Blogs
September 4, 2026 / September 4, 2026 by Gina Breckenridge
In partnership with Susan Simao, BScPhm MBA RPh ACPRDirector of Pharmacy and Medication Management at Mackenzie Health
For more than a decade, Mackenzie Health has been recognized as one of Canada’s most forward-thinking healthcare systems, helping drive digital transformation through early adoption of advanced healthcare technologies.As the first healthcare organization in Canada to implement the EPIC electronic medical record (EMR) system in 2017 and achieve bidirectional infusion pump interoperability across clinical systems, Mackenzie Health has built a reputation for breaking down information silos and creating more connected care environments.But clinical leaders across pharmacy and perioperative departments at Mackenzie Health recognized an opportunity to advance the next generation of technology in one of the most complex and high-stakes environments—the operating room (OR).RFID had already been successfully deployed within the inpatient pharmacy for years, giving clinical leaders firsthand experience with its ability to improve medication visibility and inventory accuracy. The question was not whether RFID worked, but whether that same technology could be successfully implemented within the OR. If Mackenzie Health could extend automation beyond the pharmacy and implement it within the OR, it would serve as the foundation for a system-wide model that could scale to Cortellucci Vaughan Hospital and future locations across the Ontario health system.
More than a decade earlier, the organization began exploring how RFID technology could improve the accuracy, visibility, and workflow efficiency of medication inventory managementwithin the inpatient pharmacy.
In 2014, the Mackenzie Health pharmacy team implemented Intelliguard’s Mira Prep™ Pharmacy Station to manage 40 crash carts using RFID-enabled tray management at a time when RFID adoption in Canadian healthcare was still relatively uncommon. The initiative delivered more than operational efficiencies within the inpatient pharmacy. It also established organization-wide confidence in automation. “For the cost, it’s a no-brainer in terms of workflow,” said Susan Simao, Director of Pharmacy and Medication Management at Mackenzie Health. “It brought our pharmacy team a new sense of safety and reliability.” Susan described how, during drug shortages, the pharmacy team used RFID data to confidently reduce quantities in trays, knowing exactly how much stock was on hand and what the actual utilization rates were.
As surgical volumes increased and perioperative workflows became more complex, Susan and other clinical leaders began evaluating the advantages of introducing automation to manage medication inventory in the OR.
Traditional barcode workflows relied heavily on manual scanning, creating friction in fast-paced perioperative environments and increasing the risk of human error.
Susan noted that the organization has been on a journey to “zero harm,” which heavily depends on trusted data and highly reliable systems and tools, as opposed to manual processes that are more prone to human error.
For pharmacy and perioperative teams, the operating room has historically been one of the most difficult clinical environments in which to maintain accurate medication inventory. Often referred to as healthcare’s “black hole,” the many moving parts in the OR present unique challenges in tracking medications, such as documentation gaps, creating both clinical and operational risk.Recognizing these challenges, Mackenzie Health Richmond Hill sought to replace disconnected, manual workflows with RFID-powered automation. By implementing Intelliguard’s Mira Care™ Medication Workstations across all 18 operating rooms and procedural areas, the organization aimed to improve medication visibility, streamline access, and strengthen operational efficiency without adding burden to clinicians.However, clinical leaders knew that technology alone would not solve the problem. One of the biggest barriers to OR automation is achieving alignment across multiple departments with different priorities and workflows. Mackenzie Health addressed this challenge from the very start of the evaluation process through a collaborative governance model that brought together pharmacy, anesthesia, information technology (IT), clinical informatics, operations, and frontline clinical staff.The initiative was jointly championed by Simao and Dr. Jerod Gollant, Chief of the Department of Anesthesia, who both share a vision for smarter, safer medication management.To support a successful implementation, Mackenzie Health established:
This structure created shared ownership across departments and ensured workflows were redesigned collaboratively rather than forcing technology into existing processes. The project was further supported by frontline anesthesia assistants, along with pharmacy staff, who helped validate workflows and shape workstation design decisions.“First and foremost, I give credit to our team—the pharmacy team and our anesthesia assistants—who worked really vigorously on getting all of the workflows established, testing everything, and even designing the layouts of the machines,” Dr. Gollant explained.Leading up to the January 2026 launch, Mackenzie Health teams worked closely with Intelliguard’s implementation and client support teams to map future-state workflows, including narcotic reconciliation after surgery, ensuring a smooth transition. Having previously evaluated and implemented multiple medication management technologies within the OR environment, the pharmacy, anesthesia, and clinical informatics and information technology teams brought valuable experience in workflow design and system integration, helping accelerate planning and identify opportunities for optimization. “Working with Intelliguard and their ability to be available to us was really beneficial. We were aiming for a specific implementation date, and that support made a big difference,” Dr. Gollant said. “After go-live, having Adriana from Intelliguard on-site was irreplaceable because it saved our team from having to submit tickets and wait for a resolution. Having someone here with us allowed our team to experience a higher level of support and service,” Dr. Gollant shared.
Today, RFID is fully embedded in OR workflows at Mackenzie Health, creating a more connected, data-driven approach to medication management across pharmacy and perioperative care.
Anesthesia providers now work in a true “grab-and-go” environment, where medications can be accessed quickly during procedures without additional manual documentation. Medication movement is automatically captured by Mira Care Medication Workstations, reducing workflow interruptions while increasing confidence in medication availability, accuracy, and replenishment.
“Now that RFID is a reality for us, it is a wonderful way for the anesthesia department to proceed in the operating room,” said Dr.Gollant. “With RFID in the OR, anesthesia providers don’t have to document what they’re taking out during a procedure. We just go into the drawer, take what we need, and we know that the Mira Care Workstation is documenting it. We have confidence that when medications get down to a critical PAR level, our pharmacy staff know—because of RFID—and they’ll be replaced quickly.”
For Mackenzie Health pharmacy teams, RFID has significantly reduced the manual burden of inventory management, expiration checks, and medication reconciliation, while providing item-level visibility into medication movement throughout the OR environment.
Real-time utilization data has also enabled the organization to optimize inventory levels based on actual usage patterns. Shortly after go-live, the pharmacy team leveraged trusted RFID data to identify several high-usage medications that required PAR level adjustments to maintain consistent 24-hour availability within the OR.
Beyond workflow efficiencies, the implementation has helped standardize medication management practices across clinical teams, strengthen traceability for controlled substances and recalls, and create a scalable foundation for future automation. This includes expanding RFID automation in ORs across additional hospitals within the Mackenzie Health system, enabling rotating anesthesia providers to have consistent workflows and technologies across sites.
Internal and external collaboration did not end at implementation. Ongoing feedback from clinical teams continues to shape system enhancements and workflow optimization. “We’ve given feedback to Intelliguard on the way the Mira Care Workstation screens look and how we use them, and that feedback is taken seriously. We’ve already seen updates,” Dr. Gollant said.
By treating technology vendors as strategic partners rather than just providers, the organization has ensured that its systems evolve alongside clinical needs.
By successfully implementing RFID-enabled medication inventory management across ORs at Richmond Hill, Mackenzie Health has shown how clinical collaboration, governance, and automation drive smarter healthcare operations.
As Mackenzie Health expands these services to Cortellucci Vaughan Hospital, its partnership with Intelliguard continues to support the health system’s vision for innovation and operational excellence. What began as an early investment in RFID technology has evolved into a scalable model for modern medication management, positioning Mackenzie Health to meet the demands of today’s evolving healthcare environment while continuing to lead the way in clinical innovation across Canada.