On demand controlled substances dispensing at the point of care (NarcoMedic®)

NarcoMedic is a product from Pearson Medical Technologies. Pearson is a small company out of Alexandria, LA. They’ve made a business out of bar code labeling and packaging technologies. You’re probably most familiar with their iPackRx unit dose packager and m:Print software; either as the direct product or possibly as an OEM’d version for another company.

A colleague sent me a marketing email a few days ago from Pearson announcing NarcoMedic, a “decentralized management platform” for controlled substances. It caught my attention as I thought about something like this several years ago.

As with other automated dispensing units, NarcoMedic is designed to dispense medications at the point of care, i.e. nursing unit. With that said, what caught my attention were the following points:

  • Tabletop design – 38”H x 23”L x 32”D. Med rooms tend to be cramped. It’s nice to have the option for a small unit.
  • Packages and dispenses in individual patient-specific bar coded packages (packages on demand from storage locations)
  • Packages and dispenses tablets, vials, ampules and syringes in individual packages.

Pretty interesting. As I said, it’s not a new concept, but perhaps it’s time has come. Regardless, it’s nice to see someone out there trying something new.

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Keeping up with the Joneses, or how pharmacies choose technology

Recently a colleague sent me a link to the FierceHealthIT article below. Much of what the article had to say rang true for me.

Hospitals covet neighboring facilities’ technology: “Facilities were more likely to acquire a new surgical robot if neighboring hospitals had done so, according to a study from a group of private and government researchers published in this month’s Healthcare journal… The authors found that a hospital whose neighbor had acquired a surgical robot was more likely to also get one….According to the authors, the results suggest that tech adoption may be driven “in part by competition among neighboring hospitals rather than solely by the mission to provide optimal patient care.”

This is consistent with what I’ve witnessed in pharmacy technology over the past several years. In my experience pharmacies rarely choose the technology that’s right for them. It’s much more likely that pharmacies will make decisions based on usage patterns of other local hospitals, i.e. word of mouth. That’s why it’s so important for companies in the pharmacy technology sector to get people using their products. It’s not like the consumer market where new technology can often unseat an incumbent with a whiz-bang feature or some clever marketing. No, in pharmacy it’s likely that once a decision is made that decision will stick for many years.

It’s also important for pharmacies to ensure that they’re making a wise decision when it comes to implementing new technology. They should ask themselves two questions: 1) what do I need it to do, and 2) will it fit my workflow. Answer those two questions and you’ll know if it’s right for you.

Additional thoughts on the use of gravimetrics for I.V. compounding

Scale in PECSeveral months ago I wrote about my thoughts on using gravimetrics for I.V. compounding. At the time I wasn’t convinced of the utility, but my thoughts on the matter have changed. Over the past several months I’ve had the opportunity to dig deeper and mull over my thoughts on the matter.

There was a session at ASHP Midyear back in December titled New and Emerging Strategies for Minimizing Errors in I.V. Preparation: Focus on Safety and Workflow Efficiency. The presentation covered several topics, but one thing that caught my attention was data presented on error rates for the preparation of compounded sterile products (CSPs)1 and the benefits of using gravimetrics in the process. I was skeptical about some of the numbers that were presented. Data is only as good as how it was collected, what it’s compare against, and how it’s presented. One should always question the data, especially when it runs contrary to previously held beliefs.
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IV hood sensors [idea]

I saw a commercial for the Honeywell Wi-Fi Smart Thermostat the other day. It’s a neat little gadget that reminded me of something that I’ve been thinking about for years.

The requirements for monitoring, cleaning, and analyzing conditions in an IV clean room are enormous. To get a feel for what I’m talking about I would encourage you to take some time to read through the list of surface testing, air sampling, and end product testing required by USP <797> for pharmacies that compound sterile preparations (CSPs). It’s fairly extensive and complex.
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Things get interesting as #Aesynt acquires Health Robotics

Business Wire: “Aesyntâ„¢ announced it has completed the acquisition of Health Robotics, the leading global supplier of automated technology for intravenous (IV) medication preparation, compounding and dispensing.”

For those of you that have short memories, Aesynt is basically a spin-off of the acute care pharmacy side of McKesson. It’s a big group that specializes in things like automated carousels, inventory management software, packaging and bar-coding technology, controlled substance management hardware and software, and a robotic distribution system, i.e. “the McKesson robot”.

Health Robotics is a company that specializes in IV room automation and technology. They have two robots: i.v.STATION for non-hazardous compounding and i.vSTATION ONCO for hazardous compounding, i.e. chemotherapy. Their robots compete with both Intelligent Hospital Systems – the RIVA robot – and APOTECAchemo. They also have i.v.SOFT, a workflow management system that competes against the likes of DoseEdge by Baxter, among others.

Someone at Aesynt has been paying attention. Interest in IV room technology has been steadily growing for the past few years, basically telegraphing the demand that we’re seeing today. This definitely puts Aesynt in a unique position in the acute care pharmacy space, especially when you consider that they also offer a point of care distribution system and something for anesthesia.

The acquisition of Health Robotics by Aesynt is sure to send some ripples through the world of pharmacy automation and technology. Grab some popcorn and settle back in your chair. As interest in the IV room continues to grow, and as companies begin to fight for market share, things are surely going to get interesting. Exciting stuff.

Difficulty collecting information on pharmacy technology

I’ve been collecting information on pharmacy IV room systems for the better part of the past eight months. I’m talking about system designed to help pharmacists not only manage their IV room workflow, but also help with safety, efficiency, documentation, and so on.

These systems are becoming more and more popular these days as the powers to be, i.e. the FDA and pharmacy boards are about to get heavy handed with pharmacy IV rooms.
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Gema Kit – NFC-enabled medication compliance tracking for consumers

GemaKitThis is interesting, the use of NFC tags to track patient’s medication compliance. Makes sense when you consider the ubiquitous nature of NFC on mobile devices these days.

MedCityNews: “[Gema Kit] features stickers embedded with sensors that link to a patient reporting website. These small circles go on pills, pill bottles or blister packs. The sensor is proximity-based, so when a person’s cell phone is waved at the sticker, it brings up the reporting portal. In addition to recording when a pill was taken, a user can report symptoms, side effects and mood. The touch-to-activate patches include proprietary technology but also meet NFC Forum Type 2 Tag standards. They can be read by any NFC-enabled mobile device including cell phones, tablets or readers.”

From the website:

The Gema Kit includes:

  • Dual NFC and bar code/quick response coded “patches” of various sizes that the patient adheres to the outside of their pill bottles and packs
  • Links to a free engagement website
  • Back-end data tracking and reporting service for providers

Each patch within the kit is paper thin. Through proximity of a user’s mobile device, the patch enables an instantly to a web-based patient system that will:

  • Enable logging of NIH PROMIS guided, quality of life measures at the point of care, as well as
  • Connecting patient’s to other stakeholders that are important them and to their fight.