A post-retail consumer application of RFID

in medical supply chains

Stephen M. Swartz
Department of Marketing and Logistics, University of North Texas, Denton, Texas, USA

Vijay Vaidyanathan
College of Engineering, University of North Texas, Denton, Texas, USA, and

Hari Raman
Columbia University, Plano, Texas, USA
Abstract
Purpose The purpose of the paper is to investigate the feasibility of using radio frequency identification (RFID) total asset visibility technologies for
post-consumer monitoring and ordering of medical supplies.
Design/methodology/approach A laboratory experiment in a consumer context was designed. This involved the application of RFID tag
technology for glucose monitoring and supply management.
Findings It was found that embedded RFID monitoring of blood glucose levels can be used to effectively monitor and help manage patient care. An
integrated system of monitoring and management with an effective medical supply chain information system is presented.
Research limitations/implications The laboratory study provides initial validation of the merits of the approach. Extensive human field-testing
would still be required prior to any strong inference about the viability of the technology in this application.
Practical implications The findings provide a directly relevant system design template for home managed patient care settings where selfadministered medication protocols are required. The findings may also be extended into consumable consumer products like food and beverages where
the management of home-based supplies are a critical component of supply chain effectiveness and consumer satisfaction.
Originality/value The results extend the use of RFID as a total asset visibility tool for enterprise resource planning in a supply chain. Post-consumer
consumption monitoring, tracking, and automated re-ordering have not been extensively addressed in the literature.
Keywords Condition monitoring, Supply chain management, Medical equipment, Product identification
Paper type Research paper

An executive summary for managers and executive

readers can be found at the end of this issue.

(Lopez et al., 2009; Jones et al., 2007; Shepard, 2005; and

others). Passive tags are tags that contain no independent
source of power. Instead, they are powered by the
electromagnetic radio waves that the reader sends out.
These tags are the cheapest to manufacture, but because
they have no independent power source, their range and
reliability are considerably lower than that of their
counterparts, the active tags. Active tags are RFID tags that
have their own source of power, and they do not need to be
powered by the reader. As a result, active tags have a much
higher range and are more reliable. Because they contain their
own power source, these tags are much more expensive to
manufacture.
Diabetes is a major global disease, and each year more and
more people are diagnosed with this silent killer (American
Diabetes Association, 2009). In order to help keep ones
blood sugar in check, a person must prick their finger and
transfer the blood to a special computer where the amount of
sugar in the blood is analyzed. This method of regulating
blood sugar is accurate and useful, but it is highly intrusive.
The number of children diagnosed with Type 1 diabetes
grows each and every year, and most children are very
hesitant to prick themselves every day. As a result, the risk of

1. Introduction
Radio frequency identification (RFID) has emerged as one of
the most advanced and commercially promising types of real
world total asset visibility (TAV) information technologies
(Blanchard, 2009; Shepard, 2005). In its basic form, RFID
enables the identification of individual items in a supply
chain, and serves as the source collection point of location
(and status) data in a supply chain inventory tracking and
disposition system (Ustundag and Tanyas, 2009).
The main principle of RFID is based on the
communication between a tag reader and a tag. The reader
emits radio waves in multiple directions, and the tag receives
those waves, and responds by emitting a signal back to the
reader confirming that the tag received the signal. There are
two types of tags, and four different types of frequencies
The current issue and full text archive of this journal is available at
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Journal of Business & Industrial Marketing

25/8 (2010) 607 611
q Emerald Group Publishing Limited [ISSN 0885-8624]
[DOI 10.1108/08858621011088347]

The authors wish to acknowledge Dr Ram Laksnarain for mentoring Hari

Raman on his RFID science project and for his assistance during project
experimentation.

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A post-retail consumer application of RFID in medical supply chains

Journal of Business & Industrial Marketing

Stephen M. Swartz, Vijay Vaidyanathan and Hari Raman

Volume 25 Number 8 2010 607 611

Figure 1 Product-information relationship

the children (and adults) not checking their blood sugar

because of their fear of needles, poses a major health risk. If a
person does not monitor and take corrective action to adjust
their blood sugar, they run the risk of having heart failure due
to a drastic increase or decrease in their sugar levels.
Many companies are trying to develop new products that
will check a persons blood sugar level, without making the
person provide blood for each test. Owing to the increasing
popularity of RFID, many corporations are attempting to
incorporate Radio Frequency Identification with testing for
blood sugar (RFID Gazette, 2006). The case for RFID is that
an implant of an RFID chip will eliminate the need for any
needles. Digital Angel, a branch of the RFID giant VeriChip,
invented a syringe-implantable glucose detecting RFID chip
(RFID Gazette, 2006). With a one-time injection of an RFID
tag with a glucose monitor inside the bloodstream, the patient
will be able to check on their blood sugar by using the reader
to get the information that the tag contains. Ultimately, this
glucose level information can be communicated to an event
monitoring system that can alert the patient that corrective
action is required (Freudenthal and Herrera, 2007; Masters
and Michael, 2007; Lopez et al., 2009)
The main drawback with this procedure is that it is still very
expensive to manufacture, and as a result the general
population in the USA will not be able to invest in this
product. Another problem that could arise with the
commercialization of this product is the fact that people
must insert a foreign object inside their body, and it would
stay inside their bloodstream for the rest of their life. A recent
survey reveals reluctance on the part of many people with
respect to acceptance of RFID information technologies in
personal health care applications (Katz and Rice, 2009). Just
as sometimes the body will reject transplanted organs, there is
no way to tell whether the human body will react to the
foreign object residing in the blood stream. Another way that
RFID is being tested in conjunction to diabetes is having a
RFID enabled glucose monitor attached to the body by a
catheter. The monitor reads the blood sugar and transmits the
information to a handheld reader that will tell the person
whether or not to take a dose of insulin. An insulin pump in
the monitor will be able to measure out the correct dosage of
insulin and pass it to the body through the catheter, thus
eliminating the need for an insulin shot (Jones et al., 2007;
Freudenthal and Herrera, 2007).
The concept being explored in this research effort is the
merger of location/condition data provided by embedded
RFID tags with the information technology used to support
automatic item replenishment and inventory management in
supply chain optimization systems. This effort represents an
extension of the principles of human-centric informatics
into a supply chain context (Lopez et al., 2009; Korcok, 2009;
Masters and Michael, 2007; Steinberg and Steinberg, 2009;
Ustundag and Tanyas, 2009). Specifically, a system similar to
the one described in Figure 1 is proposed. The embedded tag
provides a signal (dotted line) to the users information
technology system. An event management system will sample
blood glucose data, and signal the user when adjustment is
required. Instant messaging, a cellular call or email, or
BlueTooth alert could be used to provide the dosing
information. The user draws product from inventory and
consumes it. The inventory status is also maintained by the
event management system, and replenishment is triggered

according to business rules tailored to the users individual

requirements.
The system configuration described would support
common collaborative planning, forecasting and
replenishment (CPFR) and vendor managed inventory
(VMI) systems; the users EMS could be configured to
provide input data for virtually any automated replenishment
system (Lopez et al., 2009).
Most of the technologies required to support the system
described are already available. The one notable exception is
the collection and transmittal of the blood glucose data. The
main focus of this research, then, was an investigation of the
efficacy of using emergent technology in this context. The
technical challenges of this concept are discussed next.

2. Technical challenges
Electromagnetic wave propagation occurs when alternating
electric and magnetic fields at 90-degree angles travel in the
same direction, feeding each other (Tomasi, 2004). An
electromagnetic wave may be propagated at just about any
frequency, but the length of the antenna determines the
propagation of the wave at a given frequency (Tomasi, 2004).
Radio frequencies can penetrate through metal and other
objects. Thus, the user need not be in the line of sight with his
target. A basic RFID system comprises a tag (transponder), a
transceiver (RFID reader) and an antenna on each of them.
RFID tags can be either passive (operate without an internal
source of power) or active (with an internal source of power).
Passive tags are compact, durable and inexpensive whereas
active tags can operate over a longer range. The RFID reader
consists of a transceiver along with a decoder and an antenna.
The reader transmits a low power RF signal through its
antenna, which is received by the tag through the tags
antenna. The tag uses the power from the radio signal to
transmit data back to the receiver. Advanced forms of RFID
tags are now available at reasonable prices (Jones et al., 2007).
There are four different types of frequencies that RFID
readers run at. Low frequency readers emit radio waves at
frequencies less than 135kHz. Low frequency readers are the
cheapest available, but the range of low frequency readers, are
very limited. Low frequency RFID (around 134kHz) is used
for implants that identify livestock and pets, and only permits
communication at low data rates (Masters and Michael,
2007). High frequency readers operate at a frequency at about
13.56 MHz. These readers have a higher range than that of
low frequency readers, but as a result the cost of
manufacturing is greater. UHF (e.g. 900 MHz RFID) is
problematic for telemetry with implanted devices due to its
high attenuation by water, which is a primary constituent of
human tissue. In contrast, HF (13.56 MHz) RFID is not
substantially attenuated by water and thus is more suitable to
this application in implants (Freudenthal and Herrera, 2007).
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A post-retail consumer application of RFID in medical supply chains

Journal of Business & Industrial Marketing

Stephen M. Swartz, Vijay Vaidyanathan and Hari Raman

Volume 25 Number 8 2010 607 611

High frequency readers are also plagued by the issue of poor

performance around metals, because metallic properties, are
known to reflect high frequency radio waves. High frequency
RFID systems are currently used in the commercial RFID
market, because they provide the correct amount of balance
between ultra high frequency readers operate at frequencies of
433 MHz, and then from 860 to 950 MHz. These readers
have even more range than the high frequency readers.
Liquids pose a problem to UHF readers, because they absorb
some of the radio waves, and metals are able to reflect the
radio waves. Microwave frequency readers are the most
powerful, and they operate at frequencies of 2.5 GHz. Readers
that operate at this frequency are the most reliable with the
greatest range, but they are the most expensive. These readers
are used at the toll-booths to identify the toll tags.

and readings were noted. Sugar was added in steps of 22.5 mg

to the bowl and the steps were repeated to obtain seven sets of
readings of seven different blood sugar levels.

4. Results
Overall, the hypothesis was supported. The amount of sugar
had a direct effect on read range of the RFID system. This is
due to the effect that highly absorbent liquids have on radio
frequency identification systems. The absorbency of the blood
increased each time more sugar was added. As a result, when
the radio waves reach the tag around the blood, many of the
waves are absorbed by the blood. This will result in a decrease
in signal strength, thus reducing the read range. The stagnant
test readings were recorded from one side (side 1) for
consistency. The data showed a significant variation between
the four different samples of blood. The blood with the
normal glucose content had a read range of 29 cm. The prediabetic blood had an average read range of 20.4 cm, which
was a loss of about 8.6 cm of range lost between the normal
blood sugar level, and a 30 percent decrease. The diabetic
blood level had a read range of about 19.7 cm with a loss of
about 9.3 cm and a 32 percent decrease in read range. The
potentially lethal blood had a read range of 18.6 cm, which
resulted in a loss of about 10.4 cm and a 36 percent decrease
in read range. When plotted on a graph (see Figure 2), the
data projects an exponential curve that shows a drastic change
in the read range between the normal and pre-diabetic blood,
but then the read ranges began to level out when the diabetic
and potentially lethal blood sugar levels were tested. An
exponential equation modeled on the data yielded the
following equation:

3. Methodology
In the current study, a non-invasive method of blood sugar
measurement using radio frequency identification was
created. By using simulated blood, a similar environment to
that of the human body was created. A passive tag was placed
on the outer edge of the simulated bloodstream, and a low
frequency reader was used. Distance was used to measure the
read range of each simulation. According to the Mayo Clinic,
a normal fasting blood sugar has lower than 100 mg per
deciliter of glucose. A pre-diabetic state is said to occur
when there are 100 mg per deciliter of glucose. Finally, a
diabetic state of blood sugar occurs when there are more than
126 mg per deciliter of glucose. Because only 20mL of blood
will be used during each trial, 20 mg of sugar was used to
depict the pre-diabetic blood sugar level, and 30 mg was
used to depict the diabetic blood sugar level.
The purpose of the experiment is to analyze the effects of
glucose in human blood on the RFID system, and to create a
non-invasive method of checking blood sugar levels. The
study endeavors to examine the effect of increased amounts of
glucose in human blood on the readability range between a
RFID tag and reader. Two types of experiments were
conducted:

y 144:87x20:0618

where Y is equal to the read range and x is the amount of

glucose in grams.
The ratio of sugar to blood, however, is the same for any
amount of blood. Therefore, this equation could be applied to
any amount of sugar or any amount of blood. To find the
amount of glucose after obtaining the read range, the inverse
equation is used:

3.1 Stagnant experiment

Of the simulated blood 20 ml was filled in a test tube. The
RFID label tag was wrapped around the middle of the test
tube, and placed flat on a wooden surface. The RFID reader
was turned on, and positioned perpendicularly 0.1m away
from the test tube. The reader was moved away from the tube
in a straight line until the reader is unable to read the tag. The
distance at which the reader is first unable to read the tag was
recorded. Sugar was added in steps of 5 mg to the blood in the
test tube and the readings were repeated.

x exp 1= 2 0:618 lny=144:87

This formula could easily be programmed into a computer,

which, after proper calibration, could then make the process
Figure 2 Graph of read range vs amount of glucose for stagnant
condition

3.2 Flow experiment

The pump was immersed in a bowl containing 150 ml of
simulated blood. The flow tube was attached to circulate the
blood. The RFID tag was attached to the middle of the test
tube so that it faced outwards. The pump was turned on,
making sure blood flows through test tube and back into
bowl. A time limit of 10 seconds was allowed to remove any
air bubbles. The RFID reader was turned on and positioned it
so that it was directly in front of tube. The reader was
continuously moved away from the tube in a straight line until
the reader was unable to read the tag. The steps were repeated
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A post-retail consumer application of RFID in medical supply chains

Journal of Business & Industrial Marketing

Stephen M. Swartz, Vijay Vaidyanathan and Hari Raman

Volume 25 Number 8 2010 607 611

of checking blood sugar easier, faster, and most importantly

pain free.
The flow experiment simulated a constant stream of flowing
blood that exists within the human body. Readings from the
flow experiment had much higher read ranges, but as the
blood sugar levels increased, the read range decreased
exponentially (see Figure 3). From 90 mg/dl to 165 mg/dl,
the read range decreased from 12 to 44 percent among the six
different blood sugar levels, with the control being 75 mg/dl.
A reason for much the higher read range could be because
there was a plastic tube instead of the glass test tube that was
used in the static experiment. This experiment is more
accurate as a glucose monitor due to the increased number of
blood sugar levels and the increased number of trials. The
equation modeled after the data according to:

at a 95 percent confidence level. Therefore, the alternate

hypothesis of read data being different for the various
amounts of glucose in simulated blood has to be accepted.

y 3499:5x20:7152

5. Conclusions and recommendations

This process could be used to create a non-invasive blood
sugar monitor. Instead of using an invasive method of drawing
blood this experiment could help create a pain-free reliable
method of checking blood sugar. Instead of using simulated
blood, a test could be run on animal then human subjects,
thus producing more accurate results in respect to creating a
blood glucose monitor. The results are extensible to other
environments as well. For example, anemia is also a potent
disease in the world today. Iron content in blood (an anemia
indicator) could also be tested using RFID. High frequency
readers often have different reactions to various materials than
low frequency readers. Thus, combinations of readers and
tags could be used to develop more comprehensive patient
condition monitoring systems in the home health care setting.
The results are extensible to other environments as well.
When combined with an EMS in a supply chain management
system, the source point monitoring data can be very useful.
In this experiment, blood glucose can be monitored and data
can provide input into the EMS. The EMS can evaluate the
blood glucose levels, and signal the user with remediation
actions (timing and dosage recommendations). The EMS can
also monitor the medical supplies data, and place automated
replenishment orders through authorized prescription
medication providers as the product is consumed. The data
can also be monitored by medical professionals remotely,
simply by being granted access into the users database.
The system described has applications into other home
health care settings; a wide variety of medical data requiring
monitoring and event management could be included in the
EMS. Many such data capture applications are in
development currently (Jones et al., 2007; Freudenthal and
Herrera, 2007; Steinberg and Steinberg, 2009), and efforts
are being made to integrate this data capture technology into
responsive networks (Masters and Michael, 2007; Lopez et al.,
2009). Indeed, the technology presented represents an
application of the concept of making the end consumer an
active participant in the supply chain; truly a co-creator in
the value proposition.

where Y is equal to the read range and x is the amount of

glucose in grams.
Single factor ANOVA tests (see Table I) conducted on the
data for the stagnant-condition experiments using MS Excel
yielded a p-value of 9.18E-16. This implies that the null
hypothesis of equal means for the read ranges can be rejected
at a 95 percent confidence level. Therefore, the alternate
hypothesis of read data being different for the various
amounts of glucose in simulated blood has to be accepted.
Single factor ANOVA tests (see Table II) conducted on the
data for the flow-condition experiments using MS EXCEL
yielded a p-value of 1.46E-49. This implies that the null
hypothesis of equal means for the read ranges can be rejected
Figure 3 Graph of read range vs amount of glucose for flow condition

Table I Single factor ANOVA table for stagnant-conditions data

Source of variation
Between groups
Within groups
Total

SS

df

MS

p-value

F crit

340.6135
3.912
344.5255

3
16
19

113.5378
0.2445

464.3674

0.000

3.238872

Table II Single factor ANOVA table for flow-conditions data

Source of variation
Between groups
Within groups
Total

SS

df

MS

p-value

F crit

27488.94
348.0
27837.44

12
57
69

2290.745
6.114035

374.67

0.000

1.26341

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A post-retail consumer application of RFID in medical supply chains

Journal of Business & Industrial Marketing

Stephen M. Swartz, Vijay Vaidyanathan and Hari Raman

Volume 25 Number 8 2010 607 611

References

Further reading

Blanchard, D.B. (2009), The five stages of RFID, Industry

Week, January, pp. 50-3.
Freudenthal, E. and Herrera, D. (2007), Evaluation of HF
RFID for implanted medical applications, available at:
www.cs.utep.edu/vladik/2007/tr07-36.pdf
Jones, A.K., Dontharaju, S.R., Mats, L., Cain, J.T. and
Mickle, M.H. (2007), Exploring RFID prototyping in the
virtual laboratory, Proceedings of IEEE International
Conference on Microelectronic Systems Education, San Diego,
CA.
Katz, J.E. and Rice, R.E. (2009), Public views of mobile
medical devices and services: a US national survey of
consumer sentiments towards RFID healthcare
technology, International Journal of Medical Informatics,
Vol. 78, pp. 104-14.
Korcok, M. (2009), Tracking itinerant patients and surgical
sponges, Journal of the Canadian Medical Association,
Vol. 180 No. 8, pp. E14-E15.
Lopez, T.S., Daeyong, K., Gonzalo, H.C. and Koumadi, K.
(2009), Integrating wireless sensors and RFID tags into
energy-efficient and dynamic context networks, The
Computer Journal, Vol. 25 No. 2, pp. 240-67.
Masters, A. and Michael, K. (2007), Lend me your arms:
the use and implications of human centric RFID,
Electronic Commerce Research and Applications, pp. 29-39.
RFID Gazette (2006), VeriChip sticks it to diabetics with
glucose-sensing chip, RFID Gazette, available at: www.
rfidgazette.org/2006/10/verichip sticks.html
Shepard, S. (2005), RFID: Radio Frequency Identification,
McGraw-Hill, New York, NY.
Steinberg, I.M. and Steinberg, M.D. (2009), Radiofrequency tag with optoelectronic interface for distributed
wireless chemical and biological sensor applications,
Sensors and Actuators B: Chemical, Vol. 138, pp. 120-5.
Tomasi, W. (2004), Electronic Communications Systems:
Fundamentals through Advanced, 5th ed., Prentice-Hall,
New York, NY.
Ustundag, A. and Tanyas, M. (2009), The impacts of radio
frequency identification (RFID) technology on supply chain
costs, Transportation Research Part E, Vol. 45, pp. 29-38.

Webb, W. (2009), RFID in embedded designs: your move,

EDN Europe, January, pp. 21-4.

About the authors

Stephen M. Swartz is an Associate Professor of Logistics
Management for the Department of Marketing and Logistics
at the University of North Texas. He earned his PhD in
business administration (operations and sourcing
management/logistics) from Michigan State University in
1999. His active research efforts include compressing time-tomarket in supply chains under conditions of uncertainty and
risk, the leveraging of information technologies (particularly
RFID) to improve customer service and cost. He is published
most recently in the Transportation Journal, the International
Journal of Logistics Management, the Journal of Transportation
Management, and the Project Management Journal. Stephen
M. Swartz is the corresponding author and can be contacted
at: Steve.swartz@unt.edu
Vijay Vaidyanathan is an Associate Professor in the College
of Engineering at the University of North Texas. He received
the BSc degree in physics from Bombay University in 1985
and the BSc (Tech.) degree in electronics instrumentation
from Bombay University in 1988. He earned his MS degree in
1992 and the PhD in 1998 in biomedical engineering at Texas
A&M University. His research interests are biomedical optics,
RFID applications, and design of innovative instrumentation
systems. In addition, his teaching efforts include control
systems design, design of DSP systems and instrumentation
systems. He has published most recently in IEEE Transactions,
Elsevier and Photomedicine and Laser Surgery.
Hari Raman created an RFID experiment that tested the
reliability of tagging objects using the Radio Frequency
System for the scholastic science fair competition. His
findings won him the grand prize and first prize at the
building level, and Texas Instruments awarded him first place
in the regional competition. Hari is currently at Columbia
University pursuing a bachelors degree in biomedical
engineering.

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