Getting Creative with Managing Contrast Media

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contrast_1345558421.jpg - Contrast agents
Contrast agents provide benefits during patient exams, but they also pose safety concerns. As automated contrast injectors and other technologies have made the use of contrast media safer and less expensive, how administrators properly store and stock media remains in question. Now, with the help of barcoding and radiofrequency identification (RFID) technologies, the management of contrast agents may be a less daunting task.  

In 2004, the Joint Commission mandated that contrast agents be treated as medications, making contrast agents subject to medication management standards and mandates. Administrators were left wondering how they should properly store, handle and account for contrast supplies.

“Up until a few years ago, we didn’t need to be as concerned about controlling contrast, as far as how to secure it or how to handle it,” says G. Tim Wescott, RT, manager of invasive imaging and cardiovascular services at MidMichigan Health in Midland, Mich. “But since the Joint Commission stepped in, you can’t leave contrast media in an accessible cupboard. It must be secured.”

Besides storage, administrators must consider safety standards and proper handling of contrast agents. Wescott says that employing an inventory management system is key to success.

Barcoding vs. RFID

MidMichigan rolled out its barcoding system nearly eight years ago and, thanks to interfaces between that system and the hospital billing and purchasing systems, the staff hasn’t looked back. The automated system reads barcodes and automatically sends patient and product information to the patient’s account. While the system is still being refined for managing contrast media, once implemented, when a product needs to be reordered, the system will send out a request directly to the purchasing department.

What can RFID do for you?
Eliminate excess inventory

Improve efficiencies

Lower operational costs

Labor costs are reduced by eliminating the need for visual or manual inventory checks by sales staff

Efficiency is increased through inventory accuracy and freeing sales staff to work on value-added projects

Inventory is better managed through increased accuracy and capabilities of better data collection in analysis and forecasting
Source: Alan D. Smith, PhD, Robert Morris University
MidMichigan invested nearly $50,000 to install its inventory management system and software, according to Wescott. While there are annual support costs, he says improvement in inventory safety and management has been extraordinary.

The system better streamlines supply charges, improves the reordering process and better tracks the inventory on the shelves, according to Wescott. It also cuts down the amount of products stocked and reduces the potential for product expiration. “The system helps us track items that are slow movers, so we can rotate them out if we have the opportunity, which has generated savings,” he says.

Barcoding, inventory and supply costs have stayed flat while case volumes have risen. “If you see a 25 percent increase in volume, you would expect a similar increase in supply costs,” he says. “With our inventory management system, we have seen it come in lower than that and we are not losing charges.”

While barcode technologies have a smaller price tag, are easy to implement and straightforward to manage, RFID may  offer advantages when it comes to inventory management, says Alan D. Smith, PhD, professor of operations management at Robert Morris University in Moon Township, Pa.

RFID, which uses radiofrequency and computer-like chips to track products, recently has been integrated into the hospital setting for supply chain management. The technology offers great potential in healthcare for managing drug doses and inventory. RFID enables hundreds of individual RFID tags to be tracked on one hospital system, making it easier to locate contrast vials and other equipment by an automated process.

“RFID technology in hospitals has been shown to speed patient care and improve its quality, reduce inventory costs through loss recovery and optimize the supply chain process of purchasing and restocking supplies,” Smith says. “In some instances, RFID technology has even been used to help hospital managers make decisions on staffing levels by seeing exactly how much time nurses were spending at the bedside versus doing administrative tasks at the nurse’s station.”

While barcodes were an innovation that helped to better track inventory, they may lead to inaccurate records in a system that is not wholly automated, says Abraham Seidmann, PhD, a professor of computers, information systems and operations management at the University of Rochester in Rochester, N.Y.

Barcoding is similar to grocery store scanning in the sense that a product is taken out of the cart, scanned and placed back into the cart. But this movement can lead to misplaced products or inaccurate records. Prior to these two options, technologists monitored the inventory of contrast media vials manually, counting the numbers in stock, reordering them weekly and scanning the codes on the vials prior to injection. With RFID, the issues are resolved because the process is more automated.
RFID’s automation and real-time visibility also may eliminate problems associated with barcode use for inventory management, says Seidmann, including:
  • Exam mismatches (executing a job on the wrong patient);
  • Adverse drug events (administering the wrong dosage);
  • Stock and billing issues; and
  • Shrinkage (content expiration caused by failure to use a previously opened vial).

RFID anxiety

While RFID has the potential to transform the way administrators manage contrast media, Smith says the possible benefits of the technology and empirical data are still lacking. The automatic replenishment of products possible with RFID technology can help reduce stock-outs and restocking costs, but the technology may carry added costs, too.

“Routinely, the costs of goods are increased by adding RFID tags on a case or per item basis, accounting for roughly at least 1 percent of case/item costs,” according to Smith. Passive RFID tags run hospitals between $0.10 and $0.50 and active tags cost between $0.50 and $50, he says.

Seidmann estimates that the general costs of both the RFID cabinet and the software range between $15,000 and $40,000, depending on the system. As more hospitals adopt RFIDs, tag costs may drop to a penny each.

Kumar et al outlined how some hospitals are benefiting from RFIDs. For instance, Florida Hospital in Orlando saved $150,000 after the use of RFIDs helped to reduce the on-hand inventory in its electrophysiology department (Technol Health Care 2010;18[1]:31-46).

To add to that, Seidmann says that RFIDs can reduce costs by eliminating product expiries, which could take on 24 to 40 percent of lost costs with the improved documentation and management. Additional benefits include safety, the capability to track inventory, as well as greater reimbursement.

“RFID allows providers to document what agent is being used on what patient during which procedure,” Seidmann says. “This is helpful when it comes time for the reimbursement of supplies.

“To me, RFID is a no brainer. It’s like an air conditioner; hospitals are going to eventually have to have it.”  

Various inventory management technologies are available to help streamline supply chain management and track and monitor contrast use. As cardiovascular administrators and staff look for ways to cut costs, barcoding and RFID may be two avenues that can help get a handle on contrast media agents and other products through better tracking and inventory management.