Cool Technology for Pharmacy

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.

While not as advanced as a system like Robotic IV Automatoin (RIVA) DoseEdge offers some nice features. When followed as designed, the chances of making a mistake are limited by the barcode scanning and the photo image of the medications drawn to the appropriate dose. A syringe drawn to the inappropriate dose could easily get rejected during review of the image taken during compounding.

An additional benefit of a system like this would be the possibility to perform remote checking, via tele-pharmacy, for hospitals with limited pharmacy presence such as critical access hospitals. In addition a system such as this could potentially be used when pharmacists are unable to reach a location for unforeseen circumstances such as inclement weather or natural disaster.

Overall I like the idea behind the process and look forward to seeing the system in person sometime.

The DoseEdge website offers an interesting video of system and information on a DoseEdge road show and webinar can be found here.

Update:

The following is a comment regarding DoseEdge left at RxInformatics where this blog was cross posted:

There’s more…

Submitted by DATdoc on Fri, 02/12/2010 – 05:26.

I must first disclose that I work for the company that makes Dose Edge and am credited with being its inventor. The following is offered solely to round out the description of the product (in no particular order):

1) Transactions within the system are logged in detail making it practical to assess performance metrics on an ongoing basis, as well as to log actual fluctuations in work flow.

2) The software offers a feature called “scan events” that allow a site to create markers for events of interest in the life cycle of a dose and then track the progress of doses through those events using bar code scanning. While the value here is most obvious for the tracking of delivery of doses to patient care areas, consider other applications such as tracking returns, or creating destruction manifests (required in some states for hazardous materials).

3) Since bar code scanning is required to verify the ingredients in each dose, the NDC code of the actual drug used for each dose is recorded and available for reporting and billing.

4) The software automatically performs volume calculations based on the product scanned in by the user.

5) If the volume needed is below a site-defined threshold, and a more dilute product is available, the software prompts the user to use the more dilute product.

6) The software supports a function called “kitting” that permits a pharmacy that keeps everything outside of the clean room to assemble everything needed for a group of doses (including all the labels) into a kit (with bar code scanning of the component drug containers) that can then be passed into the clean room (or into a barrier isolator).

7) The product is offered on an SaaS model at a per-dose price; the data are ultimately kept at a hosting site that is SAS70 compliant, but are stored locally on a database cache as well to ensure continued operation even if internet connectivity is lost or bandwidth drops.

8) The procedures associated with preparation of specific drug products as well as the dose preparation procedures can be customized per drug.

9) Pharmacist checking is performed on-line using the pictures taken during preparation.

10) Doses reach the system through a print capture process that is field configurable.

11) Data are stored perpetually; pictures and original label capture images are purged after 90 days, but additional retention can be arranged at an additional per-dose price.

12) The formulary comes with information not ordinarily found in a commercial database, including the amount of diluent required for reconstitution (where applicable) and the concentration of the product, the permitted diluents, and a table of known stabilities at various concentrations, various storage conditions, and in various diluents.

13) There is a formulary update process that permits a user to download changes, select the changes to implement in their system, and then implement them at their leisure.