Thinking about a better Automated Dispensing Unit (ADU)

Automated Dispensing Units (ADUs), also referred to as Automated Dispensing Cabinets (ADCs), are nothing new to hospital pharmacy. Over 80% of hospital pharmacies use ADUs. The most common is a product from Cardinal called Pyxis MedStation. Others include Omnicell SinglePointe, McKessen AutoDose-Rx and medDISPENSE (part of Emerson Electric Co.). Currently Pyxis is the clear front runner, and for good reason. They offer a great product.
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Barcode symbologies….what’s in your pharmacy.

I had a brief exchange with a colleague a few days back and the subject of where manufacturers were headed with barcoding came up. It’s an interesting discussion. As mentioned in a previous post the number of available barcode ready, unit-dosed medications has been slowly shrinking. As manufacturers work with government agencies and pharmacy organizations to come up with a standardized barcode format, it appears that they have put their unit-dosed, barcode ready medications on the back burner.

Manufacturers have a lot of barcode options to choose from, which may be contributing to the difficulty in developing a standard. However, it is important for the pharmaceutical industry to realize that the need for a barcode standard is ultimately driven by a goal for patient safety.
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Even the best things can be improved.

I had the opportunity to speak with a nice young lady from Talyst this morning about extending our barcoding system to our pharmacy satellites. She had great insight into what we wanted to do and offered some very helpful tips. The conversation took an interesting turn when she asked me how I liked the system and where I thought improvements could be made. After the initial shock of a vendor asking me my opinion, we spent a few minutes discussing the system and how our workflow has changed for the better.

Overall, we have been very pleased with our barcoding system. I wish all platforms ran as smoothly as our Talyst products. However, there is always room for improvement. I understand that Talyst is currently working on a “big” new release of their AutoPharm software that is focused on patient safety. I don’t have specifics, but it is possible that some of the items listed here are already in the works.
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Local anesthetic allergies.

This has nothing to do with pharmacy technology, but I thought it would be worth posting. Questions about cross reactivity of one local anesthetic to another don’t come along often, but when they do it’s never easy to formulate a quick answer. Lucky for me I’m an electronic pack-rat and saved a small drug information consult I did a few years ago regarding the issue. Remember, this is for entertainment purposes only. ;-)
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Tablet recognition for safe dispensing…why not?

I recently spied a Twitter post regarding a “pill geometry” database. The idea of a database that houses the geometry of prescription tablets piqued my interest and sent my brain into overdrive. I don’t think that was the intention of the Twitter post, but it jump started by brain nonetheless.
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Safest and most efficient distribution model

Cardinalhealth.com: “The findings of this analysis demonstrated that in a decentralized medication distribution model, as the percentage of medications in an automated dispensing cabinet (ADC) is increased, there is a direct correlation with:

  1. Decreased time to initial dose
  2. Decreased missing doses
  3. Decreased pharmacist and pharmacy technician labor
  4. Decreased non value added nursing activities
  5. Increased predictability

This is no surprise as many leaders in the pharmacy world have been trying to move to a decentralized distribution model for years. The biggest roadblock thus far has been cost and lack of automation. As automation improves and becomes more available and less costly, the decentralized scenario becomes more and more likely.

Pharmacists aren’t completely worthless after all.

An article in the most recent issue of Archives of Internal Medicine reports the results of adding a pharmacist to a health care team to offer up expertise on appropriate use of medication in heart failure and hypertension.

The results showed a 35% reduction in adverse drug events, a 48% reduction in preventable adverse drug events and a 37% reduction in medication errors. They did not analyze the economic impact. However, medication errors occur in at least 1.5 million people annually and add somewhere in the neighborhood of $3.5 billion a year to the cost of healthcare.

Now, about that raise….

Digital Medicine Article in Business Week

A Business Week article this week took a look at the current state of electronic medical records (EMRs) and technology in healthcare. The author managed to deliver a mixed message without clearly differentiating between electronic medical records and patient safety issues. The article clearly focuses on the negative.
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Adverse Drug Event Occurences

I’ve been working with a group here on a Failure Mode and Effects Analysis (FMEA)  for our bar coding medication administration project (called MAK –Medication Administration checKing by our vendor, Siemens Medical ). The benefit to implementing such as system is to significantly reduce the number of errors that occur during medication administration in hospitals each year.

While researching the project I have come across several interesting facts. I would like to share them with you here.
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