What are you looking for in a “workflow management system” for the IV room?

A recent “I’ve been thinking…” by Mark Neuenschwander got me thinking; no pun intended. Mark and I have been working on a barcode medication preparation (BCMP) project for the last couple of months. My interest in pharmacy automation and technology coupled with his passion for barcoding in healthcare and patient safety have created a good working relationship. We’re currently looking at the state of BCMP as it relates to compounding in the IV room.

Everyone knows about the key players in this area, but the number of workflow management systems for the IV room in acute care pharmacies is growing. I’m currently tracking nine systems that could be included in this category, and the variation among them is significant. While all of them apply the same general concepts, each appears to be approaching the process from slightly different angles with emphasis on different areas.

Which brings me to the title of this post: What are you looking for in a “workflow management system” for the IV room? I’ve been asking this question of every pharmacist I’ve talked with recently, and it might surprise you to know that most have no idea what they want. Worse yet, very few even know what systems are on the market today much less what each is capable of.

Systems range from very basic to extremely complex, which of course equates to systems costing very little to those that are much more expensive. One would think that a healthcare system looking to purchase one of these systems would be diligent in their evaluations and find the system that matches their required functionality to their budget. Not so in most cases I’ve seen.

Here’s a prime example. I recently spoke with an IT pharmacist at a large acute care hospital that was investing in DoseEdge to meet their needs in the IV room. DoseEdge has clearly taken a huge chunk of the market in this category by offering tremendous functionality. It’s a great system, but it will cost you. DoseEdge is easily the most expensive of the systems I’ve evaluated to date. Back to the IT pharmacist. During our conversation I asked him the three questions below, along with his paraphrased answers.

1.  What other systems did you evaluate? – None. He thinks they read about “one other system”, but he couldn’t be sure of the name or the functionality.
2. What do you want out of DoseEdge? – Doesn’t know, or more accurately “not sure”. His answer shocked me. They selected a product without fully understanding what it was they were looking for.
3. Given the fact that DoseEdge has a higher cost than most other systems, what was it that made you choose it? – “Lot number and expiration date tracking.” That’s right boys and girls, they bought the most advanced IV room workflow management system on the market so they could enter, and track the lot number and expiration dates of medications used in the compounding process. They could have done this with at least two other products that I can think of for less than one-fifth the cost. Actually, they could have done this with a spreadsheet and a Samsung NX300 Camera connected to Dropbox. Total cost on that is about $600 for the camera and $500 a year for 500GB of Dropbox storage. Interesting.

It’s clear that activity around safety in the IV room is heating up. It’s been clear for several years that this was coming, but most (a majority?) of facilities simply aren’t prepared for it. Given that hospitals go into budgetary shock when they have to spend money on pharmacy automation and technology, one would think that these healthcare systems would do a better job evaluating the technology they need and finding the most cost effective option. Or at least taking full advantage of the system’s features and functions after purchasing.

It’ll be interesting to see how this area of pharmacy shapes up over the next couple of years. I’m betting that things will shift dramatically.

Pop quiz: Can anyone name five pharmacy IV room workflow management systems? I’ll give you DoseEdge since I mentioned it about. Now you only have to come up with four more. Put your answers in the comment section.