Jerry Fahrni

Cool pharmacy technology – SMART-IV

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Jerry Fahrni

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Not exactly pharmacy technology. However, SMART-IV involves integration of iv infusions with bar code scanning at the patient bedside. That’s kind of pharmacy related, in a sort of roundabout way.

Check the video below for a look at how the system works. The commentary is in Dutch, so if you don’t speak Dutch you might be in trouble. Regardless, you’ll get the basic idea anyway.

SMART-IV is a wireless monitoring system for iv infusions. According to the company’s site “SMART-IV collects data by reading various barcodes. Nurses scan their own badge, the patient’s armband, the hook that the infusion is attached to and the IV drip bag itself. SMART-IV then links the infusion to the patient and saves all the data in a central server. Nurses can use the application developed by Cegeka to monitor the status on a tablet or computer. The application also creates a digital site map which they can use to monitor all infusion stands. Personnel can use this site map to navigate to each patient’s details. The system also gives an automatic warning when for example an infusion is (almost) empty or blocked.”

I wonder what potential value this could bring to U.S. healthcare systems. Much of what SMART-IV can accomplish is already possible with smart pump technology, i.e. warning when an infusion is almost empty or block. The piece that’s missing with smart pumps is the ability to bar code scan during pump programming. Some hospitals have started doing this, but it’s rare.

A majority of hospitals already use smart pump technology. Nearly 75% of U.S. hospitals are using smart pumps, with another 7.4% planning to acquire them within the next three years. Only 16.6% of hospitals report that they have no plans to use smart pumps.(1)  With that in mind I’m not sure that a system like SMART-IV would provide any added benefit to healthcare systems already using smart pumps. Still, if you’re not using smart pump technology, SMART-IV might be worth a look.

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(1) Fox, B. I., C. A. Pedersen, and K. F. Gumpper. “ASHP National Survey on Informatics: Assessment of the Adoption and Use of Pharmacy Informatics in U.S. Hospitals–2013.” American Journal of Health-System Pharmacy 72, no. 8 (April 15, 2015): 636–55. doi:10.2146/ajhp140274.

Comments

One response to “Cool pharmacy technology – SMART-IV”

  1. Ray Vrabel, PharmD

    KISS vs Smart Pump

    Thanks for sharing. While this is very low-tech, it is amazing what it is capable of doing. Obviously, they wanted to “keep it simple…” and avoid all of the costs (initial and ongoing) with Smart pumps.

    Actually, you might call this system a “Smart Pole” because that is where the secret sauce of their technology lies. It appears that they have a load cell (i.e., electronic ability to detect weight and small variations in weight). In some regards, this is “gravimetrics at the bedside”. After that, the software appears to manage what is going on with a given patient’s IV drip.

    Features:

    (1) Barcode verification at the bedside of the right bag for the right patient, and documentation of nurse performing task.

    (2) Ability to track the rate of flow of the IV into the patient and the amount of fluid remaining to be administered using the load cell weighing technology associated with the IV pole hook. This explains why they scan the “pole” during the bedside verification system.

    (3) Assuming that the system has all of the pertinent information about the IV order (including volume and desired rate), this system is capable of remotely alerting the nurse when the bag is either running too fast, too slow, or not at all (e.g., if the IV line is occluded). It should also be able to warn the nurse prior to when the bag needs to be replaced.

    While I’m not sure this would meet the needs of an ICU patient, it is very capable of meeting the needs of the general med/surg patient population.

    From a maintenance standpoint, this is way more simple than a smart pump: No libraries to maintain, no firmware to update, no programming. All you might need someone to go around and calibrate the load cells occasionally.

    Smart technology often means “high tech” (i.e., our current smart pumps). This is a case where smart technology means low tech”. Many times less is better. This may be an example…

    Ray

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