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.
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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.
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This week’s Cool Technology for Pharmacy is the OnDemand 400 for RxMap from MTS, a company that specializes in adherence packaging systems.
According to the MTS website:
OnDemand ® 400 for RxMap ® is the first pharmacy automation equipment system designed specifically for multi-med adherence packaging.
This efficient system uses OnDemand technology to dispense multiple medications for
a single patient quickly and accurately and in a fraction of the time it would take to do it manually. This pharmacy automation equipment system utilizes a custom interface to work with your existing information systems, enabling automated workflow management in the pharmacy. This single data input process reduces input time and the possibility of data entry errors. OnDemand ® 400 for RxMap ® uses bar-code technology to accurately dispense multiple medications into one compartment – as many or as few as needed. RxMap ® Adherence Packs vary in size and shape to meet the needs of the customers you serve. The finished product is a patient – specific adherence package filled “just-in-time” for your customer.
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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.
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Tonight’s ASHP activity consisted of attending the Talyst User Group. It was a pretty big turnout, probably three times the size of the one I attended in Chicago in June.
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I read an interesting article today in the November 1, 2009 issue of the American Journal of Health-System Pharmacy (AJHP). In the article the authors report the results of survey sent to 200 hospitals in the US developed to assess the use of various informatics resources by pharmacy departments. The survey consisted of two-sections with a total of 20 questions. Only hospitals with at least 100 beds were included, and of the 200 surveys mailed only 114 were returned More information on the specifics of the survey can be found at the AJHP website here.
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The MedBoard Medication Tracking System (MTS) from Baxa is a web-based medication system designed to help you track the flow of medications from entry in the pharmacy system to delivery on the nursing unit. The MTS can be integrated into you pharmacy workflow as part of your existing bar coding system.
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The InstyMeds Prescription Medication Dispenser is a fully automated prescription dispensing machine. It is designed to be used in high traffic areas where quick medication turnaround is desired and a physical pharmacy is unavailable, such as emergency departments (ED) and acute care clinics.
The dispenser has just over 100 medication slots that can each hold a medication magazine with up to 11 prepackaged medication bottles. The formulary for the InstyMeds machine is site specific and designed by the InstyMeds Corporation. Items in the example formulary that I viewed included amoxicillin capsules, amoxicillin suspension, Auralgan otic drops, Z-Pak, Augmentin, acetaminophen tablets and elixir, ibuprofen, Vicodin, Darvocet, etc. All the items you would expect from a short visit to the ED or for little Joey with an ear infection at the urgent care. The formulary in the InstyMeds machine can be altered based on seasonal trends and inventory replacement is automatically shipped to the location when needed based on real time inventory tracking. In addition, consumables such as printer paper are also automatically tracked by the InstyMeds Corporation via an internal web cam.
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I found an interesting article in the October issue of the American Journal of Health-System Pharmacy. The article, titled Informatics in clinical instruction (Am J Health Syst Pharm. 2009 Oct 1;66(19):1694, 1699), gives a description of a software system designed by the authors that “allows students at one site to receive online and teleconference instruction from preceptors at multiple sites through remote, interactive discussion. It also allows “blogging” based on assigned videotapes, simulation modules, live patient cases, discussion questions, and primary literature review. In addition, the system facilitates clinical encounter documentation, including interviewing patients, taking physical assessments (e.g., blood pressure), taking medication histories, assessing for adverse effects (e.g., abnormal involuntary movements), and addressing potential or actual medication-related problems(MRPs).”
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The September issue of the American Journal of Health-System Pharmacy contains a vision statement written by the ASHP Section of Pharmacy Informatics and Technology. The statement represents their thoughts on the current state of pharmacy practice and contains a healthy dose of ideas on how technology can help support and improve pharmacy practice.
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