.