Jerry Fahrni

Tag: Carousel

  • Is BD Pyxis Logistics inventory management any good?

    Full disclosure, anyone reading this should take it with a grain of salt. I used to work for Talyst as a product manager for their acute care product line, and I’ve recently been involved with a Pyxis Logistics implementation. With that said, forward.

    In short, yes, BD Pyxis Logistics (“Logistics) is quite good. BD is doing something that pharmacy has needed for a long time, embracing the concept of “the enterprise” with integration across multiple areas in and out of the pharmacy. BD, as a company, has been busy over the past few years piecing together products to create a cohesive strategy. Someone has been paying attention.

    Are they there yet? Not yet, but they are on their way. To paraphrase my brother, they’re currently the worst they’re ever going to be, i.e. their products and strategy are only going to get better and mature over time.

    You’ve heard me talk about the four areas of pharmacy many times: standard storage, refrigerated storage, controlled substance storage, and the iv room.

    Basic storage are those basic shelving units that most people think of when they walk into a pharmacy. It’s where you’ll find unit-dose and bulk room-temperature items. Logistics is squarely focused on this area of the pharmacy. It works well and, at least in my opinion, does a good job of addressing inventory across multiple pharmacies. Throw in that Logistics is web-based, and it’s compelling.

    Refrigerated storage is, well, where you put things when you want to keep them cold. Same as basic storage, only refrigerated. BD doesn’t offer anything specific for this area, but Logistics handles refrigerated items just fine. It basically treats refrigerators the same way it treats static shelving and carousels. It’s just another storage area.

    Cleanroom/IV Room is where you’ll find all the supplies for compounding sterile medications. The IV room has been getting a lot of attention lately, but that has nothing to do with inventory management. Most pharmacies treat the IV room as a black hole for inventory, i.e. they lose visibility of their inventory when it crosses the threshold into the land of sterility., BD has had a product called Cato for many years. It’s now called BD Pyxis IV Prep and I’ve always been a fan. Pyxis IV isn’t fully integrated with Logistics, but they’re working on it.

    Controlled substance storage is where you’ll find all your opioids, benzodiazepines, and so on. Anything the DEA, Board of Pharmacy, and any other regulatory agency considers a diversion risk. I have a love-hate relationship with controlled substance management. This area is long overdue for improvement. With that said, I’m happy to report that BD is making inroads. The latest version of their CII safe software is integrated with Logistics, meaning no more disparate systems for controlled and non-controlled meds.

    What I like about Pyxis Logistics

    • Multiple pieces of the pharmacy puzzle. When looking at the BD Pyxis lineup, the four areas of pharmacy are closer than ever.
    • Integration that is getting better and better all the time. BD not only has the pharmacy covered — Logistics, CII Safe, IV prep — but think about their dominance in the automated dispensing unit (ADU) market. Integration is hard, but getting ADUs and pharmacy inventory seamlessly talking to one another is something I’ve been pining after for a long time.  
    • Handhelds. BD offers a handheld for Logistics. I haven’t had one in my hands but the device and functionality look good, shortening the inventory gaps even more. Talyst had a handheld device for AutoPharm years ago. Wonder what became of it?
    • Good folks to work with. I have nothing but good things to say about the people from BD that I’ve worked with. They want to do a good job.
    • Improvements are rapid and obvious. That’s the thing about most companies, they want to improve their products and keep customers happy. Improved products and happy customers equal increased adoption, which in turn leads to more sales, which leads to more money, and so on down the rabbit hole.

    What I don’t like about Pyxis Logistics

    • Reports and analytics appear weak. The system offers many canned reports and access to the company’s Knowledge Portal, but overall, it feels like they’re behind in this area. From what I’ve seen, it’s just not there. When compared to something like the analytics software from Swisslog — still don’t know the name of the product…. Pharmacy Analytics? I mentioned it here — it feels miles behind. What’s worse is that what I saw at ASHP Midyear back in December doesn’t make me feel any better about it.
    • Piecemeal products. It’s obvious what BD is doing. However, buying products and folding them into your portfolio can make things feel like they’re bolted on instead of feeling like they’re an integral part. It’s only going to get better, but one has to be willing to ride through the rough patches to get to the smooth road.
    • Lack of product maturity. “Pyxis”, the ADUs, is a very mature product that’s used in thousands of facilities. Logistics and IV Prep, not so much, and it feels like it.

    Overall, it seems as though BD is heading in the right direction. It will be interesting to see where the company ultimately goes with their strategy.

  • #ASHP Midyear 2014 game plan

    ASHP Midyear is next week in Anaheim, California. I arrive in Anaheim on Sunday afternoon, and will be there until Wednesday morning. I always look forward to Midyear as it gives me an opportunity to connect with friends I haven’t seen in a while and learn some new things.

    One of the great benefits that Midyear offers me is an opportunity to look at large amounts of pharmacy automation and technology in one place at the same time. Midyear is the only place where you will find so many vendors in one space. The exhibit hall is typically full, and it’s where I spend a lot of my time.

    While I enjoy visiting with all the exhibitors, limited exhibit hall hours means that I have to prioritize where I spend my time.

    My must-see list this year includes:
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  • Cool Pharmacy Technology – WillCall Rx from SencorpWhite

    I had an interesting call with an account executive from SencorpWhite last week. He and I talked about several things, but one thing I found particularly interesting is something the company is doing in the outpatient pharmacy space with horizontal carousels. Carousels are neat technology for those that have a need for automated storage space, i.e. you’re “space challenged” in your pharmacy. When coupled with bar-code scanning technology carousels are a good way to manage all kinds of inventory in a pharmacy.

    The system from SencorpWhite is referred to as WillCall Rx and consists of several components designed to store and retrieve prescription items that have been filled and are ready for patient pickup. I’m familiar with the WillCall Rx system and have had the pleasure of seeing it up close and personal in two large outpatient pharmacies attached to large medical centers. It’s a neat concept.
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  • Carousel technology article in AJHP

    AJHP: “Implementation and evaluation of carousel dispensing technology in a university medical center pharmacy (Am J Health Syst Pharm 2010 67: 821-829)

    Results. The estimated labor savings comparing the preimplementation and postimplementation time studies for automated dispensing cabinet (ADC) refills, first-dose requests, supplemental cart fill, and medication procurement totaled 2.6 full-time equivalents (FTEs). After departmental reorganization, a net reduction of 2.0 technician FTEs was achieved. The average turnaround time for stat medication requests using CDT was 7.19 minutes, and the percentage of doses filled in less than 20 minutes was 95.1%. After implementing CDT, the average accuracy rate for all dispense requests increased from 99.02% to 99.48%. The inventory carrying cost was reduced by $25,059.

    Conclusion. CDT improved the overall efficiency and accuracy of medication dispensing in a university medical center pharmacy. Workflow efficiencies achieved in ADC refill, first-dose dispensing, supplemental cart fill, and the medication procurement process allowed the department to reduce the amount of technician labor required to support the medication distribution process, as well as reallocate technician labor to other areas in need. ”

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  • Cool Technology for Pharmacy

    ROBOT-Rx® from McKesson is a robotic pharmacy system that automates many of the day to day operations that a technician may perform in a hospital pharmacy, such as medication storage, selection, return, restock, and crediting.

    From the manufacturer’s site:

    Every year, more than a half billion medications are dispensed error-free by ROBOT-Rx systems installed in hospitals mckesson_robotthroughout North America. Patient-specific medications are dispensed into cassettes or envelopes, facilitating cart fill, first dose, stat and now deliveries. The ROBOT-Rx also supports cabinet restocking and medication deliveries to multiple hospital sites.

    The ROBOT-Rx system provides a real-time, enterprise-wide picture of medications stored, dispensed, credited and administered through the system. The robot continuously tracks all online and offline inventory, checks itself for expired and slow-moving medications and generates restocking reports.Every year, more than a half billion medications are dispensed error-free by ROBOT-Rx systems installed in hospitals throughout North America. Patient-specific medications are dispensed into cassettes or envelopes, facilitating cart fill, first dose, stat and now deliveries. The ROBOT-Rx also supports cabinet restocking and medication deliveries to multiple hospital sites.

    The ROBOT-Rx system provides a real-time, enterprise-wide picture of medications stored, dispensed, credited and administered through the system. The robot continuously tracks all online and offline inventory, checks itself for expired and slow-moving medications and generates restocking reports.

    I’ve recently been moonlighting at a hospital that uses the McKesson Robot-Rx system. It gets a “10” for coolness, but I haven’t been impressed with its performance. Because the robotic system utilizes barcoded medications designed for storage on peg racks, many medications require additional packaging (over-wrapping) prior to stocking (see images below). The over-wrapping requires a lot of extra technician time and labor, as well as pharmacist time to check. The system is certainly an advance in automation, but I prefer the carousel technology I use at my full-time gig.

    Robot-Rx overwrapping - Front (left) and Back (right)
    Robot-Rx over-wrapping – Front (left) and Back (right)

  • Taking advantage of your carousel space.

    gapinshelvesI have posted many times on our system for barcoding medications in the pharmacy. The posts have included reference to our efforts to increase storage space.  Our goals have always been to store as many medications as possible within the carousel to take advantage of the software’s many safety features and inventory functionality. 

    Like all pharmacy departments we have several medication items that do not require significant storage space. I am talking about items like ophthalmic drops, otic preparations, small ointments and creams and some injectable items that are stocked in small quantities secondary to expense and lack of use. 

    Small bins for storing opthalmic preparations.

    During installation of our carousels we noticed small gaps in the shelving units. We approached one of the White Systems engineers on site and inquired about the small gaps. I don’t recall exactly why they were there, but the small size made the space virtually useless. Fortunately for us, the Talyst consultant that was on site to help us with the installation process sat down with us to come up with a solution. It was a simple idea really, but quite ingenious.  We purchased small bins that fit perfectly into the empty spaces. The size of the bin limited their utility for storage, but worked nicely for the smaller items mentioned above. The addition of the smaller bins created several empty spaces in the larger bins, giving us significantly more storage. 

     

     

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