I previously wrote about a live webinar put on by ASHP – Improving Safety and Efficiency in the IV Room: Key Features of Automated Workflow Systems – on Wednesday, May 20 2015. The webinar was made up of three separate, 20 minute presentations:
- Medication Error Reduction Strategy Using Dispense Preparation and Dispense Check by Tom Lausten, RPh, Director of Pharmacy at Children’s Hospital of Wisconsin.
- IV Workflow Systems: Barcode Plus Volumetric Verification by Steve Speth, RPh, Pharmacy Operations Manager at IU Bloomington.
- Automated i.v. Workflow Systems and Technologies by Caryn Bellisle, RPh, Director of Pharmacy Regulatory Compliance at Brigham and Women’s Hospital.
The presentation from Tom Lausten, RPh focused on the Dispense Preparation and Dispense Check functionality in Epic. I’ve heard quite a bit recently about the “new” functionality. I’ve had an opportunity to get a look at it firsthand. First, it’s important to understand that the Dispense Preparation and Dispense Check functions in Epic are quite rudimentary. They are what I would consider an absolute bare minimum in terms of i.v. workflow management and safety. The system is limited to bar code verification of compounding components only. It doesn’t offer image-assisted volumetric analysis, i.e. photo capability, or gravimetric measurement. You’re literally getting one half of the functionality necessary to ensure accurate compounding. Epic helps ensure that you have the correct ingredients, but fails to provide users with a method to verify ingredient amount. Hey, you can put gas in your car only, but eventually you’ll get burned if you never check the oil.
I’ve heard many argue that it’s better than nothing. I agree with that in principle, but fail to see why facilities can’t take the extra step to ensure that their patients are getting not only the right medication, but the right amounts as well. I’ve heard many reasons for failing to implement more advanced technology. Most try to rationalize their failure by citing lack of budget, but that may be the weakest of all the arguments.(1)
The presentation from Steve Speth, RPh focused on the use of DoseEdge. DoseEdge is currently the market leader in this space, and has become synonymous with semi-automated i.v. workflow management systems; think “Kleenex” and “Xerox”. The system is battle tested, but far from perfect. Steve did a reasonable job of presenting the basics of the system, as well as making a compelling case for the need for systems like these.
Caryn Bellisle, RPh Brigham and Women’s Hospital presented on their use of i.v.SOFT. from Aesynt, previously Health Robotics. I’ve been to Brigham and Women’s to see their i.v. room up close and personal. i.v.SOFT is an interesting system. It’s one of only a handful of systems that offers both image-assisted volumetric analysis as well as a scale for gravimetrics. With that said, i.v.SOFT makes up only a fraction of the market for i.v. room technologies.
Overall I think the webinar was worthwhile. It’s the first time I’ve seen several different technologies presented in a single webinar, i.e. bar code scanning only, image-assisted verification, and gravimetrics. I wish the presenters would have gone into more detail, but I understand that they had limited time.
I would encourage ASHP to continue to provide this type of education in the future as i.v. room technology will only continue to grow in importance in the coming months. Hopefully they will expand on the topic to include all relevant semi-automated i.v. workflow management systems as well as robotics. There’s plenty to explore.
- I may write more on this later. Think of pharmacy drug and labor budgets – tens of millions of dollars – along with the cost of implementing an EHR like Epic – $100 million plus in some cases – then think of the cost of an i.v. workflow management systems – less than $100K in most cases. Things that make you go hmmm.