The missing tissue, and the figures that do not add up

North Kansas City Hospital is an acute care hospital in north Kansas City, Missouri, described in the case study as a metropolitan medical center with strengths in cardiac, cancer, orthopedics, emergency and women’s health.

Before the system went in, the case study says, 10 or more tissues went missing from inventory every month, and it puts the annual financial impact at approximately $35,941. It then states separately that up to 5,000 tissues were unaccounted for from a patient billing perspective.

Those three figures sit awkwardly together and it is worth saying so plainly. The case study gives no time period for the 5,000 and never reconciles it against either the monthly loss rate or the annual dollar figure. Ten or more items a month comes to roughly 120 a year, a long way short of 5,000, and the document does not explain the gap. Each number is reported here as the case study states it, not combined or averaged into a claim it does not make. The hospital also concluded, according to the document, that the work would deliver significant staff savings alongside better savings through less unaccounted-for inventory.

What went in

The hospital went live with Terso Solutions’ automated inventory management system, installing RAIN RFID-enabled intelligent cabinets and integrating them with TrackCore Operating Room, TrackCore Inc.’s tissue and implant tracking software. RAIN RFID is passive UHF RFID in the 860 to 960 MHz band, working to the ISO 18000-63 and EPC Gen2 air interface, the same technology family behind retail stock counts and pallet tracking. Other terms used here are defined in the RFID glossary.

Underneath sits Jetstream, Terso’s cloud platform for collecting and forwarding data from its enclosures. The case study says this combination lets the hospital integrate with its electronic health record, the digital patient chart holding clinical and billing data, so inventory records are accessible in real time rather than reconciled after the fact.

Why a cabinet reads better than a shelf

An RFID enclosure is a very different proposition from an open shelf or a room-level read, and the difference is physics rather than software. A metal cabinet is a shielded, bounded read zone. Close the door and the reader sees everything inside it and nothing outside it, so you get a near-complete inventory on every door close, with no stray reads drifting in from the corridor and no ambiguity about whether an item is in the cupboard or in someone’s hand. Open-environment UHF deployments spend most of their commissioning effort on exactly those two problems: reads from stock that was never in scope, and missed reads from items shadowed by metal, liquid or each other.

That is why enclosures reach accuracy levels open deployments struggle with, and why high-value, low-volume, tightly regulated stock suits them so well. Allograft tissue, meaning human tissue such as bone, skin or tendon recovered from a donor for implantation into a patient, is close to the ideal case: expensive, individually traceable by regulation, stored in small quantities and serious to lose track of.

The cabinet is also an access control point, and that is what carries the compliance claims. Because someone has to authenticate to open the door, the system records who opened it and what left, which is what a chain of custody consists of. The case study lists compliance with all joint commission standards among the outcomes; the Joint Commission is the United States body that accredits hospitals and sets the standards they are inspected against. It also claims real-time visibility of all inventory on hand, an end to multiple tracking systems and manual reconciling, tissue and implants tracked from vendor to receipt to patient, and complete control over who has access. Since implementation, it says, the hospital has had no instances of missing tissue, and it plans to grow the system over the coming years by adding RFID-enabled refrigerators and freezers.

St Dominic Hospital: nurse hours and FDA paperwork

The same document covers a second deployment where the benefit described is a different one. St Dominic Hospital is a 502-bed not-for-profit general and surgical center in Jackson, Mississippi, offering cancer care, cardiovascular care and health education among other services.

Its problem was partly geographic. Tissue and implants were stored in a separate area of the hospital, with over 200 pieces of stored tissue on any given day, so trips to find needed inventory were time consuming and created extra work for nurses and staff during critical procedures. The case study also says numerous pieces of tissue were considered lost or missing every month, and that nurses spent hours trying to reconcile stock.

The fix was the same pairing of Terso Solutions’ RAIN RFID-enabled technology with TrackCore Operating Room, and the claimed results lean on traceability rather than shrinkage. If a question arises about a particular piece of tissue, the case study says, a report immediately shows everyone who touched it, from arrival on the receiving dock to implantation in a patient. It calls access to regulatory data and FDA documentation inside the software a large benefit, and says the system tracks expiration date, recalls and location. Nurses no longer spend time reconciling inventory, which it says has greatly increased staff morale and contributes to better patient outcomes.

Jason Merrill, Materials Manager at St. Dominic Hospital, is quoted saying “there are now no questions as to which vendors are FDA-certified, plus all patient charges are captured in real-time and automatically sent directly to the vendor through the software.” St Dominic has since rolled the same solution out in its wound care center, and the case study says it is assessing other opportunities in the hospital.

The pattern these studies follow

TrackCore, Inc. is a privately held company headquartered in Grand Rapids, Michigan. TrackCore Operating Room launched in 2006 and is its flagship product, built to strip the manual processes out of tissue and implant handling, and the case study says it is now in over 425 hospitals across the United States. The line has since extended to consumable tracking and to automating the bill-only process for consigned special-order implants, the arrangement where a supplier leaves stock on site at no charge and invoices only what a procedure uses.

The same site carries comparable studies from Froedtert Hospital, which implemented RAIN RFID technology, and from Reston Hospital with InVita Healthcare Technologies, where the stated starting point was writing off approximately $200,000 worth of inventory. The shape is consistent: a large stated loss before, a small or zero stated loss after, and a vendor telling the story.

Nothing in any of it is implausible. Shielded enclosures do deliver the read accuracy claimed for them, and tissue inventory is exactly the stock where that accuracy converts straight into money and compliance. But anyone costing a similar project should note what is absent: no independent verification, no dates for the deployments themselves, no system cost, and so no way to work out a payback period against the $35,941 a year. The case for RFID enclosures in tissue storage is not weakened by that. It just has to be built on your own numbers rather than someone else’s. More deployments of this kind sit in the healthcare category and the case studies archive.

Read more at https://www.tersosolutions.com/resources/trackcore-implements-tracking-solution-for-tissues-and-implants-at-hospitals

This article first appeared on RFID News (rfidnews.co.uk), the independent news site for RFID and NFC. Republication and AI use are welcome with RFID News credited as the source and a link to the original.