RFID for Healthcare and Life Sciences

1. RFID for Healthcare and Life Sciences April 4, 2005

2. Consumer Packaged Goods & Retail Healthcare Manufacturing Process Industries RFID Has Created a Tsunami Within Many Organizations

3. “Wal-Mart and DoD are requiring their 10,000 and 43,000 suppliers respectively to “equip all arriving pallets and cases with RFID tags for tracking purposes”… Source – Bear Stearns and Co., Inc., June 2004 “Have a written RFID plan ready to share with your board and senior management to show that you've completed an in-depth assessment of RFID”… Source – Gartner, June 2004 “RFID’s potential ROI for pharmaceutical companies is significant through improved inventory management and product-recall capability, enhanced patient safety, and as a guard against drug counterfeiting…Use of RFID by drugmakers will surpass CPG within 18 months.” Source – Meta Group, August 2004 Analysts Recognize and are Focusing on the Wave

4. Healthcare “Mandates” RFID has not been mandated directly for healthcare. However, RFID and other forms of Auto-ID are the best solution for a number of healthcare mandates • Medical suppliers to the DoD will have to comply with the RFID requirement by January 2006 if they want to be a DoD Supplier • Bar Code Auto-ID capabilities have been mandated for pharmaceutical manufactures, re-packagers, and re-labelers • Joint Commission on Accreditation of Healthcare Organizations (JCAHO) proposed a medication bar code requirement for January 2007 • Florida mandated a drug pedigree, first on a small number of at risk drugs, moving to all drugs in 2005

5. Potential RFID Benefit Opportunities for Providers • Develop a “New and Improved” Hospital Management Solution • Track all mobile assets • For patients, leverage same infrastructure to monitor: • Location for census management and capacity management in specialty areas, e.g., perioperative, radiology, cardiology, ED, Labor & Delivery • Status for safety, e.g., medication management, allergies • Administrative requirements, e.g., patient history, consents, insurance • To improve perioperative efficiency and inventory requirements visibility, develop systems that create a bill of materials by DGR on admission • Interface to existing applications that provide inventory location and quantity for consumables and non-critical items • Develop a data warehouse for all hospital infrastructure (beds, surgical rooms, X-ray etc.) and develop interfaces to update status assignment • Provide management dashboard and exception disposition

6. Pharmaceuticals, Medical Devices and Distributor Benefits • Drug anti-counterfeiting / authentication • Specimen tracking during drug development • Sample drug inventory management • Inventory tracking across the supply chain • Medical error reduction / patient safety • Automated replenishment at retailers and hospitals • Traceability for targeted recalls (1300 in 2001¹) • Tracking returns ($2B in 2002¹) • Medical device lifecycle management • Temperature monitoring • Etc. … Sources: 1 2002 HDMA Industry Profile and Healthcare Factbook

7. Drug Manufacturers are adding RFID tags to bottles of their pills to fight counterfeiting “Pfizer Inc. plans to start shipping bottles of Viagra with radio frequency identification, or RFID, by the end of next year. We're starting with Viagra because it is probably the best-known and one of the most counterfeited pharmaceutical products“ Pfizer, which sells more than $1.5 billion worth of Viagra a year, will spend several million dollars to add RFID tags to Viagra bottles. Source: Bryant Haskins , Pfizer Shipments of OxyContin bottles with the transmitters will begin this week to two large customers … The new bottles also should help authorities and the company in its battle against theft of OxyContin from pharmacies. The company said it will donate 100 hand-held scanners that can read the labels to law enforcement agencies. Source: Aaron Graham, Purdue Pharma Security Chief GlaxoSmithKline, said it too will begin using RFID on one of its products in the next 12 to 18 months. Source: ABC News Article, 15November 2004

8. Financial Impact of Counterfeiting The FDA estimates that up to 40 percent of pharmaceuticals shipped from countries such as Argentina, Colombia, and Mexico may be counterfeit. - RFID Journal 10/03 Source: NACDS Leadership Council, Counterfeit Prescription Drug Initiative, Dec. 8, 2003

9. Why RFID Instead of Bar Code? • Auto capture – Unattended, hands-free execution • No line-of-sight required • Reads multiple tags simultaneously • Dynamic, “real time” update of tag information • Fast read/write throughput • Can hold more data than Bar Codes • Increased read range capability • Secure information • Withstands harsh/dirty environments For the first time … your inventory talks to you!

10. Radio Frequency Identification (RFID) • A Family of Technologies • Technology developed in 1940s • Early application starting in 1980s • Livestock tag and trace • Toll Road Passes • Security Access Cards • Smart Labels — 1998 • The current RFID buzz is about Smart Labels A type of Auto-ID technology that uses radio waves to automatically identify individual objects

11. Data Accumulator / Savant Tags Antenna Reader • Device made up of an electronic circuit and an integrated antenna • RF used to transfer data between the tag and the antenna • Portable memory • Read-only or read/write • Active or passive • Receives and transmits the electromagnetic waves • Wireless data transfer • Communicates with the tag via antenna • Receives commands from application software • Interprets radio waves into digital information • Provides power supply to passive tags • Reads/writes data from/to tags through the reader • Stores and evaluates obtained data • Uploads filtered event data into an event filter server RFID is Automated, Wireless, Data Input and Output RFID is a tag/label with a unique identifier embedded within it that can have product specific information written to or read from the tag. This information can be accessed rapidly through RF without being in direct line of sight with the reader. “Don’t get too enamored with RFID … It’s an enabler to capture data… real value is in information systems.”

12. Raytheon 1 Divisions Ship 1. Tag includes a microchip with RFID Middleware Event 2 4 5 Integrated Outputs Integrated Processing Management Defense Defense Systems Systems • Data processed based • Trading partner on each BU’s unique Intelligence & • Customer requirements and ERP Intelligence & an antenna which stores a Information – DD25Q – ERP / SCM / CRM / Information Systems Systems MES • Each BU retains • Reader – Events initiated and its unique outputs – Sort Data executed on Missile – BU Missile Systems – Manage Facilities tag/shipment specific Systems configuration basis – Commission Tags unique electronic product code. – Filter • Data Management Network – Reader & Device – Business Intelligence Network Centric Mgmt Centric Systems – Real time analytics Systems – EPC Functions – Business activity – Apply BU Specific monitoring Raytheon Tag Counter Raytheon Aircraft – Complex event Aircraft Company correlation Company – Business process Middle ERP 3 management Raytheon Update Raytheon Technical Technical Services Services Company LLC Company LLC Benefits Space and • XXX • XXX Space and Airborne Airborne Systems • XXX • XXX Systems RFID is a Network of Hardware Technology • RFID is not “one size fits all” • What, how and when an item is tagged makes a difference in performance • Water absorbs (attenuates) RF • Metal absorbs and/or reflects RF • Successful application of the technology considers • Tag Technology • Chip – Silicon capabilities • Frequencies • Antenna • Mounting • Environment • Building • Atmospherics • EMI • Product/Application Life Cycle 7. ONS server matches the EPC number from a tag. 5. CSC’s RFID IT Infrastructure 2. Reader sends a radio signal Internet Internet Internet Internet that wakes up the chip and reads its data. 6. Enterprise Internet Internet Transaction System 4. Middleware filters raw data, controls the reader/tag network and 8. EPC Network contains applies local & detailed information… corporate business rules. 9. Radio tags automatically identify products, their movement, removal from inventory and action required at 3. Tagged Item wakes up and transmits designated points within the supply its EPC data including manufacturing chain. item number and unique serial “id” within the item family back to the reader. Key Differences: Auto-Capture, Unique ID of Item and Organization and Robust Survivability

13. Items with RFID EPC Global Network for RFID Event Server Savant receives all the EPC from the reader and sends a query over the internet to an Object Name Service seeking information about what the RFID Tag is attached to. The tags “wake up” and start broadcasting their individual EPCs Object Name Service (ONS) database, which acts like a reverse telephone directory – it receives a number and produces an address of a PML server which has extensive information about the product Object Name Server Reader Savant Source of Item Information PML Server(s) Physical Mark-up Language (PML) file will store information about each product such as a product’s name, category, when it was made and where, its expiration date, etc Applications receive the information about the product from the Savant Source of Item Information

14. Corporate RFID Serialization Alternative to alternative EPC Net The tags “wake up” and start broadcasting their individual EPCs Event Manager Savant receives all the EPC from the reader and sends information from the RFID Tags to the application. Reader Savant Lite Items with RFID EDI Advance Ship Notice 856 Applications receive the information about the product from the Savant

15. Suppliers Factory • Product/Inventory Management • Shipping Track and Trace • Delivery Factory • Routing Stages/Steps • In-Process Location • Tool Tagging Manufacturer Warehouse Transportation • Lot Traceability • Location Tracking • Cycle Counting • Program Segmentation • Outbound and Inbound In-Transits Warehouse Distributor Transportation • Asset Tracking • Utilization & Product Lifecycle Management • Patient Safety • Billing Provider Warehouse Point-of-Care Healthcare Supply Chain Applicability of RFID Business Area Process Area Application

16. Potential Vision to Secure Supply Chain

17. Use Case: Pharmaceutical Manufacturers World API Production 4 Packaging 2 Logistics 3 5 Drug Product/ Secondary Production Distribution Center • Track Totes and product from: • Chemical Source (1), to • API production (2), to • Secondary Production (3), to • Packaging (4), to • Warehouse/DC (5) 1 Organic Chemical source

18. QC Lab Shipping Tote Blending Granulation Samples to Lab LIMS Info Each movement tracked for perpetual location ID Location Info Carton to DC Compression Tableting Bottling Line Encapsulating RFID Location Tracking Server Product Info DB/ ERP MES Info Pharmaceutical Manufacturer Operations: RFID Tags on key movement containers, dollies and buggies allows perpetual location tracking, and proactive management to improve flow Receiving Dock Shipping Dock Linking location info through ERP allows connection to MES and LIMS, allowing for anticipation/elimination of bottlenecks

19. Similar opportunities and benefits can accrue for Medical Device Manufacturers as well Recieve tagged items Unpack – stow / to line Receiving Dock ID tracker Server Manufacture/assemble ERP/MES DBs package ship Shipping Dock

20. RFID in Healthcare has the potential to impact clinical, operational, and financial aspects of health care delivery

21. Instrument flow through the OR • Simplified view • Hospital specific variants • Structure • Policy • Procedures • Workflow

22. RFID Applications in the OR • Track & Trace – Instruments • Track & Trace – Specials • Count

23. Where to start: Develop an RFID Strategy • Identify real “compelling events” that must be addressed • The physics and environmental implications of RFID technologies are important and should be carefully considered • Keep the focus of effort on “The Data” – not how it is collected! • Make sure that your organization understands … • The range and technologies and suppliers associated with RFID networks and how they integrate with existing enterprise and ERP systems Strictly follow the same ROI based guidelines that have always preceded IT expenditures

24. Business Process – Readiness Assessment Strategy and Business Case Design Test and Refine Evaluate Implement Where to Start?

25. Designing and Deploying RFID Networks can be Complex

26. RFID Case Studies Sears wanted to increase their understanding of how RFID can benefit their business. • Provided on-site education for Sears team about RFID technology and future trends • Designed and deployed onsite RFID test lab to evaluate a wide range of technology • Base-lined business processes and performed RFID proof of concepts around: Distribution Center(s); Jewelry and High Value Electronics • Identified and validated several new potential business improvements in each of these areas in the retail stores, distribution centers, and suppliers • Developed a RFID roadmap that defines the future steps Approach • Validated that RFID can yield significant business gains in their business: • Distribution Center – Significant savings opportunity: Use RFID to capture and eliminate excess handling and reduce damage in White Goods SC. • Jewelry – reduce inventory counts, increase DC efficiencies • High Value Electronics – Increase inventory visibility, reduce theft, improve customer service Results Savings via RFID Enabled Tracking System for the “White Goods” Supply Chain projected to exceed $ 10 Million

27. RFID Case Studies BHP Billiton Quality Control – Hostile Environment Problem: • Processing of copper ore involves an electro-winning activity which harvests pure copper through catalytic reaction in a tank house • Quality and quantity of copper relates to the quality of the re-usable stainless steel cathodes • Poorly performing cathodes are identified by manual observation and as much as 40% copper can be off-grade as a result • Solution: • Use RFID to track individual stainless steel cathode blanks, and link that identity to information about copper quality, copper weight, cathode maintenance, and operating conditions within the tank house environment • Achieve optimal performance and maximize automation of the electro-winning tank house Acidity Dirt/Grease Electromagnetic Fields

28. Summary • RFID is a new technology that will significantly enable the Healthcare Supply Chain • Understanding and planning for the “physics” of RFID is critical • Don’t rush into it without a plan and an ROI!

29. Speaker Contact Information Glenn A. White Partner, Global Health Solutions CSC Consulting Group 1160 West Swedesford Road, Suite 200 Berwyn, PA 19312 610.407.5647 gwhite26@csc.com

30. Experience. Results.