Monday evening quarterback

What a great weekend. The Super Bowl wasn’t a blowout and turned out to be quite exciting in the end. The commercials weren’t extravagant, but were surprisingly entertaining. The one downside was the absolutely embarrassing rendition of the National Anthem sung by Christina Aguilera. For all those would be National Anthem singers out there, please don’t add to or take away from the National Anthem. When you do, you’re doing nothing more than punching this great country of ours in the face.

Anyway, here’s some other stuff I’ve found interesting over the weekend:
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Time to accept pharmacy robotics as our friend and ally

As the word “robot” passes its 90th birthday1 – introduced by Karel Capek in his play R.U.R. (Tossums’s Universal Robots) in January 1921 – it’s become obvious that robotics has not only captured the imagination of geeks everywhere, but has become a point of interest in many industries including healthcare.

Late last year ASHP began pushing the idea of a new pharmacy practice model, PPMI. The movement was a hot topic for a while, but seems to have lost a lot of steam recently – “Hence the name: movement. It moves a certain distance, then it stops, you see? A revolution gets its name by always coming back around in your face” (Tommy Lee Jones in Under Siege 1992) – Anyway, when the PPMI movement was still going strong many important people in the pharmacy world struggled with the best way to approach a new pharmacy practice model. Many believe, and rightly so, that the best way for pharmacists to reinvent themselves is to become the cornerstone of a more robust patient care model. After careful consideration I believe the best hope for developing such as model will be to rely heavily on pharmacy robotics to handle much of the repetitive dispensing duties now handled by pharmacist on a day to day bases. You know, free up the pharmacists. It’s not a new concept, but one that seems to escape us.

Obviously it will take some time to develop robotics to the point where it will be effective in such a system, and it certainly won’t be cheap, and pharmacists will have to fight with state boards of  pharmacy to accept it, and pharmacy administrators will have to work closely with their hospitals to develop such a systems, and someone’s going to have to be brave enough to step up to the plate and get stated, and so on and so forth. In other words it’s going to be hard and it won’t happen overnight.

Who’s up for a little project? For now let’s just take a quick look at some of the things that lead me to believe robotics is worth another look as a potential solution.

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It may be time to consider robotic IV preparation at the bedside

Hospitals make a lot of intravenous (IV) preparations. That makes sense when you consider that most people admitted to the hospital are there because their acute illness requires more care than can be administered at home; not always, but in most cases. This is especially true for patients in the intensive care unit, i.e. the ICU.

A fair number of the medications used in the ICU are prepared on demand for a host of reasons including stability, differences in concentration, difficulty in scheduling secondary to rate variability, etc. Any pharmacist or nurse reading this will understand what I’m talking about. Example medications that fall into this category include drips like norepinephrine, epinephrine, phenylephrine, amiodarone and nitroprusside.

Last year I mused about using devices on the nursing stations designed to package oral solids on demand at the point of care. I still like the idea for several reasons, all of which can be found in the original post.  Based on currently available technology the same concept could be applied to preparation of IV products at the bedside. Robotic IV preparation has come a long way and these devices could be used at the point of care to make a nurses, and patient’s, life a whole lot easier. The use of robotic IV preparation at the bedside could reduce wait times for nurses and lesson the workload on pharmacy.
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Cool Technology for Pharmacy

IV Automation / Robotics

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.”


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