In a previous post I mused about using an automated packaging system like InSite from Talyst as a type of automated dispensing cabinet for acute care patients. InSite was designed for long-term care and would simply be too large for the needs of an acute care nursing unit, but the technology is ideal.
However, the ATP-71 (PDF) from Swisslog is a bulk packager that can hold up to 71 canisters in a relatively small footprint: 31.5 inches wide x 29.6 inches deep x 30.6 inches high. For comparison, a Pyxis MedStation 4000 2-drawer main unit is 22.8 inches wide x 26.7 inches deep x 27.7 inches high. I would say that makes the two units comparable in terms of size, and I can tell you from personal experience that a 2-drawer main isn’t very big up close. Read more…
Talyst has been beta-testing a new customer portal for several months now. The idea was introduced to Talyst customers at their user group meeting during the ASHP Summer Meeting in Chicago last June. Beta-testing took place between the summer meeting and December 2009 when Talyst unveiled the portal to a larger user group meeting in Las Vegas at the ASHP Midyear. Attendees were given a demonstration of the portal and offered an opportunity to provide feedback on possible issues or features they’d like to see. Well, it appears that the portal is out of the beta phase and ready for use.
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 DoseEdge Pharmacy Workflow Manager, formerly IntelliFlowRx Workload Management Software by Baxa, is a system designed to track and manage intravenous (IV) medication dosages prepared by pharmacy personnel in a clean room environment. The system is touted as “The world’s first and only fully integrated workflow manager for the IV room.”
The system is designed to flow something like this:
- IV medication orders entered by the pharmacist, or other healthcare professional, are sent to the DoseEdge system where they appear on the DoseEdge touchscreen.
- When the technician, or pharmacist in some cases, accesses the order via the touchscreen instructions for preparation of the product are displayed.
- The product label is generated.
- The barcode on each injectable ingredient used for the preparation of the IV product is scanned to ensure the correct medications have been selected. Items identified as incorrect result in an audible message of “product not allowed for this dose.”
- The barcode on the IV product label generated by the pharmacy is scanned to ensure that ingredients are appropriately matched.
- Each ingredient is drawn into a syringe.
- An image of the syringe with appropriately drawn medication is taken for review by the pharmacist, or technician, whichever the case may be. This is a nice feature as it allows one to see the actual amount of drug drawn into the syringe prior to shooting it into the fluid bag.
- Ingredients are injected into the fluid bag and an image of the final product is taken.
- A final scan of the product barcode is done to complete the fill.
A friend from Talyst stopped by the pharmacy and spent the greater part of Monday afternoon and Tuesday morning taking a look at what it means to work in an acute care hospital pharmacy. We have several pieces of Talyst automation and technology in our pharmacy and he was interested in how we used it and how it fit into the general scheme of things. As we roamed the pharmacy, I began describing our Pyxis system, how we handle our replenishment, how we put our order away, how we package bulk medications, how we barcode syringes, how we handle an IV batch, how we handle infusions for our smart pumps, and so on and so forth ad infinitum. It was a good exercise for me as it often improves my understanding of something when I try to explain it to someone else. Read more…
PROmanager-Rx is an automated system from McKesson designed for dispensing unit-dosed oral solids. PROmanager-Rx has a 12,000-dose capacity and uses a conveyor system and bar-code scanner to fill orders generated through the pharmacy information system.
The system automates storage, dispensing, restocking, and various inventory management functions via the McKesson Connect-Rx software platform. And of course the system interfaces with McKesson’s pharmaceutical distribution system.
According to the McKesson product brochure:
The PROmanager-Rx™ system helps hospital pharmacies get the most out of manufacturer packaged oral solid medications. And relieves the burden of medication packaging.
It’s the only fully automated system that directly stores and dispenses pre-packaged oral solids. PROmanager-Rx is ideal for patient-centric filling. Bar-code-driven robotics scan every dose for the greatest possible safety and accuracy.
Pharmacists are freed from packaging and dispensing activities so they can play more integral roles on the clinical care team. Bar-code scanning also simplifies tasks such as managing returns, expired meds, and overall inventory.
Hospital Pharmacy: “During the process of with drawing a patient’s nicotine patch from an automated dispensing cabinet (ADC), a carousel pocket opened to reveal 2 nicotine patches and 1 fentaNYL 50 mcg/hr patch. The nurse using the ADC immediately called the pharmacy to report the discrepancy. The pharmacy investigated and found that it was not a dispensing error. Both patches (nicotine and fentaNYL) were stored in the same medication carousel, and the fentaNYL patch slipped over the top of one pocket and into another pocket that contained nicotine patches. Generally, the hospital reserved ADC carousel pockets for controlled substances, but there was a history of pilferage of the nicotine patches when stored in matrix drawers. To deter pilferage, the pharmacy began stocking them in secure carousel pockets with the tracking feature on to count the product. FentaNYL was in a nearby pocket by itself, but when the carousel turned, patches sticking up from the fentaNYL pocket were caught and dragged to another pocket that housed nicotine patches.” - This type of occurrence is more common than you might think. To prevent this type of thing from happening, many hospitals will utilize a system similar to the Pyxis CUBIE system. Pyxis CUBIE pockets are small containers with a clear plastic lid. The lid remains closed until that medication is accessed via the Pyxis medication terminal. This prevents items from jumping to another location.
Engadget.com: “Panasonic isn’t the first company to turn to robots as a means for dispensing drugs, but it looks like it’s set to become one of the bigger players in the still fledgling field, with it announcing today that it’s developing a robot that it hopes will rake it about 30 billion yen (or $315 million) by 2016. Unfortunately, Panasonic isn’t quite ready to actually show off the robot just yet, but it says it could be making the rounds at some Japanese hospitals by next March, and head into the United States and Europe sometime after that. It’s also not ready to do much talking about specifics, with it only going so far as to say that it “does not look humanoid” but rather looks like “a cabinet with lots of small drawers”, and that it’ll be able to store medical data for each patient and sort out prescriptions for up to 400 patients in about two hours. That cabinet won’t come cheap though, with Panasonic estimating that it’ll cost “several tens of millions of yen,” or hundreds of thousands of dollars.” - When I was a pharmacy student at UCSF there was an automated drug dispensing robot roaming the halls. The robot was affectionately called Elvis. It was pretty cool to see him roll out of the elevator and down the hall to the nursing station, but he was nothing like ASIMO.
I had reason to do some thinking about healthcare automation over the weekend, and after much thought decided that healthcare, specifically pharmacy, was a little strange in several ways. As an industry, healthcare rarely looks beyond patient safety when talking about technology and automation. Let’s face it, patient safety is the rally cry for any department in need of a jumpstart to complete a project that has stalled for one reason or another. Unfortunately the investment of time, energy and capital resources typically stops immediately after implementation secondary to meeting the patient safety goal. However, this model seldom allows for technology and automation to be taken to the next logical step. Read more…
Prior to the days of a clean room, most pharmacies had a designated area with one or move laminar flow hoods where they compounded intravenous (IV) medications. For lack of a better term this area was cleverly called the “IV Room”. The laminar flow hoods created a sterile work environment from which the pharmacy technicians could work. It was not uncommon for anyone making an IV preparation to simply leave the “IV Room” and wonder around the pharmacy looking for supplies when they ran short. Read more…
In a previous post I mused about using an automated packaging system like InSite from Talyst as a type of automated dispensing cabinet for acute care patients. InSite was designed for long-term care and would simply be too large for the needs of an acute care nursing unit, but the technology is ideal.
A friend from 
