Jerry Fahrni

State of Pharmacy Automation. Pharm Purch Prod. 2010; 8

I was doing a little Sunday morning reading and came across an interesting set of slides at the Pharmacy Purchasing & Products (PPP) website  (registration required to access the slides). I haven’t spent much time reading PPP Magazine, but I should because they always seem to have something good about pharmacy automation and technology in just about every issue.

Anyway, I’ve been looking at various automated packaging machines lately and thought the information at the PPP website was rather timely. According to information found at the site “After a slight dip in the number of facilities packaging medications in bar coded unit dose in 2009, this process realized a significant rebound in 2010. Nearly three quarters of all facilities now have such an operation in place. Hospitals taking advantage of the increased data capacity offered by two-dimensional bar codes also bounced back this year. In conjunction with these improving adoption rates, pharmacy directors are also reporting rising satisfaction rates with their operations. Despite a staunch minority that sees no need for a unit dose packaging operation, the vast majority of those without such a system plan to implement one shortly.” The graph in this post is from the PPP slide deck and shows the percentage of facilities using bar-code unit dosed packaging for medications over the past several years. This comes as no surprise when you consider the relative inexpensive nature of this technology when compared to other pharmacy automation, the ease of which it can be implemented and the push for BPOC in healthcare. Call it a perfect storm.

Among the methods for unit dosing medications 36% of respondents in the PPP presentation were using high-volume unit dose packaging machines. A cursory internet search revealed the following key players in the high-volume unit dose packaging race:

PACMED by McKesson

“The PACMED™ high-speed packager automates bar-code packaging of oral solid medications, improves packaging accuracy and pharmacy workflow efficiencies, and facilitates the transition to scanning bar-coded medications at the patient’s bedside.
Key Benefits

• Shrinks cabinet fill time by 70%(1).
• Reduces oral solids packaging labor by 65%(1).
• Reduces medication costs through bulk buying.
• The ROBOT-Ready™ model:
  • Increases ROBOT-Rx® system packaging productivity by 300%.
  • Optimizes ROBOT-Rx inventory by reducing offline inventory.
  • Facilitates the pharmacist check via the Drug Image Library.

Automated packaging uses significantly less labor, optimizes inventory levels, and enables bulk medication buying. The intelligent PACMED packager works virtually unattended to fulfill orders electronically, replenishing for carts, cabinets, pharmacy stock and multiple sites.

The PACMED packager automatically tracks medications by lot numbers and expiration dates, ensures refilling and perpetual inventory through bar-code verification, and standardizes bar-code formats to facilitate bedside scanning.

It also is highly scalable, accommodating from 100 to 500 line items, flexible with three sizes of storage canisters and two sizes of packages with the ROBOT-Ready model.”

(1) Weizer, Michele (June 2006) The bigger packaging picture.Pharmacy Purchasing & Products, pp. 14, 16.

ATP High-Speed Tablet Packager by Swisslog

“Swisslog’s ATP system(available only in North America) is a versatile packaging solution that provides easy filling and refilling of medications through high-speed dispensing, accurate labeling of medication pouches, flexible printing package sizes and bar-coding. The packager interfaces with pharmacy information systems for automatic replenishment of unit-based cabinets, patient carts or nurse servers.”

Additional information can be found here and here (PDF)

AutoPack by Talyst

“AutoPack Oral Solid Packaging System

AutoPack™ integrates easily with your pharmacy system to provide a fully automated packaging system for oral solid medications.

• Automate 100-500 oral solid medications with a single AutoPack
• Delivers unit-dose or multi-dose packages in a compact footprint
• Provides 19 lines of user-defined label space
• Processes up to 60 doses per minute, recognizing priority orders for immediate packaging
• Supports packaging other oral solid medications not stored on the AutoPack with an easy-to-use Special Tablet System tray
• Works seamlessly with AutoCarousel to expedite cart fills, order replenishment, and canister refills

Comprehensive

• When used with AutoLabel, supports barcoding virtually 100% of your medications
• More affordable than contract or outsourced options
• Scaled to support any size healthcare organization
• Barcodes can be defined to assure readability by your bedside scanning system

Easy to Use

• Pharmacy staff can readily support proven, effective barcoding methods
• Nurses appreciate labeling that is easy to read and scan
• Administrators, clinicians and patients are assured that a scan-ready bar code makes it all the way to the bedside

ATP Series Automatic Tablet Packager by TCGRx

“ATP SERIES AUTOMATIC TABLET PACKAGER

The industry’s most advanced pouch packaging solution, incorporating TCG’s exclusive SkipMed functionality. The ATP Series takes control of the automation of your entire stock of oral solids by dispensing current and new batches or fill external tray medications on the same screen simultaneously. The system permits narrow dose packaging to fit into nurse carts and cabinets as well as larger, multi-dose dispensing.”

The ATP scalable series is available in 128, 256, 320 and 384 medication canister models.”

More information is available here (PDF). In addition, the website had the nifty little video below. The ATP system by TCGRx offers some nice features that I haven’t seen before. Take a look for yourself.

ATP Series from TCGRx on Vimeo.

It’s interesting to note that the PACMED system from McKesson and the AutoPack system from Talyst are remarkably similar, while the Swisslog and TCGRx system resemble one another.

I found several other systems for bar-code unit dose packaging, but they were smaller units that wouldn’t fall into the same category as those above. An example of these smaller units would be the ever popular Cadet by Euclid. Every acute care pharmacy I’ve ever worked in has a Cadet. In fact, many facilities have both a high-volume unit-dose packager as well as a smaller unit like the Cadet secondary to need.

Feel free to leave information in the comment section below on any other high-volume automated packaging system you’re aware of. I would be happy to update the post with the information.

Update August 28, 2010
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Based on feedback received over the last week I have additional information to share regarding automated unit-dose packagers.

In the original post above I mentioned that it was interesting that PACMED from McKesson and AutoPack from Talyst were remarkably similar, while the Swisslog and TCGRx systems resembled one another. It turns out that the reason for the similarities is that both Talyst and McKesson distribute the JVM packaging system while Swisslog and TCGRx distribute the Sanyo packaging system. To go one step further it appears that the TCGRx ATP series packagers are distributed through Swisslog, and are in fact the same machine.

Two additional packagers to add to the list thanks to reader comments:

Medication Packager from Omnicell

The Omnicell® Medication Packager is a bar code system for the central pharmacy that enables pharmacists to improve dispensing accuracy, increase their productivity, and lower their overall costs.
Features

• Automated unit-dose medication packaging.
• Intelligent Order Routing option establishes picking processes based on user-defined settings.
• Automatic packaging resume capability allows replenishment of medications or packaging supply without restarting the batch.
• Supports patient-specific dispensing with labeling and contiguous medication packaging.
• Adapts to any distribution model.
• Automated Canister Recognition System (ACRS).
• Special Tray System (STS) allows preloading of infrequently used medications into a universal tray for in-line packaging with other canister medications—there is no need to stop production.
• WorkflowRx server available in physical server and virtual server platforms (VMware Ready).

AutoPharm by CrePharm

This can be a little confusing as CrePharm refers to their system as AutoPharm, which is same name used by Talyst for the medication management software used on their carousels here in the US.

The English is a little rough on the CrePharm site as it is a translation from Korean, but you can get the idea by reading through the information for yourself.

A couple of things that caught my eye about this packager was the use of “Free Shape Packaging” (FSP) and CrePharm’s “T slider system”. According to the manufacturer’s website the FSP technology allows automated packaging of “half tablet and all shapes of tablets, and medicines without cassette. When you fill FSP with all sorts of tablets such as half, specific shapes, or low frequency tablets and only put the container on a cup holder at the lower part, AutoPharm automatically completes dispensing and leftover tablets will be automatically collected.” It sounds like a concept similar to the STS system used by AutoPack from Talyst, but appears to use a different methodology. Unfortunately I couldn’t find more specific information at the CrePharm website.

The “T slider system” gives users access to a small number of canisters at one time instead of having to open large shelving units to access a single canister. It’s nothing earth shattering, but it is a neat concept.