RFID Pilot with Global Potential 29 April 2009

Garry Duvall, Deployment Manager Medical Logistics Division

Defense Health Services Systems (DHSS)

  Dramatically improve the responsiveness of medical logistics support  Implement business innovations that significantly increase

effectiveness of clinical healthcare delivery while reducing costs  Develop a high-quality, integrated medical logistics automated

system for use by all Army, Air Force and Navy forces in both peace and war

•  Materiel

•  Facilities

•  Equipment & Technology Management

•  Wholesale Functions

Peacetime MHS

Operational Continuum

Wartime/Contingency

DMLSS Mission Statement

Defense Finance and Accounting Service (DFAS)

Daily Supply Orders Prepared and Shipped 5pm – 4am

Electronic Invoice

Electronic Payment

Tomorrow’s Supply Orders Processed 3pm – 5pm

Daily Supply Orders Received 5am – 6am

Daily Supply Usage Order Verified and Supplies Stocked

7am – 8am

Medical/Surgical

Pharmaceutical

Tomorrow’s Supply Needs Determined 2pm – 3pm

“24”

Bringing E-Commerce to Health Care Operations

Why Investigate RFID? •  RFID could be another opportunity to build upon DMLSS’ history of increasing efficiency

and customer service by applying technology –  Need to understand the technology’s maturity and integration path in regard to how its

fits with the DMLSS architecture •  Meet DoD Mandate (dated 30 July 2004)

–  Passive RFID • January 2006: Comfort Items, Petroleum, Lubricants, Oil, Chemicals, Additives, Barrier Material, Ammunition, Pharmaceutical and Medical Materiel

• January 2007: All DoD manufacturers and suppliers must tag all individual cases, all cases packaged within palletized loads, all pallets, and unit packs of UID items

• FY 2007: All DoD logistics automated information systems involved in receiving, shipping, and inventory management were modified to use RFID to perform business transactions

–  Active RFID • Applied to all freight containers, consolidated air pallets and large engine containers shipped to/from overseas DoD receiving points

Potential Benefits

•  Increase Patient Safety •  Increase logistics velocity •  Increase resource utilization •  Reduce manual data entry / handling •  Prepare for pending ePedigree

Legislation

pRFID tag readable

Barcode was not

DoD RFID Vision: Implement Knowledge-Enabled Logistics

•  RFID will help support the warfighter and reduced costs through:

– Improved asset visibility – Track and trace of materiel – Real time inventory monitoring – Fewer lost assets – Better human resource utilization – Demand-centric supply chain Iraq - OIF

Recommendations From the Initial RFID Study

•  The short-term recommendations called for the implementation (late 2004 into 2005) of a multi-phase RFID pilot study to enable the DMLSS program to learn the following: –  How can current business processes (receiving, assembly,

and shipping) benefit from the use of RFID technology?

–  What are the potential RFID enabled business processes?

–  What changes should the program make to the DMLSS logistics application to support RFID deployment?

–  What is the program’s responsibility for sharing RFID data with other DoD and commercial entities?

–  What are the potential costs associated with the deployment of RFID solutions?

–  How do medical suppliers support this initiative?

–  How does the program adhere to the DoD RFID directive?

Recommendations from the Initial RFID Study (cont’d)

•  The pilot study will help the DMLSS program to understand potential benefits of RFID: –  Reduced duplicate orders –  Increased shipment accuracy –  Faster receiving –  Higher resource utilization: leverage people

and equipment –  Understand potential benefits of RFID to the

War Fighter : •  Better In-transit visibility: More info to the war

fighter •  Faster order turn around

•  The long-term recommendation presented a plan for the implementation, integration, and roll-out of RFID technology in a DMLSS production environment

Why Conduct a Pilot with a Prime Vendor

•  DMLSS receives most of its products from prime vendors. A pilot is necessary to better understand how RFID transactions (like receiving) will take place in a real-world environment.

•  Prime Vendors such as Cardinal and Owens & Minor are willing to pilot with DMLSS

•  DMLSS seeks to better understand ASN processing with respect to RFID data – for example, is real-time ASN processing necessary versus twice daily batches?

•  DMLSS seeks to ensure that the right logistics processes are identified •  Before any new technology is implemented on a large scale, DMLSS

would like to run a production version at a small scale to mitigate interference in daily operations at warehouses.

RFID Pilot With Owens & Minor

•  Pilot will be conducted at 3 Military Treatment Facilities: –  National Naval Medical Center, Bethesda –  DeWitt Army Community Hospital, Ft. Belvoir –  Malcolm Grow Medical Center, Andrews Air Force Base

•  Owens & Minor has agreed to tag pallets and re-pack cases of med/surg supplies

•  Owens & Minor will add RFID tag data to ASNs (Advanced Shipment Notice)

•  Development for RFID integration into the DMLSS AIS and testing of the system is complete

•  DMLSS has conducted RFID Site Surveys at each test site and planned the RFID hardware and software configurations for MTF

•  Alpha Site deployment began in August 2008

Plans for DMLSS / Owens & Minor Pilot Evaluation

•  DMLSS plans to evaluate the pilot based on metrics collected at each test site

–  Baseline metrics were collected during the RFID Site Surveys

–  Pilot is scheduled to last for approximately 6 months; metrics will be collected at 1-2 month intervals

•  Metrics that will be used in the evaluation include: –  Overall receipt processing time –  Time spent on discrepancy resolution –  Time spent sorting goods and verifying quantities –  Time spent performing data entry

DMLSS Phased Approach to Developing RFID Capability

•  Phase I –  Enable Receiving of RFID tagged Cases, Pallets,

Totes –  Process RFID EDI transactions; Pilot with Owens

& Minor –  Identify Notes coded items such as “Hazmat,

Refrigerated” –  Initial effort is for alpha sites only

•  Ft. Belvoir, Bethesda, Andrews AFB –  Funding and resources are not in place for full

deployment beyond select major sites •  Future Considerations

–  Passive Tags affixed to case/pallet + item level –  Will add QA Data to EDI 856 ASN

•  UID •  Lot Number •  Expiration Date

–  TEWLS •  Assemblage Management •  Shipping to downstream customers

The State of RFID Today

•  Numerous RFID technologies are establishing foot prints in medical logistics

– Passive RFID (pRFID) in supply chain – Asset Tracking in brick and mortar facilities – Point of Use (POU) / Point of Care (POC) in clinical environments

•  Defense Health Services Systems-Medical Logistics is working with Services, industry partners and FDA to develop standardized solutions to enhance the medical logistics supply chain

•  Through joint research, stove-piped and cost prohibitive solutions can be avoided

Asset Tracking in Medical Treatment Facilities

•  MTFs are using asset tracking systems to track high value and highly utilized items in a hospital

– Ft. Bragg has deployed Versus (Wi-Fi) at Womack Army Medical Center

– Eisenhower is deploying asset tracking with Ekahau – Real Time Locater System

– Wilford Hall investigated asset tracking using SAVI tags – Other MTFs exploring asset tracking: Bethesda, Wright Patterson,

Walter Reed, Keesler, Elmendorf

POU / POC in Clinical Environments

•  Point use technology offers benefits to track high value medical consumables in hospitals

•  Wilford Hall has installed several smart cabinets tracking inventory of over $2M

•  Mobile Aspects has developed an interface with DMLSS AIS and is awaiting DIACAP approval to turn on the interface

•  Motion Computing is offering a tablet design for clinical care

–  Offers built-in RFID reader, 1D/2D barcode scanner, built-in HF tag for asset tracking

–  Offers FIPS 140-2 certified Bluetooth CAC reader

Challenges

•  Standardization across DoD

•  Enterprise wide AIT strategy

•  Security and compliance (IA, Noteworthiness)

•  Cost of infrastructure and deployment

•  Collaboration of Government and Industry

•  Technology – supplement/replace manpower

•  Business practices and enterprise solutions

What Can Industry do to Help the DoD?

•  Vendors need to understand the DoD environment – pRFID equipment and software will be used in mobile and fixed hospitals

– Ease of use and administration – Should be interoperable – define common and open data standards – Security

•  Must have FIPS 140-2 compliant devices for wireless communications •  Data at rest encryption •  Smart card enabled for logon / authentication

– Support Worldwide pRFID use •  Fixed infrastructure - OK to have different devices for regions •  Mobile support, need one device for all regions

– Solution must be rugged

Questions?

Backup Slides

ASN WAWF

DAASC ASN ASN

PO WAWF

DAASC PO

Vendor system

PO

DMLSS

Shipment Moves from Vendor to Warehouse

Goods Shipped Goods Arrival

856 EDI Transactions

Shipm

ent Order

Receipt

Processing

DMLSS Ordering Process

Basic Pilot Components and Operation

The Power and Scope of DMLSS •  59,000 requisitions processed per day •  $19M materiel received per day •  $20B real property managed

–  420,000 RPIE items managed –  280,000 facility work orders managed –  $650M facility projects managed

•  976,000 of biomedical equipment items managed –  $3.3B of biomedical equipment items managed –  610,000 work orders generated

•  Training conducted –  600 on-site personnel trained –  13,000 e-lessons attended

•  1,126 point of use supply cabinets managed •  1,223 Customer Area Inventory Management (CAIM) decentralized ordering points

serviced •  19,000 registered users supported

–  12,000 non-COCOM users –  7,000 COCOM users

Next Steps to Encourage RFID Adoption

•  RFID deployment expectations are varied across all organizations –  DMLSS / Defense Supply Center Philadelphia (DSCP) see RFID as necessary in

order to comply with DoD mandate –  Services do not see usefulness in the technology and are reluctant to adopt until

pilot proves the technology is beneficial

•  DSCP worked an increased distribution fee for RFID into med/surg Prime Vendor contracts

–  Fee increases vary between Prime Vendors –  Owens & Minor will not use the increased fee during the pilot –  Services are reluctant to pay the increased fee and are therefore reluctant to adopt

RFID

RFID MTF Pilot

•  Validate future pRFID investment •  Validate known costs and expected

benefits •  Identify new costs / challenges

–  Information Assurance hurdles – Acceptance of WiFi – Local infrastructure change coordination – Remote support and administration –  Inconsistent WLAN configurations