I just rolled in the door from Palo Alto, where I spent most of the morning visiting the Stanford University Medical Center inpatient pharmacy. And why not, I didn’t have anything else to do today. I picked up the phone, connected with the Director of Pharmacy, Mike Brown and was on my way.
First and foremost, the inpatient pharmacy at Stanford is nice. It’s also quiet, which is a bit unusual for a pharmacy servicing such a large facility. Interestingly enough most of the non-IV related medication distribution is handled with the use of very little automation; there’s an interesting story to go along with that.
The pharmacy at Stanford has a large investigation drug service (IDS) area, which is responsible for handling approximately 300 active drug trials at the moment. Impressive. They use IDS management software called Vestigo integrated with Epic to manage everything. Itâ€™s pretty slick.
My reason for the visit wasn’t for the non-IV medication distribution or IDS, however. What I really wanted to see was their IV room, and the associated distribution process. I’d heard through the grapevine that they were using a product called Phocus Rx to manage their chemotherapy preparation. I wrote about Phocus Rx in March of 2012. I’ve heard a lot about the system over the past year, but had yet to see it action.
The IV room didn’t disappoint, it was great. They let me change into scrubs, gown up and spend about 90 minutes in the cleanroom watching the pharmacist and technicians run through the process. It’s been a long time since I’ve done anything like that. It felt good. There was something right about it.
As far as Phocus Rx goes, in my mind it’s basically a less feature-rich version of DoseEdge (post Feb 2010). Both systems use cameras and software to manage workflow, but that’s about where the similarities end. Phocus Rx uses a different camera setup than DoseEdge, i.e. the camera is located outside the hood versus inside the hood, respectively. The other differences include how information is sent to the IV workflow system, different approaches to barcode scanning, inclusion/exclusion of clinical decision support tools, and their inclusion/exclusion of gravimetric analysis for dose verification. Phocus Rx is “considerably less expensive” than DoseEdge, although the exact dollar figures remain a mystery. Which one is better? Impossible to say. That question is completely subjective and depends on your needs.
The visit was interesting, and eye opening. The pharmacy personnel in the cleanroom were courteous, professional, and quite knowledgeable about the system. It was impressive to watch. I also learned a lot, which I will now add to my ever expanding personal database of IV room technology.