Abstract:
An inventory management system provides automated management of medical item inventory and maintenance of a digital chain of custody for medical items. Medical items are labeled with an RFID-encoded tag that also displays a 2D barcode. The RFID tag and the 2D barcode both encode the same serialized Electronic Product Code (EPC) data for each specific item. Reading of the RFID tag is performed using a fixed or handheld RFID reader. Reading of the 2D barcode is performed using a handheld mobile device, such as a tablet or smart phone. The two-technology label allows for the digital chain of custody to be updated by means of RFID scanning in locations where RFID readers are available and by using a smart phone or tablet to read the 2D barcode in locations where RFID readers are unavailable.

Description:
FIELD 
       [0001]    This invention relates to the field of medical item inventory management. More particularly, this invention relates to a system for maintaining a chain of custody of medical devices. 
       BACKGROUND 
       [0002]    Hundreds of millions of dollars in expensive medical devices exchange hands each year. Such devices are shipped to sales representatives, distributors, hospital materials management, and clinicians. Delivery of a medical device to a particular person in a particular location does not always mean that the device will remain in the custody of the receiving person. The device often changes hands between multiple persons and at multiple locations. This commonly occurs when medical device sales representatives share inventory. 
         [0003]    Because of the high cost and often limited availability of stock, medical device inventory is frequently shared within a defined area by multiple sales representatives. Typically, this inventory is managed manually and may be stored in a tote bag or box in locations under control of the sales representative, such as in the representative&#39;s home or car. 
         [0004]    Inventory may also be managed in an automated fashion, such as using RFID identification technology. This is a proven and preferred option for locations such as hospitals. Items may be stored in access-controlled areas where RFID tags are read by fixed or handheld RFID readers. Problems can arise when deploying this type of technology in the field for inventory management. Some of the issues with deploying handheld RFID readers to sales representatives in the field include the high cost of the readers, complications associated with hardware maintenance, and the ability to manage items without stray RFID reads. 
         [0005]    What is needed, therefore, is a system for maintaining an inventory of medical devices using multiple identification encoding technologies appropriate for hospital and field applications, including lower cost and less complicated identification technology for users in the field. 
       SUMMARY 
       [0006]    Embodiments of the present invention provide automated management of medical item inventory and maintenance of a digital chain of custody for medical items. In a preferred embodiment, items are labeled with an RFID-encoded tag that also displays a 2D barcode. The chip contained within the RFID tag and the 2D barcode both encode the same serialized Electronic Product Code (EPC) data for each specific item. Reading of the RFID tag is performed using a fixed or handheld RFID reader. Reading of the 2D barcode is performed using a handheld mobile device, such as a tablet or smart phone. The two-technology label allows for the digital chain of custody to be updated by means of RFID scanning in locations where RFID readers are available and by using a smart phone or tablet to read the 2D barcode in locations where RFID readers are unavailable. 
         [0007]    The above and other needs are met by a method for maintaining a chain of custody of medical items that each have an RFID tag and an optical code attached thereto, both of which encode a unique identifier that uniquely identifies a medical item. In one embodiment, the method includes:
       (a) performing a scan of an interior space of a shielded enclosure in which the medical items are stored, the scan performed using an RFID reader;   (b) based on the scan of step (a), determining that a first medical item has been removed from the shielded enclosure;   (c) based on a determination that the first medical item has been removed from the shielded enclosure, updating the chain of custody of the first medical item by associating the unique identifier of the first medical item with first user identification information in a medical item inventory database, where the first user identification information identifies a first user who removed the first medical item from the shielded enclosure;   (d) scanning the optical code attached to the first medical item using a mobile computing device associated with a second user;   (e) decoding the unique identifier encoded in the optical code attached to the first medical item using the mobile computing device; and   (f) updating the chain of custody of the first medical item by associating in the medical item inventory database the unique identifier decoded in step (e) with second user identification information that identifies the second user.       
 
         [0014]    In another aspect, the invention provides an apparatus for maintaining a chain of custody of medical items that each have an RFID tag and an optical code attached thereto, both of which encode a unique identifier that uniquely identifies a medical item. In a preferred embodiment, the apparatus includes a shielded enclosure having an internal space for receiving the medical items. The shielded enclosure is configured to attenuate radio frequency signals emanated from RFID tags disposed outside the shielded enclosure to levels that are substantially undetectable within the internal space. Disposed within the internal space of the shielded enclosure are one or more RFID antennas that receive radio frequency signals emanated from RFID tags attached to the medical items disposed within the internal space. The radio frequency signals contain the unique identifiers encoded in the RFID tags. At least one RFID reader is electrically connected to the one or more RFID antennas. The RFID reader decodes the unique identifiers contained in the radio frequency signals emanated from the RFID tags. 
         [0015]    The apparatus also includes an inventory computer having a processor for executing instructions for receiving the unique identifiers decoded by the RFID reader and determining based thereon that a first medical item has been removed from the shielded enclosure. The apparatus includes a medical item inventory database in which a chain of custody of medical items is maintained by associating unique identifiers of medical items with user identification information that identifies users having custody of medical items. The apparatus also includes an inventory management server that, based on a determination that the first medical item has been removed from the shielded enclosure, operates on the medical item inventory database to update a chain of custody of the first medical item. The chain of custody is updated by associating the unique identifier of the first medical item with first user identification information that identifies a first user who removed the first medical item from the shielded enclosure. 
         [0016]    The apparatus also includes a mobile computing device associated with a second user. The mobile computing device is operable to scan the optical code attached to the first medical item, decode the unique identifier encoded in the optical code, and transmit a message to the inventory management server containing the unique identifier and second user identification information that identifies the second user. The inventory management server is operable to receive the unique identifier of the first medical item and the second user identification information and operate on the medical item inventory database to update the chain of custody of the first medical item by associating the unique identifier of the first medical item with the second user identification information. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0017]    Other embodiments of the invention will become apparent by reference to the detailed description in conjunction with the figures, wherein elements are not to scale so as to more clearly show the details, wherein like reference numbers indicate like elements throughout the several views, and wherein: 
           [0018]      FIG. 1  depicts a system for managing medical item inventory and maintaining a digital chain of custody for medical items according to an embodiment of the invention; and 
           [0019]      FIG. 2  depicts an embodiment of a method for managing medical item inventory and maintaining a digital chain of custody for medical items using the system of  FIG. 1 . 
       
    
    
     DETAILED DESCRIPTION 
       [0020]    As the term is used herein, a “medical item” is an item, device, material, substance, or piece of durable medical equipment (DME) that may be used or consumed during the performance of a medical procedure or that is dispensed to a patient to treat a medical condition or provide comfort to the patient. For example, a surgical implant is a medical item. Knee braces, negative pressure wound therapy units, blood glucose monitors, and wheelchairs are further examples of medical items. Sponges, gloves and drapes are also medical items. 
         [0021]    Each medical item has a unique identifier, such as an Electronic Product Code (EPC), encoded in an RFID tag and in a 2D barcode attached to the medical item or its packaging. In a preferred embodiment, the RFID tag and 2D barcode are combined in a single label attached to the medical item or its wrapper. 
         [0022]    As the term is used herein, a “scan” for RFID tags refers to operations performed by an RFID reader to transmit signals and receive signals from RFID tags that are in range of the RFID reader and its associated antenna(s). 
         [0023]      FIG. 1  depicts an embodiment of a system  10  for automated management of medical item inventory and maintenance of a digital chain of custody for medical items. The system  10  includes a first access-controlled shielded enclosure  12  (also referred to herein as a first cabinet) having an interior space for receiving medical items, such as medical items  14   a  and  14   b . Disposed within the cabinet  12  is an RFID antenna  16 , such as a Laird Far Field antenna having left-hand circular polarization and operating in the 902-928 MHz frequency range. The RFID antenna  16  is electrically connected, such as via a coaxial cable, to a UHF RFID tag reader  18 , such as an Impinj® Speedway® model R420. 
         [0024]    As the term is used herein, “shielded” means that the cabinet  12  is designed to prevent the antenna  16  from receiving RFID signals from RFID tags located outside the cabinet  12  at a signal-to-noise ratio high enough to trigger detection of those outside RFID tags. For purposes of this disclosure, “shielded” does not mean that absolutely all RF energy is blocked from entering the cabinet, as this would require unnecessary levels of shielding. 
         [0025]    The RFID tag reader  18  is electrically connected via a local area network (LAN) to a medical item inventory computer  20 , which may be a server computer, desktop computer, laptop computer, tablet computer or other mobile computing device. Alternatively, the electrical connection between the RFID tag reader  18  and the computer  20  is via a Universal Serial Bus (USB) interface or other serial interface. The computer  20  includes memory for storing and a processor for executing instructions for updating and maintaining inventory records as described in more detail herein. In a preferred embodiment, the computer  20  is built into a door of the cabinet  12  through which medical items are added or removed. A user interface device  19  is connected to the computer  20 , which may be used to receive user identification credentials. The user interface device  19  may include one or more of a touch screen display, a keypad, a biometric sensor such as a fingerprint reader or retinal scanner, and a code reader, such as an RFID reader, barcode reader or magnetic stripe reader. Such interface components may be used to read or otherwise receive identification information of personnel seeking access to the cabinet  12 . 
         [0026]    The computer  20  may be programmed to keep the door of the cabinet  12  locked while an RFID scan is taking place so as not to detect RFID tags on items outside the cabinet  12 . Alternatively, the computer  20  may be programmed to deactivate the RFID reader  18  when the cabinet door is open to avoid reading RFID tags on items outside the cabinet. 
         [0027]    In a preferred embodiment, the inventory computer  20  is in communication with a wide area communication network  22 , such as the Internet, through which the computer  20  communicates with an inventory management server  37  and a medical item inventory database  38 . In an alternative embodiment, the computer  20  communicates with the server  37  and database  38  via a local area network. The inventory database  38 , which may be maintained by an inventory service provider entity, stores information regarding medical items, including item EPCs, the identity of a person having custody of an item, and information identifying a location, such as an inventory storage cabinet, in which a medical item is stored. In a preferred embodiment, the inventory management server  37  executes software instructions for communicating with inventory computers  20  and  36  and mobile devices  24  and  28 , and for processing inventory records stored in the database  38 . 
         [0028]    As shown in  FIG. 1 , the system  10  may also include a second access-controlled shielded enclosure  30  (also referred to herein as a second cabinet) having an interior space for receiving medical items, such as medical items  14   b  and  14   c . The second cabinet  30  may be in the same or a different medical facility as the first cabinet  12 , or it may be in an office or home of a medical device sales representative. Disposed within the cabinet  30  is an RFID antenna  32  that is electrically connected to a UHF RFID tag reader  34 . The RFID tag reader  34  is electrically connected via a LAN to a second medical item inventory computer  36 , which may be a server computer, desktop computer, laptop computer, tablet computer or other mobile computing device. Alternatively, the electrical connection between the RFID tag reader  34  and the computer  36  is via a USB interface or other serial interface. Like the computer  20 , the computer  36  includes memory for storing and a processor for executing instructions for updating and maintaining inventory records. In a preferred embodiment, the computer  36  is built into a door of the cabinet  30  through which medical items are added or removed. A user interface device  40  is connected to the computer  36 , which may be used to receive user identification credentials. The user interface device  40  may include a touch screen display, a keypad, a biometric sensor such as a fingerprint reader or retinal scanner, and a code reader, such as an RFID reader, barcode reader or magnetic stripe reader. Such interface components may be used to read or otherwise receive identification information of personnel seeking access to the cabinet  30 . 
         [0029]    The system  10  also includes a first user&#39;s mobile computing device  24  and a second user&#39;s mobile computing device  28 . The devices  24  and  28  may be smart phones, tablet computers, or other mobile computing devices having cameras for acquiring an image of a 2D barcode. The first and second users are also referred to herein as User A and User B, respectively. The mobile computing devices  24  and  28  are in communication with one or more mobile communication networks  26 , such as a cellular data network, which is in communication with the network  22 . 
         [0030]      FIG. 2  depicts a method for managing medical device inventories and maintaining a digital chain of custody for medical devices using the system of  FIG. 1 . At some time after a medical item has been placed in the first cabinet  12  (step  102 ), the RFID reader  18  scans RFID tags on all of the medical items stored in the first cabinet  12  (step  104 ). If an RFID tag is detected that was not detected in a previous scan (step  106 ), the system determines that a newly-added medical item is in the cabinet  12 , and the unique identifier, preferably the EPC, of the new item is added to the inventory records stored in the database  38  (step  108 ). The chain of custody of the newly-detected item is also updated in the database  38  to indicate that the item is no longer in the custody of a person. 
         [0031]    At some point, a particular medical item stored in the cabinet  12  may be needed for a medical procedure or some other purpose. Medical personnel, referred to hereinafter as User A, uses the user interface device  19  to authenticate User A&#39;s credentials, thereby gaining access to the first cabinet  12  (step  110 ). User A removes the first medical item  14   a  from the cabinet  12  and closes the cabinet door (step  112 ), after which the RFID reader  18  scans RFID tags on all medical items remaining in the first cabinet  12  (step  114 ). If an RFID tag is not detected that was detected during a previous scan (step  116 ), the system determines that a medical item has been removed from the cabinet  12 . The inventory records associated with the unique identifier of the removed item  14   a  are then updated in the database  38  to indicate that the item  14   a  is no longer in the first cabinet  12  (step  118 ). The chain of custody of the item  14   a  is also updated in the database  38  to indicate that the removed item is now in the custody of User A. 
         [0032]    After removal of the item  14   a  from the cabinet  12 , another medical personnel, referred to hereinafter as User B, determines that the medical item  14   a  is needed for another medical procedure or some other purpose. User B accesses the database  38 , such as using a software application running on User B&#39;s mobile device  28 , and determines that the medical item  14   a  is in the custody of User A (step  120 ). Using the software application running on User B&#39;s mobile device  28 , User B submits a request for a transfer of the medical item  14   a  from User A to User B (step  122 ). This transfer request is preferably in the form of a first transfer request message transmitted from User B&#39;s mobile device  28 . The inventory management server  37  receives and processes User B&#39;s request, and if the database records confirm that the medical item  14   a  is in the custody of User A, the server  37  transmits a second transfer request message to User A&#39;s mobile device  24  (step  124 ) to be displayed thereon. In a preferred embodiment, the second transfer request message identifies the medical device  14   a , such as by EPC number, identifies User B as the requesting party, and provides contact information for User B, such as an email address or phone number. 
         [0033]    User A and User B then communicate and determine a location at which to meet to physically transfer the medical item  14   a  from User A to User B (step  126 ). Either prior to or during the meeting, User A scans the 2D barcode attached to the medical item  14   a  using User A&#39;s mobile device  24 . A software application running on User A&#39;s mobile device  24  decodes the unique identifier encoded in the 2D barcode to initiate a transfer of the medical item  14   a  to User B (step  128 ). In a preferred embodiment, the software application on User A&#39;s mobile device  24  transmits a first transfer initiation message with the item&#39;s unique identifier to the inventory management server  37 , which correlates this first transfer initiation message with the earlier transfer request for the same item sent by User B&#39;s mobile device  28  (step  130 ). The inventory management server  37  then transmits a second transfer initiation message to User B&#39;s mobile device  28  on which the message is displayed to prompt User B to scan the 2D barcode attached to the medical item  14   a  (step  131 ). 
         [0034]    After User A hands over the medical item  14   a  to User B (step  132 ), User B scans the 2D barcode attached to the medical item  14   a  using User B&#39;s mobile device  28 . A software application running on User B&#39;s mobile device  28  decodes the unique identifier encoded in the 2D barcode to accept the transfer of the medical item  14   a  to User B (step  134 ). In a preferred embodiment, the software application on User B&#39;s mobile device  24  transmits a transfer confirmation message with the item&#39;s unique identifier to the inventory management server  37 , which updates the records stored in the database  38  to reflect that custody of the item  14   a  has passed from User A to User B (step  136 ). 
         [0035]    At some later time, User B may want to store the medical item  14   a  in a secure location, such as the storage cabinet  30 , thereby relinquishing custody of the item. To do so, User B uses the user interface device  40  to authenticate User B&#39;s credentials, thereby gaining access to the second cabinet  30  (step  138 ). User B places the first medical item  14   a  into the cabinet  30  and closes the cabinet door (step  140 ), after which the RFID reader  34  scans RFID tags on all medical items stored in the second cabinet  30  (step  142 ). If an RFID tag is detected that was not detected during a previous scan (step  144 ), the system determines that a new medical item has been placed in the cabinet  30 . The inventory management server  37  then updates the records associated with the EPC of the newly-added item in the database  38  to indicate that the item  14   a  is now in the second cabinet  30  (step  146 ). The chain of custody of the item  14   a  is also updated in the database  38  to reflect that the item is no longer in the custody of User B. 
         [0036]    Preferred embodiments described herein use a 2D barcode in combination with an RFID tag on an item label to encode information regarding the item. It will be appreciated that other types of optical encoding devices could be used, such as standard one-dimensional barcodes, for the same purpose. Thus, embodiments of the invention are not limited to the use of 2D barcodes. 
         [0037]    The foregoing description of preferred embodiments for this invention have been presented for purposes of illustration and description. They are not intended to be exhaustive or to limit the invention to the precise form disclosed. Obvious modifications or variations are possible in light of the above teachings. The embodiments are chosen and described in an effort to provide the best illustrations of the principles of the invention and its practical application, and to thereby enable one of ordinary skill in the art to utilize the invention in various embodiments and with various modifications as are suited to the particular use contemplated. All such modifications and variations are within the scope of the invention as determined by the appended claims when interpreted in accordance with the breadth to which they are fairly, legally, and equitably entitled.