Jerry Fahrni

Tag: IV ROOM

  • Interesting developments in robotic IV preparation overseas

    One of the unexpected benefits of writing In the Clean Room has been the interest that it has generated outside the U.S. Mark and I have had some interesting conversations with people from all over the world as a result.

    One of our colleagues from Germany shared these interesting new developments from overseas. All three of the “robots” listed below are designed for compounding hazardous drugs, i.e. chemotherapy. The number of different approaches and concepts used for robotic sterile preparation is amazing.

    PharmaHelp from Fresenius Kabi
    Basically a hood with built-in automated compounded technology. The concept appears to be focused on batch preparation driven by workflow management software. The process is aided by RFID and gravimetric technology.* PharmHelp reminds me of a combination of the EXACTAMIX Compounder and INTELLIFILL I.V. There is a video at the site, but I couldn’t find a way to embed it here.

    KIRO Oncology from KIRO (Mondragon)
    Two things of interest with KIRO Oncology: 1) Dual-armed approach. The use of two robotic arms makes sense as one of the current limitations to the compounding robots I’ve seen in the U.S. is the use of a single arm. The use of a single arm creates a rate-limiting step, 2) It is “self-cleaning”. Check the video below, “self-cleaning” starts at about 1:35.

    MOTOMAN from YASKAWA (Japan)
    A MOTOMAN dual arm robot from YASKAWA. Again, dual-arm approach. I’d like to see more video on this guy as the video below isn’t very good. When I do a web search for MOTOMAN I find mostly industrial use robots. Not sure how far they are with using their technology in the IV room.

     

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    *It’s important to note that not all countries utilize bar code scanning technology like we do in the U.S. The FDA did us a big favor when they required drug manufacturers to place bar codes on medications. Not so in other countries. Many drug products in other countries do not contain bar codes.

  • Bar-Coded Medication Preparation for Chemotherapy [article]

    The September 2014 issue of Pharmacy Purchasing & Products contains an article on the use of bar code scanning during the preparation of compounded sterile products (CSPs).  The article touches on some of the topics that Mark and I cover in our report, In the Clean Room; errors in the IV room, bar code scanning during medication preparation, image capture, remote verification, and so on.

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  • In the Clean Room: A Review of Technology-Assisted Sterile Compounding Systems in the US [report]

    For the better part of the past year I’ve been working on a project with Mark Neuenschwander of The Neuenschwander Company looking at technologies used in pharmacy clean rooms to prepare sterile compounds.

    The research into this area took much longer than originally anticipated. We discovered along the way that this subject is much more complex than it appears on the surface. Information is difficult to find, some of the technologies are little more than marketing material on a company website, and the subject matter is in its infancy.
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  • Color labels for pharmacy – Quick Label Systems

    QuickLabel

    I was rummaging through my travel bag and found some items that I collected during the ASHP Summer Meeting back in June. Most of the information had to do with IV room systems, tablet identification, and so on. But there was one item that caught my eye that didn’t fit with the rest: color labels.

    I’ve written about the use of color on pharmacy labels before. It has its place, but in my opinion the major barriers have been cost and label quality. That’s why I was so interested when I saw the booth from Quick Label Systems at the ASHP Summer Meeting. The labels they had on display were spectacular. It’s difficult to see in my photo, but the image quality and label stock are top notch. The labels are tough –  really tough – resistant to water, and don’t smear. Very nice.

    The quality of the label and print gives users the ability to place a crazy array of information on the label, including the ability to embed audio or links to video using bar code technology. It’s pretty cool.

    The company isn’t a pharmacy solution in the traditional sense, but do provide OEM services for other companies. In other words, if you have a need for color labels Quick Label Systems will build color label printers with your name on them.

    Not every product that leaves the pharmacy needs a color label, but they could certainly be useful in the IV room. Using color to differentiate or highlight something that requires special attention like chemotherapy is always helpful to pharmacy and nursing.

    I’ll try to get the rest of my bag’s contents up over the next few days.

  • 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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  • Proposed USP Chapter <800> for Hazardous Drugs

    The rules and regulations swirling around acute care pharmacy clean rooms continues to grow. Recently I became aware of the United States Pharmacopeia and The National Formulary (USP–NF) General Chapter <800> Hazardous Drugs—Handling in Healthcare Settings, or simply USP <800>. I attended a webinar put on by Pharmacy Advisor that specifically addressed USP <797>, but briefly mentioned USP <800>. Then a colleague and friend mentioned it so I decided I better learn a little bit more about the proposed chapter.
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  • Cool Pharmacy Technology – Verification by MedKeeper

    I had an opportunity to spend some time at MedKeeper headquarters in Westminster, CO last week. I’ve worked with MedKeeper before, but this was the first time I had the opportunity to visit the facility and meet their team.

    MedKeeper is a company that makes several products for acute care pharmacy, specifically they develop software targeted at pharmacy operations. Some of you may know them for their medication tracking system, MedBoard.
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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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