Jerry Fahrni

IV Automation / Robotics

Today I attended a webinar from Baxa titled “Improving Sterile Compounding Quality Through Automation” given by Eric Kastango RPh, MBA, FASHP. The presentation was very interesting. I thought it was going to focus more on technology, but it was heavy on the human component of contamination in the clean room environment with only minor mention of automated IV devices. Anyway, during the presentation Kastago talked a bit about robotic automation for clean rooms and mentioned the CytoCare Robot.

The CytoCare Robot is a chemotherapy compounding robot in an ISO class 5 environment. According to the website CytoCare is “the world’s first and only automated robotic system for the safe compounding of hazardous, life-critical cancer therapy medications.”

The company website lists the CytoCare Robot’s workflow process as:

1. Pharmacists plan the preparation cycle at the managing station. CytoCare’s software integrates with hospital pharmacy systems’ software (e.g. HL7,XML).

2. CytoCare is loaded with proper drugs and final containers (IV bags, vials, and syringes).

3. A 6-axis robotic arm removes excess solutions, weighs IV solutions for accuracy, and compounds the drugs. Powdered drugs are reconstituted and drugs are mixed by single-use syringes to prevent cross-contamination. Toxic waste is safely discarded, and air curtains with 5 HEPA filters prevent accidental exposure and environmental contamination.

4. Dose accuracy is checked by three independent systems: Digital indexers control the syringe-driving mechanism, position encoders double-check the accuracy of the syringe movement, and fluid measurements are then verified using pre- and post-weight checks.

5. Final syringes, IV bags, or drug vials are unloaded and ready to administer to patients. An automatic hazardous waste management system eliminates exposure to toxic wastes. Unused drugs are also unloaded and available for reuse.

Technical specifications:

SIZE: Approximates a standard chemotherapy hood (7’6″h x 6’6″w x 3’6″d)
WEIGHT: Approximately 3,300 lbs.
INTERFACE: HL7, XML, Custom
ENVIRONMENT: Self-contained, negative pressure; ISO 5 airflow engineering with 5 HEPA filters
WASTE MANAGEMENT: Automated
ACCURACY CHECKPOINTS: 3 Independent Systems independent systems: Digital indexers control the syringe-driving mechanism, position encoders double-check the accuracy of the syringe movement, and fluid measurements are then verified using pre- and post-weight checks.

The CytoCare Robot can be acquired and installed with no upfront cost by the user. The website lists the acquisition cost of the system as $20 per dose. Looks like hardware vendors are taking note of many software vendors by offering their product as a service; Hardware-as-a-Service (HaaS) if you will. This could be important to healthcare systems as capital dollars continue to shrink.

If you would have asked me a year ago if I had any interest in IV automation or robotics I would have said no. Since coming back from the ASHP Midyear however, I’ve found these systems to be quite compelling. I definitely think there is room for this type of automation in the pharmacy of the future. The key will be how to integrate them not only into one’s workflow, but into all the other pharmacy systems.